A better way to lose weight – and be healthier - Cape Cod Healthcare

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Published on January 04, 2022

A better way to lose weight – and be healthier

Plant Based Diet

A new study published in The American Journal of Clinical Nutrition questions the conventional energy balance model of eating less and moving more to control weight. Lead study author David Ludwig, MD, an endocrinologist at Boston Children’s Hospital and professor at Harvard Medical School, pointed out that despite decades of promoting the energy balance model, it has been spectacularly unsuccessful in causing actual weight loss in the United States. According to the most recent data close to half of all Americans are obese and the numbers continue to grow.

The study proposes that it’s not how much we eat that causes obesity; it’s the types of food we put on our plates. Highly processed foods, especially those that are chemically altered and have their fiber removed, trick the body into perceiving an energy deficit. That causes the body to think it is starving, which then leads it to store more fat and expend less energy.

The study concludes that a better model for treating the obesity epidemic would be the carbohydrate-insulin model with an emphasis on eating a plant-based diet consisting of whole foods that are as close to nature as possible. Primary care physician Miguel Prieto, MD, at Bourne Primary Care agrees. 

“We’ve known for years that it’s not the amount you eat, but what you eat,” he said.

Dr. Prieto points to a prior study by physician and author Michael Greger, MD, that comes to the same conclusion as the new study. Greger points out that despite what the food industry would have you believe, all calories are not created equal. In other words, a calorie is not just a calorie in the real world.

Dr. Greger used the example of carrots versus Coca-Cola. In order to get the same 240 calories from carrots as you would from a can of soda, you would have to eat 10 raw carrots (the equivalent of five cups). The soda would still leave you hungry, but it would be incredibly difficult to actually eat 10 raw carrots. You would get full long before you were done with all of that chewing.

All of this points to the importance of calorie or nutrient density. Some foods have more calories per cup and per mouthful than others. For example, a tablespoon of oil has over a hundred calories. You could get the same number of calories from two cups of blackberries and you would be much fuller.

“When people are eating a regular diet and they just decrease the calories, the amount of weight they lose is not significant,” Dr. Prieto said. “It’s kind of like putting your body through hibernation. There are many things that are being studied about this. Number one is nutrient deficiency. The regular diet that is highly processed has a very high-calorie density but a very low nutrient density. So, your body is in starvation mode and you keep eating and eating and eating.”

Dr. Prieto also pointed out that processed foods are not filling because they don’t have any fiber in them. Americans tend to be fiber deficient, he said. That can have implications for both physical and mental health.

“The different fibers that you eat actually feed the microbiome, the flora bacteria in your gut,” he said. “And depending on what bacteria you have, they release certain compounds and some of those compounds significantly increase the incidence of depression, anxiety, autoimmune diseases, and so on. There are more and more studies about eating the right food to improve behavioral health.”

Another problem with processed foods is they are usually composed of a combination of processed carbohydrates, which are devoid of nutrition and have a high glycemic index and fat content. That, in turn, negatively affects triglyceride levels. A triglyceride is simply one sugar molecule (the glycerin) with three fats attached to it.

“That combination is extremely sticky,” Dr. Prieto said. “It’s just like when you have cinnamon buns, they coat them with butter and sugar and they’re sticky. That stickiness with triglycerides increases plaque formation. They clog the blood vessels and they clog the function of many of the receptors. One of the receptors that is clogged by the triglycerides and saturated fats are the receptors for insulin.”

That leads to insulin resistance, which then leads to weight gain. Highly processed foods also cause an inflammatory cascade in the body, which also can lead to an increased risk of diabetes, heart disease and obesity.

“We tend to focus on weight, but excess weight is a secondary thing,” Dr. Prieto said. “It’s not the issue. It’s just a manifestation of it. For example, if you have mold in your bathroom and you just concentrate on eliminating the mold versus thinking about what is triggering the mold to grow, and then addressing the root cause.”

In the case of obesity, attacking the root cause has a simple solution: eating a plant-based diet that focuses on foods that are fresh and found in nature.

“Cookies don’t grow on trees, so you don’t eat that,” he said. “When you eat natural foods, your body processes them well and those chemicals don’t interfere.”

Dr. Prieto follows his own advice. He has eaten a plant-based whole food diet for several years now. For him it’s not about weight; it’s about living healthier with a better quality of life.

“It certainly enhances weight loss if you are eating properly, but for me it’s not about the weight loss,” he said. “Skinny people die too. It’s not that the weight loss is the goal. It’s just the means by which you don’t have to see a myriad of doctors and have to do a multitude of procedures and so on.”