Blog | Monday, November 22, 2010

The twinkie diet


"Hey ... where did those cupcakes go?"

Like a never-ending western North Carolina climb where each switchback reveals another uphill, and the finish is shielded by tall pines, the struggle to lose weight and to stay lean is incessant.

In wrestling weight gain, competitive cyclists share the same mat as "regular" Americans. Like jockeys, all competitive bike racers strive for maximal leanness. It's physics: Weigh less and the same number of watts push you farther and faster, especially when going uphill or accelerating from a slow speed. Remember those velocity problems in Physics 101?

But is it conceivable that losing weight, even if accompanied by lower cholesterol levels, could be detrimental to long-term wellness? Obviously, the question answers itself.

Unless your Internet connection has been interrupted in the last few days, you have probably heard of the "Twinkie diet." Kansas State University nutrition professor Mark Haub tested the hypothesis that if he reduced his daily calorie consumption from 2600 to 1800 he would lose weight.

Here's the cool part: To amplify his findings that calorie restriction is all that is required to lose weight, he primarily ate a convenience-store diet. Calories came from processed food, high in trans fat and high fructose corn syrup--the worst of the worst. Oreos, Hostess cakes, Little Debbie snacks, sugary cereals and Doritos were his staples. (He ate vegetables in the presence of his kids.)

The results were incredible. It worked. Not only did he lose 27 pounds, but he also markedly improved his cholesterol level and lowered his total body fat percent. Stunning. Despite the high-calorie inflammatory content of his food, faithfully adhering to a daily calorie restriction resulted in weight loss.

The message is that potato chips do not cause fatness, regularly eating the whole bag does. A few M&M's are okay, just not hundreds of them.

A master of the obvious is Professor Haub. He isn't saying he is any healthier, no one would argue that. He just makes it harder for the dietary perseverators, the nutritional elite, the peddlers of weight loss scams, to make a simple solution complex. Sorry.

It's a quandary isn't it: We want our obese patients to lose weight, but we cannot advocate junk food as the main entree. We want both fewer calories and more nutrients.

Reducing inflammation is the key to heart health. Keeping blood vessels healthy comes from good sleep, regular exercise and a good diet. Regularly eating inflammatory trans-fats and insulin-spiking high glycemic snack foods will surely negate the positive effects of weight loss.

But at least Dr. Haub has helped doctors shorten the coaching session part of an office visit with an obese patient. To the commonly heard phrase, "Doc, I really don't eat that much," we can respond--compassionately--that studies show that if you eat fewer calories you will lose weight.

In discussing "these studies" with our patients it will be best to omit the methodology section of Dr Haub's experiment. No worries, we are now a headline-only society anyways.

Seriously. Who ate those cupcakes?

This post by John Mandrola, MD, appeared at Get Better Health, a network of popular health bloggers brought together by Val Jones, MD. Better Health's mission is to support and promote health care professional bloggers, provide insightful and trustworthy health commentary, and help to inform health policy makers about the provider point of view on health care reform, science, research and patient care.