A Study published in the Journal of the American Medical Association (JAMA)1 has highlighted that science may have invested a lot of money on a dead end when it comes to resolving the obesity question and perhaps should look more closely at lifestyle change. Every variation and combination of carbohydrate (CHO) including, high GI, Low GI, low CHO intake, high fibre has been researched. High protein, low protein, specific proteins and fat has also had most variations examined at one time or another; and yet despite these numerous studies, some of which produce quite good results, others really finding not much difference when you consider long-term outcomes the results do not make good reading.
The ability to keep weight off, or should I say fat with just about all these studies is poor if not insignificant when you examine three year and especially five year follow up. They have all demonstrated varying amounts of weight loss the mean differences are as small as 1kg and are also inconsistent. There have been four meta-analyses more recently and these have studied and included somewhere between 13 to 24 trials in each instance. The degree of participation and whether goals for diet or activity were met showed the strongest correlation with weight loss and this was the only thing that could be consistently demonstrated. If when you follow a programme you are losing weight the fact that you stick with the programme is not really a very surprising finding. What these meta-analyses have exposed is that there really isn’t one specific dietary regime that has any efficacy in the long-term.
The article in JAMA then goes on to consider that spending more money researching differing combinations of macronutrients in any variation is not too likely to produce any findings that would significantly advance our understanding of how best to deal with the obesity epidemic. Most research that has been undertaken and in some cases repeated has ended up producing very similar outcomes. What is really required is a far greater understanding of the behavioural, biological and environmental factors associated with establishing and then most importantly maintaining a lifestyle change. These lifestyle changes have to encompass both diet and physical activity/exercise.
One of the most important factors in making any change to behaviour is psychological readiness. My research, which was conducted both in the UK and New Zealand, has found that if an individual is not psychologically ready to make a change there is a strong possibility that they will fail long-term. By assessing an individual’s ‘readiness to change’ I could predict who was likely to be successful at losing weight. The LEAN Man System (www.leanmansystem.com) uses the assessment of psychological readiness as a foundation for the whole programme. Future research into weight management must look at how people make lifestyle changes and most importantly how they then sustain this change in behaviour. It is evident that many combinations of foods can possibly assist fat loss but if these combinations are not sustainable then long-term they are of no use. You must be psychologically ready to change your behaviour (lifestyle) and the changes you make you have to make for life. Therefore from a dietary perspective they have to be both sustainable and realistic.
It might just be time to stop studying diet and start concentrating more on lifestyle change. The evidence from the past twenty years seems to indicate that this is the case. If you would like more information about nutrition and weight loss the simply complete the simple form below to receive seven FREE videos.
- Pagoto, S.L. and Appelhans, B.M. (2013) A Call for an End to the Diet Debates. Journal of the American Medical Association. 310 (7); 687-688.