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05/22/2022
The Calorie Principle and Weight Gain; The Causality Has Been Obscure
Contents
- The birth of the "calories-in/calories-out" theory
- Obesity is still on the rise
- Carl von Noorden's book
In Japan, most people believe that “taking in too many calories and lack of exercise are the causes of being overweight,” which I believe is largely due to statements made by experts, nutritionists, etc. on television.
When I launched this website in 2014, I wanted to argue against that in my website, but I couldn’t find any academic papers and other resources that showed the "causal relationship between caloric intake and becoming obese."
However, around a year after I started blogging, I came across this great book: “Why We Get Fat” written by Gary Taubes. It is surprising that it was published in Japanese in 2013.
After all, this is the only book I can rely on. In explaining what I want to say, I first needed to let you know that, "the direct cause of being overweight is not determined by overeating.”
1. The birth of the "calories-in/calories-out" theory
"Ever since the early 1900s, when the German diabetes specialist Carl von Noorden first argued that we get fat because we take in more calories than we expend, experts and non-experts alike have insisted that the laws of thermodynamics somehow dictate this to be true.
Arguing to the contrary, that we might actually get fatter for reasons other than the twin sins of overeating and sedentary behavior, or that we might lose fat without consciously eating less and/or exercising more, has invariably been treated as quackery－ "emotional and groundless," as the Columbia University physician John Taggart insisted in the 1950s in his introduction to a symposium on obesity. “We have implicit faith in the validity of the first law of thermodynamics," he added.
Such faith is not misplaced. But that does not mean that the laws of thermodynamics have anything more to say about getting fat than any other law of physics.
Newton's laws of motion, Einstein's relativity, the electrostatic laws, quantum mechanics －they all describe properties of the universe we no longer question.
But they don't tell us why we get fat. They say nothing about it, and this is true of the laws of thermodynamics as well.
It is astounding how much bad science－and so bad advice, and a growing obesity problem－has been the result of the experts' failure to understand this one simple fact. The very notion that we get fat because we consume more calories than we expend would not exist without the misapplied belief that the laws of thermodynamics make it true."
(Gary Taubes. Why We Get Fat. New York: Anchor Books, 2011, Pages 72-3.)
(*snip*)
"In 1934, a German pediatrician named Hilde Bruch moved to America, settled in New York city. She was “startled,” as she later wrote, by the number of fat children she saw－”really fat one, not only in the clinics, but also on the streets, subways, and in schools.” This was two decades before the first McDonald's franchises was born, and more to the point, 1934 was in the depths of the Great Depression.
Bruch put in effort in the treatment of obese children. It was hard to avoid, she said, the simple fact that these children had, after all, spent their entire lives trying to eat in moderation and control their weight as directed, and yet they remained obese.
The physicians of Bruch's era weren't thoughtless, and the doctors of today are not, either.
They merely have a flawed belief system－a paradigm－that stipulates that the reason we get fat is clear and incontrovertible, as is the cure.
We get fat, our physicians tell us, because we eat too much and/or move too little, and so the cure is to do the opposite. （*snip*)
▽“The fundamental cause of obesity and overweight," as the World Health Organization says, “is an energy imbalance between calories consumed on one hand, and calories expended on the other hand."
We get fat when we take in more energy than we expend (a positive energy balance, in the scientific terminology), and we get lean when we expend more than we take in (a negative energy balance).
Food is energy, and we measure that energy in the form of calories. So, if we take in more calories than we expend, we get fatter. If we take in fewer calories, we get leaner.
This way of thinking about our weight is so compelling and so pervasive that it is virtually impossible nowadays not to believe it. Even if we have plenty of evidence to the contrary－no matter how much of our lives we've spent consciously trying to eat less and exercise more without success— it's more likely that we'll question our own judgment and our own willpower than we will this notion that our adiposity is determined by how many calories we consume and expend."
(Taubes. Why We Get Fat. Pages 3-6.)
2. Obesity is still on the rise
"Consider the obesity epidemic. Here we are as a population getting fatter and fatter.
Fifty years ago, one in every eight or nine Americans would have been officially considered obese, and today it's one in every three. Two in three are now considered overweight, which means they’re carrying around more weight than the public-health authorities deem to be healthy.
Throughout the decades of this obesity epidemic, the calories-in/calories-out, energy-balance notion has held sway, and so the health officials assume that either we're not paying attention to what they've been telling us －eat less and exercise more－or we just can't help ourselves.
Malcolm Gladwell discussed this paradox in The New Yorker in 1998.
“We have been told that we must not take in more calories than we burn, that we cannot lose weight if we don't exercise consistently," he wrote. “That few of us are able to actually follow this advice is either our fault or the fault of the advice. Medical orthodoxy, naturally, tends toward the former position. Diet books tend toward the latter. Given how often the medical orthodoxy has been wrong in the past, that position is not, on its face, irrational. It's worth finding out whether it is true.”
(Taubes. Why We Get Fat. Pages 7-8.)
(Gary Taubes’s thoughts on the relationship between thermodynamics and weight gain)
"Obesity is not a disorder of energy balance or calories-in/ calories-out or overeating, and thermodynamics has nothing to do with it. If we can't understand this, we'll keep falling back into the conventional thinking about why we get fat, and that's precisely the trap, the century-old quagmire, that we're trying to avoid."
(Taubes. Why We Get Fat. Pages 73.)
3. Carl von Noorden's book
Japanese television programs still continue to show doctors and nutritionists confidently saying, "The cause of weight gain is, of course, overeating or lack of exercise,”which I find disgusting. However, I hope you can see how flimsy and baseless these theories are.
By the way, I obtained Carl von Noorden's book (archive), which is shown at the beginning of the quotation. You can read it at the following link:
10/15/2021
The Combination of Undernutrition and Obesity Among the Poor Can be Possible
Contents
- The case of undernutrition and obesity
- What should we do?
- Being underweight and being overweight can coexist: My thoughts
Most of the parts of this article are citations from a book, but at the end of this article, I will explain how it is related to my experience.
[Related article] → Wealthy Ones Get Fat? Poor Ones Get Fat?
1. The case of undernutrition and obesity
"This combination of obesity and malnutrition or undernutrition (not enough calories) existing in the same populations is something that authorities today talk about as though it were a new phenomenon, but it's not. Here we have malnutrition or undernutrition coexisting with obesity in the same population eighty years ago."
(Gary Taubes. Why We Get Fat. New York: Anchor Books, 2011, Page 24.)
(In the mid-1930s, New York City)
"In 1934, a young German pediatrician named Hilde Bruch moved to America, settled in New York city, and was “startled,” as she later wrote, by the number of fat children she saw—“really fat ones, not only in clinics, but on the streets and subways, and in schools. (*snip*)
But this was New York City in the mid-1930s. This was two decades before the first Kentucky Fried Chicken and McDonald's franchises, when fast food as we know it today was born. This was half a century before supersizing and high-fructose corn syrup.
More to the point, 1934 was the depths of the Great Depression, an era of soup kitchens, bread lines, and unprecedented unemployment.
One in every four workers in the United States was unemployed. Six out of every ten Americans were living in poverty. In New York City, where Bruch and her fellow immigrants were astonished by the adiposity of the local children, one in four children were said to be malnourished. How could this be?(*snip*)
It was hard to avoid, Bruch said, the simple fact that these children had, after all, spent their entire lives trying to eat in moderation and so control their weight, or at least thinking about eating less than they did, and yet they remained obese."
(Taubes. Why We Get Fat. Pages 3, 4.)
(The case of a native American tribe, the Sioux, in 1930's)
Two researchers from the University of Chicago studied Native American tribe, the Sioux living on the South Dakota Crow Creek Reservation. These Sioux lived in shacks “unfit for occupancy,” often four to eight family members per room. Fifteen families, with thirty-two children among them, lived “chiefly on bread and coffee.” This was poverty almost beyond our imagination today.
Yet their obesity rates were not much different from what we have today in the midst of our epidemic: 40 percent of the adult women on the reservation, more than a quarter of the men, and 10 percent of the children, according to the University of Chicago report, “would be termed distinctly fat.”
But the researchers noted another pertinent fact about these Sioux: one-fifth of the adult women, a quarter of the men, and a quarter of the children were “extremely thin."
The diets on the reservation, much of which, once again, came from government rations, were deficient in calories, as well as protein and essential vitamins and minerals. The impact of these dietary deficiencies was hard to miss: “Although no counts were taken, even a casual observer could not fail to note the great prevalence of decayed teeth, of bow legs, and of sore eyes and blindness among these families."
(Taubes. Why We Get Fat. Pages 23-4.)
(In the slums of São Paulo, Brazil)
"This is from a 2005 New England Journal of Medicine article, “A Nutrition Paradox-Underweight and Obesity in Developing Countries,” written by Benjamin Caballero, head of the Center for Human Nutrition at Johns Hopkins University.
Caballero describes his visit to a clinic in the slums of São Paulo, Brazil.
The waiting room, he writes, was “full of mothers with thin, stunted young children, exhibiting the typical signs of chronic undernutrition.
Their appearance, sadly, would surprise few who visit poor urban areas in the developing world. What might come as a surprise is that many of the mothers holding those undernourished infants were themselves overweight.(*snip*)
If we believe that these mothers were overweight because they ate too much, and we know the children are thin and stunted because they're not getting enough food, then we're assuming that the mothers were consuming superfluous calories that they could have given to their children to allow them to thrive.
In other words, the mothers are willing to starve their children so that they themselves can overeat. This goes against everything we know about maternal behavior. (*snip*)
Caballero then describes the difficulty that he believed this phenomenon presents: “The coexistence of underweight and overweight poses a challenge to public health programs, since the aims of programs to reduce undernutrition are obviously in conflict with those for obesity prevention.”
Put simply, if we want to prevent obesity, we have to get people to eat less, but if we want to prevent undernutrition, we have to make more food available. What do we do?"
(Taubes. Why We Get Fat. Pages 30-1.)
2. What should we do?
"In the early 1970s, nutritionists and research-minded physicians would discuss the observations of high levels of obesity in these poor populations, and they would occasionally do so with an open mind as to the cause. (*snip*)
Here's Rolf Richards, the British-turned-Jamaican diabetes specialist, discussing the evidence and the quandary of obesity and poverty in 1974, and doing so without any preconceptions: “It is difficult to explain the high frequency of obesity seen in a relatively impecunious [very poor] society such as exists in the West Indies, when compared to the standard of living enjoyed in the more developed countries.
Malnutrition and subnutrition are common disorders in the first two years of life in these areas, and account for almost 25 per cent of all admissions to pediatric wards in Jamaica. Subnutrition continues in early childhood to the early teens. Obesity begins to manifest itself in the female population from the 25th year of life and reaches enormous proportions from 30 onwards.”
When Richards says “subnutrition,” he means there wasn't enough food. From birth through the early teens, West Indian children were exceptionally thin, and their growth was stunted. They needed more food, not just more nutritious food. Then obesity manifested itself, particularly among women, and exploded in these individuals as they reached maturity.
This is the combination we saw among the Sioux in 1928 and later in Chile— malnutrition and/or undernutrition or subnutrition coexisting in the same population with obesity, often even in the same families. (*snip*)
Referring to obesity as a “form of malnutrition” comes with no moral judgments attached, no belief system, no veiled insinuations of gluttony and sloth. It merely says that something is wrong with the food supply and it might behoove us to find out what.(*snip*)
Again, the coexistence of underweight and overweight in the same populations and even in the same families doesn't pose a challenge to public-health programs; it poses a challenge to our beliefs about the cause of obesity and overweight."
(Taubes. Why We Get Fat. Pages 29-32.)
3. Being underweight and being overweight can coexist: My thoughts
<About undernutrition and overweight>
First, I would like to explain, based on my experience, that the coexistence of undernutrition and obesity are not contradictory messages.
I repeat that when I was very thin, under forty kilograms, at first, I was eating high-calorie foods such as deep-fried foods or sweet, but I couldn’t gain weight. And then, I realized that I could gain weight by digesting all the foods in my whole intestines and inducing intestinal starvation.
The easiest way to induce intestinal starvation was to eat digestible refined carbohydrates (rice, white bread, noodles, starches, etc.) and a little easy-to-digest protein (and not to eat other foods), but since it lacked energy and essential nutrients for my body, I felt dizzy from the undernutrition.
If I ate eggs, vegetables, beans, or fish, or drank milk to add more essential nutrients, though the nutritional profile was better, I couldn’t gain any weight. For me, it was because I couldn’t digest them well.
IIn short, a higher ratio of digestible refined carbohydrates in the meals and eating fewer fibrous vegetables, fat, and other indigestible foods are more likely to induce intestinal starvation and cause one’s set-point weight to increase.
It’s probably certain that a deficiency of vitamins and/or minerals can cause illnesses, but being overweight is not contradicting being in a state of undernutrition.
<About the coexistence of being underweight and overweight>
Getting back to what Caballero refered to, even if people eat similar foods in the same group, it may lead to a different result in the body.
Some people who digested all the foods in their whole intestines may have gained weight—which means their set-point weight went up by intestinal starvation— and ended up becoming overweight.
However, those who were not able to digest all the foods in their whole intestines remained underweight. I believe that leaving Just a little bit of undigested food in the intestines makes it hard to induce intestinal starvation. (Being extremely thin can cause poor digestion, so it makes it even harder for them to induce intestinal starvation.) A small difference sometimes makes a big difference in the end result.
To sum up, what happened in the groups in poverty situations is a similar phenomenon that is happening in our modern society.
When someone doesn't eat much and is fat, we tend to assume that they are inactive or have a slow metabolism. And when someone who eats a lot but is thin, we tend to assume that they are active or have a fast metabolism.
Most researchers just try to fit everything into the theory that “fat people eat too much or are physically inactive” for some reason.
However, if we look at these ideas I’ve presented with an open mind, we can say that this is the same phenomenon as the "coexistence of thin and obese" in the same population.
At the risk of repeating myself, being overweight is not necessarily the consequence of overeating.
11/21/2019
The Women's Health Initiative Dietary Modification Trial
(References: “The Obesity Code”: Dr. Jason Fung, 2016)
(In the U.S.)The National Institutes of Health recruited almost 50,000 post-menopausal women for the most massive, expensive, ambitious and awesome dietary study ever done. Published in 2006, this randomized controlled trial was called the Women's Health Initiative Dietary Modification Trial. This trial is arguably the most important dietary study ever done.
Approximately one-third of these women received a series of eighteen education sessions, group activities, targeted message campaigns and personalized feedback over one year. Their dietary intervention was to reduce dietary fat, which was cut down to 20 percent of daily calories. They also increased their vegetable and fruit intake to five servings per day and grains to six servings.
They were encouraged to increase exercise. The control group was instructed to eat as they normally did. Those in this group were provided with a copy of the Dietary Guidelines for Americans, but otherwise received little help. The trial aimed to confirm the cardiovascular health and weight-reduction benefits of the low-fat diet.
The average weight of participants at the beginning of the study was 169 pounds (76.8 kilograms). The starting average body mass index was 29.1, putting participants in the overweight category (body mass index of 25 to 29.9), but bordering on obese (body mass index greater than 30). They were followed for 7.5 years to see if the doctor-recommended diet reduced obesity, heart disease and cancer as much as expected.
The group that received dietary counseling succeeded. Daily calories dropped from 1788 to 1446 a dayーa reduction of 342 calories per day for over seven years. Fat as a percentage of calories decreased from 38.8 percent to 29.8 percent, and carbohydrates increased from 44.5 percent to 52.7 percent. The women increased their daily physical activity by 14 percent. The control group continued to eat the same higher-calorie and higher-fat diet to which they were accustomed.
The results were telling. The“Eat Less, Move More”group started out terrifically, averaging more than 4 pounds (1.8 kilograms) of weight loss over the first year. By the second year, the weight started to be regained, and by the end of the study, there was no significant difference between the two groups.
Did these women perhaps replace some of their fat with muscle? Unfortunately, the average waist circumference increased approximately 0.39 inches (0.6 centimeters), and the average waist-to-hip ratio increased from 0.82 to 0.83 inches (2.1 centimeters), which indicates these women were actually fatter than before. Weight loss over 7.5 years of the Eat Less, Move More strategy was not even one single kilogram (2.2 pounds).
This study was only the latest in an unbroken string of failed experiments. Caloric reduction as the primary means of weight loss has disappointed repeatedly.(*snip*)
Many people tell me, “I don't understand. I eat less. I exercise more. But I can't seem to lose any weight.” I understand perfectly-because this advice has been proven to fail.
Do caloric-reduction diets work? No.
(Overeating Experiments: Unexpected Results)
THE HYPOTHESIS THAT eating too much causes obesity is easily testable. You simply take a group of volunteers, deliberately overfeed them and watch what happens. If the hypothesis is true, the result should be obesity.
Luckily for us, such experiments have already been done. Dr. Ethan Sims performed the most famous of these studies in the late 1960s.（*snip*)
Could he make humans deliberately gain weight? This question, so deceptively simple, had never before been experimentally answered. After all, we already thought we knew the answer. Of course overfeeding would lead to obesity.
But does it really? Sims recruited lean college students at the nearby University of Vermont and encouraged them to eat whatever they wanted to gain weight. But despite what both he and the students had expected, the students could not become obese.(*snip*)
Dr. Sims changed course. Perhaps the difficulty here was that the students were increasing their exercise and therefore burning off the weight, which might explain their failure to gain weight. So the next step was to overfeed, but limit physical activity so that it remained constant. For this experiment, he recruited convicts at the Vermont State Prison. Attendants were present at every meal to verify that the caloriesー4000 per dayーwere eaten. Physical activity was strictly controlled
A funny thing happened. The prisoners' weight initially rose, but then stabilized. Though at first they'd been happy to increase their caloric intake, as their weight started to increase, they found it more and more difficult to overeat, and some dropped out of the study.(*snip)
After the experiment ended, body weight quickly and effortlessly returned to normal. Most of the participants did not retain any of the weight they gained.
11/21/2019
There Are Two Steps to Lose Weight the Right Way
-
Contents
-
- There are two ways to lose weight
- How to lower one's set-point weight
- What is your specific diet?
- Differences from low-carb diets
- The meaning of the “two-step"
- Health benefits
<The bottom line>
Although this is not a diet blog, since I’m writing the reasons why people gain weight, naturally, I thought about ways to lose weight, and I felt that I should write about it.
In this post, I will only write about my theory for losing weight. Please understand this is not based on practice, but I hope this will help someone.
1. There are two ways to lose weight
Just like the phrase “to gain weight” has two meanings, “to lose weight” also has two meanings.
【Related article】 Two Meanings to the Phrase "Gaining Weight"
(1) In the case you rebound
The first way is done by eating less and exercising more, as in conventional calorie-restricted diets. This method requires constant hunger.
The human body is thought to have a homeostatic function, and I use the "set-point" theory of body weight to explain its stable weight.
When food intake is significantly reduced and body weight decreases, the body perceives this as an energy crisis. In response, the body's protective metabolic mechanisms kick in to preserve energy stores, causing energy expenditure to drop significantly, more than expected[1,2]. Additionally, in my view, prolonged hunger increases the body's absorption rate as it tries to maximize nutrient intake.
Furthermore, the secretion of hormones that stimulate appetite increases, while the secretion of satiety hormones is suppressed[3]. You start feeling an overwhelming urge to eat.
In most cases, weight loss doesn't last long, and eventually, you rebound back to your original weight range.
In other words, attempts to sustain weight loss invoke adaptive responses involving the coordinate actions of metabolic, neuroendocrine, autonomic, and behavioral changes that ‘oppose’ the maintenance of a reduced body weight[4].
[Related article]
Dieting Doesn’t Work in the Long Run
(2) Lower the “set-point weight” itself
I believe that the problem of obesity lies in the body’s “set point” being higher than normal.
As I mentioned in (1), the fact that obese individuals show metabolic resistance to calorie-restricted diets suggests that, for some people, obesity is a natural physiological state[5]. Animal studies also support the view that obesity is a state of energy regulation at a higher set-point[5].
Therefore, in order to lose weight properly, it is necessary to lower the set-point itself that serves as the foundation for maintaining the current state. I will cite relevant literature on this topic.
"There appears to be a “set point” for body weight and fatness, and the problem in obesity is that the set point is too high.(*snip*)
There are two prominent findings from all the dietary studies done over the years.
First: all diets work. Second: all diets fail.
What do I mean?
Weight loss follows the same basic curve so familiar to dieters. Whether it is the Mediterranean, the Atkins or even the old fashioned low-fat, low-calorie, all diets in the short term seem to produce weight loss. Sure, they differ by amount lost–some a little more, some a little less. But they all seem to work.
However, by six to twelve months, weight loss plateaus, followed by a relentless regain, despite continued dietary compliance.(*snip*)
So all diets fail. The question is why.
Permanent weight loss is actually a two-step process. There is a short-term and a long-term (or time-dependent) problem. "
( Fung J. 2016. The obesity code. pages 62,215 )
2. How to lower one's set-point weight
I believe that the "long-term problem" Doctor Fung refers to is addressing the underlying cause of the elevated set-point and lowering the set-point itself without triggering the body's resistance mechanisms.
Specifically, instead of enduring hunger, I think we can gradually lower the set-point by following certain rules, eating more nutrient-dense and less digestible (slow-digesting) foods to reduce hunger. This is because, according to my theory, the primary cause of weight gain, which leads to an increase in the set-point, is due to the mechanism of intestinal starvation.
In other words, we need to do the opposite of feeling hungry at the time.
Although I can't fully explain it at this point, I believe that when the intestines are filled with nutrient-rich, undigested food, such as fibrous vegetables, beans, and dairy products, it signals to the body that "there is still enough food."
As a result, the body doesn't perceive it as a crisis and doesn't trigger resistance mechanisms involving changes in metabolism or neuroendocrine responses.
Additionally, as hunger decreases, appetite diminishes, and absorption rates gradually decline. Eventually, I assume that body fat would decrease due to the coordinated actions between the brain—particularly the hypothalamus—and organs and peripheral tissues, etc.[6]
■It may be difficult to understand how eating food reduces absorption rate, but imagine, for example, eating a snack bread and a glass of orange juice.
If you eat it when you are starving, your blood glucose level will jump up, whereas if you eat it three hours after finishing a well-balanced lunch, your blood glucose level will not rise as much.
Even when you go out for drinks, if you haven't eaten anything for almost ten hours, you may get drunk faster, but if you eat a good lunch and have ice cream two hours before drinking, you will get drunk more slowly. In other words, if you keep eating less digestible food to reduce hunger, the absorption rate should decrease.
３．What is your specific diet?
I think the key is to reduce carbohydrate intake to a certain extent and conversely increase meat, fish, oil/fat, fibrous vegetables, seaweed, nuts, dairy products, etc. to reduce the time you feel hungry.
(If you feel a little hungry, eat something. Eat regularly even if you don't have an appetite.)
Specifically, I believe there are two ways to do this.
(1) The way to actually improve your diet
♦Reduce carbohydrate intake (rice, bread, noodles, etc.) by half to a third.
♦Eat low G.I. carbohydrates if possible, such as brown rice, whole-grain bread, cold rice (starch turns indigestible once cooled down) and al dente pasta.
♦Increase foods other than carbs such as meat, fish, fat/oil, dairy products, nuts, fibrous vegetables, seaweed, etc.
♦Avoid processed foods, fast food, and snacks as much as possible, and prioritize minimally processed foods.
♦Eat at least three meals a day, and if you feel hungry between meals, it's okay to have a snack.
♦Of course, you can combine this step with running or gym workouts, but since calorie burning is not the goal, it's better to consume something like milk before or after exercising.
<Regarding fat intake>
Fats are an important energy source for the body, and at the same time a cause of weight gain for some, but I believe that it is a food that can help us lose weight depending on how we eat it.
Fats have traditionally been considered 'fattening' because they have a high energy density of 9 kcal per gram. However, since fats take longer to digest, consuming them frequently can help sustain a feeling of satiety and, in my opinion, even contribute to weight loss. (Of course, it differs from person to person)
[Related article] Eating Fat/oil Can be a Deterrent to Gaining Weight
(2) Slow down the digestive enzymes
For those who digest food quickly and don't easily feel satiated no matter how much they eat, Method (1) may have limited effectiveness. In fact, some may even gain weight due to the extra calories consumed.
In my theory, having a 'higher set weight' is related to an increase in absorption efficiency. Additionally, as obesity levels increase, losing weight can become more difficult because they digest food quickly and their absorption rate doesn’t decrease easily. Therefore, Method (1) is not necessarily incorrect, in theory.
In a similar case, in addition to improving the diet, it may be helpful to take medication that, for example, slows down the digestive process for fats and proteins, or decreases one’s appetite.
By slowing down the working of the gastrointestinal tract or lowering the ability to digest food, undigested food will remain longer in the intestines, which will have the same effect as (1) above.
( Naturally, it must be done under a physician's guidance.)
４. Differences from low-carb diets
I can’t recommend extreme carb-cutting like the ketogenic diet, but I believe it ends up being similar to a low-carb diet in practice.
Advocates of low-carb diets claim that the real cause of weight gain is carbohydrates, which triggers insulin release, and that instead of limiting them, you can eat as many protein-and fat-rich foods as you like to make up for the calories.
In reality, however, it is not "you can eat" but rather "you have to" in order to lose weight.
If you reduce meat, fish, and fats/oils as well, you will feel hungry just like in a conventional calorie-restricted diet, and such diets do not work for long, as studies have shown.
My theory is that carbohydrates are only an indirect cause of weight gain making it easier to induce intestinal starvation. The point is only that we should consume more less digestible (slow-digesting) foods, which slow down the digestion process and suppress hunger. So, while carbohydrates are not necessarily bad, I believe that cutting the amount of carbohydrates in the diet will be more effective.
Of course, it is possible that reducing glucose, which provides immediate energy, may speed up weight loss in the short term.
5. The meaning of the “two-step”
For those who have been dieting by eating less, their caloric intake may at least increase . So "eat more to lose weight" may sound fishy.
However, reducing caloric intake is not the final point.
・In the short term, you may not experience the dramatic weight loss that comes with calorie-restricted diets, but by slightly reducing caloric intake and eating more less digestible (slow-digesting) foods to reduce hunger, there is a possibility of gradual weight loss.
・In the long term, by continuing this approach, I suspect that the signal that "there is enough food" may take hold, and through the interaction between the brain—especially the hypothalamus—organs, and peripheral tissues[6], the set-point weight itself may decrease, leading to a body that doesn't experience the rebound effect.
Currently, even some researchers who recognize the concept of a body’s set-point view obesity as an incurable chronic disease[7]. They state that lifestyle interventions and obesity medications do not permanently alter the body’s set point, so weight loss achieved through dieting is not sustained, and weight lost with medication tends to rebound once the treatment is stopped[7].
However, in my view, this is because calorie-restrictive diets are fundamentally flawed. By focusing so much on calorie reduction, dieting has come to be seen as a difficult process that means giving up one’s favorite foods and enduring hunger. This approach only activates the body’s resistance mechanisms.
6. Health benefits
Even if you don't lose much weight, the health benefits are immeasurable. For example, while vegetables, legumes, nuts, fermented foods, and dairy products contain some calories, I believe there's no need to worry about that.
As many nutritionists and gut health experts say, these foods are rich in vitamins and minerals, promote a healthy gut microbiome, improve gut health, boost immunity, and help prevent spikes in blood sugar. These benefits far outweigh the calorie content and likely help prevent and/or improve lifestyle diseases. Even minimally processed meats and seafood are essential, as they provide protein, fats, and minerals that are vital for the body.
The bottom line
(1)Just as the phrase "to gain weight" has two meanings, "to lose weight" also has two meanings.
To avoid rebounding, the set-point weight itself must be lowered.
(2)Lowering the set-point weight requires a two-step approach:
・In the short term, reducing refined carbohydrates and processed foods, etc. and conversely increasing nutritious, less digestible foods while adjusting caloric intake, can help reduce hunger and, in turn, may gradually lead to weight loss.
・In the long term, by continuing this approach, I believe that signals that "there is enough food" may permeate the body, which, through the interactions between the brain, digestive system, pancreas, and fat tissues, the set-point weight itself can be reduced, making the body less likely to rebound.
(3)As obesity levels increase, losing weight with diet alone may become more challenging.
I consider this is partly because they digest food quickly and don’t easily feel satiated, resulting in no reduction in absorption efficiency.
In such cases, administering medication to slow down digestive enzymes or reduce appetite might be effective for some patients with obesity.
(4)Even without significant weight loss, eating balanced meals regularly is beneficial for maintaining health and may help prevent and/or improve lifestyle-related diseases.
References：
[1]Hall KD, Guo J. Obesity Energetics: Body Weight Regulation and the Effects of Diet Composition. Gastroenterology. 2017 May;152(7):1718-1727.e3.
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08/14/2019
Gaining Weight by Intestinal Starvation; What Does It Mean?
Contents
- Hunger in Africa and hunger in the modern era
- Why do we gain weight during periods of starvation?
- What happens when one’s set-point weight is elevated?
Let me explain something about the core of this blog.
Perhaps for most of you it is hard to believe me, but I’ll just write the facts as they are, as I experienced them. I did not write this from my imagination, but based it on my own analysis of what actually happened to me.
When I got into college, my total body weight fell down to the thirty-kilo range, so I knew exactly why I gained almost five kilos so rapidly in a few days, even though I didn’t eat much.
1. Hunger in Africa and hunger in the modern era
The idea of storing fat in the body as a reserve against starvation is something every researcher considers at one time or another.
However, it is said that this theory is an idea that has been rejected by researchers throughout history. This is because many overweight people often eat more, and many African refugees are thin and malnourished.
One might say, “If starvation makes us fat, then African refugees would be obese.”
However, please understand that this is a true state of starvation (malnutrition) in which the people can’t eat even if they want to, and I’m stating that it is different from what I call “intestinal starvation.”
African refugees do not have access to digestible food, and malnutrition even diminishes their ability to digest food and nutrients.
In contrast, many of us in developed countries are more likely to eat westernized foods made from wheat, meat, eggs, etc., which provide good nutrition and are easier to digest. Therefore, if we focus on the inner workings of our intestines, we are more prone to inducing intestinal starvation.
The reality is that being overweight has become a problem even among the poor populations in the world. What is common in these cases is not the excessive intake of calories or sugars, but rather a diet that is low in nutritional value and unbalanced, often due to a reliance on inexpensive refined carbohydrates and a lack of vegetables.
2. Why do we gain weight during periods of starvation?
In my blog, I mentioned that one’s set-point for body weight goes up by inducing intestinal starvation, and I want to explain what it means here. For the sake of explanation, I will use plants as an example.
(1) For plants, eating food and gaining weight is done by adding "fertilizer." This fertilizer is the equivalent to our diet, and of course, we need to use fertilizer periodically for growth.
However, using too much fertilizer doesn’t usually result in producing a bigger plant, and if we use it too often, it may sometimes have a negative effect.
The same goes for humans, and just eating a lot of calories doesn’t necessarily mean we all gain weight and become overweight. Even if we eat only one meal a day, as long as it’s well-balanced, there will be enough nutrition left in the intestines to be absorbed.
(2)Using an example of a plant, weight gain by inducing intestinal starvation and an increase in set-point for body weight could be explained in the same way as a plant that is extending its roots and taking in more nutrients. (See figure below)
When there is not enough nutrition, plants grow their roots deeper into the ground seeking more nutrients, and the same phenomenon occurs when we humans digest all the food in our entire intestines (or it may be the small intestine only), and intestinal starvation is induced.
(It is said that “the small intestine is the second brain” or that “it has a will,” and I clearly felt the will of my small intestine.)
Actually the villi (*1) of the intestines do not grow, but I believe that the following phenomena occur:
(*1)In order to absorb more nutrients efficiently, the interior of the small intestine has a folded structure, with numerous protrusions called villi on its surface (Fig. 1). Additionally, microvilli develop on the surface of these villi.
It is sometimes said that if all of these were spread out, the surface area inside the small intestine would be equivalent to that of a tennis court.
(Fig. 1: Villi of the small intestine)
First, I believe that the intestines (especially the small intestine) is the first organ to sense whether or not food is present. This is determined not only by the amount of energy, but also by how far the food has been digested. (For this reason, even if you eat a large amount, if your diet is heavily skewed towards easily digestible carbohydrates, intestinal starvation can be induced.)
When undigested substances, including fiber, remain in the intestines to some extent, the body perceives that “there is still food,” even if you're hungry. However, when all the food is digested (or very close to it), the small intestine sends a signal to the brain that “there is no food.”
In response, the body attempts to absorb more nutrients, and microscopic substances attached to the villi (or microvilli) of the small intestine detach (Fig. 2). This, in turn, increases the surface area for absorption, thereby boosting absolute absorption ability.
This causes weight gain, suggesting an increase in the set-point for body weight, and reaches a new equilibrium at a higher set-point within just three to four days.
( Fig.2 )
In other words, weight doesn't gradually increase due to excess calories being stored bit by bit. Instead, the body normally maintains a stable set-point weight, but at some point, it suddenly jumps, whether by 300 grams or 500 grams, all at once (Fig. 3).
In summary, I believe that one of the key factors in the fundamental difference between obese and lean people involves their absorption ability.
[Related Article]
( Fig.3 )
In Japan, obese individuals sometimes say things like, “I gain weight even just by drinking water.”
Of course, water alone does not make them fat, but I don't think it is totally wrong. It reflects just how efficient their absorption rate is.
3. What happens when one’s set-point weight is elevated?
(1) Once you gain weight, it becomes more difficult to lose weight
When your set-point for body weight goes up and you gain weight, it means that the balancing point, in terms of "energy- in, energy-out," has gone up, which can generate a more positive energy cycle and make it more difficult to lose weight.
When dieting, temporarily reducing the caloric intake to lose weight means reducing the "fertilizer" in the example of a plant. However, it is only a temporary weight loss, and you will likely return to your original weight when you start eating a normal diet again (the rebound effect).
Moreover, the reason why each time some people diet, they rebound and gain more weight than before is that skipping meals or eating light meals (not enough vegetables) can lead to intestinal starvation, which can further increase your set-point weight.
(2) More muscle, too
It is not that after you get fat, you gain muscle to support it. Since the overall absorption of nutrients increases, I believe that weight gain, at least to some extent, involves not only an increase in body fat but also lean mass such as muscle.
When a fat person loses body fat, they often have a thick, muscular chest or thighs. After body fat is gained, would the muscles around the chest and neck thicken to support that weight? (This varies widely from person to person.)
(3) Cause-and-effect reverse phenomenon
The increased intake of nutrients as a whole, including protein, creates a positive cycle of energy, which leads to the following phenomena.
Since digestive enzymes, hormones, etc. are also made from proteins (amino acids), it could enhance the ability to digest food and potentially bring about changes in the hormonal systems that regulate appetite and other functions. So, it is no wonder that people with larger bodies or stronger stomachs generally eat more than others.
There exists a cause-and-effect reversal phenomenon: people do not gain weight because they eat more, but because the bigger they are, the hungrier they become, and in turn, they eat more.
(4) Those who are overweight are prone to gaining more weight
Even if everyone eats exactly the same amount, people with big bodies－big, meaning large with some extra body fat or muscularly built－, or obese people, are more likely to feel hungry, which means that they eat relatively less, and they tend to gain more weight little by little.
It may be a vicious circle where a person eats modest amounts and gains weight, and if they skip meals or eat less to lose weight, they gain even more weight in the long run.
【Related article】→What Does It Mean to Eat Relatively Less?
On the other hand, if a lean person eats balanced meals three times a day, every day, he or she doesn’t induce intestinal starvation. And there is a good chance they will stay the same weight and have the same appearance for the rest of their life, regardless of caloric intake.
Therefore, "fatness" and "non-fatness," in this regard, are not due to obesity genes.
Also, for people like me who are very thin, being thin itself can reduce the amount of protein and other nutrients that can be taken in, thus a negative energy cycle continues. In turn, the muscles that support the stomach and intestines become weak and droopy, and the ability to digest food is also diminished by not secreting enough digestive enzymes.
This is a vicious circle where thin people can’t gain weight and remain thin.