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Eating Less Is More Important Than What You Eat

I was raised by a health food zealot, and have been “eating clean” for most of my life. I have been an editor of a peer-reviewed nutrition and obesity journal, a food critic, and a dairy farmer. I am passionate about food – but I am also passionate about science. And I have to tell you, that for measurable health benefits, how much you eat is more important than what you eat.

I know this is controversial, and I’m certainly not saying that we should throw out all our leafy green veggies and grilled chicken and chow down on a diet of Twinkies and beer. But what I am saying is that the relative importance of food volume versus food quality has been misrepresented. We are focusing too much on specific nutrients and not enough on total caloric intake. I’d guess that what we eat is about 10% of the obesity problem, and how much we eat is 90% of the problem, but we spend 90% of our time talking about changing and improving what we eat rather than portion control strategies.

Consider these research-based findings :

1. The CDC has determined that 90% Americans get all the nutrients they need from the food they eat. Even “crappy” US diets actually do provide the minimum nutrients needed to avoid disease and malnutrition. I know this is surprising, but vitamins and supplements are simply not needed by most people.

2. Measurable health benefits occur from weight loss as small as 5-10% of total body weight. You don’t need to be a bikini model to achieve the health benefits of weight loss. You can decrease your blood pressure, sugar, and cholesterol with modest weight losses. In my opinion, leanness under about 25% body fat (for women) is mostly an aesthetic choice, not one of medical necessity.

3. Exercise benefits are largest at minimal levels. Going from sedentary to slightly active provides a larger health benefit than all additional increments of exercise. Thirty minutes of exercise, five times a week, is the minimum bar set by the Department of Health and Human Services. Anything beyond that is still valuable, but doesn’t decrease health risks by as much.

4. It matters more to lose weight, than it matters how you do it. Head-to-head studies of one diet versus another have repeatedly shown minimal differences in health benefits between the diet groups. The benefits occur from the weight loss, not from the manner in which it was lost.

This is all good news. Americans can achieve healthier outcomes with less effort than generally believed. Regular exercise, and a calorie-controlled diet (rather than rigidly controlling the macro and micro nutrients) are all that is required to substantially reduce the risk of many costly and unpleasant diseases. If you want to further optimize your health by eating a diet rich in fruits and veggies, whole grains, low-fat dairy, healthy fats, and lean protein please do so! But better to be a normal weight than obese due to eating too much of that healthy diet.

The bottom line is that you don’t have to give up eating the things you like, you just have to eat less of them. Even Olympian Carmelita Jeter eats Hostess cup cakes occasionally. And she’s the fastest woman in the world!

P.S. This blog post was inspired by a Twitter conversation with @Judith_Graham who said that the complicated issue of what to eat was too difficult to address in 140 character exchanges. Thank you, Judith!

P.P.S. Also, I’ve been thinking a lot about well-meaning but misguided (IMO) health policy issues raised by mayor Bloomberg’s ban on Big Gulps and the AMA’s endorsement of soda taxes. Bloomberg was pointing in the right direction (the size of the soda, not the soda itself was the problem), but I don’t believe you can regulate good behavior. Education and personal responsibility are the way to go.

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10 Responses to “Eating Less Is More Important Than What You Eat”

  1. Harold Jones says:

    Dr Val,
    Thanks for the expanded commentary. Agree that most Americans eat WAY too much and exercise WAY too little. As you are aware there are some real biochemical reasons to eschew sugars, artificial sweeteners and the like, but by and large most everyone benefits from your Rx to eat less and exercise more:)

  2. I agree, Harold. Sugar is like alcohol – best enjoyed in small portions. ;-)

  3. Carolyn Thomas says:

    Execellent overview here, Dr. Val! I agree that portion control is a key factor in healthy eating and weight control, but I’ve always been intrigued by my family’s apparent inability in resisting certain types of foods. Consider the concept of resealable bags of chocolate chips. Are there actually people out there, we wonder, who open up a new bag of chips, pour out the cupful they need for the cookie recipe, and then reseal the package instead of nibbling away at it while the cookies bake as we seem to do?

    Hence my concern about the Twinkies analogy here. For me, there would be simply no such thing as eating one Twinkie, which is why they never make it into my shopping cart and certainly never into my home. I know myself – and I know I couldn’t stop at just one.

    And as a lifelong foodie, I found that there’s nothing like surviving a heart attack to really pique my interest in heart-smart eating, daily exercise and maintaining a healthy weight. That’s how I discovered Dr. David Kessler’s book, The End of Overeating (and other authors) that explore the role of brain chemistry in our eating habits. Highly recommended.

    Finally, an observation of your comment: “I don’t believe you can regulate good behavior”. We actually do have several good examples of how regulation indeed has influenced our behaviour in society. Consider how smoking rates have plummeted since smoking in public places was banned. We wear seatbelts and bike helmets where usage is regulated by law. We put our infants into government-approved car seats now instead of just tossing them into the bassinet in the back seat.

    Lots of evidence in fact supports societal change through regulation – and often, that change comes about ONLY through regulation.


  4. Sean says:

    Just a thought.
    Remember that a calorie is not a calorie. It’s about quality of calories as well.
    But I agree – we preach about fixing this obesity epidemic, and in the process we’ve confused and complicated the issue.
    I also think NY’s mayor is on the right track.. but may have to tweak the end result.
    One thing is for sure.. what we’ve been doing up until now is NOT working, in fact in my opinion it’s contributing to the growing epidemic.

  5. Thanks for your thoughtful comments, Carolyn and Sean. As for the “irresistible Twinkie” issue – I know what you mean (I can’t resist chocolate-covered pomegranate seeds – weird, right?) It’s a little bit like alcohol and alcoholism – some of us can have wine in the house and enjoy a glass now and then, and others can’t resist drinking the whole bottle (and therefore have to avoid it all together). If you’re a chocolate chip-a-holic (unable to maintain portion control on them) then yes, you shouldn’t have them in the house. But you probably wouldn’t feel that it was right to prohibit others from purchasing and keeping chocolate chips in their homes. ;-) That’s what I meant about the difficulty with regulating “good [eating] behavior” – it’s not enforceable when it comes to food. Tobacco, yes – though sadly even with our best regulatory efforts, one in four or five Americans still smokes!

    And as for not all calories being created equal – that’s true from a nutrient perspective. But… an extra 500 calories a day of peaches versus butter doesn’t matter. It’s all going to my bottom line (literally).

    What we’re doing on the nutrition front in America isn’t working because we teach people to demonize certain food groups (fat is bad! carbs are bad!) rather than portion sizes. A little fat is ok, a little sugar is ok… and you can even LOSE weight eating a certain food group exclusively if you keep the total calories down (sure you may feel like crap and eventually become nutrient-deficient). But the science says that it’s better to be a healthy weight, no matter what you eat, than to eat healthy things and be obese. It’s hard to believe that it’s less risky to be a Twinkie-eating skinny person than an obese person who eats too much of a heart-healthy diet… but that seems to be what the data show at this point. ;-)

  6. Paul says:

    I love this. So well put. I’ve dropped 120 pounds but given up nothing. I eat sensibly most of the time, watch calories, try and walk 30 minutes a day. It’s not easy but it is simple. As I said on my Blog, weight loss is a marathon not a sprint. Thank you.

  7. A hearty congratulations on your amazing weight loss success, Paul! And yes, this is a marathon… one that never ends though… Sigh. :-)

  8. Carolyn Thomas says:

    They make “chocolate-covered pomegranate seeds”?!?! Where can I find these?!

  9. Adam Abraham says:

    thanks Harold Jones! your post is really interesting and proving the innovative and healthful suggestions and tips about health .i always appreciate your experiences which you have shared with us.thanks
    elder care Maryland

  10. Diane L Randle says:

    Thank you for your blog. I fell in with one of Dr. Oz’s ‘miracles’ and am awake tonight because of raspberry ketones and having palpitations. I’m prone to PVC”s with caffeine intake etc. so am not too worried about them.

    Anyway, Dr. Oz is indeed sounding more like a snake oil salesman every day.

    One thing I would like to recommend for people wanting to lose weight, and it’s something I intend to get back to, is eating really delicious food and only eating while you eat.

    The other subject I would like to broach is the change in wheat over the past half century. My Dad, who passed at nearly 80, grew up around wheat farms and he said to me ‘The wheat doesn’t look the same anymore.’ He was right. It’s not the same anymore, it’s all hybridized semi-drwarf with very large seed heads compared to the wheat we ate in the 60′s.

    I can’t eat bread anymore. I had a stomach ache and poor bowel movements (constipation or too loose) for decades trying to eat ‘healthy whole grain’. Since stopping wheat I’ve lost 35 pounds (five years ago).

    Anyway, there now seems to be evidence that wheat no longer metabolizes in the body the way it used to. The University of Sydney did a study and equated wheat’s affect on blood glucose to table sugar.

    Celiac has gone up four fold.

    I wonder if you have an opinion on that?

    I did, a few months back when I was still ‘Mezmerized by Mehmet’ (sorry, I’m a writer) write to Dr. Oz but I don’t think he knows anybody selling a wheat supplement.

    Thanks again!
    Have a great 2013!

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