news story today - 500 calories

[Catrin]

Apparently there has been a study where they put a group of obese people on a 500 calorie diet for a couple of months and found it helped their cardiac health.

Setting aside their comments on the effect of such a restrictive diet on their heart health, how can this be a good idea? 500 calories is pretty darn close to starvation level, and that is without physical effort - OF COURSE they lost weight, who wouldn't? They found that the participants did lose fat around their heart, but what happens once they start eating a normal diet?

[Pax]

How does that not destroy their metabolism??

[Biciclista]

I bet they are extremely obese and were monitored in a hospital. The body is capable of amazing things. but your last sentence what happens after they start on a normal diet... you know what will happen... unless they change their lifestyle.

[pll]

Seems to be this one?
http://www.marketwatch.com/story/res...tes-2011-11-28

The patients had diabetes and very high BMIs. And the sample (15) is tiny...

I think just my breakfast has more than 500 calories, but my BMI is close to the lower bound of normal and I am relatively active.

[Catrin]

At the end of the short report, they said that the participants kept the heart-health benefits even if they gained a "little" weight back (define little). PLL thanks for looking that report it, it has to be the same one.

Hopefully the participants were encouraged to become more active after the study was over and were helped to adopt a more sustainable diet.

[TsPoet]

Years ago someone did a study that showed that starving mice resulted in much longer lives. The mice were extremely calorie restricted and emaciated, but they lived.
The conclusion was, um, er, never mind. (that's my interpretation of the conclusion).

[Catrin]

Years ago someone did a study that showed that starving mice resulted in much longer lives. The mice were extremely calorie restricted and emaciated, but they lived.
The conclusion was, um, er, never mind. (that's my interpretation of the conclusion).

That's right, I remember that now. I also remember a small study of monastics and hermits in Greece who consume very little, and they found an increased lifespan for them as well.

[Melalvai]

I've heard that rodents on a restricted diet live longer.
Quantity vs quality of life.

[Susan]

Why didn't they just put them on a healthy diet to the same effect? The study just shows that everyone starves on 500 calories a day and in so, loses fat, even fat people... surprise surprise. I don't get the point of such studies.

[pll]

We are focusing on the weight issue. One significant result of the study was that all the participants (all had diabetes type 2) stopped needing insulin injections. That in itself might be a motivator for them to stick to the 500 calories regime.

[OakLeaf]

But I wonder what the activity level is/was for any of these groups - the study participants, the mice, the ascetics.

The picture I have in my head of the ascetics is people spending the day in stationary prayer and meditation, eating so little because it is what they get from begging, but also having an extremely minimal caloric burn, sweat rate and micronutrient requirement (unlike other types of monks who subsistence farm as a form of strenuous active prayer).

The abstract of the paper isn't online yet, but Medscape has a summary. It doesn't mention activity level at all. And it's too early for me to bother looking up the mouse study.

It's notable too that the study was done by radiologists and primarily focused on pericardial fat and heart function. Heart function regressed along with the weight regain in the follow-up period, but pericardial fat returned at a significantly lower rate. I'd like to see endocrinologists' and exercise physiologists' take on this. I don't doubt that getting off insulin is major. But the summary says over and over again how highly motivated the study participants were and how dangerous the regimen was, how it should be undertaken only under strict medical supervision.

The fact that all the hoopla in the press is about the weight loss and glucose tolerance, when what they were actually studying was heart function - well....

I just can't imagine that a diet like this would provide enough protein, electrolytes, vitamins or minerals to sustain activity. Bare calories for ADLs and gentle exertion can come from body fat, but what about asking these people to raise their heart rates? And were they getting most of their nutrition from pills?

I know what I need when I'm in even a minimal training cycle, and I know that even when I'm in the peak of marathon training, my daily activity is LESS strenuous and less sustained than humans evolved for. I think it's basically only the Iron men and women who exert themselves as much as every one of our ancestors did every day. I just don't see it.

[Dannielle]

at some point a line is crossed where the risks of extreme obesity outweigh the risks of extreme dieting. for the average person who has a few pounds to lose it wouldn't be the wisest way to go...there are better options. but I can see how for the extremely obese it might be a valid option. it's certainly less risky than gastric bypass surgery.

I do have some personal experience with calorie reduction to a point some might consider extreme. Never had a problem with nutrient levels or protein or anything like that (my Dr monitored vitamin/mineral levels and I tracked macronutrients daily so I know protein needs were met). I was able to exercise just fine. No energy issues at all.

And I haven't regained any of the weight lost during that time. I gradually raised calories as I got closer to my goal and my weight actually settled about 20lbs below where I was when I raised calories to a maintenance level.

[lph]

To answer the original question - this is a good idea because/if/when it teaches us something we didn't know, or gives a definite answer to something we've been guessing at until now. And I don't think the question really was "will they lose weight". I think it was more along the lines of "is it possible, by extreme measures, to kick-start a process that saves lives but that also takes a long time, has a high drop-out percentage and is risky because people can actually die before they get that far".

Personally I think it's fascinating that short-term intervention can have such drastic results on serious medical problems. I hope it can get put to good use somehow.

[Dannielle]

that's exactly it! there's a point where making a change...any way, any how...is the most important thing. and getting out of a place of extreme unhealthiness as quickly as possible trumps learning to eat in a sustainable and optimal manner (that's important too but can come later).

When I first began losing weight I had to lose 70lbs before I could walk one mile. And I mean before I could accomplish a mile walk. It was too taxing to do regularly. It took 2 days in bed to recover from the effort.

I was so unhealthy that losing one pound per week would have kept me at a dangerous weight for YEARS. When you have 20lbs to lose a pound a week makes sense. When you have more than 200lbs to lose it doesn't make as much sense.