Suppose you were reading the health section of a newspaper looking for ideas on how to lose weight, and you came across an article that started like this:

Whether you are just starting a New Year’s diet or struggling to maintain a healthy weight, a provocative new study offers some timely guidance. It isn’t so much what you eat, the study suggests, but how much you eat that counts when it comes to accumulating body fat.

The findings are the latest in a string of studies to challenge claims that the secret to healthy weight loss lies in adjusting the amount of nutritional components of a diet—protein, fat and carbohydrates.

I don’t know about you, but I’d assume that provocative new study involved adjusting the nutritional components of a diet – protein, fat and carbohydrates.  Let’s check:

In the study, to be published in Wednesday’s issue of the Journal of the American Medical Association, 25 young, healthy men and women were deliberately fed nearly 1,000 excess calories a day for 56 days, but with diets that varied in the amounts of protein and fat.

Hmmm  … it appears that the provocative new study which supposedly proves the secret to healthy weight loss isn’t a matter of adjusting the ratio of protein, fat or carbohydrates is

1)  a study of people who intentionally gained weight instead of losing weight

which

2) manipulated the balance of fat and protein, but not carbohydrates.

Let’s read on:

While those on a low-protein diet—about 5% of total calories—gained less weight than those on a normal- or high-protein regimen, body fat among participants in all three groups increased by about the same amount. Typical protein consumption is about 15% of calories, while the U.S. government recommends it make up between 17% and 21% of total daily calories.

The findings suggest that it matters little whether a diet is high or low in fat, carbohydrates or protein, it’s calories that build body fat.

It matters little whether or a diet is high or low in fat, carbohydrates or protein?  I must be missing something here … did the researchers change the ratio of carbohydrates in the diet nor not?

The patients in the Pennington study ranged in age from 18 to 35 and had BMIs between 19 and 30. (Between 25 and 30 is considered overweight.)  They lived at the center’s metabolic unit for between 10 and 12 weeks and were fed the 1,000 extra calories a day for the final eight weeks of their stay. Carbohydrates were held steady at about 41% to 42% of calories while fat levels varied with the protein regimen.

Brilliant.  Study subjects were put on three different diets designed to induce weight gain, the carbohydrate ratio was virtually the same across all three groups, and yet media health reporters are telling us the provocative study proves that manipulating the fat, carbohydrate or protein content of a diet won’t help us lose weight.

After eight weeks, all participants in the study gained weight. The 16 men and nine women made similar gains. The low protein-diet group gained about seven pounds, about half the 13.3 pounds added on by the normal protein participants and 14.4 pounds put on by the high protein group.

If you read the full study (which I did), you’ll learn that the low-protein group didn’t gain as much weight because – despite overeating by 1,000 calories per day – they lost muscle mass.  The other two groups gained muscle mass, with the high-protein group gaining the most.  I’d say that’s an important difference.  Losing muscle mass is a great way to slow your metabolism.  Gaining muscle mass raises your metabolism.  The results listed in the study seem to confirm that point:

The low protein diet had 6% of energy from protein, 52% from fat, and 42% from carbohydrates. The normal protein diet had 15% of energy from protein, 44% from fat, and 41% from carbohydrates. The high protein diet had 26% of energy from protein, 33% from fat, and 41% from carbohydrates.

Overeating produced significantly less weight gain in the low protein diet compared with the normal protein diet group or the high protein diet.  Body fat increased similarly in all 3 protein diet groups and represented 50% to more than 90% of the excess stored calories. Resting energy expenditure, total energy expenditure, and body protein did not increase during overfeeding with the low protein diet.  In contrast, resting energy expenditure and body protein (lean body mass) increased significantly with the normal and high protein diets.

Elsewhere in the study, the researchers provide more details:  the low-protein group lost an average of 1.5 pounds of lean body mass, while the high-protein group gained an average of 7 pounds of lean body mass.  When you overeat by 1,000 calories per day and still lose muscle, you know it’s a lousy diet.

The effects on metabolism may not have produced significant differences in fat accumulation in the short duration (less than two months) of this study, but I suspect that since the low-protein group was losing muscle mass, we’d see more of a difference over time.  Interestingly, the researchers didn’t say exactly how much extra body fat each group gained.  They only told us the difference wasn’t significant:

The overall increase in fat mass for all 3 groups was 3.51 kg (95% CI, 3.06 to 3.96 kg) from baseline and was not significantly different between the 3 groups (P = .89), although the low protein group added on average more than 200 g of fat (about 2000 kcal).

I also found these paragraphs interesting:

With the low protein diet, more than 90% of the extra energy was stored as fat. Because there was no change in lean body mass, the 6.6% increase in total energy expenditure reflects the energy cost of storing fat and is close to the estimate of 4% to 8% for fat storage derived by Flatt. With the normal and high protein diets, only about 50% of the excess energy was stored as fat with most of the rest consumed (thermogenesis).

The extra calories in our study were fed as fat, as in several other studies, and were stored as fat with a lower percentage of the excess calories appearing as fat in the high (25%) protein diet group.

I’m confused … if the low-protein group stored 90% of their extra energy as fat, while the other groups only stored 50% of their extra energy as fat, how did they all end up gaining the same amount of body fat?

Maybe I’m just not getting the math involved, but never mind.  Even if all three groups did gain the same amount of body fat, this study doesn’t really tell us anything about how to effectively lose weight, and it certainly doesn’t prove anything one way or another about the effects of manipulating the carbohydrate content, since the carbohydrate ratios were virtually identical.

Another researcher who commented on the study in a Reuters article put it nicely:

Donald Layman, a food science researcher at the University of Illinois in Urbana, said it’s difficult to see how the findings apply to a general population that isn’t being overfed such a protein-deficient diet, in the case of the low-protein group.

“It’s an interesting scientific study, but from an obesity standpoint, I don’t think it tells us anything,” he told Reuters Health.
Bingo.  Even if the protein ratio made little or no difference on fat accumulation in an over-eating study conducted in a metabolic ward, most of us aren’t trying to get fatter.  We’re trying to get leaner.  And we don’t live in metabolic wards where our meals are prepared for us and every calorie is tabulated.  We live in the real world where we don’t (and can’t) count every calorie, and where the amount of food we eat is determined by our appetites.  Protein is satiating.  When we eat higher-protein foods, we tend to eat less.  When we eat high-carb meals, many of us find our appetites going all out of whack, and we eat more.

The lead researcher for the study was George Bray, who seems to have dedicated his career to proving that the federal government’s dietary guidelines are correct – and if he has to cleverly design studies to achieve that goal, or write conclusions that aren’t backed up by the actual data, by gosh he’ll do it.

It was Bray who conducted the study on salt restriction that I mentioned in my Science For Smart People Speech, the one in which a drastic reduction in dietary sodium produced a whopping two-point drop in blood pressure.  Based on that meaningless result, Bray concluded that sodium restriction is an effective means of controlling hypertension.  (Say what?  Two points is a meaningful reduction in blood pressure?  I don’t think so.)

Here’s Bray offering his conclusion from the latest study:

“If you over-eat extra calories, no matter what the composition of the diet is, you’ll put down more fat.”

Really, Dr. Bray?  If you wanted solid scientific evidence that the composition of the diet is meaningless, why was the ratio of carbohydrates the same in all three groups?  Since you blasted Gary Taubes in your review of Good Calories, Bad Calories, we know you’re well aware of the hypothesis that it’s carbohydrates, not protein or fat, that promote fat accumulation … so why didn’t this provocative study include a group that restricted carbohydrates?  After all, none of the low-carb diet gurus recommend anything close to a ratio of 40% carbohydrates.

I think the answer to that question can be found near the end of the study.

This study was supported in part by the US Department of Agriculture.

Over my holiday break, I read an excellent new book on weight loss titled The Smarter Science of Slim.  Jonathan Bailor, the author, has (according to the preface) been researching the science of weight gain and weight loss for 10 years, and it shows:  the index of references at the back of the book runs more than 70 pages. Despite immersing himself in heavy-duty nutrition science while writing this book, Bailor had the good sense to explain what he’s learned clearly and simply.  In other words, the book passes my “Aunt Martha” test.

In a nutshell, the book’s message comes down to this:  Most of us will never lose weight and keep it off by simply restricting calories. Permanent weight loss requires changing your body’s set-point, and your body’s set-point is largely determined by hormones.  To shed body fat, we need to clear what Bailor terms a hormonal clog in the fat-metabolism system.  Clearing the clog is, of course, a matter of choosing the right foods and the right kind of exercise, not just eating less and moving around more.

I believe we can’t emphasize that point often enough.  Yes, you can starve yourself and lose weight.  But losing weight without changing your set-point – the amount of fat your body wants to maintain – is a bit like pulling a big ol’ rubber band into a stretched position and trying to hold it there forever.   Sooner or later, you’re going to tire of the effort and let go … and then that rubber band will snap back to its original size.  That’s why most low-calorie diets fail over time.  It’s why so many contestants from The Biggest Loser have regained the weight they lost.  (Many have also ended up with depressed metabolisms for their efforts.)

Early in the book, Bailor takes on the calories-in/calories-out view of fat loss and shreds it with data from several studies.  In one study, for example, researchers had thin people and fat people stop eating completely -– call it a zero-calorie diet.  Then the researchers determined what the subjects’ bodies burned for energy. The results were, as Bailor notes, depressing:  The thin subjects obtained 61% of their calories from stored body fat, while the fat people only obtained 39% of their calories from stored body fat.  Worse, they burned up more of their own muscle mass than the thin people.  Lose muscle, and all you’re doing is slowing your metabolism.  As Bailor writes:

Think about that for a second.  Despite having more body fat, the heavy people burned less body fat.  In the words of the researchers, “… obese patients could not take advantage of their more abundant fat fuel sources.”  The heavy people burned what relatively little muscle tissue they had rather than burning the excess body fat they were drowning in.  They needed to burn body fat, but did not burn body fat effectively.  This is where the idea of a clog comes into play.

In a subsequent chapter, Bailor reviews the scientific literature on exercising more to lose weight.  You can probably guess what he found:  In study after study, exercise has failed to produce more than a few pounds of weight loss … not exactly the result an obese person hopes to achieve.

The key to lasting weight loss, Bailor writes, is to focus on consuming SANE foods.  SANE is his acronym for the qualities of a food that affect weight gain:

• Satiety – how quickly calories fill us up and how long they keep us full
• Aggression – how likely calories are to be stored as body fat
• Nutrition – how many nutrients (protein, vitamins, minerals, essentially fatty acids, etc.) the calories provide
• Efficiency – how many calories can be stored as body fat

As he explains:

The more Satisfying, unAggressive, Nutritious and inEfficient a calorie is, the higher its quality.  The more SANE it is.  The more body-fat burning hormones it triggers.  The more it clears our clog and prevents overeating.  The more it restores our ability to burn body fat and maximizes our need to burn body fat.

The more unSatisfying, Aggressive, not Nutritious and Efficient a calorie is, the lower its quality.  The more inSANE it is.  The more body-fat-storing hormones it triggers.  The more it creates a clog and encourages overeating.  The more it destroys our ability to burn body fat and removes our need to burn body fat.

The next four chapters explain each of these four factors in detail.  You won’t be surprised to learn that the most inSANE foods are sugars and refined starches, while the most SANE foods are non-starchy vegetables, meats, eggs, seafood and some dairy products.

High-protein foods are a perfect example of SANE foods.  Research has shown that protein is satiating –- we eat partly to satisfy our daily protein requirements, so if we’re eating low-protein foods, our bodies tell us to keep eating.  Protein is also the macronutrient least likely to be converted to stored body fat.  Bailor takes the reader through a brief bit of biochemistry in one chapter to demonstrate that if we consume 300 calories of protein, at most 105 of those calories can be converted to fat.  The rest is lost in the conversion process.  In other words, protein is low on the Efficiency scale.

By contrast, 211 calories from 300 calories of refined starch can potentially end up as body fat.  Starch is twice as high on the Efficiency scale as protein, and also high on the Aggression scale because it triggers high blood sugar and high insulin levels that encourage our bodies to store fat.  I was pleased to see that there’s an entire chapter in The Smarter Science of Slim on how insulin and other hormones affect weight gain, all explained pretty simply.

In other chapters, Bailor reviews how our hunter-gatherer ancestors ate, where today’s lousy standard dietary advice came from, why the “cholesterol kills!” theory is full of bologna, and how starchy/sweet foods ended up becoming our dietary staples.  Then he moves on to how we can eat smarter and lose weight without starving ourselves.

Given his SANE scale, it’s no surprise that the diet he recommends is pretty close to a paleo diet:  lots of vegetables, plenty of protein, a bit of low-sugar fruit, some nuts now and then, and perhaps a few dairy products.

Where he separates himself from the low-carb crowd is in the proportions of protein, fats and carbohydrates he recommends.  While he does a nice job of debunking the theory that saturated fat and cholesterol are bad for us, his SANE diet still limits dietary fat in favor of extra protein and carbohydrates (compared to most low-carb diet plans, that is) as a means of promoting weight loss.  Consequently, he suggests consuming egg whites and low-fat dairy products instead of the full-fat varieties.  He also recommends getting about a third of our calories from carbohydrates, with the caveat that we get those carbohydrates from SANE fruits and vegetables instead of sugars and refined starches.

While I believe the diet he recommends is a good one — far better than what most people consume — I’m not convinced that a ratio of one-third fat, one-third protein and one-third SANE carbohydrates is necessary to lose weight.  It certainly hasn’t been the case for me.  Bailor has agreed to do a written interview for a post next week, so I’ll ask him to explain why he recommends those specific proportions.

The last section of the book is dedicated to exercise.  Even though Bailor describes early in the book why most exercise does little for weight loss, he’s certainly not opposed to exercise … he just wants us to engage in exercise that actually helps.  The key is to work our muscles briefly but intensely, then give them adequate time to recover.  In that regard, what he recommends is a lot like Fred Hahn’s Slow Burn program.  The main difference is that Bailor favors working the muscles with negative resistance … that is, exercising the muscles to the point of failure while lowering heavy weights instead of while lifting them.  (Tim Ferriss makes the same recommendation in The 4-Hour Body, at least as an alternate workout.)

Once again, Bailor describes the crucial role hormones play in our body composition.  In one surprising (to me, anway) study he recounts, researchers divided subjects into two groups:  the first group exercised only one arm, while the second group exercised the same arm, but also both legs.  At the end of the trial, researchers measured how much the subjects had increased their arm strength.  The result:  the subjects who exercised just one arm were 9% stronger on average in that arm.  But the group that also exercised both legs were 37% stronger on average – in the arm!  The reason?  Hormones.  As Bailor writes:

Leg-training worked more muscle and therefore triggered more whole-body-transforming hormones than arm training.  All those whole-body-transforming hormones benefit seemingly unrelated muscles more than exercising those muscles directly.

Body composition is largely determined by hormones.  What we choose to eat –- not how much — and how we choose to exercise – now how often or for how long — has a huge impact on the hormones our bodies produce.  That’s the message of The Smarter Science of Slim.  It’s a message people struggling to lose weight and get fit need to hear.

I have a list of questions for my upcoming interview with Jonathan Bailor, but feel free to post your own in the comments.  I’ll pick a few to add to my list.

Since the kitchen in our new house is short on counter space, Chareva bought a kitchen cart with a wooden cutting-board top.  The manual included instructions on how to season the cutting board with oil.

Coconut oil is good, according to the manual, because it’s highly stable.  Mineral oil is fine, too.

But, explained the manual, you don’t want to season the cutting board with vegetable oils because … wait for it … THEY GO RANCID TOO QUICKLY.

But hey, if you leave them in a cupboard for a few months and then cook your meals in them, that’s good for you.  Just ask the health experts.

Sheesh …

Fat Head finally made it to iTunes.  If you haven’t seen it yet, now’s your chance to rent or download it.

Here’s a link.

(Sorry, U.S. iTunes only for now … we’re still trying to get away from our foreign “distributor,” who hasn’t distributed anything and has ignored my many requests to put the film on iTunes overseas.)

I used to have a love-hate relationship with New Year’s. Like countless other people, I began each year with a resolution to finally lose some serious weight and keep it off. That was the “love” part … I loved feeling righteous and disciplined as I wrote down those all-important “action steps” to achieve my goal. By gosh, I’m really going to do it this year!

Unfortunately, my action steps always included sticking to some low-fat, vegetarian, or very-low-calorie diet, which led to the “hate” part … I hated waking up each succeeding January 1st knowing I was no leaner (and often fatter) than the year before. Naturally, I attributed the sorry result to a lack of willpower. I’d think back on all the times I surrendered to hunger and blame myself for caving in, instead of blaming the diet for making me feel ravenous.

Then, proving myself to be what Moe Howard might describe as “an intelligent imbecile,” I’d more or less repeat the previous year’s failed action plan:  going to the store to stock up on rice cakes, Slim-Fast, pasta, fat-free pasta sauce, whole-grain cereals, skim milk or soy milk, Garden Burgers, Egg Beaters, butter-flavored spray for the low-fat popcorn, etc.  One year I even bought a big ol’ electric treadmill and promised to walk on it for an hour every night.  And guess what?  I did.  Unfortunately, my waistline wasn’t impressed.

My love-hate relationship with January 1st is long gone. After returning home from our holiday trip to Illinois, Chareva and I spent part of the weekend arranging our closets in the new house and deciding which clothes to take to Goodwill. Before hanging some dress slacks (which I almost never wear) in my closet, I figured it would be a good idea to try them on first. You can see how they fit in the picture below.

I bought those slacks two years ago, after I’d already lost a chunk of weight. Since I tend to store fat above the beltline – belly and love handles – I didn’t need smaller pants when I first lost weight after making Fat Head. But in the past couple of years, I’ve gone from wearing a size 38 to a size 36, and now the size 36 pants are actually a bit too loose. Size 34 pants are a bit too snug, so I’m probably a size 35. You won’t find that size in stores, so I’m putting up with the loose 36 pants for now. If I end up wearing a size 34 someday, cool. If not, that’s cool too. Reaching that size might require shrinking the width of my pelvis, and no diet will accomplish that.

The point is, I’ve continued getting a bit leaner over these past two years without starving myself, without counting calories, and without limiting myself to tasteless foods I don’t really like. I live on a meaty, high-fat diet most people would consider indulgent, and yet I no longer struggle with my weight. I no longer wake up on New Year’s feeling disgusted with my body and promising to do something about it. My resolution this year is to keep doing what I’ve been doing.

I know I can keep that promise.

Happy New Year.

I wrote this a couple of years ago, but I’m reposting it for the newer readers.
Happy Holidays — Tom

‘Twas the night before statins, and all through the land
Our lipids were lethal, as we’d soon understand.
Our eggs were all stacked in the fridge with great care
In hopes they’d be scrambled, or fried if we dare.

The children were calm and well-fed in their beds,
While visions of sausages danced in their heads.
The dads, mostly lean, and wives often thinner
Had just settled down for a porterhouse dinner.

When out in the world there arose such a clatter,
They sprang from their plates to see what was the matter,
And what on the cover of TIME should appear,
But an arrogant scientist, peddling fear.

Cheers and belief from an ignorant press
Gave a luster of truth to the new, biased mess.
So away to the doctor we flew in a pack,
In hopes of a plan to end heart attacks.

He was dressed in all white from his neck to his butt
(which conveniently hid the size of his gut).
He sat us all down for a well-meaning chat:
“More carbohydrates — avoid all that fat!”

So sugars and starches we passed through our lips,
Only to wear them on bellies and hips.
Our hearts with their plaques continued to swell,
We grew diabetic and weren’t feeling well.

The doctor announced it was likely our fault –
We were, after all, still eating salt.
“But there’s no other option,” he said with shrug,
And pulled out his pad to prescribe some new drugs.

“Now Crestor! Now Zocor! Then Lipitor next!
Now Lipex! Now Lescol, and best take Plavix!
To the depths of the liver! To the artery wall!
Force it down, force it down, foul cholesterol!”

Our appetites crazed, we soon looked like blimps.
Our children lost focus, our manhood went limp.
The doctor examined joints now wracked with pain
And concluded the patients were old or insane.

He chose Celebrex for muscles that ache,
And added Cialis to the drugs we should take.
“Now stick to your diet, and be of good cheer,
If this doesn’t work, I’ll do lap-band next year!”