A Menu for weight loss?

By John

The idea that it's not just the calories that matter in weight gain and loss but the foods that we eat is starting to break into the mainstream.

On the 11 July 2011 Radio Nationals Health Report ran a segment on a recently published study on the long term effects of a variety of foods and lifestyle factors on weight gain.

Dr Norman Swan interviewed Associate Professor Dariush Mozaffarian, a cardiologist and epidemiologist from the Harvard Medical School in Boston who ran the study.

The US based study followed tens of thousands of people over many years. They looked at changes in diet, changes in lifestyle habits, changes in physical activity, and so on, and how that related to weight gain or loss every couple of years.

They found that some foods were positively associated with weight gain; some were neutral, and some were negatively associated, that is: the more you ate the greater the weight loss.

It turns out that any kind of starch or refined complex carbohydrate such as sugar was associated with weight gain, something that the Paleo community has known for a long time.

Also red meat (processed or unprocessed) was also associated with weight gain. There was no information on the origin of the meat (beef?, lamb?, etc - but being the US, I would guess most likely to be beef) or its quality (grass or grain fed).

They found that dairy (whole fat milk and cheese) were neutral with respect to weight gain despite their fat content and that foods that have higher fat content, like nuts, were associated with fat loss.

The interview tends to blip over the topic of fats and concentrates on the glycemic index and glycemic load of carbohydrates as well as the positive effects of higher activity levels and adequate sleep. Being a cardiologist, Prof Mozaffarian sticks to the orthodox view on heart disease, cholesterol, and saturated fats - it's so ingrained he doesn't even state it explicitly, it's just implied that it's bad for you.

At this stage the cognitive dissonance kicks in and Dr Swan praises the low GI carbs as a good dietary approach.

The bottom line message is at least heading in the right direction:"...avoid processed refined foods and eat things like fruits and vegetables, wholegrains, nuts and yoghurt and think about the type of carbohydrates that you eat and be active...".

The Paleo/Low Carb community has a differing view on fats and grains but the evidence against refined carbohydrates and starchy foods is clearly impinging on the mainstream. Unfortunately, it may still take many more years before mainstream nutritional advice and public policy start to shift.

Unfortunately, anyone listening to the segment is still likely to come away from it just thinking "low GI is the way.”

The full paper in the New England Journal of Medicine is unfortunately behind a paywall as it would be interesting to see the detail. As Andy Gibbons reminded us at the Nutrition talk last Friday: it's often more enlightening to read the full scientific papers which can sometimes paint a different story to the official summaries, abstracts, and conclusions.

Something that would have been interesting to know would have been the health outcomes over time of the people in the study taking into account their diet and lifestyle.

You might be amused to see that the first comment on the transcript refers to Gary Taubes.


References

Mozaffarian D et al.
"http://www.nejm.org/doi/full/10.1056/NEJMoa1014296" Changes in
Diet and Lifestyle and Long-Term Weight Gain in Women and Men. New
England Journal of Medicine, June 23, 2011;364:2392-404 (full paper is
behind a paywall - this link is just to a short preview)

Transcript can be found
"http://www.abc.net.au/rn/healthreport/stories/2011/3264734.htm#transcript"

Audio as mp3 is
http://mpegmedia.abc.net.au/rn/podcast/2011/07/hrt_20110711_0830.mp3