5 Steps to prevent Heart Disease

Sunday, June 12, 2016

Fascinating discussion over trial that happened 4 years ago



Low carb diet reduces metabolism less than low fat diet link

David Ludwig vs Kevin Hall  6-7-16


Persistent metabolic adaptation 6 years after “The Biggest Loser” competition Kevin Hall May 2016

"Conclusions

Metabolic adaptation persists over time and is likely a proportional, but incomplete, response to contemporaneous efforts to reduce body weight."

 The Biggest Loser NYT article by Gina Kolata 2016

"Danny Cahill

46, speaker, author, land surveyor and musician, Broken Arrow, Okla.
Weight Before show, 430 pounds; at finale, 191 pounds; now, 295 pounds
Metabolic Rate Now burns 800 fewer calories a day than would be expected for a man his size."
“It is frightening and amazing,” said Dr. Hall, an expert on metabolism at the National Institute of Diabetes and Digestive and Kidney Diseases, which is part of the National Institutes of Health. “I am just blown away.”
It has to do with resting metabolism, which determines how many calories a person burns when at rest. When the show began, the contestants, though hugely overweight, had normal metabolisms for their size, meaning they were burning a normal number of calories for people of their weight. When it ended, their metabolisms had slowed radically and their bodies were not burning enough calories to maintain their thinner sizes."

“We eat about 900,000 to a million calories a year, and burn them all except those annoying 3,000 to 5,000 calories that result in an average annual weight gain of about one to two pounds,” he said. “These very small differences between intake and output average out to only about 10 to 20 calories per day — less than one Starburst candy — but the cumulative consequences over time can be devastating.”
“It is not clear whether this small imbalance and the resultant weight gain that most of us experience as we age are the consequences of changes in lifestyle, the environment or just the biology of aging,” Dr. Rosenbaum added.

The effects of small imbalances between calories eaten and calories burned are more pronounced when people deliberately lose weight, Dr. Hall said. Yes, there are signals to regain weight, but he wondered how many extra calories people were driven to eat. He found a way to figure that out.
He analyzed data from a clinical trial in which people took a diabetes drug, canagliflozin, that makes them spill 360 calories a day into their urine, or took a placebo. The drug has no known effect on the brain, and the person does not realize those calories are being spilled. Those taking the drug gradually lost weight. But for every five pounds they lost, they were, without realizing it, eating an additional 200 calories a day.
Those extra calories, Dr. Hall said, were a bigger driver of weight regained than the slowing of the metabolism. And, he added, if people fought the urge to eat those calories, they would be hungry. “Unless they continue to fight it constantly, they will regain the weight,” he said.
All this does not mean that modest weight loss is hopeless, experts say. Individuals respond differently to diet manipulations — low-carbohydrate or low-calorie diets, for example — and to exercise and weight-loss drugs, among other interventions.
But Dr. Ludwig said that simply cutting calories was not the answer. “There are no doubt exceptional individuals who can ignore primal biological signals and maintain weight loss for the long term by restricting calories,” he said, but he added that “for most people, the combination of incessant hunger and slowing metabolism is a recipe for weight regain — explaining why so few individuals can maintain weight loss for more than a few months.”
Dr. Rosenbaum agreed. “The difficulty in keeping weight off reflects biology, not a pathological lack of willpower affecting two-thirds of the U.S.A.,” he said.
Mr. Cahill knows that now. And with his report from Dr. Hall’s group showing just how much his metabolism had slowed, he stopped blaming himself for his weight gain.
“That shame that was on my shoulders went off,” he said.

The above is a great article in NYT by Gina Kolata.  I hope she tells us the rest of the story about the reduction of metabolism in the reduced obese and if low carbohydrate vs. low fat vs. high intensity exercise can prevent it.



 The above is from page 134 of The Tubby Traveler from Topeka when I took issue with Dr. Hall's calculation of 300 calories a day in the energy gap of the reduced obese.  I wrote my book in 2011.
 I used Michael Rosenbaum and Rudolph Liebel's research that people who lose 8-10% of their weight reduced the amount of calories burned during movement by 42%.  Thus instead of needing to walk 3 extra miles a day, my calculation came to an extra 5-6 miles a day.
The people in NWCR walk an hour a day.  3-4 miles a day?  However, if scale goes up they walk more and watch calories more carefully.  At 1500 calorie a day diet I suspect they already are 300 calorie below Dr. Hall's calculated energy gap. 
Subsequently with the Greatest Loser Data my viewpoint has been validated.

NYT Journalist wars

How to treat decreased metabolism of the Biggest Loser

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