Could advising people to eat less and exercise more INCREASE their risk of getting fatter?

Some time ago one of my blogs focused on the thoughts of Dr Andrew Wadge – Chief Scientist at the Food Standards Agency (FSA) in the UK. The blog specifically focused on his broadside at ‘detox’ regimes. I can understand that someone may be a bit sceptical of such regimes. However, if Dr Wadge wishes to express his withering attitude to such regimes, bearing in mind he is the CHIEF SCIENTIST (emphasis mine) at the FSA, would it be too much for him to use some actual science making his case? In reality, he uses none – not one study or citation. Nothing.

Earlier this week, I came across another of Dr Wadge’s blogs. It concerns a piece that appeared in the Daily Mail. The piece was an extract of a book entitled Big Fat Lies by Hannah Sutter. I know Hannah and like her. She started a company (Go Lower) that makes low carbohydrate foods. I’m generally supportive of low-carb eating, and am broadly supportive of Hannah’s work. I have not read Hannah’s book, but I did read the extract of it in the Daily Mail. You can read this piece here.

Dr Wadge’s blog post starts with this sentence

“Despite the absurdity of Hannah Sutter’s proclamation in Saturday’s Daily Mail that government advice to ‘exercise more and eat fewer calories’ is making people fat, I felt I had to respond.”

In his response, Dr Wadge invokes the calorie principle. He trots out the usual concept that weight control is all about calories in and calories out. Yet, in the Daily Mail piece, Hannah Sutter claims that we’re eating less and exercising more and actually getting fatter. She might be right. She might be wrong. According to Dr Wadge’s theorising, though, she must be wrong. And yet, he does not provide a single scientific study or piece of research that disproves Hannah Sutter’s assertion.

Central to Hannah Sutter’s argument is that carbohydrate is a major driver of obesity, because of its influence on the ‘fat-making’ hormone insulin. Dr Wadge does not engage at all with this key concept.

Hannah Sutter also takes a swipe at the oft-quoted idea that exercise promotes weight loss. For the most part, aerobic exercise is quite ineffective in this regard, and I think she’s right to point it out. You can read more about this here. Again, Dr Wadge does not engage with this from a scientific perspective.

What he does do, though, is draw our attention to the fact that Hannah Sutter owns a “website selling a weight loss programme”. This is a conflict of interest, I suppose. But such a conflict is most relevant if Hannah Sutter’s ideas can be demonstrated to be false. As yet, Dr Wadge seems unable to do this in any meaningful way.

It seems somewhat ironic to me that he appears to discredit Hannah Sutter by pointing out that she is a “lawyer and not a scientist”. But it’s clear from the extract that Sutter’s book refers copiously to the science. Dr Wadge does not. At all. Since when did scientists get a ‘free pass’ – a right to say what they like without validation just because they are a scientist?

The comments that come after this blog post are generally sharply critical of Dr Wadge and generally point to science which, again, Dr Wadge steadfastly refuses to engage in.

The fact is, there is a plausible way in which the advice that people should be eating less and exercising more might be fuelling the burgeoning rates of obesity. Eating less calories for a lot of people translates into ‘eat less fat’. Why? Well, because we’re constantly reminded that a gram of fat contains about twice as many calories as carbohydrate or protein. But a low-fat, high-carb diet (as encouraged by the FSA and most health professionals) tends, as Hannah Sutter points out, to disrupt blood sugar levels. The resultant surges of insulin are fat-making in the body. Plus, disruption in blood sugar can lead to blood sugar lows which cause us to be hungry – especially for carbohydrate (as so the cycle can repeat). Plus, carbohydrate foods, compared to those rich in protein, sate the appetite less overall. In short, encouraging people to eat a few calories and emphasise carbohydrates can drive people to overeating the very foods that are most fat-making in the body.

And what of exercise? Well, as I detail here, the calorie burn during exercise is generally quite modest. Plus, when people exercise more, they can find it quite difficult not to eat more as a result. A look at the evidences supports Sutter’s stance that conventional advice just doesn’t work.

Dr Wadge’s opinion appears to be that the failure of the advice stems from individuals not following that advice. His blog ends with this sentence:

“I’m surprised that Ms Sutter didn’t consider that perhaps it’s the people who aren’t following government advice are ones who are getting fatter.”

I wonder if Dr Wadge has ever considered the fact that its the advice and theories on which governement advice is based that might be flawed?

Dr Wadge has exposed himself here as he did before regarding detox regimes. So great appears to be his bias that he feels it unnecessary to engage with actual science to make his point. I notice that Dr Wadge’s blog goes under the name “hungry for science”. Yes, quite.

For more details on Hannah Sutter’s book see here.

Dr Briffa’s new book – Waist Disposal – the Ultimate Fat Loss Manual for Men – is now available. To learn more about the book click here.

To buy Waist Disposal from click here.

11 Responses to Could advising people to eat less and exercise more INCREASE their risk of getting fatter?

  1. Arthur Davidson 31 March 2010 at 10:05 pm #

    Dr. Briffa,

    I am interested in the details of one piece of supporting evidence for the bias in favor of carbs over fats for weight loss: the energy density. Everyone uses the energy per gram to argue that carbs should be more filling with fewer calories, by a factor of about 2.

    On the other hand, it seems to me that the stomach does not weigh its contents, but might be sensitive to its volume. So we should ask what is the energy content per unit volume of food, not per gram.

    So we want to know the grams per cc of fats vs sugar. Anyone with experience in a kitchen will know that when sugar is added to water it sinks, while fat of any type floats, so we know sugar is denser. A little poking around on the internet shows the volume density of sugar is about 1.5, while fats come in at around 0.92. Thus, though fats have twice the energy per gram of carbs, they have only 60% of the grams! This means that fats have only about 20% more energy per unit volume than carbs, in the lab.

    In the stomach sugar dissolves while fats don’t. Thus the energy density difference per unit volume between them in the stomach is probably negligible.

    To me, this argument dissolves any presumptive justification against a high fat diet for weight loss.

    Am I on to something?

    Arthur Davidson

  2. Bill 1 April 2010 at 3:00 am #

    I’ve added Wadge’s blog to my favourites, in the “opposition” folder. I will definitely be commenting.
    I despair that people like him are setting strategies to improve the nation’s health.
    All these so-called eminent, highly qualified doctors, many influenced and coerced by corporate pharmacy and the food supply chain.

    We may be facing difficult times ahead as a nation, and as budgets are squeezed I’m going to make sure I do my best for my health, proactively.
    I’m not waiting for vitamin D3 to be officially approved and supplemented properly. Life’s too short.
    As for saturated fats…….
    Thank goodness we have the internet, and wonderful resources, unselfishly provided for the greater good by the likes of Dr Briffa.
    n=1 Look after yourself, cos nobody else will do it for you.
    Paleo for life.

  3. Margaret Wilde 2 April 2010 at 12:52 pm #

    Calorie counting and advice about increasing exercise to reduce obesity are ineffective, counter-productive and often damaging. – See the article in the British Medical Journal of November 2003 for actual research on what happens when this advice is followed! – Over 800 obese adults were put on energy deficit diets, given diet sheets and plenty of instruction and help from trained staff, and apparently, visited fortnightly for a year, at the end of which they had GAINED weight! This mirrors the real experience of obese people, viz. – dieting makes you fat.

    It is commonly accepted now, except by the ‘experts’, that less than 5% of dieters actually lose weight, and most gain weight as a result of dieting. – Even the ones who manage to lose weight do not usually improve their health. – See,11381,1515455,00.html for a report in The Guardian of Monday, June 27th 2005. It is about a huge research study of nearly 3000 people over a period of 18 years. The study found that overweight people who diet to reach a healthier weight are more likely to die young than those who remain fat. It also found that dieting causes physiological damage that in the long term can outweigh the benefits of the weight loss.

    Contributing to the increase in obesity we have the widespread prescribing of steroids and HRT and other drugs which cause weight gain, aka fluid retention, and the failure of many doctors to adhere to the protocols connected with the prescribing and monitoring of steroids. But pre-eminent, in my opinion, is the catastrophically damaging calorie-reduction advice that continues to be given despite such a wealth of evidence that it is bad advice.

  4. Mack Parnell 2 April 2010 at 2:35 pm #

    I am a true believer in the calories in and calories out theory but am not a believer of the standard cardio based way of burning the calories. As a personal Trainer I have experienced great results by cutting out the flat line medium intensity cardio that is commonly known as the fat burning zone and replacing it with high intensity short bursts of exercise.
    High intensity interval training is often avoided because its quite hard work but it the best for keeping your muscles strong and healthy. Coupling this with high protein low carb diet your muscles stay in great condition. Having more muscle versus fat makes you body much more efficient at controlling its weight.
    I think the big problem is the mix most people take on is the low fat low protien high carb and minimal amounts of fat burning cardio.

  5. Catherine Dignan 2 April 2010 at 2:41 pm #

    Surely only about 25 per cent of fat burning is determined by activity levels, while the other 75 per cent is determined by an individual’s resting metabolic rate, which in turn depends on the ratio of muscle to fat and on other genetic or metabolic variations. It used to puzzle me why my friends who beetled about in their cars were stick thin, while I who out of necessity walked everywhere was not. Targeted exercise aimed at increasing muscle mass should therefore be an effective tool, but is not the whole story.

    The main story for many individuals is control of insulin which is achieved by restricting carbohydrates and ensuring a balance in favour of protein with each meal. Fats are not only essential to health but incredibly useful in insulin control and therefore hunger. Those who become insulin resistant through (for that individual) over-consumption of carbohydrate (doesn’t seem to matter whether the carbs are refined or wholefood) will have a hard time of it trying to lose weight on the “low fat, high carb” regimes beloved by establishment thinking.

    Replacing fats with sugar, or anything that converts more quickly to sugar such as carbohydrates (refined or otherwise) and raises insulin levels too much on a regular basis or even worse – keeps them elevated – doesn’t make logical sense to me and I’m no scientist.

  6. Carol 2 April 2010 at 3:28 pm #

    I’ve posted a number of comments to Wadge’s blogs and none have ever been posted. I have questioned the FSA links to the processed and junk food industry and asked why they still recommend carbs as the mainstay of an allegedly healthy diet. The FSA Nutrition Strategy committee is populated by:
    Gavin Neath, Global CSR Director of Unilever UK
    Salman Amin, President of PepsiCo UK & Ireland
    Steven D Esom, Director, Food Division, Marks and Spencer
    David Cheesewright, Chief Operating Officer, Asda
    Sir Alexander Macara, President of the National Heart Forum
    Peter Vicary-Smith, Chief Executive of Which?
    Justin King, Chief Executive of Sainsbury’s
    Lord Whitty, Chairman of the National Consumer Council
    Ian El-Mokadem, Managing Director of Compass
    with this kind of influence, why should we expect science?!

  7. Neil Fiertel 2 April 2010 at 9:22 pm #

    I was recently diagnosed as pre type 2 Diabetic and saw two dieticians and as well a nurse trained in nutrition as well. I received complex and barely consistent dietary advice, some of which I felt goes against rational or scientific understanding of physiology but misses the principle that we evolved as omnivore/hunter gatherer creatures and not herbivores. I was told consistently to eat a small potato/ whole grain bread or equivalent with each meal. One suggested six small meals a day or three with three snack and the other three meals consisting of a certain number of grams of carbs for each of them..more that I would ever want to eat..ever. I used my own judgment and I found an very detailed science based article regarding the role of protein and fats as well as carbs in energy usage in the body which showed through our physiological uptake that carbs are burned first and fats second but if there are too much of either, they will be stored. Well, we sort of knew that intuitively BUT proteins have no storage site in the metabolism of humans and thus any that are excess to the needs of muscle maintenance are broken down and the energy from them is used for metabolism and are never stored as gained weight. The argument calls for low saturated fats due to the correlation with atherosclerosis which may or may not be really proven BUT the addition of polyunsaturated fats/monosaturated fats but in lowish quantities and a definite decrease..substantial decrease in carbs in any form AS THERE IS NO EVIDENCE WHATSOEVER THAT IT MATTERS A JOT WHETHER THE CARBS ARE IN SUGARS AS IN JUICE OR SO CALLED COMPLEXES SUCH AS PASTA OR WHOLE GRAIN BREAD..THEY ARE FOUND RAPIDLY IN THE BLOOD ANY WAY YOU EAT THEM! For a person trying to maintain a steady and low blood glucose level the eating of more than a very modest amount of carbs is counter indicated by this result and eating a more reasonable protein rich diet along with oils found in nuts and avocados, fatty fishes and so forth gives one essential fats and proteins and little rapid uptake carbs. THE SPURIOUS AND UNSUBSTANTIATED ARGUMENT ABOUT EATING TOO MUCH PROTEIN AND THAT IT WILL DAMAGE THE KIDNEY IS NOT A CLINICAL FACT AT ALL AND THOSE THAT HAVE KIDNEY DISEASES ARE AN EXCEPTION TO THE ADVICE BUT THAT A PERSON WITH NORMAL KIDNEY FUNCTION DOES NOT DAMAGE THE KIDNEYS EATING HIGHER PROTEIN DIETS. NOTE I SAID HIGHER PROTEIN AND THE REMAINDER BEING MORE FATS THAN CARBS. As I need to lower my blood sugar and am overweight substantially I must admit I considered the idea of dieting a horror and when I tried to follow the insane carb counting nonsense of the dietary professionals I knew immediately that it will come to nothing for me at least. I have modified the diet to be protein rich and carbohydrate reduced but not an Atkins extreme. For example I eat five piece of fruit each juices which were formerly a large part of my drinking habits and have substituted only water and tea and unsweetened soy milk. I get much of my fibre in a cereal which is as close to horse food as possible with unsweetened youghurt (and thus very low carb) and the rest of the day, meals are small and scattered and are high in vegetables and legumes, fish or chicken and fruit scattered about. In 6 weeks I have lost 7 kg. I am not dying to eat all the time, I feel better than I did before, I do not crave sweets at all, am sated after a meal of legumes and salad and have come to like the soymilk. If I need a snack it is an apple or perhaps a spoonful of peanut butter ( pure and unsalted). Did I say a low salt diet? No I did not but I will say it here. I eat canned fishes often and they are sometimes saltier than I would like but that is the only salt that I have in my diet and thus overall that is contained. Potassium input is good from the raisins at breakfast or the prunes I often eat as the snack ( 3) and my fish meals. I am being specific about the food choices as one will note the low levels of fats also but the higher levels of good proteins in such foods as 2% bf cottage cheese and fruit for a lunch of a half wrap of chicken or ham or yes..two eggs with veggies omelet. One must in other words not only change one’s eating habit but also lower the physiological thermostat so that lowering blood sugar does not make one hungry. It takes a week or two to do that but I have no doubt I will lose a LOT of weight if I carry on with this regimen. I do not in other words count carbs..I count on NOT eating much of it..well lower than what they suggest is appropriate which was around 240 g a day. I suggest that 150 or sometimes less works for me. Oh yes, I feel great. That ought to mean something.

  8. Hilda Glickman 3 April 2010 at 12:58 am #

    Neil, I found you reply very interesting. Have you gone back and told your dietician? You should. Hilda

  9. bobby dean 3 April 2010 at 9:09 am #

    Neil, that’s alot of carbs for prediabetic and if do this long term could become full blown diabetic. Do you use a bg meter after each meal so you know you are eating what works for you. Have you had an A1C, is it under 6, Do you read Dr Bernstein, Dr William Davis, Dr Robert Su, good mentors along with Dr Briiffa about stopping diabetes and heart plague which pre diabetics and diabetics suffer from.

  10. Mark 23 July 2010 at 11:47 pm #

    Five years ago I was 16 stone and had a BMI of 34. I got that way by overeating, mainly overeating rice, pasta, bread, potato and noodles. After all, I had read in various health articles in popular newspapers to ‘fill up’ on these types of food and all will be ok as long as I avoid saturated fat.
    I have managed to slim down to a healthier 12 stone 10 but I encountered a problem along the way. Often, a couple of hours after a ‘healthy’ high fibre breakfast I would feel weak, shakey, light headed, iritable and hungry. In order to remedy the problem I would eat a chocolate bar or biscuits until the feeling subsided and I felt normal again.
    Obviously this situation was unsatisfactory in the context of maintaining healthy weight loss. I visited my Doctor who conducted various tests, mainly for diabetes. The results were negative and I was advised to have a more substantial breakfast, meaning more carbohydrates such as extra toast or more porridge.
    Around 6 months ago, after reading about the low carb approach I decided to restrict my carbohydrate intake. Since then I haven’t experienced the mid-morning weak, shakey, light headed, iritable and hungry feeling and my weight has once again begun to gradually decrease towards my 12 stone goal.


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