Should dieters focus on feeling full after a meal, rather than counting calories, for best results?
- The researchers compared the effects of a diet focused on food choices to those of a diet focused on calorie counting.
- Both diets resulted in similar small circumferential weight losses after one year, although neither resulted in significant weight loss.
- More studies are needed to understand how these diets can be optimized for weight loss.
The prevalence of obesity increased from 30.5% to 41.9% among the United States population between 1999 and 2020. Over the same period, cases of severe obesity increased from 4.7% to 9.2%.
Reducing obesity is a key public health goal because it can increase the risk of other chronic diseases, such as type 2 diabetes. So far, most behavioral interventions for obesity, emphasize caloric restriction and portion size limits.
However, weight regain after weight loss is common. A meta-analysis of 29 long-term weight loss studies found that nearly 80% of participants regained weight within 5 years.
Some studies suggest that diets that focus on satiety and satiation by including higher levels of protein And fiber may be more effective than calorie counting in maintaining weight loss. Satiety refers to not being hungry, while satiety is feeling satisfied with a meal.
Further study of diets that promote satiety and satiety could improve weight loss interventions.
Recently, researchers compared the weight loss effects of two diets. One diet focused on healthy food choices and the other on reducing calorie intake.
They found that diets based on food choices can be a practical alternative to calorie counting approaches, although neither produced significant weight loss results after one year.
The study was published in Annals of Family Medicine.
For the study, the researchers recruited 261 adult participants who were overweight and from low-income backgrounds. Participants had an average age of 42, about 95% were female, and 86% were Latinx.
They randomly divided the participants into two groups. One group followed a diet focused on calorie reduction, National Diabetes Prevention Programwhile the other followed MyPlate schemewhich focuses on healthy nutritional intake with an emphasis on fruits, vegetables, grains, protein foods and dairy products.
Participants engaged in both plans for 12 months. Interventions included 11 touchpoints, including:
- two educational home visits
- two group training sessions
- seven coaching phone calls over 6 months.
In the end, participants in the MyPlate intervention group and the calorie counting intervention group lost an average of 3.15 centimeters (cm) and 2.72 cm from their waist circumference, respectively.
A total of 59.1% of people in the MyPlate group and 53.5% of those in the calorie counting group lost weight at the end of the study.
However, the researchers found that neither intervention led to a significant reduction in body weight. Those in the MyPlate group lost an average of 0.34 kilograms (kg), while those in the calorie counting group lost an average of 0.75 kg.
Both groups reported increased satiety and satiety over the course of the study. Those in the calorie counting group, but not the MyPlate group, also reported a decrease in hunger. Participants in both groups also experienced improvements in quality of life and mental health.
The researchers further noted an association between the number of sessions participants attended and weight-related changes. Those who did not attend the sessions experienced no change, while those exposed to between one and six sessions or between seven and 11 sessions experienced modest and significant improvements, respectively.
Neither group experienced a significant decrease in systolic or diastolic blood pressure at 12 months, although those in the MyPlate group experienced a slight decrease in systolic blood pressure at six months.
Medical News Today speak with Dr. Debbie Fetterteaching assistant professor of nutrition at the University of California, Davis, who was not involved in the study, on when MyPlate-based interventions may be more convenient than calorie-counting diets.
“Using food-based approaches may be easier for people to incorporate into their daily lives. This approach allows people to identify foods, rather than meticulously tracking their food intake using some type of app/resource,” she said.
“Also, what may be surprising is that the nutritional data is not even entirely accurate. For example, the calorie amounts you see on food labels may have a margin of error of +/- 20%. If someone is using calorie counting to adjust their body composition, they may be unknowingly using the wrong data. Calorie counting can also be attributed to unhealthy eating behaviors, so it is important that consumers are aware of this and decide which approach is right for them,” she added.
Dr. Johanna Finkleclinical assistant professor of OB/GYN and specialist in obesity medicine at the University of Kansas Health System, also not involved in the study, further said DTM:
“I always tell my patients that protein will keep you full longer. The type of protein also matters. The composition of our diet impacts the release of our gut hormones and our gut microbiome. (This means that) healthier foods – as promoted by the MyPlate intervention – can keep us healthier from a hormonal and gut microbiome perspective, which, in turn, translates to more satiety and more of weight loss.
DTM asked Dr. Deepa Iyengarprofessor of family medicine and obesity expert at McGovern Medical School at UTHealth Houston, not involved in the study, which patients might be better suited for MyPlate interventions and calorie reduction.
According to her, “MyPlate is for most people since it’s just (about) introducing a balanced diet with different food groups; calorie counting can also be used for most foods, but is more often used in diabetic patients.
DTM also spoke with Dr Felix Spiegela bariatric surgeon at Memorial Hermann in Houston, TX, who was not involved in the research, supported the study.
He noted, “People who eat because they are actually hungry and crave the feeling of fullness are best suited for MyPlate. People who snack and graze and who rarely feel a real feeling of hunger in their belly are better at counting calories. Also, if you’re a type A person, who wants control, you might benefit more from calorie counting.
Asked about the limitations of the study, Dr. Finkle said DTM that the study did not include details such as:
- how patients were instructed to eat
- food time
- how fast they eat
- which part of the plate they ate first.
“The study (also) did not use a digital tool like my fitness buddy which can be easily used to count calories. is generally not available in a primary care setting. (Interventions may not) achieve the same results without (similar) home visits, education, etc.,” she pointed out.
Dr. Fetter added that “
“However,” she said, “it is important to have nutrition interventions tailored to people’s communities and cultural backgrounds. To further strengthen the study, researchers may consider adapting the education to focus on cultural/traditional foods that are personally meaningful to their target population.
Dr. Spiegel noted that a key limitation is that after 12 months of the intervention, neither group reported significant weight loss and waist circumference decreased very little.
“Both techniques can work to produce weight loss. However, these programs need to be much more structured and guided. If this is done, the results could be more meaningful,” he told us.
Dr Fetter said: “Working with participants to develop a diet that works for them can lead to (a) greater likelihood of integrating these healthy changes into their daily lives.”
“It may also be easier for participants to imagine a vegetable or whole grain, rather than XX number of calories or grams of fiber. Using a food-based approach can bring nutritional concepts to life and provide realistic examples. Participants may have greater confidence in implementing dietary changes, such as choosing brown rice over white rice.”
– Dr. Debbie Fetter
She noted, however, that adjusting body composition and maintaining weight loss can be difficult, and she always recommends seeing a doctor to determine if any changes are needed.
“I also recommend working with a Registered Dietitian to develop a healthy diet that will help you reach your goal safely and effectively. There are a lot of factors that influence our body composition, and it’s not as simple as calories in versus calories out. Everyone is different and losing or gaining weight is complicated,” she concluded.
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