Weight Loss Study Results Show that Calories Count

A study that ended several years ago was published this month in the American Journal of Clinical Nutrition, and so is making its way back into the news. The message cuts through much of the hype and confusion surrounding diets today.

How the Study Was Done

This study charted the weight gain or loss over a two year period for participants from the Boston, Massachusetts and Baton Rouge, Louisiana areas. Participants could be either gender, between the ages of 30 and 70, and were overweight at the start of the trial.   There were 1638 participants in this trial, divided equally between the two research sites. Eighty percent of the participants were able to complete the study, by providing a body weight measurement at the end of two years.

There were four different types of macronutrient profiles in the random diets that were assigned to participants. Two were high fat diets, one with a high carb-low protein ratio and one with low carb-high protein. The other two were low fat diet, each with the same high carb-low protein ratio and low carb-high protein ratios. Specifically, here are the percentages of macronutrients for each group:

  1. 20% fat, 15% protein, and 65% carbohydrates  (low fat, average protein)
  2. 20% fat, 25% protein, and 55% carbohydrates (low fat, high protein)
  3. 40% fat, 15% protein, and 45% carbohydrates (high fat, average protein)
  4. 40% fat, 25% protein, and 35% carbohydrates (high fat, high protein)

You can read the details of the methods used in this study in a New England Journal of Medicine article.

Weight Loss Study Results

At the end of the study the amount of weight loss and the change in waist measurement was the same between participants on a high and low protein diet, and participants on a high and low fat diet.  So those dietary changes did not have a significant impact on the amount of weight that was lost.  Here are a few of the interesting findings of this study:

  • Most of the weight loss occurred in the first six months, after which some participants began to slowly regain weight while some continued to lose. There was no significant difference among the diet groups for who gained or lost weight.
  • Over 50% of the participants ended up with a lower body weight at the end of the two year study.
  • All of the diets resulted in reduced risk factors for cardiovascular disease and diabetes, although some showed a stronger protection in certain areas. You can read the details at the NEJM link above.
  • Craving, fullness, and hunger and diet-satisfaction scores were similar at 6 months and at 2 years regardless of which diet a participant was following.
  • Attendance at the group sessions was a strong predictor of weight loss at the end of the two year period.  (Other studies have also showed that continued contact with the dieter results in a greater weight loss, suggesting that weight loss is influenced by behavioural factors.
  • At the end of the study participants across all four diets were reporting similar energy intakes and similar levels of physical activity.
  • Participants tended to adjust their levels of fat, protein and carbohydrate during the course of two years so that by the end their diets were much more similar than at the beginning. Weight loss results were similar across all four diets, showing that the percentage of macronutrients that you eat is not as important as adhering to a certain level of calories each day.

What Does This Mean for You?

The key here is that in order to lose weight you have to stick to your diet, regardless of whether that diet is low fat, low protein or low carb. There is no magical percentage of macronutrients that will help you to melt off the pounds. How can you stick to your diet for the long term? This study showed that social support and instruction in the group setting had a positive effect on weight loss.  Those people who were successful in losing weight also tended to self tailor the diet to one that they could eat long term, even though this meant that they changed the amount of fat, protein and carbohydrate they were eating. So if you can’t live without carbohydrates, there is no need to put yourself on a low carb diet. You probably won’t keep it up long term anyway. Instead enjoy your carbs but limit them to stay under a calorie level where you can lose weight or maintain your weight.

Six Things Besides Food That Can Influence Weight Control

Weight control boils down to the amount of energy that you eat, and the amount that you burn off. You can lose weight by burning off more calories than you eat, and if you want to gain weight you need to eat more calories than you need. It’s so simple, so why is it sometimes so hard? It sometimes seems that there are more factors involved in weight control than just the amount of food you are eating. Sometimes you might lose weight when you think you have been eating a lot, and sometimes you just can’t get rid of that stomach fat no matter how much you diet. Here are some things that might be influencing how much fat you have, and how quickly you burn off calories.

Insulin and weight gain

One of the actions of insulin is to clear sugar out of the blood stream, and move it into the cells. This is necessary to provide your cells with energy, but if you have too much insulin it can create problems. You can become hypoglycemic, a condition where you feel weak and shaky, yet find yourself gaining weight. When the glucose is constantly cleared out of your blood stream it causes you to be hungry, and you will eat more throughout the day. The final result is that the glucose moved into the cells, if it is more than they need at the time, gets stored as fat.

There are a number of triggers that tell your pancreas to release insulin into your bloodstream. One is the amount of glucose in your blood. Eating a steady diet of sugars and carbohydrates throughout the day will trigger a steady supply of insulin into your system.  The glucose is moved into your cells and liver where it is ultimately stored as fat and glycogen. Your body never gets a chance to use your glycogen stores or break down the fat cells, because it is always in the mode of storing energy. This also increases appetite, and you are probably going to eat more carbs and sugars, creating a cycle.


You produce cortisol every day, in a regular pattern where amounts are usually higher in the mornings and lower at night. When you are under stress, you produce higher levels of cortisol in order to prepare the body to deal with an emergency, or the “fight or flight” response. This hormone affects many systems in your body, and several of them can influence weight gain. Cortisol stimulates the release of insulin, which clears glucose out of the blood and sends it to the cells. When you are under chronic stress, your cells are being fed glucose repeatedly when they really don’t need that extra energy, so they store it up as fat. Because your blood glucose is always low, you have an increased appetite. Fat buildup under these conditions also tends to be around the stomach, which is not only an unattractive place for fat, but puts you at a higher risk for heart disease.

Besides chronic stress, physical injury, caffeine, and the herb licorice will raise cortisol levels.  Just one cup of coffee can elevate your cortisol levels for 12 hours.  Lack of exercise, poor nutrition, especially being low in Vitamin C, and not getting enough sleep can cause your cortisol levels to go up.


The hormones secreted by your thryoid glands are closely linked with your metabolism. Inadequate amounts of these hormones can cause hypothyroidism, which slows down the metabolism, and causes weight gain, fatigue, weakness and feeling cold all the time.   Excessive amounts of thyroid hormones cause hyperthyroidism, which have the opposite effects – weight loss, increased appetite, feeling warm, rapid heart rate and diarrhea, among other symptoms. While it may sound attractive to have your metabolism speeded up in this way, it can actually be very dangerous for your heart. Both of these conditions can be diagnosed by a simple blood test and need to be treated medically.


Medications that can cause you to gain a few pounds include anti-depressants, mood stabilizers, diabetes medications, oral contraceptives and steroids. Some of these medicines may actually increase your appetite so you are taking in more energy. Some may cause you to retain water, or slow down your metabolism. Obviously you will be on one of these drugs for a medical reason, so if you are having a problem with weight gain you should check with your doctor to see how it can be helped. You should NOT just stop the medication yourself, as the consequences of that may be worse than gaining a few pounds.

Premenstrual Weight Gain

You may not necessarily turn into a monster at that time of the month, or maybe you do!  Most women are going to have some degree of PMS symptoms that will affect their weight.  During this time your hormones are fluctuating.  Estrogen and progesterone have been at high levels for a couple weeks and then they drop suddenly.  Serotonin levels, which affect your emotional health, are low.  It is unclear exactly which of these hormones causes the bloating and irritablity that many women experience every month, which can cause a weight gain of several pounds.  The low serotonin levels will make you crave carbs.  To get through this time you need to first of all realize that it is temporary, and if you wait it out things will go back to normal.  Then, there are a few things you can do to alleviate your symptoms.  Make sure that you get plenty of rest, and don’t skip exercisingDon’t eat salty and processed foods as these will make you retain even more water.  Avoid alcohol and caffeine during this time, as they will only aggravate your symptoms.  Drink lots of water to prevent bloating.  Supplementing your diet with calcium (1000 mg) and magnesium (200 mg) is said to help alleviate symptoms.  Stick to a diet of only complex carbohydrates (whole grains, no sugar) and high protein foods.    If you don’t give in to the temptation, you won’t get on that vicious cycle of eating junk food that is so difficult to break.  If you have severe symptoms, see a doctor about getting some medication.

Macronutrients in your diet

A steady diet of sugar and carbohydrates raises your insulin levels and makes you store fat. Protein is released more slowly into your bloodstream and doesn’t raise insulin levels, so you should include some protein in all your meals. Fat in your diet makes you feel satisfied, helps you absorb several vitamins and phytonutrients, and some fatty acids are essential for us to stay alive. Rethink the idea that fat is bad. You need some fat in your diet.  Sugar is the new fat, in fact it turns to fat in your system. Avoid sugar like you have been taught for years to avoid fat.  This doesn’t mean you can have bacon for breakfast every morning now. Eat everything in moderation.

You will lose weight on a low fat diet because you are cutting out a lot of calories, however they are notoriously hard to follow long term.  They are boring, and unhealthy, because your body needs a certain amount of fat to function.  Also, you are probably replacing those fat calories with extra carbs.  A very low carb diet such as Atkins will also make you drop the pounds quickly.  You are probably eating less calories when you go on this diet, and it includes exercise, drinking plenty of water and eating a lot of vegetables as part of the regimen.  Any diet that has you taking in less calories than you burn will cause you to lose weight, whether it be low carb, low fat, eating raw foods or eating only grapefruit.  However these diets are only sustainable in the short term, and then you will go back to your normal eating and gain the weight back.  Beware of diets that ask you to cut a major group of foods such as fats or carbohydrates completely out of your diet.  Each of these food groups contains a set of important nutrients that you will be missing.

Mind your weight by controlling what you can in your lifestyle.

As you can see, there are many factors that influence weight control and metabolism, and they can make it seem like you don’t have control over your weight.  Here are some lifestyle choices that can help you to keep control over this part of your life.  They are not all glamorous and fun, but they will make you feel better and make your life more enjoyable.

  • Avoid stress.  If you are living a life of chronic stress, see what you can do to ease up on yourself.  Practice meditation, pray, exercise more, or find an outlet that will help to relieve stress.
  • Physical stress such as constant pain or inflammation raises cortisol levels.  Evaluate your situation, maybe with a health care pro, to see how you can alleviate your pain or physical stress.
  • Exercise regularly, at the most rigorous level that you can manage for your age and health.  Exercise lowers cortisol and insulin levels, relieves stress, and burns off extra calories.
  • Avoid caffeine, which raises cortisol and insulin levels.  You may be surprised at how good you feel when you cut down on the amount of caffeine in your diet.
  • Make getting a good night’s sleep a priority.  Well rested is less stressed, and this will give you a healthier metabolism.
  • Figure out how many calories you need, and then learn to keep track of how many you are eating each day.  You may be surprised to find that you are eating a lot more than you suspected, or that you don’t need as many calories as you did when you were younger.
  • Drink lots of water.  Although it doesn’t make sense, this can keep you from retaining water, which leads to puffiness and weight gain.
  • Avoid salty and processed foods that can make you retain water.
  • Avoid sugars whenever you can, and stick to complex carbohydrates like whole grains, rice, beans and vegetables.
  • Stay away from toxins like alcohol, drugs, pesticides, food colorings, teflon, etc.  This list can go on and on depending on how vigilant you want to be.  Less toxins mean less stress for your system, and a healthier metabolism.

To read about BPA and obesity, see my recent post Does This Soup Make Me Look Fat?

What changes have you made in your life to stay healthy and mind your weight?

Calculating Calories for Weight Control

Weight control is a big issue in the United States, and many other countries where there is an abundant food supply.  After all, who doesn’t want to look and feel their best? In spite of all the fads out there telling you to cut one food group or another out of your diet, here is the bottom line: you must burn off as much energy as you take in if you want your weight to stay the same. If you want to lose weight, you must burn off more energy than you take in.   This is borne out by a study published in the New England Journal of Medicine in February of 2009. The study found that a reduced calorie diet will result in meaningful weight loss, whether it emphasizes fats, proteins or carbohydrates.  The key is in the calories, or your energy intake.

How to Calculate Calories for Weight Control

You will find that many web sites have a handy calorie calculator. Just punch in your age and activity level, and find out how many calories you need.  The problem is, if you use several different ones you will find a whole bunch of different numbers. I got a range of over 700 calories from 4 or 5 different calculators, and that could be disasterous for my diet if I choose the upper range and it is wrong. Here is how to figure out your calorie needs the old fashioned way.

First, calculate your Basal Metabolic Rate, or BMR.

Basal metabolic rate is how fast you burn energy just to stay alive. This is all the metabolic functions your body performs such as respiration, cell repairs, digesting and metabolizing food, and the like. It is influenced by many factors such as age, weight, height, gender, how much muscles and fat you have, hormones, glandular issues like how well the thyroid is functioning, body temperature and how much exercise you get. Some of these things can be easily worked into your calculation, and some like the hormones and glands would need a more thorough evaluation by a doctor.

The Harris-Benedict Formula is a BMR calculator that takes into account your height, weight, age and sex. You can use the English or metric system to figure out your BMR. I tried both ways and the result differed by only one calorie, so use whichever you are more comfortable with. If you want to convert your measurements, multiply inches by 2.54 to get centimeters, and multiply kilograms by 2.2 to get pounds.

Harris-Benedict Formula for BMR

For women: 655 + (4.3 x weight in pounds) + (4.7 x height in inches) – (4.7 x age in years)   Or, if you want to use metric measurements:

655 + (9.6 X wt in kg) + (1.8 X ht in cm) – (4.7 X age in years)

For men: 66 + (6.3 x weight in pounds) + (12.9 x height in inches) – (6.8 x age in years)   Or, if you want to use metric measurements:

66 + (13.7 X wt in kg) + (5 X ht in cm) – (6.8 X age in years)

If you need help with the math, you are going to figure out everything in parentheses FIRST. Then, do your adding and subtracting from left to right. So you end up with 665 + total in parentheses + total in parentheses – total in parentheses. You can see from this formula how age affects your metabolism. That last number increases as you age, and you have to subtract that from the calories you are allowed to eat every day.  So as you get older you must either eat less food, or increase your exercise in order to avoid a slow weight gain over the years. You can also see that men burn off WAY more calories than women.  Life is so unfair.

Second, calculate the extra energy you need for your activities.

After finding the number of calories you need to just carry on, you will use an Activity Multiplier to take in to account the exercise you are getting, or your active lifestyle. If you are a real couch potato, the Activity Multiplier probably will not help you much.

The Activity Multiplier

If you think the number you have so far is shockingly low, activity is your chance to bring it up to a level where you can eat a normal diet. You will multiply your BMR by a number based on your normal activity level. Here are the activity guidelines:

BMR x 1.2  Sedentary:  You get virtually no activity, being a couch potato at home, and working at a desk job all day.

BMR x 1.375   Light activity:  You exercise lightly from one to three times a week.

BMR x 1.55   Moderate activity:  You exercise three to five times a week.

BMR x 1.725   Frequent activity:  You exercise six to seven times a week.

BMR x 1.9   Extreme activity:  You are training for an event and exercise hard once or more a day, or you have an extreme physical job.

Examples of light activity are walking slowly, easy bicycling, light housework. Moderate activities are a brisk walk, dancing, playing ping-pong, skating, or anything that warms you up.  Heavy activity would be running, bicycling fast or on hills, swimming, high intensity games like basketball or soccer.  Basically, working up a sweat. Boxing, rowing and mountain climbing are extreme calorie burning activities. So what if you go for a light walk 6 days a week? Instead of using the light activity rate you could bump it up to the moderate rate. In other words, use your own judgement if you don’t fit exactly in these guidelines, but be honest with yourself. You will be able to tell soon enough if your results are working to help you maintain or lose weight.

Adjusting the Calorie Level for Weight Loss or Gain

If you want to lose weight you must eat less calories than this amount, and if you want to gain you must eat more. Your body uses 3500 extra calories to store a pound of fat, and must burn off that much extra to lose a pound. Eating only 500 calories less each day will make you lose about a pound a week. For two pounds a week you will need to adjust your intake by 1000 calories, etc. Decide how many pounds per week you want to lose or gain, then multiply that number by 500 and add or subtract it from your Daily Calorie Needs.

This is where you discover that you may not be able to lose weight as quickly as you were hoping. If your calories needs are already on the low side because you are older or have a low activity level, subtracting 1000 calories brings the number down too low to be practical. Dropping below 1000 calories a day may be harmful to your health and slow down your metabolism too much. This means you will just have to resign yourself to losing weight more slowly.

Is there anything you can do about this? The aging factor can’t be changed, but you can gain some leeway by increasing your activity level. Calories burned during regular, vigorous exercise can come right of the bottom line of your day’s quota of calories.

There are many online programs that make it easy to keep track the calories you eat and how many you burn. Loseit.com has been a wonderful tool for me in helping to control my weight.

Do you have any favorite tools that you use for weight control?