So ... undereating & the metabolism - is it true/possibl

[slugmom]

Jeff, thank you for taking time to answer this and posting links to where it has been addressed before. I am reading and re-reading those other posts, as well. You must either be incredibly patient or are getting a bruise on your forehead from banging your head at all this misinformation and misunderstanding being brought up and going round and round. I appreciate that you're still helping us understand!

I'm surprised oatmeal has a lower caloric density - it's higher fat by % calories than most other cereal grains, isn't it?

I think I am really starting to understand, but do still have some practical application questions (er, more accurately, ramblings)

One of the things that appeals to me most about this program (as compared to others, and of course besides the whole healthiest thing) is the idea that you can "eat until you're full" ... I understand what you're saying about how caloric density of MWL foods is what makes that possible, but that one might still gain weight if they over-eat on the most calorie dense foods.

When I misunderstood the whole lower metabolism so eat more idea, I loved this because when I felt hungry I thought, "Why, I should eat MORE MWL foods!" ... and of course I'm sure we SHOULD eat when we're hungry. But since this "but calories will always count" correction has come up, my brain is hesitating. The rational side of me wants to pursue health and let the weight loss be a slow and steady side benefit. But the irrational side of my brain is slow to catch up, and now it says, "oh, wait, before you eat, you better worry about calories and caloric density" ...

using these as examples:
Popcorn is allowed on MWL
Fruits are limited
Popcorn has a much higher caloric density - due to it being mostly air.
Even brown rice, potatoes, and barley are above that 400 threshold
fruits are not

So ... if optimizing weight loss is my goal ... and I'm legitimately hungry, or really munchy and want a snack ... which would be better? Popcorn? Fruit?

I'm not quite ready to be happy "snacking" on baby carrots and raw veggies. I know some people do that, happily. I'm working towards that.

But I have found myself the last few days putting off eating and being probably overly-concerned about which meal or snack choice would be best, because "calories DO count" and I don't want to end up on the high side, but I also don't want to weigh, measure, or calculate.

[Ed Miller]

slugmom,

it eventually and almost always leads to portion control, which leads to hunger, which leads to binging

This is what has finally helped me learn to EAT when I'm hungry. If I don't eat because I want to "lose faster" I get hungry and then eventually - days or weeks down the line - I get fed up with it and feel the overwhelming urge to binge.

While starving myself may be the fastest way to lose weight over the next few days, for me it is definitely not the fastest way to reach my goal weight. The fastest way to reach my goal weight is to eat healthy foods when I'm hungry because I'm ultimately not going to succeed if I treat my body and hunger drive like an adversary.

[momof4]

But since this "but calories will always count" correction has come up, my brain is hesitating.

Something that had me confused at first was when I heard the "eat more, weigh less" message. I originally thought it meant to eat more calories, but it means eat more volume. That's a big difference!

[JeffN]

But since this "but calories will always count" correction has come up, my brain is hesitating.

Something that had me confused at first was when I heard the "eat more, weigh less" message. I originally thought it meant to eat more calories, but it means it more volume. That's a big difference!

Correct! And a very important point. You can eat more "volume" and more "weight" but not more calories!

In Health
Jeff

[Quiver0f10]

I'd love to see the above sections answered, because I too have found that if I eat too many potaoes, rice, oats etc, even with eating only MWL foods in addition to the starches, that I will not lose weight and even have gained. I consistantly have to resort back to calorie counting to lose.

In the end, calories will always "count" but the problems is just "counting" calories is ineffective because 1) we have very poor tools that are highly inaccurate to count calories with, 2) it eventually and almost always leads to portion control, which leads to hunger, which leads to binging, 3) there are many other factors that may influence the daily fluctuations in weight that we have no way to control for (fluid balance, etc), Even fecal content of the bowels can cause a weight change of several pounds when eliminated if elimination is not regular.

There is just no way to micro manage all these details on a daily basis and that is why trying to micro-manage energy balance on a daily basis is virtually impossible. Some days it will not make any sense and some days it may make too much sense.

This is why calorie density is the much better approach. MWL is based on calorie density. However, the MWL does not recommend living on just starches and gives recommendations for those who are finding the basic recommendations not enough for them to lose weight. We are all individuals and may have different levels of activity, exercise, NEAT, etc. and have to make adjustments accordingly. I reviewed some of these in a recent thread. One of the main recommendations is to increase the volume of vegetables in all your starch based meals to 1/3 to 1/2 of the volume of the plate/bowl.

In regard to calorie density, in my lectures, I say that the group that kept the calorie density of the meals below 400 calories per pound (not 600) all lost weight. Most starches are 500-600 calories per pound with oatmeal being the only exception I know of at around 325. I also say that in the 400-600 calories per pound group, some gained, some lost and some maintained all depending on activity levels, body size, etc. However, these are not cut and dry lines and are taken from averages in studies and may vary slightly depending on the individual.

What doesn't vary is the laws of physics, energy balance and thermodynamics.

I would recommend that instead of calorie counting, lower the caloric density of your meals even further and take into account the other adjustments I recommended in the other recent thread.

In Health
Jeff

Thanks, Jeff for explaing it (again) to me. I do get it, but I am a little slow sometimes

[slugmom]

slugmom,

it eventually and almost always leads to portion control, which leads to hunger, which leads to binging

This is what has finally helped me learn to EAT when I'm hungry. If I don't eat because I want to "lose faster" I get hungry and then eventually - days or weeks down the line - I get fed up with it and feel the overwhelming urge to binge.

While starving myself may be the fastest way to lose weight over the next few days, for me it is definitely not the fastest way to reach my goal weight. The fastest way to reach my goal weight is to eat healthy foods when I'm hungry because I'm ultimately not going to succeed if I treat my body and hunger drive like an adversary.

Ed - thank you! Sometimes I can't see the forest through the trees, and it's posts like that that help me put things all back in perspective. Sometimes what's *ideal* intellectually doesn't matter so much as knowing what's *good* and will help me reach my long term goals. I had missed that line in Jeff's post, but you both are exactly right. I know oatmeal, barley, potatoes, fruit, veggies, are ALL good and work for me. If I get too hungry obsessing over what's *best* I'll end up binging on something far worse.

[JeffN]

Jeff, thank you for taking time to answer this .... I appreciate that you're still helping us understand!

Your welcome.

I'm surprised oatmeal has a lower caloric density - it's higher fat by % calories than most other cereal grains, isn't it?

Yes, fat effects calorie density and generally speaking, the higher the level of fat the higher the calorie density but fat is only one factor that effects calorie density. However, oatmeal is not very high in fat but only a little higher in fat than other whole grains. If it was way higher in fat than the fat content would really matter. For example, nuts/seeds are 75% fat and since the level of fat is sooo high, it is a major contributing factor in why the nuts are so high in calorie density.

Water content is another major factor that has a big influence in determining calorie density and oatmeal is a high water content food. Nuts/seeds are also very low in water content. So, there are several factors that contribute to calorie density that we have to consider.

One of the things that appeals to me most about this program (as compared to others, and of course besides the whole healthiest thing) is the idea that you can "eat until you're full"

I agree

I understand what you're saying about how caloric density of MWL foods is what makes that possible, but that one might still gain weight if they over-eat on the most calorie dense foods.

Correct.

Popcorn is allowed on MWL

Yes, but Popcorn is a fairly high in calorie density at 1800 calories per pound. While it is allowed on the MWL program it is not a food I would personally recommend in unlimited amounts for weight loss. IMH(P&P)O, if consumed, it should be portioned and limited.

Fruits are limited

Fruits are fairly low in calorie density, averaging around 250-300 calories per pound and while I do understand Dr Mcdougall's rationale for limiting them on the MWL, I would tend to be a little more lenient in regard to their consumption.

Popcorn has a much higher caloric density - due to it being mostly air.

Popcorn has a much higher calorie density due to its low water content.

The air adds "volume" but unlike the volume that water adds to foods, the volume that the air adds, is not as filling as the volume that water adds. The reason is, air does not contribute weight, just volume, and volume with weight (such as water has) is a bigger contributor to satiety.

Even brown rice, potatoes, and barley are above that 400 threshold fruits are not

Correct.

So ... if optimizing weight loss is my goal ... and I'm legitimately hungry, or really munchy and want a snack ... which would be better? Popcorn? Fruit?

IMH(P&P)O, and based on calorie density, of the two, I would say fruit. However, vegetables would be a better choice and/or a meal of 50% starch and 50% vegetables (and/or fruit) by volume. A meal of 50% starch and 50% vegetables by volume would have a very low calorie density. So, a bowl of 50% oatmeal and 50% berries by volume or a bowl of 50% rice and 50% veggies by volume may be the better choice. You get the starch to help satisfy you and the fruit and/or veggies to help lower the calorie density.

I'm not quite ready to be happy "snacking" on baby carrots and raw veggies. I know some people do that, happily. I'm working towards that.

Why?

Remember, no one is recommending that and veggies alone may leave you hungry and not satisfied. Remember, this is not a vegetables based diet but a starch based diet. Diluting the starches with vegetables and/or fruit to lower the calorie density is the best solution.

But I have found myself the last few days putting off eating and being probably overly-concerned about which meal or snack choice would be best, because "calories DO count" and I don't want to end up on the high side, but I also don't want to weigh, measure, or calculate.

Review the principles of calorie density, and the recent post I made about adjustments to the MWL and follow the recommendations above, and you will be fine. It may take some time to become comfortable with these principles but once you do, it will become second nature.

In Health
Jeff

[JeffN]

More on "yo-yo" dieting..

In Health
Jeff

Weight Cycling and Mortality Among Middle-aged or Older Women
Alison E. Field; Susan Malspeis; Walter C. Willett
Arch Intern Med. 2009;169(9):881-886.

Conclusion- Repeated intentional weight losses were not predictive of greater all-cause or cardiovascular mortality.

[Partly Cloudy]

Thank you, Jeff! This is so helpful.

[JeffN]

In other words, as long as all your attempts to diet are done through a healthy eating and exercise program, then there are no negative effects and there may even be some benefit (i will find the references) .

Here they are..

In Health
Jeff

The following is a conversation I had with some professional RDs about this topic and I am reprinting it here word for word.....

As I know this is a topic that seems to evoke lots of responses, at many levels, I thought I would take the time to reprint some points from the article,and make some comments, in case anyone wants to dicuss them

And, as I have noted before here on this list many times, I do want to acknowledge that I agree that there are some really bad diets out there and that many people have really bad experiences with diets and many people who do some crazy/dangerous things to lose weight, and there are even some of us (health professionals) that recommend really bad diets........,

but....... that doesnt mean that "all" dieting is bad, or that "dieting" per see is bad or my recommending a very healthy, high carbohydrate, high fiber, nutrient dense and filling meal that "they" will like, for someone trying to lose weight, is somehow insanity. In fact, it seems to me that the article supports such a recommendation.

The article clearly states exactly that..."Among these adolescent dieters, a significant percentage report unhealthy or dangerous weight-loss methods, including use of diet pills, fasting, skipping meals, or using very-low-calorie diets (Table 2). Dieting can be associated with both positive and negative consequences. Dieting adolescents report more health-promoting behavior, such as increasing fruit and vegetable intake, decreasing fat intake, and increasing exercise;"

It also noted that most all the negative consequences of dieting were associated with the these "dangerous" diet habits and not healthy dieting. However, somehow, we want to throw all attempts to diet out. To me, this seems to argue not against dieting, but against unhealthy dietary practices.

I agree.

It says that many of the physical problems are associated with diets that are too low in calories and or the low carb, high fat/protein diets....

"The common theme in many of the reports of morbidity and/ or mortality related to dieting practices is the use of diets that induce ketosis (very-low-calorie diets or low-carbohydrate/high-fat diets)."

And, it was the same for the negative psychological consequences also....

" The most negative patterns of psychosocial and health behavior were found among frequent dieters and purgers.."

And

" Seventy-four percent of patients with bulimia attributed the development of their eating disorder to the inability to maintain a low-carbohydrate diet, leading to carbohydrate craving and subsequent cycles of binging and purging.30 "

That's why I don't recommend a low calorie or a low carb diet nor did I the other day.

I am posting the summary/conclusion and the section of positive aspects of dieting at the end of my post for those who don't have time to go to the article. In the light of all the negative about dieting on this list, I think they are important. And, as most of the negative comments about dieting is in relation to working with the obese, i find the following comments from the article most interesting...

"Dieting and weight loss in obese teens have several potentially positive health outcomes. "

I do not see this article in anyway as "anti" dieting, or "anti" trying to help people eat better. In fact, it recommends in its conclusion... "When weight loss is necessary, the most appropriate method remains modest caloric restriction incorporating a balanced intake of macronutrients and micronutrients, along with increased physical activity. "

All these points support the recommendations I made the other day here and at other times, and my concern with the other recommendations that were made.

Dieting is not bad. Dieting can be very positive.

Regards

Jeff


From the article...

Psychologic and Physiologic Effects of Dieting in Adolescents SOUTHERN MEDICAL JOURNAL • Vol. 95, No. 9

POSITIVE CONSEQUENCES OF DIETING
Despite potential dire outcomes with improper use, positive health consequences are associated with moderate dieting behavior in adolescents. Moderate dieters, those using all dieting methods except vomiting, diet pills, and extreme calorie-restriction, reported more health-promoting behavior than their nondieting and extreme-dieting (those vomiting or using diet pills) counterparts.9,10 Moderate dieters had increased fruit and vegetable intake, a lowered fat intake, and increased physical activity when compared with the other 2 groups. Those trying to lose weight are more likely to decrease servings of high-fat meats and dessert foods and increase days of hard exercise, compared with nondieters.11 Dieting and weight loss in obese teens have several potentially positive health outcomes. Insulin
resistance, hyperinsulinemia, and high cholesterol levels decrease with weight reduction in obese adolescents.5,19 Escobar et al19 found that altered hepatic insulin clearance in obese children was reversible with weight loss, resulting in near-normalization of serum insulin levels. In addition to correction of abnormal results of serum chemistry tests and insulin resistance, weight loss in morbidly obese subjects decreases upper-airway obstructive symptoms and improves sleep function.5 Although energy restriction with moderate dieting has been associated with decreased linear growth, the decreased linear growth velocity is temporary and not associated with permanent stunting.20 A multidisciplinary weight-reduction (calorie restriction with moderate exercise) program for obese adolescents showed that the majority of subjects were able to sustain normal growth velocity while effectively decreasing body
weight.21

SUMMARY
Approximately 60% of adolescent females and 25% of adolescent males have dieted at some point in their lives (Table 1). Among these adolescent dieters, a significant percentage report unhealthy or dangerous weight-loss methods, including use of diet pills, fasting, skipping meals, or using very-low-calorie diets (Table 2). Dieting can be associated with both
positive and negative consequences. Dieting adolescents report more health-promoting behavior, such as increasing fruit and vegetable intake, decreasing fat intake, and increasing exercise; however, dieting in adolescence is also associated with increased health-risk behavior,
such as alcohol and tobacco use, delinquency, and suicide attempts. Additionally, dieting is often undertaken by adolescents who are not above the ideal or normal body weight for their age and physical stature.

Dieting appears to have more negative than positive consequences on the psychologic health of adolescents. Adolescent weight-loss behavior is associated with poor body image, negative psychosocial risk factors, and possibly decreased coping mechanisms, leading to decreased self-esteem. A strong correlation between dieting and the onset of eating disorders exists. One of the most alarming issues regarding dieting is the report of associated mortality. While many of the reports are anecdotal and the majority of patients diet without sequelae, scientific data support potential adverse physiologic consequences of dieting and weight loss, including loss of electrolytes, minerals and trace metals, histologic changes of the myocardium, as well as the potential adverse effects of free fatty acids on myocardial function. Alterations of electrolytes (sodium, potassium, magnesium, and calcium), minerals, and trace metals may be related to decreased intake (anorexia, deficient diets) or increased losses from the gastrointestinal tract (bulimia or laxative use) and the kidneys (ketosis).

Given all of the potential consequences of dieting and its associated behaviors, obesity prevention should be the primary intervention point, with improved education of parents, adolescents, and children regarding appropriate eating patterns and behaviors. When weight loss
is necessary, the most appropriate method remains modest caloric restriction incorporating a balanced intake of macronutrients and micronutrients, along with increased physical activity. Considering the previous reports of serious cardiac sequelae, very-low-calorie diets or
ketogenic diets should be undertaken only under a physician’s direct supervision, with a pre-diet ECG and frequent cardiac monitoring during the course of the diet. The common theme in many of the reports of morbidity and/ or mortality related to dieting practices is the use of diets that induce ketosis (very-low-calorie diets or low-carbohydrate/high-fat diets). With very-low-calorie diets, ketosis is induced by inadequate caloric intake and fatty-acid mobilization, while with low-carbohydrate diets, ketosis is induced by decreased insulin-release.When such diets are followed without supplementation, alterations of electrolytes, minerals, and trace elements may result in Q-T prolongation and the potential for cardiac dysrhythmias.

Eating disorder risk during behavioral weight management in adults with overweight or obesity: A systematic review with meta-analysis
First published: 15 March 2023 https://doi.org/10.1111/obr.13561

https://onlinelibrary.wiley.com/doi/10. ... Ec.twitter

Summary
This systematic review examined change in eating disorder risk during weight management interventions. Four databases and clinical trials registries were searched in March and May 2022, respectively, to identify behavioral weight management intervention trials in adults with overweight/obesity measuring eating disorder symptoms at pre- and post-intervention or follow-up. Random effects meta-analyses were conducted examining within group change in risk. Of 12,023 screened, 49 were eligible (n = 6337, mean age range 22.1 to 59.9 years, mean (SD) 81(20.4)% female). Interventions ranged from 4 weeks to 18 months, with follow-up of 10 weeks to 36 months post-intervention. There was a within group reduction in global eating disorder scores (20 intervention arms; Hedges' g = −0.27; 95% CI −0.36, −0.17; I2 67.1%) and binge eating (49 intervention arms; −0.66; 95% CI −0.76, −0.56; I2 82.7%) post-intervention, both maintained at follow-up. Of 14 studies reporting prevalence or episodes of binge eating, all reported a reduction. Four studies reported eating disorder symptoms, not present at baseline, in a subset of participants (0%–6.5%). Overall, behavioral weight management interventions do not increase eating disorder symptoms for most adults; indeed, a modest reduction is seen post-intervention and follow-up. A small subset of participants may experience disordered eating; therefore, monitoring for the emergence of symptoms is important.

[JeffN]

The Physiological Effects of Weight-Cycling: A Review of Current Evidence
Review Curr Obes Rep. 2024 Jan 3.
doi: 10.1007/s13679-023-00539-8

PMID: 38172475 DOI: 10.1007/s13679-023-00539-8

https://pubmed.ncbi.nlm.nih.gov/38172475/


"Twenty-three cross-sectional and cohort studies (including subjects with a history of weight-cycling compared to those without such history) and interventional studies (evaluating physiological effects during one or more cycles of weight loss and regain) were identified, conducted in generally healthy adults across various age groups, races, and both genders, who had normal weight, overweight, or obesity. Eighteen studies investigated the association between weight-cycling and body weight or BMI, and thirteen of them found no significant association. Fifteen out of twenty studies also found no increase in FM, and none of eighteen studies found a decrease in LBM. Twelve out of fourteen studies reported no adverse changes in RMR either. The overwhelming majority of evidence suggests that weight-cycling (yo-yo effect) is not associated with any adverse effects in body weight, body composition, and metabolic rate. Accordingly, healthy individuals who struggle with overweight or obesity should not be discouraged from repeated attempts to lose the excess weight."