For Weight Control, Focus on Healthy Foods, Not Calories

James J. DiNicolantonio, PharmD Associate Editor BMJ Open Heart Cardiovascular Research Scientist Saint Luke's Mid America Heart InstituteMedicalResearch.com Interview with:
James J. DiNicolantonio, PharmD
Associate Editor BMJ Open Heart
Cardiovascular Research Scientist
Saint Luke’s Mid America Heart Institute

Medical Research: What is the background for this study? What are the main findings?

Dr. DiNicolantonio: Focusing on calories misdirects eating away from healthy foods (that are higher in calories – such as nuts, salmon, and avocados) and towards harmful foods (e.g. rapidly absorbable carbohydrates – including added sugars such as table sugar and high fructose corn syrup).

Treating obesity should not focus on decreasing caloric intake, rather, it should focus on eating quality foods.  Lower calorie foods – that are high in rapidly absorbable carbohydrates – drive increased hunger throughout the day, whereas higher calorie foods (such as full-fat milk and eggs) leads to satiety.  Consuming rapidly absorbable carbohydrates leads to increased total caloric intake throughout the day (driven by insulin resistance and leptin resistance).  These metabolic consequences derived from overconsuming these types of foods leads us to eat more and exercise less.  In essence, eating more and exercising less doesn’t cause obesity, overconsuming rapidly absorbable carbohydrates causes us to eat more and exercise less, which then causes obesity – a subtle but important distinction.

Medical Research: What should clinicians and patients take away from your report?

Dr. DiNicolantonio:

1.) Clinicians and the public health community should promote the consumptions of whole/minimally processed foods that make eating less and moving more more possible, 2.) The public health community (and patients) should stop focusing on calories, which misdirects eating away from healthy foods and towards harmful foods.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. DiNicolantonio: More randomized clinical trials (both ad libitum and isocaloric exchange trials) testing the metabolic effects of rapidly absorbable carbohydrates (which includes added sugars) should be performed.  The literature mainly consists of short-term trials, and we do not know the full cardiometabolic consequences of overconsuming these types of refined carbohydrates over the long-term.

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