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A recent article suggests that the long held view on what
causes obesity is inherently flawed.
A recent article1, published in The American Journal of Clinical Nutrition, presents a bold alternative to the accepted theory that obesity results from an energy imbalance, a model that has been the foundation for universal assumptions and research on obesity. However, the paradigm shift supported by the article’s seventeen authors suggests that this long held view on what causes obesity is inherently flawed because it is overly concerned with how obesity occurs rather than why some people accumulate more fat than others.
For the better part of the last century, the prevailing view has been that overweight and obesity result from the gap between calories consumed and calories expended. The preponderance of research has accepted this as its theoretical grounding. David Ludwig and colleagues dispute this in their article, proposing that the body’s hormonal response to a high-glycemic-load diet increases fat, and their carbohydrate-insulin model considers more closely a range of factors that influence how individuals store fat.
One of the authors offers an analogy to explain what they believe to be the flawed premise of energy imbalance by comparing to wealth gain.2 That is, it is unlikely that an economist would accept the theory that people become wealthy because they take in more money than they spend. Although true to a degree, it does not consider how or why some people are able to gain wealth while others struggle. They suggest that the same concept holds true for weight and explain why some people gain weight even when their caloric intake is the same, or less than others.
Greater Awareness = New Views of Obesity Treatment
Acknowledging this shift could have a domino affect on treatment. While it would be unlikely to reduce the number of fad diets that hit the market each year, it could potentially shift the focus of what weight management looks like. That is, greater importance could be placed on what is consumed more so than how much.
In this way, weight loss approaches that have been rigorously tested and found to yield positive outcomes, such as a Very Low Calorie Diet (VLCD), could benefit much of the population with obesity. Although reduced caloric intake is fundamental to VLCD effectiveness, of greater importance and relevance to the view presented in the article is the strong emphasis of a comprehensive, multidisciplinary team-based approach.
VLCD programs that are customized to address the specific needs and abilities of individual patients get to the core of the hypothesis presented. Trained and professional registered dietitian nutritionists and exercise physiologists design programs to meet patients’ nutritional and physical needs, focusing more on what patients eat and how that impacts their hormones and metabolism. They, along with behavioral psychologists, also take time understand patients’ relationship with food, and provide support and encouragement during their weight loss journey.
Regardless of how the carbohydrate-insulin model is received, challenging the norm can ignite new research and spur new models. Given the exponential growth in obesity levels and related diseases, this holds promise for those on either side of the debate.
Sources:
- The Carbohydrate-insulin Model: A Physiological Perspective on the Obesity Pandemic
- How a ‘Fatally, Tragically Flawed’ Paradigm has Derailed the Science of Obesity
About the Author: Dr. Andrea Pampaloni has over 20 years of communication experience across corporate, academic, nonprofit and government sectors. She provides research and writing services on a range of business issues and industry-specific topics to prepare white papers, articles, proposals, presentations, technical content, and speaking points, as well as marketing-communications content such as blogs, website content, newsletters, news releases and award submissions. Dr. Pampaloni’s research findings have been presented at national and international conferences and published in peer-reviewed journals, and she is a ghostwriter for three books, a Forbes article, and several corporate blogs.
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IMPORTANCE OF MEAL REPLACEMENTS IN WEIGHT MANAGEMENT
A two-year randomized trial of obesity treatment in primary care practice. (Wadden TA, Volger S, Sarwer DB, Vetter ML, Tsai AG, Berkowitz RI, Kumanyika S, Schmitz KH, Diewald LK, Barg R, Chittams J, Moore RH. New England Journal of Medicine. 2011 Nov 24;365(21):1969-79.) Primary care physicians (PCPs), collaborating with medical assistants, helped obese patients lose an average of 4.7% of their initial weight at 24 months. This loss, which was accompanied by improvements in cardiovascular risk factors, was achieved with enhanced brief lifestyle counseling, which combined quarterly PCP visits, brief lifestyle coaching delivered monthly, and provided for the use of meal replacements to enhance weight loss.
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BENEFIT OF MEAL REPLACEMENTS IN WEIGHT MANAGEMENT
 The benefit of replacing grocery foods with balanced nutritional Meal Replacements is a useful clinical tool to support calorie restriction and provide optimal levels of macro and micro nutrients. It is known that incorporation of added protein during calorie restriction aids in satiety as well as supporting lean body mass and metabolic rate.
In 2009 the American Dietetic Association supported inclusion of Meal Replacements in their position statement on Weight Management.(1) It was reported that Meal replacements, containing known energy and macronutrient contents, are a useful strategy to eliminate problematic food choices or complex meal planning while trying to attain a daily caloric deficit. Substituting one or two daily meals or snacks with meal replacements in the form of liquid meals, meal bars or calorie-controlled packaged meals may be used as part of the comprehensive weight management program. In a review by Hymesfield, randomized controlled studies that used meal replacements for at least three months were compared to a conventional reduced calorie diet. It was determined that while both groups lost weight, dieters using of meal replacements lost more weight after 1 year.(2)
Weight loss after one year averaged 7-8% from base line which was comparable or above the level observed with pharmacologic weight loss studies and the level known to lower disease risk. Meal replacements have also been an effective alternative for dieters with diabetes.
In addition to simplifying meal planning it can help dieters achieve healthy blood glucose levels while they are learning skills to balance their dietary carbohydrate intake. Cheskin et.al.(3) reported that a diet using a portion-controlled meal replacement diet (PCD) yielded significantly greater initial weight loss and less regain after 1 year of maintenance than a standard, self-selected, food-based diet. Meal replacements were also utilized in the multi-center Look AHEAD (Action for Health in Diabetes) study (4) with over 5000 participants. During the weight loss phase it was found that the number of meal replacements consumed was significantly associated the amount of weight loss. At the end of one year the group using meal replacements lost 6.8% of their initial weight compared to only 0.7% for the group without meal replacement use. After initial weight loss participants in this multi-year study were encouraged to continue to replace one meal and one snack per day with liquid shakes and meal bars. Weight loss maintenance is another good fit for meal replacements. Continuing to substitute a meal replacement for one or two daily meals or snacks has been found to support long term weight maintenance.(5)
REFERENCES:
1. Position of the American Dietetic Association: Weight Management Journal of the American Dietetic Association. 2009; 109;330-346.
2. Heymsfield SB, van Mierlo CA, van der Knaap HC, Heo M, Frier HI. Weight management using a meal replacement strategy: meta and pooling analysis from six studies. International Journal of Obesity and Related Metabolic Disorders. 2003 May;27(5):537-49.
3. Cheskin LJ, Mitchell AM, Jhaveri AD, Mitola AH, Davis LM, Lewis RL, Yep MA, Lycan TW. Efficacy of Meal Replacements Versus a Standard Food-Based Diet for Weight Loss in Type 2 Diabetes. The Diabetes Educator. 2008; 34: 118-127.
4. Wadden TA, Neiberg RH, Wing RR, Clark JM, Delahanty LM, Hill JO, Krakoff J, Otto A, Ryan DH, Vitolins MZ; Look AHEAD Research Group. One Year Weight Losses in the Look AHEAD Study: Factors Associated with Success Obesity. 2009; 17: 713-722
5. Layman DK, Evans EM, Erickson D, Seyler J, Weber J, Bagshaw D, Griel A, Psota T, Kris-Etherton P. A moderate-protein diet produces sustained weight loss and long-term changes in body composition and blood lipids in obese adults. Journal of Nutrition. 2009. 139(3):514-21.
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Happy Cooking!
Traditional "CORNED" BEEF & CABBAGE sure is tasty, but it's typically loaded with preservatives and sodium. In this healthy recipe makeover, we slash more than 2,300 mg of sodium with our quicker twist on the St. Patrick's Day classic. To get great flavor without the additives found in store-bought corned beef, we rub ground pickling spice onto steak instead.
Quick "Corned" Beef & Cabbage
By: EatingWell Test Kitchen
Total: 45 mins Servings:4
Ingredient Checklist
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2 tablespoons pickling spice
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1 teaspoon dry mustard
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3 sticks of celery or one celery root
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½ teaspoon ground pepper, divided
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½ small cabbage, cored and cut into wedges
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8 small carrots, trimmed
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2 cups halved baby potatoes
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4 tablespoons extra-virgin olive oil, divided
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2 tablespoons malt vinegar or white-wine vinegar
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1 tablespoon chopped fresh dill, plus more for garnish
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1 teaspoon whole-grain mustard
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1 pound skirt steak, trimmed
Directions
Instructions Checklist
Preheat oven to 450 degrees F.
Grind pickling spice in a clean spice grinder (or coffee grinder); transfer to a small bowl and combine with dry mustard, salt and 1/4 teaspoon pepper. Toss cabbage, carrots and potatoes in a large bowl with half the spice mixture and 2 tablespoons oil. Transfer to a large rimmed baking sheet. Roast, stirring once, until tender, 25 to 30 minutes.
Meanwhile, whisk 1 tablespoon oil, vinegar, dill, mustard and the remaining 1/4 teaspoon pepper in a small bowl. Set the vinaigrette aside.
About 10 minutes before the vegetables are done, cut steak in half crosswise (if it's one long piece) and rub with the remaining spice mixture. Heat the remaining 1 tablespoon oil in a large skillet over medium-high heat. Cook the steak, turning once, 2 to 3 minutes per side for medium-rare. Let rest on a clean cutting board for 5 minutes, then thinly slice against the grain.
Drizzle the roasted vegetables with the vinaigrette and serve with the steak.
Before serving, salt only if needed
Nutrition Facts Serving Size: 3 oz. steak & 1 3/4 cups vegetables Per Serving:
437 calories; protein 27.7g; carbohydrates 27.4g; dietary fiber 6.4g; sugars 8.6g; fat 24.1g; saturated fat 5.6g; cholesterol 73.7mg; sodium 480.3mg
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What’s inside
Lutein and Zeaxanthin – Essential nutrients for the eye. These carotenoids support retina and macular health, along with clear focus. They help filter out the most harmful wavelengths of UV rays in sunlight and blue light from computers, smartphones and TV.
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Shown in studies to support natural killer (NK) cell function, which is important in maintaining a strong immune system.*
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Older adults (ages 55-75) who took a daily multivitamin and mineral supplement with zinc, vitamin C and vitamin D in a 12 week study experienced feeling under the weather for shorter periods of time and with less severe symptoms than a control group that received a placebo.*
These new findings from Oregon State University researchers were published in the journal Nutrients.
As people get older, the risk of vitamin and mineral deficiencies that contribute to age-related immune system deficiencies rises. Across the US and Canada research suggests more than 33% of older adults are deficient.
"A decline in the immune system is most often characterized by increased levels of inflammation, reduced innate immune function and reduced T-cell function," said Adrian Gombart, professor of biochemistry and biophysics at Oregon State University, and a principal investigator at the Linus Pauling Institute. "Since multiple nutrients support immune function, older adults often benefit from multivitamin and mineral supplements."*
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