Layout of wide selection of wholesome healthy foods on white

Weight Loss Is About Diet Quality, Not Quantity

Whole Foods 300x199 - Weight Loss Is About Diet Quality, Not Quantity


If you, or someone you know, has ever tried to lose weight, chances are it’s been all about portion control, counting calories and measuring.


I get it. I’ve done it. For myself and for patients/clients.


I was ‘schooled’ in the now antiquated notion of calories in/calories out, a.k.a. “energy balance”


For that, I apologize. Both to my clients of yesteryear and to myself. A new study in the Journal of the American Medical Association continues to support the idea that when it comes to diet (the overall food pattern you eat), and calories, quality and not quantity, is more important.


Are all calories created equal?

Don’t get me wrong, calories do count. Eat too many and you’ll gain fat. Cut back, and you’ll lose weight. That’s not a matter of opinion but a matter of fact. Some of you may remember the professor who lost weight on the Twinkie diet? A highly processed food product yes, but he was able to tightly control the number of calories he ate. But let’s face it, that doesn’t really cut it in the real world.


Twinkie Diet helps nutrition professor lose 27 pounds 


But there is a difference in how your body ‘metabolizes’ calories depending on where those calories come from. Food quality also influences how ‘satisfying’ those calories are which influences eating over the long run.


This is consistent with other research that has shown that the body uses more energy to digest whole foods than it does processed foods. With processed foods, much of the “digestion” has been done; the body doesn’t require much effort to digest refined foods.


Halibut Stew with Chorizo and potato in a bowl with bread 300x225 - Weight Loss Is About Diet Quality, Not Quantity


In this latest study, the quality of food choices (e.g. minimally-processed/refined, whole foods versus highly processed) influences weight loss over the course of a year.


Those who cut back on added sugar, refined grains, juice, and highly-processed foods etc. while focusing on nutrient-dense foods like fruit, vegetables, meats, fish, lentils, nuts and seeds etc. lost weight without worrying about counting calories or portion control.


Participants also lost weight whether they followed the lower fat/higher carb or the higher fat/lower carb diets. The ratios of ‘macros’ [fat, carb & protein] didn’t matter.


Postprandial energy expenditure in whole-food and processed-food. Implications for daily energy expenditure


Is destiny written in our genes?

This strategy of focusing on diet quality also worked regardless of their genetic make-up. Researchers looked at 3 different genes (PPARG rs1801282ADRB2 rs1042714, and FABP2 rs1799883) that are involved in fat and carbohydrate metabolism. Previous studies have suggested that these genes will influence weight gain/loss in response to the amount of fat and carb in the diet.


This better designed study casts doubt on previous (retrospective) studies (not the best study design) that have tried to link genetics to one’s tendency of weight gain and weight loss based on their genes. This nutrigenomics approach has been marketed to personalize a person’s unique intake of carbs, fat and protein for individualized weight maintenance plans.


It seems that recommending different diets based on people’s DNA makeup or their ‘tolerance’ for carbs or fat isn’t that straightforward.


Cornflakes and skim milk 300x200 - Weight Loss Is About Diet Quality, Not Quantity


Diet quality needs to be qualified

The subjects in this study were divided into one of two groups: “healthy” low fat, and “healthy” low-carb.


Soft drinks, fruit juice, and muffins made white flour, with some of the oil being replaced by applesauce, rice cakes, white rice and Special K or Corn Flakes are all “low fat” but they’re also lower in quality when it comes to vitamins, minerals, phytonutrients, protein, and fiber. “Healthier” low fat foods used in the study were brown rice, quinoa, fresh fruit, 1% milk and yogurt, barley, steel cut oats, lentils and lean meats.


Likewise, “healthier” low carb foods included salmon, avocado, hard cheeses, Non Starchy Vegetables , nuts/seeds and nut butters and not bacon, butter, fat-bombs, low-carb bars or shakes. It is possible to eat these poorer quality lower-fat and lower-carb foods and lose weight but it’s definitely MUCH more difficult given their piss-poor ability to promote and maintain a sense of ‘satiety’ after eating and in between meals.


Neither group increased their overall physical activity and rather than strict guidance on calories etc but were rather coached on focusing on whole or “real” foods [code for no highly processed foods], and to eat until satisfied and not hungry. Researchers never set a number for subjects to follow.


Effect of low-fat diet interventions versus other diet interventions on long-term weight change in adults: a systematic review and meta-analysis.


Some people did gain weight in the study but on average, there was significant weight loss; some lost between 50 and 60 pounds or 23 to 27 kg. Low-carb group lost 13 pounds while those in the low-fat group lost about 11.7 pounds. Pretty much dead even.


Those who lost weight reported  that the study helped them to “change their relationship with food” which is a massive shift in the behavioural aspects of eating.


While not a new concept, there is a difference between low fat eating when it comes to quiona, lean meat and vegetables versus low-fat brownies or low-carb chips compared to an egg.


Like most things in life, it’s quality that really counts…


As well, eating minimally-processed whole foods is a preferred way to help manage weight not only because they are metabolized differently but because they are ‘self-limiting’. It takes longer to eat whole foods; they take more bits and chewing, they force you to slow down and fill you up faster. Trying comparing how long it takes you to eat a Big Mac (4 bites if you’re honest). You’d have to eat about 8 medium apples to get the same number calories from the highly processed hamburger. A concept that’s leverage in the eating plan from a few years ago called “Volumetrics”.


The more you focus on quality, the greater the odds that poorer quality foods will be displaced from your daily fare and the details will start to take care of themselves.


Quinoa Porridge 300x200 - Weight Loss Is About Diet Quality, Not Quantity


Doug Cook RDN is a Toronto based integrative and functional nutritionist and dietitian with a focus on digestive, gut, mental health.  Follow me on FacebookInstagram and Twitter.