McDonalds and Twinkies.. Ridiculous Ideas from educated people

Two unusual diets that led to weight loss and the improvement of metabolic profiles have been in the news lately.  In an earlier draft of this paragraph, I was harsh in calling out both dieters – a science teacher and a nutrition professor. I felt and still feel that they should be mindful of their positions of influence and temper their enthusiasm for diets that are probably unhealthy and suspiciously fad-like.  In addition, both men offer simplistic explanations for obesity and unrealistic advice for groups they appear to be judging.

In the first example, a high school science teacher, John Cisna, eats meals from McDonald’s for 90 days, loses weight, and improves his metabolic profile (i.e., his blood fat and cholesterol levels). Mr. Cisna refers to his self-imposed diet as an experiment and determines that the choices people make, not the food sold at McDonalds, makes them fat. 

Mr. Cisna is correct; our choices have everything to do with our outcomes.  He is incorrect in assuming that everyone has the same choices available to them. In his pseudo experiment (more on that in a moment), he had his students choose his daily meals within certain parameters.  The parameters were that he consume 2000 calories a day and stay within the recommended daily allowances of certain macronutrients (e.g., total and saturated fat).  The local McDonald’s franchise covered the cost of the meals.  In news stories about his 90 day diet, Mr. Cisna points out that he had to be smart about what he was doing.  If he ate a high fat breakfast, he would have to choose a lower fat lunch or dinner in order to stay within his parameters. This is exactly what the Dietary Guidelines for Americans tell us to do, and what so many of us have trouble doing.  Mr. Cisna is an educated man with above average numeracy who had 3 people watching the numbers with him. He was also able to make choices among all price ranges. In some of Mr. Cisna’s interviews, he suggests that people who blame McDonalds for their obesity lack self-control. I do not expect, nor should he, that the average McDonald’s customer has his same math skills or assistants to help them track their calories. And tracking calories and other macronutrient amounts IS important. We already know from scientific study that fast food and sit down restaurants generally serve foods that contain at least a half a day’s worth of calories, fat, sugar and salt.  People who obtain most or all of their meals from fast food and sit down restaurants, especially in the absence of nutrition labeling – and math skill - are at great risk for consuming a diet that is harmful to their health. 

In addition to controlling his calories, which he did not do before the McDonald’s diet, he also began exercising for 45 minutes a day.  

Mr. Cisna’s diet plan was not an experiment and we cannot make causal inferences from his personal results. An experiment by definition requires multiple subjects randomized into treatment conditions, including one in which nothing changes.  In most situations, if a person reduces their caloric intake and increases their exercise they will begin to lose weight and this initial weight loss will improve their metabolic profile, especially if they are following the recommended nutritional guidelines.  Because Mr. Cisna’s 90-day diet was not in any way an experiment, I am left with a few questions: What would happen if he did this for 90 more days?  What if he ate at McDonald’s but did not have the nutrition information available to help him stay within his parameters?  What if he had very little money with which to purchase the food?  What would happen if a woman followed his exact plan?  Or a younger person or an older person or a person of a different ethnicity?  What if he did this for 6 mos. or a year or for his whole life, as some seem pressured to do?   

In the second example, a nutrition professor, Dr. Mark Haub, eats Twinkies, etc., for 10 weeks, loses weight and improves his metabolic profile. He refers to his diet as a class project stemming from his teachings in nutrition.  I am just aghast by this, but as I researched him a little further, I saw that his doctorate is not in nutrition; it is in exercise science/physiology.  Dr. Haub has also been vocal about his results and suggests that the convenience store diet – something people living in food deserts might be forced into – are not necessarily bad and will not lead to obesity– as long as one makes the right choices.  

I feel that Dr. Haub’s extrapolations are out of place and far too simplistic.  It feels like an example of an over educated, privileged person suggesting he knows what an ‘other’ less privileged person is experiencing.  

He claims that his convenience store diet, which for him meant that 2/3 of his calories came from snack foods, caused his weight loss and improved his metabolic profile.  Like Mr. Cisna, Haub did not conduct an experiment and headlines misrepresent what he actually did. 

Professor Haub consumed a lot of sugary, processed snacks similar to and including Twinkies, but he also ate some vegetables, took a multivitamin and drank protein shakes.  In addition, and this is huge, he reduced the amount of calories that he consumed - from 2600 to 1800.  

I have the same concerns and questions about this diet as I did the McDonald’s one.  I suspect that the reason for Dr. Haub’s weight loss is that he reduced his intake by 800 calories.  (He has told reporters that he monitored this closely by writing down everything he ate.) I further suspect - and evidence supports - that over time, a diet high in processed, sugary cakes will lead to metabolic irregularities and poor health.  Lastly, and most importantly, he made a statement to one reporter that he wanted to be able to say that the diet was unhealthy, but the “data doesn’t support that.”  The data do not support anything… it was not an experiment or a quasi-experiment.  It was not research – there are no ‘data’. 

Both Dr. Haub and Mr. Cisna put themselves on a diet to lose weight.  During the time that they were on the diets, counting calories and exercising, they lost about 30 pounds each.  This weight loss may have triggered improvement in their metabolic profiles as well – this is an assumption because we do not have a counter-factual or comparison group.  It makes sense that the weight loss did cause the improvement. It does not make sense to suggest that a long-term diet of processed foods high in sugar or fried foods high in fat and sodium is health promoting.  Science already tells us that there are adverse consequences to this kind of diet pattern.  Both men’s claims as presented in the media are misleading. Cisna did not eat McDonalds without careful attention to calories and the macro-nutrient content of his meals, his choices were not limited by cost and he significantly increased his exercise. Dr. Haub’s diet included vegetables, protein shakes and vitamins; this is not similar to a diet consumed by someone who has limited income and has to eat most of their meals from a convenience store.  

In my opinion, the headlines and the diets they report are pure sensationalism.  Please, choose your calories from foods with health promoting properties, like those recommended by the Nutrition Source at Harvard.

Easy Weight Loss

Sorry, there is no such thing. My headline should be, “Weight Loss Not Easy,” but then fewer people would read the post - and people need to read this post.  Right now, masses of people are searching for that one pill, powder, or cream that will melt away excess fat with no behavioral change required.  Said pill, powder, cream DOES NOT EXIST.  It does not! Think about this carefully.  There are more overweight/obese adults in the United States and similar countries than there are normal weight adults. Because excess fat is associated with disease and being overweight can affect ones physical and psychological health, a simple remedy would be groundbreaking.  If this remedy currently existed, 70% of the US would not be overweight.

Products promising weight loss – fast, substantial, permanent, and painless – are simply fraudulent.  Unfortunately, the makers of these products do not have to submit them to clinical trials where efficacy is established or to post market trials where effectiveness is established – i.e., the FDA does not regulate the products.   However, the companies that sell supplements/weight loss products must tell the truth about them in advertisements. 

Truth in advertising is a law and the Federal Trade Commission (FTC) is responsible for its enforcement.  The FTC is understaffed and it takes years for them to get a falsely advertised product off the market.  The FTC went after 4 companies this week – read here, and has started the year with increased efforts to protect consumers, updating their guidance to both businesses and consumers for the first time since 2003.

I like the guidance the FTC provides to businesses, because in their communication to them, the FTC enlists the support of businesses and suggests that by screening the ads that they publish, businesses are protecting themselves from being associated with a ‘bad’ company – an unscrupulous company.  This is a good strategy because if media polices the ads, the FTC caseload could be reduced.  The FTC could go after and prosecute violators quicker.  I will benefit, too.  There will be fewer sensational, commercials that raise my blood pressure.

The FTC encourages media to stop and think about an ad before publishing or airing it. They offer 7 ‘gut checks’, but I can be more concise.  If an advertisement sounds too good to be true, it is too good to be true. You cannot lose weight if you do not change something about your eating and activity: the number of calories you consume, the type of calories you consume, the amount of exercise you do, the type of exercise you do. It is best to address all of these, but research suggests that diet alone will work to some extent.

You can read all the claims for businesses to watch out for here.

The scientific study of fat gain and loss is dynamic.  It feels like we learn something new every day, and indeed some of the things we believed to be true are not.  (I didn’t ‘know’ this before grad school, but in science things are never proven, only disproved).  Nutrition scientists once thought that all fat was bad in excess, but that no longer appears to be true.  They, and we – the public, also believed that a calorie is a calorie, but that truism is under current scrutiny as well.  I tell you this because I know many of you have become frustrated with and distrustful of science.  That is no reason to turn to supplement makers, I assure you; the makers of weight loss supplements deserve much less of your trust.  The fact that we are learning more about fat gain and loss through science is a good thing.  One of the most important new findings is that being over fat – as a population or as individuals – is caused by multiple factors.  Researchers have not identified all the factors, and the ones they have identified are not completely understood.   But we know some things in the aggregate.  For example, calories (amount and type) matter most and genetics matter least (by matter, I mean the amount of impact these factors have on body fatness).  Somewhere in between these two extremes is the amount and type of physical activity one engages in and metabolism.  An important note about metabolism is this:  an individual’s metabolism is affected by what and how much he or she has eaten over his or her lifetime and the amount of body fat he or she has carried.  In other words, a metabolism can become dysfunctional and this individual dysfunction makes it hard for anyone to prescribe generic weight loss advice - not everyone who cuts their calories and increases exercise will have the same results.  This is the painful truth.  In addition, I’d like to disavow you of the notion of a set point weight.  Instead, consider this: if a person does a certain thing and loses 10 pounds but then stops doing that certain thing, their weight will return to its previous level.  That is not destiny – the weight returned to its previous level for a specific reason – a person’s actions. 

In summary and in closing, no diet supplement leads to easy weight loss.  In the absence of disease, body fat does not melt away. Please consider this before you spend your money and invest your hopes in a weight loss supplement. The FTC is cracking down on companies who market products as if the products were weight loss miracles, and is asking businesses to give ads a ‘gut check’ before they agree to publish them.  Losing excess body fat is important and safe ways to do so exist.  One way to maintain a healthy weight is to follow the guidelines suggested by the Harvard Nutrition Source and to commit to daily or near daily exercise that increases your heart rate for 30 or more minutes.

Lipozene is not YOUR solution

Do you want to lose weight or maintain a healthy one?  Monitor your calories and eat a nutritious, plant based diet that is low in energy density, solid fats and added sugars as recommended in the current Dietary Guidelines for Americans. 
To lose weight, it is necessary to upset the energy in energy out balance that you currently maintain.  If you can figure out the amount of calories you are consuming on average right now you will know the amount you are currently burning - on average.  Talk to a nutritionist and consider the Weight Watchers program to design a weight loss program to meet your needs.
Exercising more than you are now will add a little to the energy expended(used) side, but it takes a lot of effort to burn a few calories from exercise.  Reducing your intake is sometimes easier and quicker. 
 Get to know calories:
  If you understand that a soda has 200 calories, a tablespoon of oil has 120 and whole milk (1 cup =150 cals) and cheese are calorie dense, you can make adjustments that reduce calories without much pain. A great many apps and websites can help you to learn the calorie content of foods.  You do not need to know everything, or count everything, but you must become familiar with the amount of calories in foods because you may be eating much more than you realize.  Soon the calorie labeling law will help you assess your meals away from home.  Here is the website that I visit the most often.
Avoid Gimmicks
When ads tell you that you can lose weight without changing anything - it is A LIE.  It is NOT POSSIBLE.  Especially avoid fiber supplements, such as Lipozene.  Though the advertisement states that clinical trials have proved weight loss, no details or publication of this research exists. And if you read the fine print, the average pounds lost in two months is less than 4. Supplements such as this are not regulated by the FDA and we can't judge their safety or efficacy without this protection.
In a research review of 14 scientific studies of the main ingredient of Lipozene, glucomannan, the average weight loss was less than 2 pounds.  Yes - it worked, but for how long?  Lipozene pills cost about 60 dollars for a months supply and they are just water soluble fiber tablets.  They make a person feel full but come without the health benefits of fiber that is found in a plant based, whole grain, fruits and vegetable diet.
As I researced for this blog, I reviewed the Dietary Guidelines, which recommend at least 25 grams of dietary fiber a day.  I also read this FANTASTIC post on the Harvard Nutrition Source website.  Please read.

HSPH Nutrition Source. Fiber: Start Roughing It! 
Accessed 1-1-2013. www.hsph.harvard.edu

To the right is a chart from that website.  It lists the two types of fiber and foods that are good sources of them.  The recommendations for fiber intake do not specify amount by type.  Intuitively, it seems best to have a diet rich in both. Health studies involving fiber sometimes differentiate between the two.  You can learn about disease prevention from fiber intake by clicking on the link provided above.