Diets and body composition (Review)

[Will Brink]

This new ISSN position paper summarizes what people need to know about diet and bodycomp:

International society of sports nutrition position stand: diets and body composition

Journal of the International Society of Sports Nutrition201714:16

Abstract

Position Statement: The International Society of Sports Nutrition (ISSN) bases the following position stand on a critical analysis of the literature regarding the effects of diet types (macronutrient composition; eating styles) and their influence on body composition. The ISSN has concluded the following.

1) There is a multitude of diet types and eating styles, whereby numerous subtypes fall under each major dietary archetype.

2) All body composition assessment methods have strengths and limitations.

3) Diets primarily focused on fat loss are driven by a sustained caloric deficit. The higher the baseline body fat level, the more aggressively the caloric deficit may be imposed. Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects.

4) Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands. The composition and magnitude of the surplus, as well as training status of the subjects can influence the nature of the gains.

5) A wide range of dietary approaches (low-fat to low-carbohydrate/ketogenic, and all points between) can be similarly effective for improving body composition.

6) Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition. Higher protein intakes (2.3–3.1 g/kg FFM) may be required to maximize muscle retention in lean, resistance-trained subjects under hypocaloric conditions. Emerging research on very high protein intakes (>3 g/kg) has demonstrated that the known thermic, satiating, and LM-preserving effects of dietary protein might be amplified in resistance-training subjects.

7) The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition.

8) The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis.

9) There is a paucity of research on women and older populations, as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training. Behavioral and lifestyle modification strategies are still poorly researched areas of weight management.

https://jissn.biomedcentral.com/articles/10.1186/s12970-017-0174-y

 

[user_joe]

Can't comment on #9, but the other 8 seem to be things that have remained true for decades through all the fads. Good info.

 

[Guided_by_Voices]

I would caution people struggling with fat loss and who are willing to study the topic in detail not to take the points in the posted review at face value. Almost every one of these points parrots the mainstream view and which are deceptive, glossed over and/or which have a lot of evidence to the contrary.
Diets that work long term (as in permanently) for people who are not naturally lean and who are not life-long athletes (probably about two thirds of the western population) generally share at least four key characteristics:

- They shift the metabolism toward fat burning
- They radically reduce hunger
- They maintain a healthy metabolic rate
- They eliminate chronically elevated insulin

Lower carb, high (healthy) fat diets have a major advantage for many people in all of these.

So, applying this to the points, applying caloric deficit alone (Point 3) has been consistently shown to not work well for most people in the long term. Additionally "caloric deficit" implies eat less, however if eating less (as the only variable) provokes a slower metabolic rate, as it does in most people, then it will often be counter-productive. There have been many studies on this including identical twin studies (the twin that went on the most "diets" ended up fatter than the other.) Layne Norton has talked extensively about this, as have many others. I believe every major study which has tried the eat less and move more approach without addressing the points above has failed over the long term, and the recent follow-up of the "biggest losers" weight rebound is yet another example of this. The mainstream blames this on non-compliance per point 8, (AKA people are lazy gluttons) however I can personally attest that when your body is working with you instead of against you per the points above, you are going to be far happier and more successful. The mainstream recommendations basically decrease fat burning, increase insulin, increase hunger and reduce metabolic rate, so suggesting that these are just as effective rarely works in the real world. "Suppressing adaptive thermogenesis" is actually a valid point (if I am correctly interpreting what is a confusing double negative) but it contradicts the rest of the points since most diets that rely solely on calorie-restriction promote adaptive thermogenesis (AKA a slower metabolic rate).

Like point 3, Point 5 is very deceptively worded. There is a huge difference between "can be" and "likely will be". Yes, almost every diet has worked for someone somewhere, including the potato diet, the rice diet, the starch diet the twinkie diet, etc. However my experience and understanding of the best evidence is that diets that support (minimally) the points above are most likely to work for by far the most people.

Something to keep in mind about studies is that you have to actually look at the details of the study because the headline findings in the abstract often do not accurately represent the study. For example:

- Some prominent studies that claim to evaluate a low carb diet were not low enough in carbs to trigger the major mechanisms by which low carb diets work
- Some of the studies that claim to evaluate intermittent fasting have used low calorie diets on the fasting days which have a very different and ineffective physiological affect in comparison to true fasting

Dr. Daniel Ludwig's talk (available as a podcast) from last year's Metabolic Therapeutics conference is one of the best summaries I have heard of the problems with the eat less and move more concept, so I would encourage those who want a good summary of the studies to track that down.

I could go on but my point is that people should really study this topic in detail if they have the need and be very skeptical of anything that suggests it is as simple as eat less and move more, at least for a significant percentage of people.

 

[Jinzang]

This may sound cynical, but when reading the position paper of an organization, you should know who is sponsoring them. In this case the sponsors include GNC.

 

[Will Brink]

This may sound cynical, but when reading the position paper of an organization, you should know who is sponsoring them. In this case the sponsors include GNC.

You're not going to find a sci/med org without sponsors and knowing the head people at ISSN as I do, I can tell you there's no sponsor(s) telling them what to write in a position paper like that, which is more than we can say for the government nutrition guidelines...published papers in the ISSN journal is peer reviewed and as someone who has done peer review of the ISSN, again, I can tell you no one told me anything in terms of how to do the job of reviewing a paper. Having said that, no org that has humans in involved id without it's bias. The Q is, do they support the position paper with quality data? The answer is yes too that.