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View Full Version : Calories in vs. Calories Out--proof?


Patrick Poblocki
02-26-2009, 06:32 AM
Anyone read this yet? It appears that calories in/out is THE MOST IMPORTANT factor in weight loss.

This is a work friendly site.)

http://content.nejm.org/cgi/content/full/360/9/859

Thoughts?

Pat

Steven Low
02-26-2009, 06:47 AM
It is an important factor, but it isn't the only factor.

As long as you're getting decent macros and you have decent insulin sensitivity,... then yes, it is probably the most important factor at that point.

Garrett Smith
02-26-2009, 07:38 AM
This study was far from simply calories in, calories out. Here's why:
Weight-Loss Intervention

The nutrient goals for the four diet groups were: 20% fat, 15% protein, and 65% carbohydrates (low-fat, average-protein); 20% fat, 25% protein, and 55% carbohydrates (low-fat, high-protein); 40% fat, 15% protein, and 45% carbohydrates (high-fat, average-protein); and 40% fat, 25% protein, and 35% carbohydrates (high-fat, high-protein). Thus, two diets were low-fat and two were high-fat, and two were average-protein and two were high-protein, constituting a two-by-two factorial design. The four diets also allowed for a dose–response test of carbohydrate intake that ranged from 35 to 65% of energy. Other goals for all groups were that the diets should include 8% or less of saturated fat, at least 20 g of dietary fiber per day, and 150 mg or less of cholesterol per 1000 kcal. Carbohydrate-rich foods with a low glycemic index were recommended in each diet. Each participant's caloric prescription represented a deficit of 750 kcal per day from baseline, as calculated from the person's resting energy expenditure and activity level.

Blinding was maintained by the use of similar foods for each diet. Staff and participants were taught that each diet adhered to principles of a healthful diet29 and that each had been recommended for long-term weight loss, thereby establishing equipoise.1,2,26 Investigators and staff who measured outcomes were unaware of the diet assignment of the participants.

Group sessions were held once a week, 3 of every 4 weeks during the first 6 months and 2 of every 4 weeks from 6 months to 2 years; individual sessions were held every 8 weeks for the entire 2 years. Daily meal plans in 2-week blocks were provided (see the Supplementary Appendix). Participants were instructed to record their food and beverage intake in a daily food diary and in a Web-based self-monitoring tool that provided information on how closely their daily food intake met the goals for macronutrients and energy. Behavioral counseling was integrated into the group and individual sessions to promote adherence to the assigned diets. Contact among the groups was avoided.

The goal for physical activity was 90 minutes of moderate exercise per week. Participation in exercise was monitored by questionnaire30 and by the online self-monitoring tool.
Changing fiber intake, lowering glycemic index, keeping a food diary, and getting dietary counseling. Most of us here would agree that doing any/all of those things would improve general body composition, as they generally improve quality of the diet.

If it was all about calories, the glycemic index should have been avoided, because that in itself is saying that some "calories" have a different impact than others.

As I've said before, the same person could eat chocolate cake for a month straight versus a meat/veggies/good fat diet for a month straight--they would likely feel different and have different body comp at the end of a month due to the effects of different foods on things like hormones. It will never be as simple as only calories.

I didn't go back and check, but I'm assuming that measures of actual body composition were not taken. This was simply measuring weight loss, be it muscle or fat. Not a wise approach, if that's what they did.

Mike ODonnell
02-26-2009, 10:06 AM
While calories is important....people don't know how to count anyways....the beauty of Paleo foods....you just seem to lose weight with no hastle!

Duke McCall
02-26-2009, 10:54 AM
A few thoughts:

(1) As Dr. G noted, the study did not look at body composition or any other objective measure of health (or fitness). It only measured weight lost. In my opinion, the goal of the study (or what the study measured) misses the mark.

(2) 25% protein constitutes a "high protein" diet!?! I don't think so.

(3) What MOD said. I do not count calories. It is not in my genetic make up, so any "diet" that requires me to count calories will fail, irrespective of the macronutrient balance.

Patrick Yeung
02-26-2009, 11:58 AM
Not to mention people tend to underestimate their calories by as much as 20% and over estimate their work effort by as much as 30%.

Id have to find the study, but they compared what people considered vigorus exercise versus moderate. For a person who was obese, walking up a flight of stairs was enough to burn em out, while someone who was fit running a mile may be moderate. Not sure if they based their study of exercise like this, or if they calculated actual expenditures.

Though, food log may solve the calorie counting problem.

Gittit Shwartz
02-26-2009, 01:00 PM
the beauty of Paleo foods....you just seem to lose weight with no hastle!

A 5'1 woman with less than 100 lbs of LBM will need to count calories, no matter how philosophically intact her diet is. Even if she is doing WODs.

It kinda bugs me to see this claim posted so often because I think (correct me if I'm wrong) that it mostly applies to people who are very overweight, had a crappy diet before, or have an excellent metabolism - yet that's not even the majority of the people reading it. Then they wonder why they're not getting results. Maybe you could append a disclaimer :)

Mike ODonnell
02-26-2009, 01:09 PM
A 5'1 woman with less than 100 lbs of LBM will need to count calories, no matter how philosophically intact her diet is. Even if she is doing WODs.

It kinda bugs me to see this claim posted so often because I think (correct me if I'm wrong) that it mostly applies to people who are very overweight, had a crappy diet before, or have an excellent metabolism - yet that's not even the majority of the people reading it. Then they wonder why they're not getting results. Maybe you could append a disclaimer :)

Yes...the majority of people I deal with are usually overweight....so it applies to them. The leaner the people are, the more "tricks" you need to get rid of stubborn BF such as cycling high/low calories and carbs.

Then again....I've learned what people"say" they do...and "actually" do...can vary quite dramatically! My whole life is a disclaimer!

Duke McCall
02-26-2009, 01:10 PM
Perhaps an appropriate disclaimer would be that different approaches work for different people--at least when it comes to calorie counting.

Arien Malec
02-26-2009, 02:01 PM
I didn't go back and check, but I'm assuming that measures of actual body composition were not taken. This was simply measuring weight loss, be it muscle or fat. Not a wise approach, if that's what they did.

Waist circumference was measured, and didn't show difference between groups.

The only differences between the groups in terms of outcomes were:
1) LDL decreased most for the high carb groups
2) HDL increased most for the high fat group
3) Insulin sensitivity did better in all groups but the highest carb group.

If you think high LDL is the highest risk factor for disease, you'll take away a recommendation for low fat; if you think low HDL and insulin resistance are the biggest risk factors, you'll take away a different recommendation.

A really neat study, all in all.

My takeaway is the same as I've commented multiple times:

There are multiple paths to health, but none of them include refined carbohydrates and processed oils.

I'd also note this isn't the only study in this area, and other studies have shown an advantage to reduced carbohydrate diets. Again, all in all good stuff.

Brian Stone
02-26-2009, 02:57 PM
A 5'1 woman with less than 100 lbs of LBM will need to count calories, no matter how philosophically intact her diet is. Even if she is doing WODs.

It kinda bugs me to see this claim posted so often because I think (correct me if I'm wrong) that it mostly applies to people who are very overweight, had a crappy diet before, or have an excellent metabolism - yet that's not even the majority of the people reading it. Then they wonder why they're not getting results. Maybe you could append a disclaimer :)

I'm not sure I buy into the good vs. bad inherent metabolism thing. I saw a program where BBC did a study on the metabolism claim, though it was far from comprehensive and scientifically valid since they only tested a single pair of people. Still, I found the results pretty interesting.

I began to very poorly summarize the program but found this summary here:
http://www.bbc.co.uk/sn/humanbody/truthaboutfood/slim/fatthin.shtml

In short, they found no validity to the genetic "high and low metabolism" claims made.

I have not done much research otherwise on this point and intend to, but wanted to add that.

Duke McCall
02-26-2009, 03:12 PM
Arien, you are correct that the study did examine weight circumference and other risk factors for heart disease (which not suprisingly show a correlation between weight loss and a decrease in heart disease risk). And, I agree the study is interesting reading.

My frustration is with the limitations of the study, which no doubt were by design, but which will be overlooked by the general public (and the media) in assessing the study results. The goal of the study was to assess, and what it principally measures, is the effect of the macronutrient composition of different diets on weight loss. It does not, in my opinion, provide a true (or full) assessment the health effects of the macronutrient composition of different diets, which is of at least equal significance in my opinion (but then again what do I know :)).

You are right, though, the information it does provide is interesting and provides a good starting point for another study!

Patrick Yeung
02-26-2009, 07:40 PM
http://www.latimes.com/features/health/la-sci-diet26-2009feb26,0,4499014.story
(wfs)

Looks like they spun it already! The best part is, in the begining, it says...

Two decades after the debate began on which diet is best for weight loss, a conclusion is starting to come into focus. And the winner is . . . not low-carb, not low-fat, not high protein but . . . any diet.

But, then at the end....

Few of the people in the current study strictly adhered to the calorie limits and the composition of their diets, suggesting it is just too difficult to do so, Gardner said. For example, those assigned to consume 35% of their calories as carbohydrates actually consumed an average of 43%, and groups that were supposed to eat a 20%-fat diet averaged 26%. In the end, many of the participants were eating diets that were more similar than dissimilar.

And.... Where was the High fat - High Protein diet? Or IFing and zoneing eating schedules to name a few....

Matthew Bacorn
02-26-2009, 07:55 PM
I really think there is something to the food quality mattering more than calories

I am about a week in to SS, and have been eating way more than usual while lifting intentionally light weights to nail down technique. I've also been walking around a lot less.

Today I weigh the same as i did a week ago, look leaner, and have more energy.

I have a few theories as to why, but i'll save them until i'm a little further into this

Mark Bennett
02-27-2009, 02:57 AM
Most all studies have limitations, faults or bias etc. Thatís why I carry out an experiment of one :cool:

Garrett Smith
02-27-2009, 04:22 AM
My mother-in-law (who works at Canyon Ranch) heard about this study on the news and told me she thought BS...she has been learning something!

Scott Kustes
02-27-2009, 08:19 AM
Even if it does come down solely to calories in/out, certain calories, namely protein and fat, are more satiating than others. That makes it much easier to keep calories low.

Kevin Perry
02-27-2009, 09:46 AM
pfft these studies are always biased. Calories in/out may be what it comes down to but there is a big difference between the health and body comp of that person who uses quality calories vs. that person who eats the SAD.

Mike ODonnell
02-27-2009, 09:46 AM
People are so worried about calories and counting.....when they have no clue how much they can actually burn or use in a day....plus that doesn't even put into perspective how low calorie days and high calorie days can even out over time....the body is more complex than one set of daily parameters. I've seen overweight women trying to eat 2500 calories for a "strong metabolism" (I don't even want to go there...) because their trainer used some magic formula and told them to eat that much....yeah ok, and they wonder why they are still overweight in 2 months.

Scott Clark
02-27-2009, 05:21 PM
This study was the topic of today's Science Friday on NPR. The scariest part of it was when they started taking calls and everyone was talking about how they still include brownies and cake in their daily diet, just less of it now. Well, that IS what is being promoted by the blanket cals in/cals out thing, so it's not surprising.

Not that such foods don't have their place as a treat, but you know.

Mike ODonnell
02-27-2009, 06:42 PM
Not that such foods don't have their place as a treat, but you know.

the general public "treat" themselves too much daily......got to work...get a treat....made it till lunch...another treat.....survived one day....one more treat.....

Gittit Shwartz
02-28-2009, 12:42 PM
I'm not sure I buy into the good vs. bad inherent metabolism thing. I saw a program where BBC did a study on the metabolism claim, though it was far from comprehensive and scientifically valid since they only tested a single pair of people. Still, I found the results pretty interesting.

I began to very poorly summarize the program but found this summary here:
http://www.bbc.co.uk/sn/humanbody/truthaboutfood/slim/fatthin.shtml

In short, they found no validity to the genetic "high and low metabolism" claims made.

I have not done much research otherwise on this point and intend to, but wanted to add that.

I've seen studies to that effect too. Not using the genetic cop-out at all. It's just by the time people start thinking maybe they should change their eating habits, these habits have already induced metabolic disorder. From the numbers I've seen someone who is hypothyroid my have a BMR that is 30-40% lower than normal.

And of course there's no argument that a smaller person burns less calories while restaurant portion sizes stay the same.

Craig Loizides
03-05-2009, 03:21 PM
It looks like there was actually very little difference in what the study participants ate.

The goals were (C, P, F):
65/15/25
55/25/20
45/15/40
35/25/40

The food actually eaten was:
53/20/27
51/21/28
48/20/33
43/21/35

So, protein was exactly the same, carbs only ranged from 43 to 53, and fat from 27 to 35. It's not surprising that the results are similar in the different groups.

Garrett Smith
03-05-2009, 04:34 PM
Seriously, Craig, is that what they actually ended up eating?

Hard to believe the garbage conclusions that the media is force-feeding people with this joke of a study, if that is really true.

Aaron Gainer
03-14-2009, 10:53 AM
Calories in vs Calories out is the basis to lose weight mathematically. However, if someone isn't losing weight, are their hormones out of whack(thyroid, insulin, etc...)? Are they eating a bunch of starchy carbs? If the answer to both, then fix the diet and be strict with fruits, veggies, and meats.

As the saying goes: You eat like shit, be prepared to feel like shit.

Ben Fury
03-29-2009, 11:28 PM
My takeaway is the same as I've commented multiple times:

There are multiple paths to health, but none of them include refined carbohydrates and processed oils.



Indeed. Aboriginals around the world were relatively healthy before we showed up with all our flour, sugar and shortening. Now they're all getting fat and falling over obese and diabetic with CVD. The benefits of civilization? Blockbuster movies do not begin to make up for the downside!

Derek Weaver
03-29-2009, 11:39 PM
How much of it is the food and how much of it is the crappy lifestyle?

I saw on another forum a study where people ate McDonald's or some other fastfood place every day (sort of an anti-Super Size Me) but kept calories in check. Weight was down and blood profiles improved.

I'm not an advocate for this kind of approach at all, just food for thought. Take a group of hunter gatherers (at some point this applied to all of our ancestors), and have them sit on their backsides all day with tons of food... and they're going to get fat and sick.

Scott Clark
03-30-2009, 03:33 PM
How much of it is the food and how much of it is the crappy lifestyle?

I saw on another forum a study where people ate McDonald's or some other fastfood place every day (sort of an anti-Super Size Me) but kept calories in check. Weight was down and blood profiles improved.

I'm not an advocate for this kind of approach at all, just food for thought. Take a group of hunter gatherers (at some point this applied to all of our ancestors), and have them sit on their backsides all day with tons of food... and they're going to get fat and sick.

I think this is the main point. It's like the recent red meat study that was released last week.... it doesn't delve into the individual's lifestyle whatsoever or the content of their overall diet. The pathetic yet expected result of the study was having it's findings embellished and spun by the media to claim something that isn't there. I do believe that an active lifestyle does worlds of good, but I don't buy for a second that it can cover up the damage done from poor nutrition.

I believe the documentary you're referring to is Fathead. I've seen the youtube clips, need to see the whole thing.

Mike ODonnell
03-30-2009, 05:07 PM
A big Mac won't give you insulin resistance.....drinks with 50g of sugar will.

Derek Weaver
03-30-2009, 06:33 PM
Drinks with 50 grams of sugar followed up by absolutely zero activity will speed the process.

Ben Fury
03-31-2009, 11:35 PM
I believe the documentary you're referring to is Fathead. I've seen the youtube clips, need to see the whole thing.

Fun, funny AND educational. Makes its own sauce!

http://www.fathead-movie.com/