Monday, April 16, 2007

Diet - Not a Numbers Game Afterall

When searching online for topics to write about, I often hit google news and conduct a search based on various keyword combinations - diet, health, obesity, weight, diabetes - and I'm never disappointed by the sheer number of results. On Friday I noted that the headlines are often contradictory and those I posted were all within the first five pages of results using just two keywords - diet and health - in a search of the news headlines.

So, what are we to make of dieting to lose weight? Is it a losing proposition? If it is, then why the repeated attempts to encourage the masses to diet? And, most importantly, does dieting really work?

I think it's safe to say that the most widely recommended diet for weight loss - a calorie restricted, low-fat, carbohydrate rich diet - fails the test long-term. While intially reducing weight, in the long-term, such diets do little to improve health and enable a stable, lower weight over time.

The failure of the dietary recommendations are no small matter, various agencies go to great pains to explain away the long-term failure and wind up making the issue one of personal failure rather than admit the flaw is in the recommendations.

Whether or not an individual is able to lose weight and maintain the weight loss becomes a moral issue - having willpower over hunger, taking responsibility for portions, just eat less, just exercise more, stop buying junk food, etc. When the outcome is positive, the diet worked; when the outcome is negative, the person failed to follow directions.

As Malcolm Evans summed up in his commentary, Dieting is Fine Because it is Becoming Official, "The argument goes like this - the state in its wisdom has spoken; overweight is a health issue and as such it becomes a moral issue concerning wellness, interdependencies and budgets. Weight is to be managed downwards and to disobey will result in an implicitly escalating scale of reputational and material penalties (including the denial of certain health care provision). Biomedicine currently prioritises a sense of cure over comfort. The emphasis in almost all cases is to be seen to be powerful in the chemical intervention, with much less emphasis on empathy in relation to the inevitable, or on the emotional and psychosomatic dimensions. It is a culture that allows ten minutes and the prescription of a tranquilliser. It is also a culture which disallows the complexity of overweight and seeks rapid intervention, preferably leading to the mapping of satisfactory digits to numbered targets. In the absence of a magic weight control pill (how Big Pharma would love to have one of those that was in any way remotely effective!), dieting is perpetuated despite the accumulating evidence that it is a largely ineffective alone as a long-term solution."

As I noted on Friday, Fred Hahn said it well, "Fat loss and health is NOT a numbers game - it's a hormonal game. And a game that requires full understanding of the rules."

Yet the government and leading health organizations continue to perpetuate a dietary approach based on numbers - calories, fat grams, saturated fat grams, milligrams of cholesterol, sodium intake, fiber intake, the size of portions, and the number of minutes you engage in exercise each day. It's all about counting one or more things each day in your diet and lifestyle.

All of the recommendations made to the masses come back to one single hypothesis - dietary fat is deadly and must be limited to not only keep calorie intake balanced - fat has nine calories per gram and carbohydrate and protein just four - but to prevent development of chronic disease.

Recently the obession with total fat has relaxed a bit, from strictly maintaining an intake below 30% of calories, to an allowance now of a range between 20% and 35% of calories. But this concession comes with a stricter limit on saturated fat; we're now told to limit saturated fat to less than 7% of our calories, making it next to impossible to meet nutrient requirements for essential amino acids in those who are overweight or obese.

Ah, the unintended consequences of playing, on paper, with macronutrient ratios.

You see, if we take the recommendation to consume less saturated fat to heart, and also strictly limit our cholesterol intake as also recommended, we are left with significantly less animal foods in our diet each day, now dependent on plant-based sources of protein to meet our essential requirements for amino acids.

Surely, you say, there must be strong evidence to support these recommendations? Surely we can easily meet our essential amino acid requirements with a plant-based diet? Surely a diet recommended by the government and leading health organizations must be soundly established by scientific data and be shown to lead to long-term outcomes in health and well-being?

Well, not so fast.

Here is where, as Fred Hahn called it, the "hormone game" comes into play and the rules are such that if you're not playing within them, your health suffers.

The first, and most important rule you need to know in the "diet game" is eat your protein; and make it complete protein.

Tomorrow I'll explain why and then discuss the other rules of the "hormone game" to give you insight into why everything we're told about diet is either wrong and causing more harm than good in your metabolism!

Then, throughout the week, we'll sort out what to eat if you're trying to lose weight and improve your health for the long-term.


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  2. Anonymous5:19 PM

    Being slightly pedantic, shouldn't we be more precise in the use of the word 'diet'? There are many different diets not just weight loss diets.
    If any weight loss diet can produce the goods, even in the short term, then it can't be said to have failed, regardless of whether it's healthy in the longer term.
    I feel the words we use direct the way we think, and if what we want is for people to adopt a lifelong change in their eating habits, then 'diet' should not be used, even if it's a quick and convenient bit of shorthand.
    Great blog BTW.

    Neil Wilkinson

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