Monday, June 20, 2011

My answer - Part 2. Want diet compliance? Ply them with Alcohol

[Note:  This post is the second part of a multi-part response to a particularly annoying and misleading article written by a registered dietitian on a weight loss website.  My responses appeared on the weight loss website in February, but have been removed from there due to censorship issues.  Here's the link to My Answer, part 1: here  ]
OK, OK, maybe that title was a bit over-dramatic, but you DID click, didn't you? Good! Now, where were we? 

Oh, yes, that first experiment, where non-obese, non-dieters went on a 30:20:50 diet for a bit and then were told to eat whatever they wanted to. 
Surprise? They ate less, 441 calories a day less on average, without much hunger. That's quite a dramatic shift. 

And the problem with that is?? There were some problems. First, to entice the participants to continue with the program, they added one "free" meal per week. Now it wasn't really free, the participants presumably kept track of what they ate at that meal, and reported it accurately. They were also allowed up to two drinks per week. They were also allowed to make substitutions for local, seasonal produce. (Out with the yukky canned fruit that was listed on the menu page!) 

It was reported that the participants had reduced their calories spontaneously during the final 12-week period, and they continued to lose weight without feeling too hungry. But what I thought was odd is that they went through all this trouble to capture baseline data, and then left the first weight data point off the chart. Why would they do this? It's probably because they were losing so much weight in the first few days, and the data probably wouldn't look all that good if the bulk of the weight lost during the entire study was during the first two weeks of stabilization. I'll bet they lost alot, based on their reports of really high hunger at that time, and because, like many of us, who doesn't lose about 4 pounds in the first days of practically ANY diet? 

OK, time for a re-cap. The researchers say they doubled the protein percentage from the baseline, but, since it's ISOCALORIC, they also had to take the fat down by 40%. You might think by reading just the title and the abstract of the paper that all these good results were because they upped the protein, but the researchers concluded that the good results were because of the lowered fat! (They probably put this in as a nod to the "experts" who insist that eating a low-fat diet helps with weight loss, totally ignoring the satiety issue in the process.) 

What's the "REAL" reason that the diet worked? It's hard to tell, because they changed so much stuff, but here are some potential reasons: 
1. They increased the protein percentage 
2. They decreased the fat percentage 
3. They allowed alcohol so partying it up with red wine will get you thin
4. They allowed a free meal, so being in control of your choices and having a social life will get you thin. 
5. They allowed seasonal produce so being a locavore/macrobiotic will get you thin (this is my fave reason). 
6. And there is another reason. But first.... 

In the abstract, they also added something that totally dumbfounded me. They actually said that the reason that the so-called "low-carb" diet works is because of the satiating effect of the extra protein. Call me simple, but I would think that a possible reason a low-carb diet might work is because it is low-carb. But since that is nutritional heresy, they didn't even discuss it directly, although they danced around the issue in the discussion section. 

But I'm wanting to get back to reason 6. There's something else going on here. In this experiment, researchers said that they increased protein, decreased fat, and kept carbs constant. But that's not what really happened. When they left people to their own devices, they decreased their calorie intake, which resulted in the relative reductions in ALL the macronutrients. Using a hypothetical 2000-calorie stabilized participant, when they ate whatever, they were averaging only 1559 calories, which works out to 117 grams protein, 35 grams fat and 195 grams carb. Compared to the baseline, that's an increase of only 45 grams protein, a decrease of 43 grams of fat and a DECREASE of 55 grams carb. Here's reason number 6 in a line all by itself. 

6. They decreased the amount of actual carbs by 22%. 

Which reason is it? Can't tell. Yet the researchers came up with reason 1. 

Next: Going back to the first "sister" study. 

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