A groundbreaking study was published in the Journal of the American
Medical Association on June 27, 2012 by Dr. David Ludwig out of the
Boston Children’s’ Hospital settling the debate about how we lose and
Up until this moment there have been two sides to the weight loss discussion.
Side A – Quantity, how much we eat determines our weight. In essence
the calories we take in minus the calories we burn will determine our
fate. For example: If we require a 1400 calories per day and we eat 1900
calories then we are at a surplus of 500 calories that will get stored
as fat and cause us to gain weight. If we require 1400 calories and
consume 1400 calories then we break even for that day and will not gain
Side B – Quality, the quality of our food matters. For example: If we
require 1400 calories per day and we eat 1400 calories it will depend
on the food groups that make up those calories which will determine
weight gain. In essence if we eat 1400 calories of potato chips those
will be metabolized differently than 1400 calories of chicken. The
quality side argues that even if we eat within our caloric limits
certain foods are more likely to be stored as fat than others.
In this study Dr. Ludwig took a group of obese patients and put them
on a starvation diet to lose 10% of their body weight. In this case a
300lb person would lose 30lbs and be 270lbs at the beginning of the
The starvation part is not the interesting part.
This next part is what is most interesting:
Patients were then divided into three groups and given 3 different food plans.
Dr. Ludwig wanted to see what would happen to these patients over 30
days when they were given the same caloric load but different qualities
1) Group one was put on a high carbohydrate low fat diet. (60% carbohydrate, 20% protein, 20% fat)
2) Group two was put on a low glycemic diet similar to a diabetes diet. (40% carbohydrate, 40% fat, 20% protein)
3) Group three was put on a high protein, high fat, and low carbohydrate diet. (60% fat, 30% protein, 10% carbohydrate)
At the end of 30 days Group three, the very low-carbohydrate diet,
had the most beneficial effects on energy expenditure and several
metabolic syndrome components. Group one had the most unfavorable
outcome of all the groups.
Note from Dr. P: This is something that
Naturopathic Doctors have known for some time. Calories in, minus
calories out, are an extremely generalized view of the complex
metabolism of the human body and typically only help younger individuals
lose weight. As we age hormonal fluctuations contribute to a sluggish
metabolism and weight loss becomes increasingly difficult. I can’t tell
you how many times I have heard this, "Dr. Purcell, I don’t know what
happened I’m gaining weight and my diet hasn’t changed, I’m still eating
what I always ate.” Women’s bodies’ change every 5 years. What worked
when you were 30 is not going to work when you are 40. That means we
need to change our food choices. Women especially are plagued by weight
gain in peri-menopause and the quality of the calories makes the biggest
difference for weight loss and a healthy weight.