Before the next diet decision

Ketogenic Diet Does not

Here is the little secret about dieting: All diets work until you inevitably fall off the diet bandwagon. Thankfully, against our frustrations but for the sake of our survival, the biology of weight abhors loss, be it in the face of uncertain food environments in the traditional societies or in the unprecedented abundance of the developed world. This explains why the hunter-gatherers maintain the same body weight all their adult life even in the austere environments. Humans have high metabolic rate but are endowed with uncanny ability to store fats to fuel the daily energy expenditure in the absence of intestinal sources of energy from hours to several weeks. While there is a limit to the amount of glycogen or “body starch” that the body can store, there is no hard end to how much fat the body can accomodate. If you feed the body incessantly there is always a space to deposit the unused energy as fat.

As bluntly put by Herman Potzer, the author of Burn: “There is no other way to gain weight…every calorie of fat you carry is a calorie you ate and didn’t burn off.” Herman also corrects our universally misconception about the biology of weight by stating that the body was not designed for a “beach-ready bikini body” or to keep us fit and healthy but to survive and reproduce. Therefore, even at the risk of chronic diseases, the body would continue to store unused energy, even if excessively, solely for anticipated future survival which in modern times never comes. According to CDC, a whopping 73.6 percent of Americans aged twenty and over are either overweight or obese. On a lighter note, if there were Weight Police, a whole lot of us would have steep fines to pay as most carry a few pounds more than indicated on their driver licenses.

The innocuous mention of the word fat could threaten relationships and often comes off as insensitive with feelings badly hurt. Just like some of us get frustrated with computers, especially on the days the system decides not to work, the biology of fat equally has no emotion and works against your sincere attempts at losing weight. This inevitably creates opportunities for all kinds of diet programs promising all you can eat with guaranteed weight loss. There is also the Diet Wars among low carb, high fat die-hards and everything between. I must confess, while I am no disciple of high fat or high carb followers but incline to high fat diets as a nutritional intervention for people with diabetes, admittedly, I have appeared to downplay calorie in the past, especially since calorie cannot be accounted for in the multiple biochemical pathways of metabolism. As they say in Hausa language: Na tuba (I’m sorry!). Afterall, there is something, in fact a whole lot, to energy balance: Energy you do not burn, be it from carbohydrates or fats, would be stored as fat.

Man has realized over the millennia that all foods work and has been aptly described as opportunistic omnivore by eating any kind of foods available with no preference for any macronutrients. A 2005 diet study randomly assigned 160 people to Atkins (carbohydrate restriction), Zone (macronutrient balance), Weight Watchers (calorie restriction) and Ornish diet (fat restriction). At the end of one year, no diet was any easier to adhere to, but adherence led to modest weight loss irrespective of diet. In a head-to-head ketogenic versus high carbohydrate diets, a 2018 study randomly assigned 609 non-diabetic healthy overweight or obese individuals to low-fat versus low-carbohydrate diets. At 12 months there was no significant difference in weight loss between the diets indicating no superiority of one diet over the other.

In fact, you can lose weight on crappy diets. Few years ago, magician Penn Jillette lost more than one hundred pounds on boring potato menu called “monotrophic diet.” Sure enough, people get tired of eating same old thing and end up eating less and less. To prove its about calorie, Mark Haub, a professor of human nutrition went on a junk diet by eating twinkies, nutty bars and powdered donuts for 10 weeks but limited his daily calorie intake from 2,600 to 1,800 calories per day. While this is probably unhealthy, it is also very unrealistic to limit calorie intake on ultra-processed foods which is the main reason for this article. That said, Mark lost seventy-two pounds on low calorie “convenient store diet.”

The greatest impediment to weight control is the “Garden of Eating” we have created with exposure to varieties of cheap palatable foods that are failing our ancient satiety signal. The brain, specifically, the hypothalamus is bombarded with the overwhelming task of balancing intake and expenditure with exposure to unprecedented pleasure rewarding circuitries of ultra-processed foods, a phenomenon called sensory specific satiety. For instance, one may be absolutely full on a main course meal but would not have problem making room to satisfy the firing sweet neurons for desserts. We have so much to the point that we have aligned ourselves into a tribal line of high fat versus high carb faithful and the unsuspecting lay public are bombarded with all kinds of fad diet programs that are chasing their hard earned currencies. Thrown in the mix are promises of age defying “superfoods” that are supposed to keep us young and healthy forever.

The diet and weight loss programs are estimated to be a 71-billion-dollar industry, but studies show that 95% of diets fail. As we have seen, the problem with weight loss is not entirely the refined sugar from your soda drinks, donuts or doritos, it is the unprecedented exposure to highly palatable foods that keeps us wanting more. Again, quoting Herman Pontzer, who has worked with Hadza hunter-gatherers for over a decade: “Hadza food isn’t very exciting. Aside from the honey and some of the tangy fruits, it’s all quite bland. Spices are unheard of …Nearly all the food is served on its own, either raw, roasted, or boiled…not what most Westerners would describe as tasty or even appealing.”

Contrast that with food commercials on your TV or the glossy pictures of foods shared on social media and magazines. In the end, volume matters, for the dose makes the poison, as they say in toxicology. You may choose calorie restriction, high fat, high carb diet or fast intermittently, all diets work but in the long run, and in no different from covid exposure, be mindful of your food exposure. That is the crux of the matter.

 

Mukaila Kareem, a doctor of physiotherapy and physical activity advocate, writes from the U.S.A and can be reached through makkareem5@gmail.com

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