A calorie is a calorie after all

On February 26, 2009, in nutrition, public health, research, by Karen Grepin

There is great debate within the public health circles of whether the mantra that “a calorie, is a calorie, is a calorie” is in fact true when it comes to losing weight. The popularity of diets such as the Atkins diet suggests that certain combinations of calories, in this case low carbohydrate and high protein diets, may be superior to others with regards to weight loss. There are scientific studies (some supported by the Atkins Foundation) to support this claim. When I was a student at the Harvard School of Public Health, I attended the weekly nutrition seminar (they always had great lunches) and I remember great and heated debates about whether there was a violation of the laws of thermodynamics at play.

It has been speculated that part of the debate stemmed from the fact that many of the studies in question had very small samples of patients (some really small, like 20 or so), potentially unrepresentative populations, and that follow-up periods were very short. A recent study published this week in the NEJM tried to overcome these challenges by randomizing 800 patients to different diets and follow-up with the patients over 2 years. The study finds little difference between the diets in terms of short term weight loss, or long-term weight loss maintenance suggesting that the old adage is true.

While this clearly does not put the debate to rest once and for all, it does certainly suggest that much of what we have been led to believe of late is probably not true. The only real way to lose weight through diet is to reduce calorie intake. Darn.

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