Monday, May 23, 2016

"untrue" that excessive calories caused obesity

So according to the National Obesity Forum (as reported by the BBC), it is
There's usually a gram of truth underlying each new bit of dietary advice that pops up in the news every 5 minutes. But it's generally buried under a mountain of hyperbole. It now seems clear that the anti-fat advice that I grew up with was somewhat exaggerated. However, does the NOF really expect us to believe that this fine fellow:


built up his fine physique through a strenous regime of cold showers and beatings alone? Incidentally, he's not one of the really fat ones, but he won the one tournament that we went to.

Nothing about this on the NOF website, which seems a bit odd.

23 comments:

PeteB said...

It's been really annoying me this story and how uncritically it is being reported in the press.

Dr Aseem Malhotra NOF : “Eat fat to get slim,” he concludes. “Don’t fear fat; fat is your friend.”

The report says (according to the BBC) "it is highly irrelevant how many calories a portion of food on a plate contains" and it was "untrue" that excessive calories caused obesity."

Don't these sort of absolutionist statements ring any warning bells with science reporters ?

Perhaps the current health advice is not media savvy enough and doesn't have a good enough narrative

http://www.nhs.uk/Livewell/Goodfood/Pages/Healthyeating.aspx

A diet based on starchy foods such as potatoes, bread, rice and pasta; with plenty of fruit and vegetables; some protein-rich foods such as beans, pulses, fish, eggs, meat and other proteins; some milk and dairy foods or dairy alternatives; and not too much fat, salt or sugar, will give you all the nutrients you need.
When it comes to a healthy diet, balance is the key to getting it right. This means eating a wide variety of foods in the right proportions, and consuming the right amount of food and drink to achieve and maintain a healthy body weight.

PeteB said...

Found a great blog on food and pseudoscience - latest article

http://angry-chef.com/blog/the-most-unfashionable-defence-of-all

James Annan said...

Have to say that in this case the beeb at least is being pretty critical - eg the headline! And it leads with someone saying it's irresponsible.

I do think the evidence saying sugar is a bigger problem and fat a lesser one than previously thought is mounting up though. But that's not to say all sugar is bad and unlimited fat is harmless of course.

PeteB said...

I think the one thing that previous advice got wrong was cholesterol - specifically advising against foods that contained high cholesterol, which wasn't based on research - just misplaced 'common sense'. The advice for sugar, salt and fat came from a series of surveys in the late 90s / early 2000s and that advice is still basically valid (although I agree it looks like saturated fats weren't quite as bad for us as we thought , when we take the totality of the evidence now)

http://www.food.gov.uk/sites/default/files/multimedia/pdfs/nutrientinstitution.pdf

9. We know from the National Diet and Nutrition Surveys3 4 5 that while on average, the population consumes about the right amount of total fat, the highest consumers of fat are eating close to 50% of their energy as fat; far greater than recommended amounts.
10. These surveys also tell us that on average the population consumes too much saturated fat, salt and non-milk extrinsic sugar (NMES, some people call this added sugars). We also know that for different sections of the population, some people have intakes of vitamins and minerals below recommended levels.

Tom Dayton said...

The best source I've ever seen for info on obesity is the blog "Whole Health Source" by neurobiologist and obesity researcher Stephen Guyenet. Most recently, for example: http://wholehealthsource.blogspot.com/2016/01/testing-insulin-model-response-to-dr.html

Steve Crook said...

I *think* that what they're saying is that calorie counting can be unreliable because different food types are metabolised differently, and thus it's hard to predict what will be laid down as fat from any given meal.

In addition, for the very obese, the metabolic changes in insulin response mean different responses to different food types.

@Tom Dayton. Interesting site. It's not the first time I've seen Glucagon mentioned, there's this https://www.youtube.com/watch?v=VjQkqFSdDOc (Prof. Roger Unger)on the relationship between glucagon and insulin.

PeteB said...

Rather good critique here

https://www.bhf.org.uk/heart-matters-magazine/news/behind-the-headlines/fat-controversy-hits-headlines

jch1952 said...

I've been a naughty boy and have not been to the doctor since January 2015, at which time I weighed around 218 pounds. I went on a low-fat diet. Gave up french fries, potato chips, dressings, sauces, sugar drinks, a ton of bread,etc. I have an appointment on Friday. I weigh 166 pounds. They're going to wonder what happened. Counting calories is essential. Keeping track of exercise is essential. Personally, fatty foods are problematic... too dense.

James Annan said...

Well done! No question, fatty foods make it easy to pile up the calories. So does sugary food :-)

The Japanese approach is to make food so boring that people give up on it before eating too much. Now they are increasingly discovering that (western) food can actually taste nice, obesity is growing there too...

MikeR said...

'I *think* that what they're saying is that calorie counting can be unreliable because different food types are metabolised differently'
Indeed. And calorie counting may be totally the wrong paradigm; too much else going on. No one would use calories to explain why someone without enough pituitary hormone isn't growing ["why aren't you feeding him?!"], and the rest of us may be similar: hormonal triggers may affect how much gets turned into fat and how much is metabolized.

PeteB said...

There are definitely a lot of areas around nutrition and obesity that are not well understood yet. My problem with the nof report (why isn't it on their website ) is that they are pushing very definite views that there is not a good evidence base for and trying to undermine the current public health messages which is widely recognised by most nutritionists as the best we can advise based on the totality of current evidence (ie balanced diet, plenty of fruit and veg, startchy carbohydrates, protein, fat and not too much sugar, salt and saturated fats) plus exercise. Yes, there are individual studies that seem to indicate different approaches but you have to take account both the quality and totality of studies
It is slightly ironic that some of the campaigners that are campaigning that one food group was demonised (fat) which ended up in manufacturers replacing fat with sugar now seem to think it is a good idea to demonise another food group rather than the balanced diet which is the current advice of most nutritionists

MikeR said...

http://www.dailymail.co.uk/news/article-3617076/Diabetes-patients-defy-NHS-Thousands-rebel-against-guidelines-controlling-condition-diet-low-carbohydrates.html
Just saw this.

James Annan said...

Sorry, linking to the DM is the equivalent of godwin, you lose :-)

I'm not well informed on medical advice for diabetes but not entirely surprised that a low-GI diet is helpful, especially for type 2. However, calorie counting can't be *entirely* the wrong paradigm: if you don't believe me, try 3000 per day for 6 mo, then 1000 per day for 6 mo, and report back...I think I can predict the outcome pretty much irrespective of food types and balance so long as it's not ridiculous.

PeteB said...

The press love a good diet ping pong
http://www.dailymail.co.uk/health/article-3047764/It-s-time-start-eating-carbs-ve-demonised-diet-gurus-doctors-say-cutting-carbohydrates-ruin-health-make-weight.html

I'd rather trust the professionals. Call me cynical but I notice at the top of the diabetes.co.uk website (mentioned in yesterday's mail) has a banner advert taking a third of the screen for an amazon diet book for low carb diets. Like all diets it has a short term effect but I'm very sceptical of a long term benefit (more likely the opposite by messing up your resting metabolic rate. Diabetes.org.uk seems a much better source of advice

MikeR said...

According to one person I know (haven't looked it up), the diabetics associations in the US are much more into low-carb diets for type 2 diabetes than in the UK. I'm not sure it's easy to "trust the professionals"; it may depend on which country's professionals you consult.

"calorie counting can't be *entirely* the wrong paradigm": Well, just speaking for myself, that sounds like a mistake. Obviously if you starve yourself, you'll lose weight, but that doesn't mean that calories are the bottleneck in all scenarios or even most. Just speaking for myself, I can lose five pounds in a week by dropping (almost all) carbs, even if I eat a lot of meat and don't cut down my total calories at all. I have done this numerous times. (I gain it back, because I can't stand it for long.) Anecdotal evidence convinces me that there are plenty of others like me.
That would seem to be evidence that "counting calories" is missing something important.

PeteB said...

Look pretty similar to me, maybe the US version slightly more anti fat but that may be because US typically eat more fat, the UK one is slight more nuanced

https://www.diabetes.org.uk/Guide-to-diabetes/Enjoy-food/Food-and-diabetes/I-have-Type-2-diabetes/What-can-I-eat-type-2/

http://www.cdc.gov/diabetes/managing/eatright.html

PeteB said...

The press love a good diet ping pong
http://www.dailymail.co.uk/health/article-3047764/It-s-time-start-eating-carbs-ve-demonised-diet-gurus-doctors-say-cutting-carbohydrates-ruin-health-make-weight.html

I'd rather trust the professionals. Call me cynical but I notice at the top of the diabetes.co.uk website (mentioned in yesterday's mail) has a banner advert taking a third of the screen for an amazon diet book for low carb diets. Like all diets it has a short term effect but I'm very sceptical of a long term benefit (more likely the opposite by messing up your resting metabolic rate. Diabetes.org.uk seems a much better source of advice

James Annan said...

Oh, Mike, I forgot to say earlier, if you're losing 5 pounds in a week there's no way that's body mass, the vast majority of it will be water. 5 pounds of fat would represent more than your entire calorie consumption over that time.

Glycogen has a lot of water bound up with it, so carb-depletion (which directly results in glycogen depletion) is routinely accompanied with a rapid weight loss, which is equally rapidly reversed when you increase the carbs again. Counting calories was never meant to account for water!

PeteB said...

Resignations

http://www.theguardian.com/society/2016/jun/03/anti-obesity-campaigners-resign-over-low-fat-diet-report

Worth reading to the very end to see the row back

PeteB said...

“Though individual opinions differ within the forum, as a group, the NOF supports the principle of discussion and, therefore, the right of those named authors to produce an opinion paper based on their own view without prejudice or penalty.” haha

PeteB said...
This comment has been removed by the author.
MikeR said...

"5 pounds of fat would represent more than your entire calorie consumption over that time."
Dr. Annan, your last comment may be very relevant and correct, but this one just seems to reflect the calorie paradigm again. If there are other triggers that determine whether a body burns or stores fat, there isn't any reason why a person can't lose more than his calorie consumption. Not saying that's true, it's just that I don't understand the comment.

James Annan said...

Mike, well just ignore that for now, and focus on the bit about water loss, because that is well established and not controversial. Alternatively, try keeping to your diet for more than 2 weeks, and see if you lose 5 pounds per week indefinitely. There's no need to make up some new paradigm for diet, when your observations are explained by simple well-established principles.