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It’s the Fat that Matters
Calories Add Fat that Doesn’t Always Show Up on Your Scale
When you step on the scale the weight you see isn’t the whole story. What’s missing is how much is fat and how much is muscle, your body composition. That’s old news to most fitness-minded people, but it’s something that everyone needs to know. It’s a key point in an important new study about diet and weight control. When it comes to fat gain, the new study says, it’s how much you eat, not what you eat, that counts. You might never know it, however, if you go by weight gain alone.
Excess calories are what matters when it comes to fat gain. If you eat too much—carbohydrate, fat, or protein—you will gain fat. The new finding is that a deficiency in protein makes matters worse. Short-change protein, eating the same number of calories, and you will not gain as much weight. But you will gain just as much fat as you would have if you had eaten adequate protein. It won’t show up on your scale, however, because you'll end up with less lean body mass. (Vegans beware.)
The study is the latest in a long line challenging the concept that manipulating macronutrients (carbohydrate, fat, and protein) is the secret to weight control. The Atkins Diet and the Zone Diet are two examples of commercial attempts to lose weight by juggling the ratio of carbohydrate, fat, and protein.
Some researchers maintain that diets low or high in protein are “less metabolically efficient” and, therefore, produce less weight gain, Dr. George A. Bray and his colleagues tell us in introducing their study. “This concept is appealing from an evolutionary perspective because the ability to waste ‘excess’ calories when eating an unbalanced diet would ensure an adequate supply of nutrients while avoiding risks to survival as a result of excess weight gain,” they explained. “Overeating a diet low or high in dietary protein may maintain body weight through metabolic inefficiency because of the energy cost involved in sparing lean body mass with a low protein diet but expanding lean body mass with a high protein diet,” they continued.
In other words, low or high protein diets are said to make the body work harder, which means you don’t gain as much weight.
The Bray study was designed to test this assertion under tightly controlled and randomized conditions. Based on the earlier findings, the researchers anticipated that a diet high in protein would lead to less weight gain. (They were wrong.)
To test this hypothesis, they fed 25 healthy, young men and woman 1,000 excess calories daily for eight weeks, varying the proportion of protein and fat. Participants were randomly divided to diets containing low (5%), normal (15%), and high (25%) protein. All meals were taken in strictly controlled conditions; participants lived in the metabolic ward of an inpatient research center. Carbohydrates were held steady at 41% to 42% of calories, while fat intake varied with protein content. Participants were monitored to make sure they ate all the food they were given. (Regular exercise was not part of the routine.)
The basic menu was the same for all participants. Protein sources included turkey, chicken, tuna, and pork chops. Tuna salad provides an example of how protein intake was controlled. The low protein group received more mayonnaise and less tuna, while the high protein got more tuna and less mayonnaise; the normal protein group split the difference.
The surprising results:
The low-protein diet group gained significantly less weight: 7 pounds compared to 13 pounds for the normal protein group, and 14 pounds for the high-protein group. Importantly, body fat increased practically the same in all three groups: 8.07 #, 7.62 #, and 7.59 #, respectively. Change in lean body mass also differed significantly; it went down 1.54 # in the low-protein group, and up 6.33 # and 7.02 #, in the normal and high protein groups, respectively.
What’s the importance of these findings? What’s the take away message?
Focus on Fat
The theory that overeating on a low or high protein diet would produce less weight gain did not stand up under rigorous experimental testing. “The low protein diet group gained less weight than the normal or high protein groups,” Bray and his colleagues reported—and explained why. How the body reacted to the three calorie-loaded diets is really quite remarkable.
The researchers accounted for all excess calories (energy) consumed through energy stored as fat and in protein or energy expended. “With the low protein diet, more than 90% of the excess energy was stored as fat,” Bray et al wrote. (That can’t be good.) The remaining 10% reflects the energy cost of storing fat. “With the normal and high protein diets, only about 50% of the excess energy was stored as fat,” the researchers continued. After accounting for the cost of storing fat, the balance of the energy expenditure apparently reflected the higher cost of protein turnover and storage. Replacing and building muscle is a high cost activity.
Remember that the normal and high protein groups gained twice as much weight as the low protein group. The additional weight gain was made up of lean muscle mass.
Importantly, resting energy expenditure responded differently to low and high protein intake. “Neither resting energy expenditure, nor lean body mass increased in the low protein group,” the researchers wrote. “In contrast, the [build up] of lean body mass in the normal and high protein groups was the principle contributor to the increase in resting energy expenditure.” So, protein does matter. (More below)
“In summary, weight gain when eating a low protein (5% of energy from protein) was blunted compared with weight gain when eating a normal protein diet (15% of energy from protein) with the same number of extra calories,” the researchers concluded. “Calories alone, however, contributed to the increase in body fat. In contrast, protein contributed to the change in energy expenditure and lean body mass, but not to the increase in body fat.” (Emphasis mine)
“The body was confronted with excess calories, but it didn’t care where they came from,” Dr. Bray, a researcher at Pennington Biomedical Researcher in Baton Rouge, Louisiana, told The Wall Street Journal. “The only thing it can do is put them into fat,” he continued.
It’s calories that build fat. That’s important to know; overweight and obesity is a growing problem all over the world. It makes no difference whether you eat carbs, fat, or protein; if you eat too much, you’re going to get fat. That’s the first lesson, but there’s more.
Another important message is that protein content does matter. Those eating 15% or 25% protein gained lean muscle mass along with the fat. That’s a good thing, because more muscle means faster metabolism. The problem is that the diet low in protein caused a decrease in lean body mass.
“There is no health-related benefit to a reduction in lean body mass,” Dr. Bray stated. That’s a bit of an understatement because, by slowing metabolism, lower lean body mass encourages further weight gain. An editorial that accompanied the report of the study in the January 4, 2012, Journal of the American Medical Association focused on the negative effect of overeating beyond weight gain.
The editorial by Zhaoping Li, MD, PhD, and David Heber, MD, PhD, Center for Human Nutrition at the David Geffen School of Medicine at UCLA, emphasized that body weight gain may underestimate the hazards of the Western diet, which tends to be high in fat and carbohydrates and low in protein. As shown in the Bray study, that diet (low protein) causes fat gain that doesn’t show up on your bathroom scale. “Accumulation of excess fat is associated with obesity related conditions, whereas increased muscle mass is beneficial because of its positive effect on metabolism,” Li and Heber explained. “Humans are better adapted to starvation with subsequent maintenance of lean body mass than they are to overfeeding, which results in body fat accumulation,” they added.
Gaining fat and losing lean body mass—which the typical American does as he or she grows older—is a prescription for disaster. On the bright side, “it is possible for patients who exercise and eat adequate protein to build lean body mass,” Li and Heber counseled. “Because muscle weighs more than fat per unit of volume, it is possible for patients to gain weight with muscle mass while reducing waist circumference and intra-abdominal fat.”
You can gain muscle and lose fat at the same time, a change that shows up in the mirror and how your clothes fit—but not on the scale. That’s a message doctors should be giving their patients.
At minimum, doctors (and everyone else) should look beyond body weight. “The goals for obesity treatment should involve fat reduction rather than simple weight loss, along with a better understanding of nutritional science,” Li and Heber concluded. Specifically, doctors should warn their patients about the hazards of eating a diet high in calories and low in protein.
* * *
All of this comes down to three simple Don’ts: 1) Don’t neglect protein intake (don’t overdo it either), 2) Don’t be taken in by complicated and onerous macronutrient formulas, and 3) Don’t overeat.
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