“A hypocaloric diet, whatever the proposed type, is an inadapted treatment to chronic disease, like obesity. All diets are inefficient on the long term. The weight loss is generally small, about 1-2 kg a year. The results are the same, independently of the type of diet, and the patient’s compliance is clearly the main key to succeed. About 80% of patients regain weight the first month following the diet, and only 1% can keep the obtained weight a year later. Nearly half of the patients involved in a diet program give up before the end. Finally, because of risks of macro and micro nutriments deficiency, certain diets are to be avoided and hypocaloric diet shouldn’t be proposed.”
~ from, Hypocaloric Diets: Which Ones to Advise/Avoid? Di Vetta V, Clarisse M, Giusti V.
Readers of this blog are, of course, not the least bit surprised by the above quote, as it is common knowledge within the larger Paleo community; conventional dieting fails miserably, and those currently engaged in conventional dieting are, for the most part, well — miserable. The 10,000-dollar question remains, however; why do these diets fail? Now, in my real-world, day-to-day comings and goings, I’m not much concerned with whether I’m hypercaloric or hypocaloric. I know that, by whatever mechanism is at work in my Paleo way of life, over the long-haul I’ll maintain single-digit body fat levels coupled with a stellar blood profile; my health will be excellent and my vitality vibrant. And all of this will come free of any feeling of depravity, gnawing hunger, rampant cravings or lethargy. I’ll have no need for a calculator or scale, nor will I ever be concerned with meal timing. I am a curious sort, though, and so I wonder: Am I, over the long haul, actually either ingesting fewer calories or burning more calories than in my pre-Paleo days? Is it a combination of the two? Or, does the total calorie content really not play that significant a role?
I know I’m not going to raise the eyebrows of any long-time TP readers by stating that, in my opinion total calorie ingestion plays a minor, short term role in weight control (body fat and lean tissue) when compared to the hormonal/enzymatic environment elicited by the ingestion of those calories. In other words, it’s the type of calorie ingested that trumps the amount of overall calorie ingestion.
Now, it’s obvious to the most casual of observers that caloric restriction below the basic metabolic rate (BMR) and total calorie expenditure will result in weight loss. But are all hypocaloric diets created equal? Again, TTP readers know the answer, but, for purposes of comparison, let’s take a look at this study:
Comparison of the Atkins, Zone, Ornish, and LEARN Diets for Change in Weight and Related Risk Factors Among Overweight Premenopausal Women. The A TO Z Weight Loss Study: A Randomized Trial
Now, let’s have a gander at the recent Harvard study (Diets That Reduce Calories Lead to Weight Loss, Regardless of Carbohydrate, Protein or Fat Content) that I wrote about here.
Just what, exactly, is going on here? We seem to be getting mixed signals. If a calorie is truly a calorie, then what is going on with this Atkins group? Thanks to Chris, at Conditioning Research, for finding this apropo cartoon, from this very smart and witty collection.
The problem with scientific studies, though, lay in (1) the minutia and, (2) in the interpretation. And, as the above cartoon so very well illiterates, correlation does not necessarily imply causation.
Well, here’s the short version of my take on the issue
There is a dramatic shift to fat burning when insulin levels are low and/or not overly released with each caloric ingestion. Insulin immediately shuts down fat burning (the release of stored FFAs – free fatty acids) and begins the process of moving FFAs, and excess glucose in the blood stream into body fat. By comparison to a high carbohydrate meal, very little insulin is released by eating the TTP/Paleo way, and this slight rise in insulin will occur over a period of hours — not seconds or minutes as would be the case from eating the usual high carbohydrate, high glycemic-value, high total caloric load (all contributing factors) typical of the “normal”, western diet.
It is very clear to me that the bodily chemical processes (especially the action of insulin) that entail the digestion of all foods work via certain, distinct pathways, and knowing these pathways gives us the tools to knowingly adjust our diets which, over time (and which is clearly demonstrated by empirical evidence), can cause us to correctly assume what is optimal for our individual body types, and to allow ultimate control of our body composition. My contention is that that function of determining how a fuel calorie (glucose and fatty acids) will be utilized — whether stored as fat, or burned as energy in the muscles,or in the act of bodily repair/replenish — is carried out primarily by the hormone insulin via interaction with the enzyme lipoprotein lipase (LPL). It is interesting to note as well (though a bit of-topic for this discussion), that sex hormones also interact with LPL, which is why men and women gain/lose/carry body fat differently. It is insulin, though, that acts as the primary gatekeeper, the traffic cop, so to speak, in the ultimate partitioning of the end-products of food ingestion.
So what does all of this mean in practical terms? Well, it means that it’s your insulin levels that will determine what is to become of the calories you’ve ingested. A high insulin level (resulting from consumption of a high carbohydrate meal) will do two things, primarily (1) it will shunt the excess ingested calories to be stored as fat, and (2) it will shutdown the release of FFAs from the body’s fat deposits. The flip side of this is the maintenance of a low insulin environment via the elimination of simple carbohydrates and the limitation of complex carbohydrates. In other words, and from a purely biological or homeostatic perspective, lean people are not those who have the willpower to exercise more and/or eat less. They are simply people whose bodies are programmed to send the calories they consume to the muscles to be burned rather than to the fat tissue to be stored —the precise reason that Lance Armstrong and his ilk can get away with the massive amounts of carbohydrates they consume with no (outward) noticeable affect. A less active a person would tend to go the other way, shunting off calories to fat tissue, where they continue to accumulate to excess. This shunting of calories toward fat cells to be stored or toward the muscles to be burned is a phenomenon known as fuel partitioning. It is also why I think of the body more as a capacitor, rather than a simple thermodynamic machine; a capacitor whose charge/discharge properties are controlled primarily via insulin, the level of which is primarily controlled by the type and amount of carbohydrate ingestion.
So, is a calorie just a calorie? Well, no more than a bullet is just a bullet, I suppose. Would you rather be shot by the rubber variety, or a “cop killer”? Keep that metaphor in mind before you fork-up that next mouthful of pasta.