tag:blogger.com,1999:blog-8859456735165996893.post6575112903199573660..comments2024-03-28T02:36:04.078-07:00Comments on Health Correlator: All diets succeed at first, and eventually failNed Kockhttp://www.blogger.com/profile/02755560885749335053noreply@blogger.comBlogger28125tag:blogger.com,1999:blog-8859456735165996893.post-63541793390486825412012-03-15T22:53:50.635-07:002012-03-15T22:53:50.635-07:00have you looked at jon gabriel's book, the gab...have you looked at jon gabriel's book, the gabriel method? <br />He has some interesting ideas about how t stress causes obesity and that dieting is such a stress. It's an alternative to the arguments of which type of diet is better than the next. I've tried Atkins a few times over the years and lost less each time. The last time I lost nothing but still had a rebound of weight gain...not what Iwould classify as effective. I often feel that the first time I try any new eating plan it is always more effective than in subsequent tries. Maybe the placebo effect is involved, maybe the body has a memory of previous adaptations.<br />A long time ago I read something by a doctor who used calorie restriction in only one circumstance - with patients who were too thin. He restricted their intake for a couple of days until they lost a couple of pounds and then they would gain it all back plus a little more. Sound familiar? he would repeat until they were at an ideal weight.In his opinion , a calorie restricted diet was for weight gain! that story has always stuck in my head. Unfortunately, he had no prescription for weight loss. <br /><br />trinaAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-8859456735165996893.post-82603427992264101512012-02-20T10:33:04.318-08:002012-02-20T10:33:04.318-08:00From my experience of listening to patients who ar...From my experience of listening to patients who are on a 'low carb' diet, they feel "deprived". They look at pastries, cake, junk and can't or won't make the realization that these things are not 'food'. They are energy but not nutrition. So of course, as soon as these people loose a whack of weight, they begin to tentatively indulge in 'life's great pleasures'. At first, nothing happens. So this gives them courage. Eventually and suddenly the pounds begin to pack on again. Much emotional trauma and denial ensues.<br /><br />So long as anyone thinks that processed junkfood and high sugar desserts and snacks are desirable, the chance that any weight loss effort will result in permanent change is nil.Gabriella Kadarhttps://www.blogger.com/profile/18294468426599703416noreply@blogger.comtag:blogger.com,1999:blog-8859456735165996893.post-4050104187908583772012-01-29T20:01:17.158-08:002012-01-29T20:01:17.158-08:00Wow!, Dr. Parker, now you are speaking like a thin...Wow!, Dr. Parker, now you are speaking like a thin person. I had to scratch my head after reading the A to Z study, why did everyone gain weight later?, and concluded that people just weren't in compliance. Then when I got into the LC maintenance zone I saw firsthand how the plans may be more suboptimal than advertised. The plan was to get almost to goal weight and "slide" into it, gradually increasing carbs and then backing off that if there was weight gain. Trouble is, once many start doing it, you just shoot straight back up. Taking it down to the earlier strictness doesn't help. Most LC authors don't discuss this, and judging by many comments here, just don't believe it. Dr. Calvin Ezrin discusses it, but gives no reason or real solution, other than "don't stop". Others write it off to age or some sort of newly-acquired character disorder or inability to use measuring cups even if they weren't needed before.<br />Thank you for this post. Maybe now someone will take it seriously. I thought, "Hey, what if the CW researchers are correct? What if LC sucks and people gain it back?" We are absolutely throwing away all this great data by brushing the problem off as non-compliance.Exceptionally Brashhttps://www.blogger.com/profile/13177479330600606059noreply@blogger.comtag:blogger.com,1999:blog-8859456735165996893.post-24596617871846133352012-01-29T14:49:35.555-08:002012-01-29T14:49:35.555-08:00BTW, I'm a member of the NWCR, largely because...BTW, I'm a member of the NWCR, largely because I think low-carbers are vastly underepresented--only about 11% of the registry is low-carbers, which some use to infer that low-carb doesn't usually work. (The NCWR questionnaires are so skewed in the direction of the low-fat paradigm as to be hilarious--but I suspect they also put off a lot of low-carbers.)<br /><br />Most of the study results on long-term weight loss maintenance (>3 years) quote the usual claptrap about the majority of successful losers practicing continued low-fat dieting, portion and calorie control, not skipping breakfast, daily cardio, and yada yada yada. And it's true--that's what MOST people in the NWCR are doing.<br /><br />But in a couple of studies, Phelan et al decided to see what the differences were between low-carb dieters in the registry and the majority:<br /><br />http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17925473&ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum<br /><br />It's worth hunting down the full text.<br /><br />The bottom lines: <br /><br />--Low-carb dieters had no more tendency to regain<br />--Low-carb dieters ate more daily calories (~500 cal/day more)<br />--Low-carb dieters did not tend to deliberately restrict portions or calories<br />--Low-carb dieters engaged in less physical activity (~900 cal/week)<br /><br />...all while maintaining their weight loss.David Isaakhttps://www.blogger.com/profile/04928598446742324391noreply@blogger.comtag:blogger.com,1999:blog-8859456735165996893.post-12154131717691975572012-01-29T14:44:41.938-08:002012-01-29T14:44:41.938-08:00Perhaps most diets fail. I lost 130 pounds in abou...Perhaps most diets fail. I lost 130 pounds in about 9 months starting June 2010, and have kept it off without any real conflict. <br /><br />I am actually surprised how easy and fun it really is. The only real challenge is keeping a steady stream of whole foods that minimize modern industrialized food processing. <br /><br />I don't want to think of myself as an anomaly. In the end, its not really about dieting. Its about our health; how we retain, regain, and maintain it.Anonymoushttps://www.blogger.com/profile/04422687319390073486noreply@blogger.comtag:blogger.com,1999:blog-8859456735165996893.post-65848605576777420512012-01-29T14:31:03.634-08:002012-01-29T14:31:03.634-08:00I think it's important to distinguish between ...I think it's important to distinguish between outright failure and a modest rebound.<br /><br />I think when most people approach their target weight (or reach or whiz down past it), they have been focused on nothing but the scale. Fat loss can be fairly rapid; lean body mass gain is slow. <br /><br />I think someone at what they perceived before as their target weight, who eats enough protein and keeps exercising will find is that:<br /><br />1) If the diet was low-carb and is loosened, there will be rebound of anywhere from 3 to 7 pounds--glycigen and water and some degree of rehydration;<br /><br />2) There will be a "creeping weight gain" of 2-4 pounds per year of lean body mass.<br /><br />The lowest weight I hit was 147 lbs. When I went to a trainer to be hydrostatically weighed, he told me my body fat was in a fine range (12.7% at that time), but that frankly he thought I was underweight and should add more lean mass. I'm now around 160 lbs most days. I'd still like to swap some fat for muscle, but that's a slow process.<br /><br />I'm never sure how much I believe in Sheldon's somatotypes--whcih you've discussed before--but his rules state:<br /><br />Ectomorphs lose weight easily, gain weight only with difficulty<br /><br />Mesomorphs gain and lose weight easily<br /><br />Endomorphs gain weight easily, and lose it only with difficulty.<br /><br />This suggests that there will be few if any endomorphs in a diet study; it will be mesos and endos. One could also hypothesize that endos will be overrepresented, because even though mesos can easily become overweight or even obese, they are more likely to do something effective about it without medical assistance or monitoring.<br /><br />So it might be that the people who lose weight and maintain most of their loss tend to be mesos (although the can expect some creping weight gain if they keep pumping iron!) Those who lose weight but regain all of it soon are endos.<br /><br />Just a hypothesis--and one that doesn't count on willpower to explain everything.<br /><br />--------------<br />PS I also think that prolonged daily calorie restriction makes everything riskier in tersm of weight regain, and think a high-calories dya at least once a week while losing weight is a wise policy.David Isaakhttps://www.blogger.com/profile/04928598446742324391noreply@blogger.comtag:blogger.com,1999:blog-8859456735165996893.post-55883202841157944222012-01-25T15:24:46.821-08:002012-01-25T15:24:46.821-08:00Hi Ned,
I was thinking more on food choices. Actu...Hi Ned,<br /><br />I was thinking more on food choices. Actually, an ADF regimen can be modified to include some calories on "fasting" days, say 15-20% calories of the calories needed for maintaining weight. However, I think the fact that virtually any food can be eaten more freely on eating days might make people tolerate (initially, they should be able to adapt) a fasting day. See it like a a kind of "reward day". Works in the same manner as a planned "cheat meal/day", which makes people efforts "pay off". You are not eating one day knowing that the next day, you will be able to eat without restrictions. <br /><br />If you couple this regimen with weight training, you should expect increased fat loss and minimal muscle loss on fast days, as research has shown.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-8859456735165996893.post-43499263149845474042012-01-25T13:48:18.490-08:002012-01-25T13:48:18.490-08:00Dr. Ayers mentions this aspect.
The following l...Dr. Ayers mentions this aspect. <br /><br />The following link also mentions how diversity of gut flora is linked to obesity: the more diverse, the less obese one usually is.<br /><br />http://ecophysio.fieldofscience.com/2011/04/correlation-between-gut-bacteria-and.html<br /><br />http://www.sciencemag.org/content/332/6025/32<br /><br />What may complicate he issue further is quite simply the heavy use of antibiotics in the past of individuals.Asimhttps://www.blogger.com/profile/12680880808056066311noreply@blogger.comtag:blogger.com,1999:blog-8859456735165996893.post-30953089859996955182012-01-25T13:40:29.329-08:002012-01-25T13:40:29.329-08:00Maybe the gut flora that is present is signaling f...Maybe the gut flora that is present is signaling for the past food 'experiences'. All of these diets don't take into account the flora, meaning the same bacteria is present in their gut as prior to the diet, the only difference really is their ratios have changed.<br /><br />Another point to mention about hunter-gatherers is they eat straight off the plants, meaning they are exposed to a much more diverse set of bacteria that will eventually settle in the gut.Asimhttps://www.blogger.com/profile/12680880808056066311noreply@blogger.comtag:blogger.com,1999:blog-8859456735165996893.post-66701742542516764322012-01-25T08:10:09.046-08:002012-01-25T08:10:09.046-08:00After years of yo-yo dieting I was fortunate enoug...After years of yo-yo dieting I was fortunate enough to find low-carb and have maintained a 40-lb weight loss for 10 years now. As you point out, it's not easy and requires constant self-monitoring. What I find even more frustrating is the struggle to find useful information that actually works to help me maintain my weight and deal with health issues resulting from a lifetime of poor nutrition. All those tax dollars that once they're paid out I have no control over going into misguided research! Thank goodness for bloggers like you!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-8859456735165996893.post-55912363223097598742012-01-25T07:04:51.604-08:002012-01-25T07:04:51.604-08:00Hi Richard. I think that the changes in metabolism...Hi Richard. I think that the changes in metabolism that we see in the formerly obese, which seem to be very real, are reversible. I’ll have more to say about that topic in a post that should be up soon.Ned Kockhttps://www.blogger.com/profile/02755560885749335053noreply@blogger.comtag:blogger.com,1999:blog-8859456735165996893.post-72402307225218178062012-01-24T18:53:29.470-08:002012-01-24T18:53:29.470-08:00The idea with the Paleo diet (and by this I mean P...The idea with the Paleo diet (and by this I mean PaNu) is not caloric restriction, which requires will (or won't)-power, but caloric reduction or substitution. Instead of excess carbs on eats more saturated fats. The result is a weight loss that I believe is relatively easy to maintain EXCEPT if the "adherent" begins to seriously increase carb consumption.<br /><br />For myself, although I have never been obese, I can see extra weight come back on when extra carbs are consumed.<br /><br />On the other hand, are we looking for the starving-hunter look, or the reasonably-well-fed hunter look? (Which would be more attractive to the opposite sex?) <br /><br />But isn't obesity itself the cause (or part of the cause) of the problem? It seems to me that the body is re-programmed when that much extra fat is created and stored, and that very fat people end up with different metabolic issues from people who were never very fat.Richardhttps://www.blogger.com/profile/13579689230767618822noreply@blogger.comtag:blogger.com,1999:blog-8859456735165996893.post-26209928101012428672012-01-24T06:23:14.027-08:002012-01-24T06:23:14.027-08:00Hi Steve. Yes, and it seems that those who succeed...Hi Steve. Yes, and it seems that those who succeed tend to be the ones who are the most methodical in their adherence to a way of eating that leads to an optimal nutrient/calorie balance in the long run.<br /><br /> Your comment reminded me a bit of this essay by Dr. Eades on the adherer’s effect:<br /><br /> http://www.proteinpower.com/drmike/statins/the-adherer-effect/<br /><br /> Here is an academic paper on the topic, also linked in the essay:<br /><br /> http://circ.ahajournals.org/content/119/15/2051.abstract<br /><br /> Of course those whom some would call good adherers would be referred to as obsessive-compulsive by others.Ned Kockhttps://www.blogger.com/profile/02755560885749335053noreply@blogger.comtag:blogger.com,1999:blog-8859456735165996893.post-12247126098176888592012-01-24T01:40:16.099-08:002012-01-24T01:40:16.099-08:00It's worth mentioning that "The Fierce Pe...It's worth mentioning that "The Fierce People" is a) a portrait of one tribe out of of thousands, and b) controversial enough in its portrayals to have had two full-length feature films made about it.<br /><br />Portrayals of African hunter-gatherers, such as the Hadza and the various tribes of Bushmen (see Elizabeth Marshall's "The Old Way" and Michael Finkel's <a href="http://ngm.nationalgeographic.com/2009/12/hadza/finkel-text" rel="nofollow">The Hadza</a>) paint a quite different picture. <br /><br />Culture is not the invention of farmers. Hunter-gatherer societies are quite diverse, and it is not possible to paint them all with one broad brush.<br /><br />Steve Parker: That's an excellent point.<br /><br />Kindke: "Despite the billions of $$$ poured into obesity research, the only solution for obesity we have thus far is "will power" exerted by the patient."<br /><br />Any successful diet must minimize the role of willpower: dietary restriction raises cortisol, and cortisol makes us eat more (note: not the only mechanism at work). I've raised this point before, <a href="http://www.gnolls.org/2342/restrained-eating-willpower-and-why-diets-fail-why-are-we-hungry-part-3/" rel="nofollow">here.</a><br /><br />JSJ. Stantonhttp://www.gnolls.orgnoreply@blogger.comtag:blogger.com,1999:blog-8859456735165996893.post-11650254439171128862012-01-23T21:01:27.851-08:002012-01-23T21:01:27.851-08:00"All diets succeed at first, and eventually f..."All diets succeed at first, and eventually fail."<br /><br />Hi, Ned. <br /><br />Here's what I'd say: "Most diets succeed at first, and eventually compliance with the diet fails."<br /><br />Not as succinct, but more accurate, I think. You can see it in all the long-term diet studies, like Shai's DIRECT trial (NEJM 2008). Folks stop following their assigned or chosen diet.<br /><br />-SteveSteve Parker, M.D.https://www.blogger.com/profile/13127995984175635389noreply@blogger.comtag:blogger.com,1999:blog-8859456735165996893.post-18078903470224017672012-01-23T16:22:28.489-08:002012-01-23T16:22:28.489-08:00Hi Jim. This seems very reasonable.
I would a...Hi Jim. This seems very reasonable.<br /><br /> I would also recommend moving toward minimally processed foods as much as possible. <br /><br /> Needless to say, doing only that (avoid processed foods) doesn’t seem to entirely solve the problem.Ned Kockhttps://www.blogger.com/profile/02755560885749335053noreply@blogger.comtag:blogger.com,1999:blog-8859456735165996893.post-51455207290133484182012-01-23T16:19:41.401-08:002012-01-23T16:19:41.401-08:00Hi Lucas. Wouldn’t alternate day fasting involve s...Hi Lucas. Wouldn’t alternate day fasting involve some serious restriction as well, on the days one is not eating?Ned Kockhttps://www.blogger.com/profile/02755560885749335053noreply@blogger.comtag:blogger.com,1999:blog-8859456735165996893.post-22355919102028853622012-01-23T16:18:15.511-08:002012-01-23T16:18:15.511-08:00Yes Kindke. I hear a lot about the brain controlli...Yes Kindke. I hear a lot about the brain controlling fat storage, usually said in the context of more automatic brain mechanisms.<br /> <br /> But there are the subconscious thoughts too, and “guerrilla warfare” is played in that realm too.<br /><br /> Most people who embark on a heavy-duty calorie restriction program soon start obsessing about food, dreaming about it. Many become psychotic.Ned Kockhttps://www.blogger.com/profile/02755560885749335053noreply@blogger.comtag:blogger.com,1999:blog-8859456735165996893.post-90410834023491517112012-01-23T16:13:44.446-08:002012-01-23T16:13:44.446-08:00Hi Sam. These long-term adherents to the Optimal D...Hi Sam. These long-term adherents to the Optimal Diet (actually a variation of it) seemed to be doing fine, but they were certainly not lean:<br /><br /> http://bit.ly/rW065aNed Kockhttps://www.blogger.com/profile/02755560885749335053noreply@blogger.comtag:blogger.com,1999:blog-8859456735165996893.post-88171734242881930022012-01-23T16:10:12.472-08:002012-01-23T16:10:12.472-08:00Instead of picking an eating plan and hoping that ...Instead of picking an eating plan and hoping that it will lead to calorie balance, it is more effective for weight maintenance to discover where calorie balance is by counting calories and weighing oneself, and then to find the most satisfying way to eat within that strict calorie level, so that one always feels satiated.Jimhttps://www.blogger.com/profile/01237465111190530578noreply@blogger.comtag:blogger.com,1999:blog-8859456735165996893.post-2392654364625330722012-01-23T16:09:35.392-08:002012-01-23T16:09:35.392-08:00Hi Galina. Not sure how many years until one is gu...Hi Galina. Not sure how many years until one is guaranteed success; there is an issue of modified metabolism here (some call it “broken”), which I’m planning on discussing soon. But 2-3 years keeping most of the body fat lost off already makes one a minority, virtually an exception.Ned Kockhttps://www.blogger.com/profile/02755560885749335053noreply@blogger.comtag:blogger.com,1999:blog-8859456735165996893.post-1909009114390687592012-01-23T16:05:57.107-08:002012-01-23T16:05:57.107-08:00Good points Gretchen and Nigel.Good points Gretchen and Nigel.Ned Kockhttps://www.blogger.com/profile/02755560885749335053noreply@blogger.comtag:blogger.com,1999:blog-8859456735165996893.post-85477154767558244982012-01-23T13:00:18.972-08:002012-01-23T13:00:18.972-08:00In my opinion, the most problematic part of dietin...In my opinion, the most problematic part of dieting is restriction. Whichever diet you choose to follow, you are restricting something, which for many people is impossible to maintain. <br /><br />I am getting more and more convinced that the best dieting plan is intermittent or alternate day fasting. It makes you feel that a. you are not restricting calories, b. you are eating big amounts of food and c. you can eat "whatever you like" without having to count calories.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-8859456735165996893.post-19890170933951185432012-01-23T09:17:37.640-08:002012-01-23T09:17:37.640-08:00I think this is a testamont to perhaps how little ...I think this is a testamont to perhaps how little we are consciously in control of our bodies. Dieting requires extreme conscious exertion, which will not last forever.<br /><br />Those who maintain weight loss do so because they are still monitoring everything they eat. As soon as that stops, fat comes back.<br /><br />Despite the billions of $$$ poured into obesity research, the only solution for obesity we have thus far is "will power" exerted by the patient. sighKindkehttps://www.blogger.com/profile/15841418412425329998noreply@blogger.comtag:blogger.com,1999:blog-8859456735165996893.post-20601575294764569772012-01-23T09:14:18.157-08:002012-01-23T09:14:18.157-08:00Ned,
All of the data that I've seen regarding...Ned,<br /><br />All of the data that I've seen regarding the long-term (up to 5 years) failure of weight-loss plans have involved calorie-restricted diets.<br /><br />Do we have any good long-term follow-ups for ad libitum LCHF diets?Sam Knoxhttps://www.blogger.com/profile/15632591648777098250noreply@blogger.com