Sosiaalinen media, keskustelufoorumit, blogit ja ns. terveysjournalismi (eli terveys-otsakkeen alla kulkevat höpöhöpöjutut nettilehdissä)  käyvät taas kuumina: onko kalori kalori vai onko vähähiilihydraattisella ruokavaliolla sittenkin ns. aineenvaihdunnallinen etu?

Tässä lyhyt yhteenveto pöhinästä, lukea sen kokonaan kaikkine linkkeineen jaksanee vain todellinen hard core -tyyppi, joka oikeasti haluaa ymmärtää, mistä on kyse.

Sanastoa:

total energy expenditure (TEE)

resting energy expenditure (REE)

Low-carb Metabolic Advantage Dogma (MAD)

Calorie Denial Syndrome (CDS)

”Things got a little crazy backstage at the 2012 Low-Carb Fashion Awards.” (lainauksesta kiitos Anthony Colpolle)

Kohu alkoi tästä tutkimuksesta

Effects of Dietary Composition on Energy Expenditure During Weight-Loss Maintenance

Conclusion  Among overweight and obese young adults compared with pre–weight-loss energy expenditure, isocaloric feeding following 10% to 15% weight loss resulted in decreases in REE and TEE that were greatest with the low-fat diet, intermediate with the low–glycemic index diet, and least with the very low-carbohydrate diet.

Michael Eades tweettasi

What is the real take home message from the recent JAMA article on the metabolic advantage? http://bit.ly/KXuEod

Eadesin linkki vei minulle entuudestaan tuntemattoman Peter Attian sivuille artikkeliin  Good science, bad interpretation

This study reproduced a number of results which have been noted for decades:

  1. Low carbohydrate, high fat diets reduce TG and raise HDL-C more than other diets.
  2. Low carbohydrate, high fat diets improve insulin sensitivity more than other diets.

It never hurts to hammer those findings home again, but the really dramatic finding of the study was the impact of macronutrient balance on REE and TEE.   To our (NuSI) counting, 81 studies over the past 80 years involving 4,094 subjects for more than 1.2 million subject-days have attempted to ask this question – many of them attempting to “prove” that all calories are created equally.  While none (i.e., not one) have refuted the alternative hypothesis, most of them had enough methodologic limitations that it was difficult to know for certain if the type of food – rather than the number of calories – was playing an important role.

This study, while still limited (e.g., short duration, small sample size), makes one of the more compelling cases that all calories are not created equally.

Marion Nestle kommentoi Food Politics -blogissaan Does where calories come from matter to weight maintenance? A new study says yes, but I’m  skeptical.

Under the relatively short, highly controlled feeding conditions of this study, the composition of the diet may indeed matter to metabolism.  But does diet composition matter for weight maintenance in the real world?

Other longer term studies of “free-living” people out and about in their communities show little difference in weight loss or maintenance between one kind of diet and another.

More research needed!

Anthony Colpo kommentoi totutulla tyylillään (ja ensin perinteiset MAD-teesit toistettuaan) Finally, a Study that Proves a Low-Carb Metabolic Advantage? Yeah, Right…

So you can see that the true story is a little more complicated and somewhat different to the one low-carb shills are trying to portray. Rather than a clear-cut case of reduced drops in REE and TEE during a low-carb diet, the indvidual results are in fact much more haphazard, with some subjects in fact showing markedly greater drops in REE and TEE during the low-carb diet.

Meaning that if you adopt a low-carb diet expecting an increase in metabolism, based on the results of this study, there’s a very strong possibility you’ll be sorely disappointed. Heck, you may just suffer the same fate as other well known purveyors of this belief and be forced to don a belly-restraining girdle to hide the contradictory evidence hanging from your waist.

Evelyn Kocur aka Carb Sane  kommentoi  blogissaan What we really learn from Ebbeling et.al

Now for the bottom line take home message.   Unless the researchers are lying to us by omission, within the macronutrient ranges investigated in this study:
The quantity of calories mattered,
The quality of those calories did not matter

Think about this one long and hard Gatewing and Gary Taubes and anyone still suffering from CDS (calorie denial syndrome), and perhaps go watch and rewatch the BBC program on YouTube I linked to HERE — and pay especial attention to the metabolic chamber study with the twins.
 Ebbeling et.al. may well go down in history for being more informative of what’s wrong with science and ”science” journalism than its ultimately inconsequential results.  But rest assured … more study is needed, for a longer time … for more $$.  Sigh.

Evelyn Kocur laittoi linkit BBC:n TV-sarjaan vähähiilihydraattisen ruokavalion – ja sen tutkimisen – historiasta. Sarja on katsomisen arvoinen, varsinkin CDS:ää poteville . Jaksoissa 1 ja 2 kerrataan vhh:n historiaa  ja keskitytään Atkinsin teorioihin. Kiinnostavaksi sarja käy osissa 4 ja 5, joissa selvitetään tutkijoiden tutkimustuloksia aiheesta. Tutkimustulokset osoittivat Atkinsin teoretisoinnit virheellisiksi, mutta mielenkiintoisia asioita tuli kuitenkin esiin…

Oma kantani: olen avoin uudelle tiedolle, mutta tämän tutkimuksen aiheuttama reaktioni on sama kuin Nestlen:  tarvitaan lisätutkimuksia, toistaiseksi olen skeptinen.


LISÄYS:

virtuaalikamu  lähetti seuraavat lainaukset, joissa tutkimuksessa mukana ollut tri Ludwig kommentoi heartwirelle antamassaan haastattelussa:

”Senior author Dr David S Ludwig (New Balance Foundation, Obesity Prevention Center) told heartwire:

”Extreme restriction of fat or carbs can have bad effects. The best long-term approach will be to avoid restriction of any major nutrient-either fat or carbohydrate-and instead focus on the quality of nutrients. This is not to say that the number of calories isn’t important, but it’s now saying we should ALSO pay attention to the quality of those calories.  So the argument that the food industry likes to make-that all foods can be part of a healthful diet as long as you watch calories-is really misleading at best. ” Relatively unprocessed, low-glycemic-index foods are best, things that our grandmother would recognize. Choose relatively unprocessed foods whenever you can and cut back on white bread, white rice, potato products, prepared breakfast cereals, and, of course, concentrated sugars.”

”With the low-carb diet, the researchers observed increases in CRP, a measure of chronic inflammation, and 24-hour cortisol, the key stress hormone, ”suggesting that any initial advantages were eroded over time by these biological stressors,” Ludwig notes. And the low-fat diet-as well as resulting in the least energy expenditure-”exacerbated many of the components of the metabolic syndrome, so insulin resistance, triglycerides, and HDL cholesterol were all worse on this diet,” he explained. Hence the study, despite its limitations, ”provides the strongest support for a novel concept, that all calories are not alike from a metabolic perspective. This has been postulated before, but never shown in this context,” Ludwig says.”