The idea that "salt is bad for you" is entrenched in the American mindset; sodium's right up there with trans fats and cigarettes. We now commonly see ads warning us of the high sodium content of processed foods.

 I take the idea …"that a normally healthy person should restrict salt"… with a grain of salt.
i.e. to take a statement with 'a grain of salt' or 'a pinch of salt' means to maintain a degree of skepticism about its truth. The phrase has been in use in English since the 17th century;

In reality, the IDEA THAT SALT IS BAD FOR US IS NOT (and has never been) BASED ON SOLID EVIDENCE. Even worse, the idea is dangerously wrong: we need salt to live, and not eating enough can make a person die.

Salt does not cause our bodies to gain or lose fat.
Salt has no calories.

High consumption of salt only results in temporary weight gain as it causes the body to retain water. Low consumption of salt can result in temporary weight loss as it causes the body to expel water. It is normal and healthy to see these water weight fluctuations.

Our blood is 0.9% salt and it is continually flowing through our lymphatic system. Salt is also necessary for the production of hydrochloric acid, the digestive enzyme secreted by the stomach in order to digest protein. It’s important for nerves and muscles. When we sweat we can taste the salt coming out of our skin. Salt is vital for life’s existence. Put a salt block outside and all animals will consume it.

A diet low in salt can eventually lead to dehydration. Salt holds water in the body, and without it, people can actually dehydrate and die even while drinking water.

The anti-salt campaign began in the 70s, based on two pieces of flimsy research. Although researchers quietly acknowledged that the data were 'inconclusive and contradictory' or 'inconsistent and contradictory'... publicly, the link between salt and blood pressure was upgraded from hypothesis to fact, probably because there was no other good suspect at the time to blame for hypertension.

After studying new research conducted since 2005, a committee commissioned by the Institute of Medicine and CDC issued a report that "said there was no rationale for anyone to aim for sodium levels below 2,300 milligrams a day" .

One study found that among people with moderate to severe heart failure, those who consumed less salt were more than three times more likely to be readmitted to the hospital; another found that older folks with high blood pressure consuming less than 3,000 mg of sodium a day were as likely to suffer heart problems and strokes as those eating more than 7,000 mg a day. The average, across cultures and generations, is around 3,700 mg, suggesting this is probably around a naturally healthy range.

Despite this evidence, the American Heart Association has not amended its low-sodium recommendations.

Here’s an recent article by a medical professional about this subject.

To Salt or Not To Salt
        by Dr. Ayra Sharma, M.D. - May 20, 2013

Unbeknownst to many readers, the first 10 years of my research career was built largely on studying the effects of salt (or rather sodium chloride) on blood pressure.

In over 40 peer-reviewed publications, we described in excruciating detail the physiological effects of increasing and decreasing sodium intake, in many cases using single-blind randomised trial designs in hundreds of volunteers.

We not only examined the effects of salt on blood pressure but also on a wide range of physiological, metabolic and psychological parameters. We studied the effects on acid-base balance, we conducted genetic studies, we even performed in vitro studies on cells cultured from “salt-sensitive” and “salt-resistant” individuals.

In many respects, these studies left me as confused about the role of sodium on these parameters as I was before. Not that we did not report findings that helped us better understand the complex physiology of sodium homeostasis – it is just that we failed to convincingly demonstrate any major health implications of these findings.

In some cases we even reported adverse consequences of sodium restriction resulting both in significant elevations in plasma lipids and insulin resistance (perhaps not surprising given that reducing sodium intake markedly stimulates both the sympathetic and renin-angiotensin systems – the very systems we seek to block to reduce cardiovascular risk).

That was almost 20 years ago – the field does not appear to be much clearer today.

Thus, although surprising to some, I must admit that I was by no means surprised by the report on sodium released last week by the Institute of Medicine, with the rather revealing conclusion that,

“…the evidence from studies on direct health outcomes was insufficient and inconsistent regarding an association between sodium intake below 2,300 mg per day and benefit or risk of CVD outcomes (including stroke and CVD mortality) or all-cause mortality in the general U.S. population.” (or any other population for that matter)

This is not to deny that despite considerable methodological problems (not least in the actual measurement of salt intake), there is evidence to support the idea that higher salt intake may affect blood pressure and possibly cardiovascular risk. However, the data is certainly far less conclusive than food bloggers and health activists would lead us to be believe.

Not surprisingly, the same activists and organizations are now up in arms stopping just short of criticizing the scientific credibility of the IOM expert committee – no doubt, the same folks would have been applauding the conclusions of this “illustrious panel”, had the findings been more in line with their own activist agendas.

What is perhaps even more infuriating to those who have always considered the issue of sodium recommendations a slam-dunk case is the statement by the IOM that, there is in fact no basis on which to draw recommendations for the general public in recognition of the fact that significant proportions of the population may require higher sodium intakes and may even be likely to suffer harm from overly enthusiastic sodium restriction.

While I have no illusions that this report will in any way put the century old debate to rest (indeed the report calls for further research), I think that there is a much bigger message in this report that should let us tread cautiously when it comes to dietary recommendations in general.

Let us remember that associations (on which so many of our assumptions about healthy diets depend) simply do not prove causality, even when backed by seemingly plausible biological hypotheses derived largely from rodent toxicology.

We should also remember that fancy statistical predictions on the vast number of lives lost or saved by altering the population intake of this or the other nutrient, are generally based on sometimes rather heroic assumptions that may well explain whey they are rarely (if ever) borne out by actual interventions.

Thus, whether we are talking about salt, fat, carbs, sugar, fiber, gluten, calcium, Vit D, dairy or red-meat, a degree of humility in advocating for policies and other measures to reduce or increase this or the other is generally in order.

Seldom in the field of nutrition are things as cut and dried as some will have us believe – if only food were as simple as tobacco.

                          Dr. Sharma’s Obesity Notes – www. drsharma.ca
 

A statement often quoted is:

“Eat to live, don’t live to eat.”

This was a statement made by Socrates, a Greek philosopher who lived from 469 BC to 399 BC. He was the teacher of Plato, and he was executed for corrupting the young.

There are many ways to look at the issues and values of life.
Thousands of years ago, Socrates stated his own opinion on the value of food in life, which has been quoted many times since then. 
               

I disagree. 

Yes, eating food is required for the body’s survival, and our bodies are designed to make us regularly fulfill that necessary function. However, I choose to value the process of eating highly, simply in and for itself. Food tastes good. I enjoy eating it, and find it to be one of the most pleasurable ongoing activities of life.

As far as I’m concerned, “living to eat” is a perfectly acceptable value choice. 

Life requires us to constantly deal with conflicting values. I want to eat as much delicious food as often as possible. But I also want my body to be a “normal” weight. My vanity; my wish to move my body without pain and be generally in good health are some of the basic reasons for my desire to avoid obesity. So, how do I handle these conflicting values? 

Below is an article which involves that issue.
 

Food is Not Just Fuel,
and That Matters for Your Diet

                               by Dr.Yoni Freedhoff, M.D. - April 17, 2013

Some 12,000 years ago, on the banks of a small river in the western Galilee region of northern Israel, the Natufian people were burying one of their elders. She was a shaman—a medicine woman—and they buried along with her the wing tip of a golden eagle, the pelvis of a leopard, the front leg of a boar, the horns of a male gazelle and a severed human foot.

And while the true meanings of these burial accoutrements were unclear to the archaeologists who found her in 2008, the meaning the 70 charred tortoise shells and the gnawed and marrow-stripped bones of three aurochs— giant extinct cattle—was obvious. They were evidence of a great feast. As well, they were proof of the fact that food isn't simply fuel for our species—food is used for comfort, food is used for celebration and, in all likelihood, food has been used that way since we took our first figurative steps in the savannahs.

Yet, for many modern-day dieters, the use of food for comfort or celebration is expressly forbidden. Those who worry about weight may deny themselves of their lives' most comforting or celebratory indulgences for fear of their—almost by necessity—larger numbers of calories (green leafy vegetables don't tend to be much of a comfort) and their "bet-you-can't-eat-just-one" allure.

Those who worry about health may deny themselves entire food groups—food groups that they may in fact enjoy a great deal but avoid out of fear of a potential health risk or as a result of following a theoretical but as yet unproven eating philosophy.

So what's the problem? Doesn't it make sense to forbid the danger foods, the treats that simply can't be resisted or those groups of foods whose consumption may be unhealthy? Would cutting them out not further a dieter's aims, or is there a downside a person might want to consider?

The past 60 years of dieting, both for health and for weight management, have certainly seen a great many different approaches and options. But the one shared commonality is that, for the vast majority of dieters, diets are short-lived, white-knuckled affairs that, regardless of their actual dietary edicts, can be fairly described as planned suffering. And therein lies the rub.

We're not particularly good as a species at perpetual and unnecessary suffering. And just as we have been celebrating and comforting with food since time immemorial, so too have we tended to avoid unnecessary suffering. Ultimately, when life inevitably throws a blindly restrictive dieter a curve ball, dietary suffering tends to fall by the wayside; and when life lets up, the tendency for most is not to pick it up again.

I sometimes think of blindly restrictive dieting like an icy cold lake on an unseasonably hot day. You work up the nerve to dive in and, after the initial shock wears off and numbness sets in, you splash around happily for a while. But once you climb out, the memory of that initial frigidity is enough to keep you warmly on dry land— diving back in is almost never an option.

So instead of adopting a blindly restrictive, icy-cold lake diet, my advice is for you to practice thoughtful reduction. It's not about whether or not a food or an indulgence is allowed; it's whether or not you feel it's worth it to you, where worth isn't determined solely by calories or content, but also by circumstance, desire and the human condition.

Sometimes it's worth comforting or celebrating with the most nutritionally terrifying of foods. Just make sure, if you've decided it's worth it, to also ask yourself what's the smallest amount of that delicious awfulness that you need to like your life. A small bit of here-and-there awful, and maybe you'll actually stick to your new and improved dietary intake. But deny yourself that chance, and I'd bet, eventually, you'll find yourself right back at your all-you-can eat, unhappy square one.

Dr.Yoni Freedhoff, M.D.
www. health.usnews.com and www. weightymatters.com

 
Even siblings consuming similar diets may respond to calories differently, let alone people of different age, shape, gender, and lifestyle.

One calorie for one person is often more, than one calorie for someone else, and this is one reason why weight-loss diets, and weight maintenance diets, can fail.

AGE DIFFERENCE. Younger women of the exact same shape, weight, height, and even genetic background will always lose weight faster on the exact same diet as older women.

You are not your 20+ year old daughter. She is at the peak of her procreation mission with a metabolism to match. She is still learning about the world around her and has an incredibly busy brain, which is a large consumer of glucose. Her body may still be growing. She is healthier. She may be taller. Her body has more muscles, even if she is the exact same size and shape as you are. She has only half of your genes; the other half is from her father. She is more active simply because she can be. She sleeps better than you, even if she sleeps less. She needs more calories simply because she is younger. As the body ages, it needs less and less calories to maintain the same weight.

SMALLER MUSCLE MASS. The female body contains significantly less muscle than males of similar shape and weight. Women experience faster loss of muscle throughout pregnancy, breastfeeding, and natural aging. Since muscles are one of the most demanding users of energy, their age-related loss reduces the rate of energy uptake, and, correspondingly, increases the gain of body fat.

GLUCOSE UPTAKE BY MUSCLES. Along with the brain, central nervous system, and blood, muscles are the most prolific consumers of glucose. That is why most men on a low-carb diet lose weight faster than women and don’t gain it as quickly with a larger intake of carbohydrates.

Women require fewer carbohydrates than men, yet at the same time improperly structured ultra-low-carbohydrate diets can be inappropriate for older women because these may tend to accelerate muscle wasting.

GREATER FAT MASS. Women have a higher ratio of body fat to total body weight than men. Body fat is essential for reproductive functions, healthy pregnancy, and nursing. As body fat falls below a certain level — around 10% to 15% — infertility and amenorrhea (the absence of a period) set in.

Because body fat plays such an essential role in female reproductive and overall health, women gain fat faster than men on similar or smaller amounts of foods.

THERMOS  EFFECT. As one gains fat, the body lowers the internal rate of energy metabolism (i.e., produces less heat) because the internal organs are cuddled in the warm blanket of one’s own fat, or, as doctors would say, adipose tissue. That is why overweight people are far less sensitive to cold than skinny ones. Unfortunately, this effect has a profoundly negative impact on the ability to lose weight because the rate of metabolism is so much lower, and this has little or nothing to do with thyroid or adrenal glands that one might think are “underactive.”

HEIGHT. A person’s height is an important factor in energy metabolism and, correspondingly, in obesity and weight loss. All other things being equal, taller people lose weight faster because their “lengthier” bodies expend more energy to support cardiovascular, respiratory, and thermogenic (keeping itself warm) functions.

This doesn’t mean that tall people don’t become overweight or obese - They DO. Still, on the exact same diet they will be losing weight faster and gaining it slower. This observation becomes important when determining portion sizes.

When foods are plentiful,
satiety is portion-oriented, not need-oriented.
In other words, we don’t eat as much as we NEED,
but we eat as much as we WANT.

Portions nowadays are designed to accommodate an “average” person’s capacity to ingest foods until his or her stomach is totally loaded. When there are more tall/large/overweight people in a society with larger stomachs, short/small/skinny people inevitably overeat.

The shorter a person is, regardless of gender, the more attention that person must pay to portion sizes. Shorter people also face the greatest difficulty during weight loss because their stretched out stomach and mental perception of satiety are preconditioned to eating larger portions of foods.

INNATE RESPONSE TO REDUCED CALORIE INTAKE. The body doesn’t really know the difference between weight loss and starvation. All it knows is that it is under duress from undernutrition and facing extinction. That is why a scarcity of nutrients during weight loss diets, or even from poor nutrition, instantly lowers the energy and structural metabolism, throttles down weight loss, and speeds up the accumulation of body fat. In females, this is partly in order to protect a female’s reproductive health and milk supply for potential offspring from the possibility of starvation-related death.

ENERGY REQUIREMENTS. With all other things being equal  - temperature, level of activity, age, height, and weight  - the female body still has a lower demand for energy from proteins, fats, and carbohydrates than the male body, due to not only substantially less muscle but also smaller lungs and a smaller heart, less blood volume, and an inherently less physically demanding response - flight instead of fight -  to external stress. This difference is particularly significant in the reduced uptake of energy from glucose by the blood, muscles, and central nervous system.

An identical piece of cake for one person may represent twice as many relative calories to a similarly shaped person. In other words, when eating cake, a female body will use a portion of its calories for energy, and the balance goes right into making body fat, while a similar male body will use the entire allotment of calories from the exact same cake exclusively for making energy, with nothing left for fat.

The same can be said about fats and proteins, though the difference may be not as drastic as with carbohydrates because a larger portion of these nutrients is used for structural metabolism. The demands of structural metabolism in women may be greater than in men (with all other things being equal) because female reproductive functions demand a greater deal of nutrients.

The dietary requirements for a woman’s energy, particularly from carbohydrates, are substantially less than a man’s. When it comes to losing weight, the situation is stacked against women, who need to decrease their caloric intake considerably more than men to accomplish the same amount of weight loss in the same span of time.

REPRODUCTIVE HORMONES. The reduction of estrogen related to age, pregnancy, lactation, stress, undernutrition, and contraceptives may lead to gradual weight gain typical for middle-aged women and diminish the rate of weight loss. Since adipose tissue (i.e., body fat) produces estrogen in parallel with the ovaries, some believe the female body compensates the age-related decrease of ovarian estrogen by lowering the rate of energy metabolism in order to accumulate more fat, thereby allowing it to produce more estrogen.

FOOD PREPARATION. Usually, women spend more time in the kitchen while cooking for their families. Unfortunately, the continuous exposure to food comes with an increase in appetite, hunger, cravings, and, in many cases, inevitable overeating. For many people, food preparation is a definite obesity hazard.

EATING OUT. Restaurants don’t provide a gender-specific menu. Identical steaks are placed in front of a petite woman and an oversized, bodybuilding man as a matter of course. Women, who dine out often, must be mindful of this Truth and demand half portions or split main courses with their companions.

CHRONIC DIETER SYNDROME. Women have a propensity for recurrent dieting. Each consecutive diet cycle, especially one low in fat and protein, can compromise the body’s essential endocrine functions, slow the rates of metabolism, and stimulate the over-consumption of carbohydrates, which leads to the accumulation of more fat and reductions of muscle and bone mass

SOME people believe that a weight loss diet is like an antibiotic in that … if a pill is taken, one needs to finish the full course; otherwise, antibiotic-resistant bacteria that may harm you later is created. According to this THEORY, … the more a person diets halfway, the more resistant that body becomes to weight loss and more accommodating to weight gain.

Why Count Calories?

Weight loss is difficult.
No Diet / “Way-of-Eating” /” Lifestyle” / “Non-Diet” transforms our eating habits overnight. Nor will it change the fact that we live in a culture where overeating is the national pastime. To lose a significant amount of weight … especially when one has had great difficulty losing weight in the past, …. it’s a good idea to count calories.

Counting calories is tedious.
Yes, this DOES require keeping some kind of food log and then laboriously converting that food into calories (or buying a software program that will do it. My own personal choice is DietPower) Yes, it is especially difficult to count calories when eating a lot of meals away from home and on the run.

As irksome as this task may be, it is not the main reason people hate to count calories. The heart of this resistance is the reluctance to become Accountable for our own behavior.

If we record every morsel of food that we eat, we can no longer deny the way we regularly overeat.

Most overweight people eat far more than they realize. The statistics are sobering. A paper published in the New England Journal of Medicine stated that obese women were eating 47 percent more calories than they were aware. These women truly believed that they were eating modest amounts of foods and that their obesity was caused by a physical problem, such as a slow metabolism or other disorder. When their physical tests came back normal, they were forced to take a closer look at how much they were really eating.

Virtually everyone … even people without weight problems … underestimate how much they eat. In one study, a researcher was working with a group of lean, healthy young women. Part of the study involved having the women live in a metabolic ward where they would have no access to food other than their hospital meals. The researcher wanted the women to maintain their current weight, so she asked each one to estimate how much she normally consumed. Later, when she served the women the amount of food they thought they had been eating, they lost weight. The researcher had to add as many as 1,000 more calories a day to what they THOUGHT they had been eating, before they stopped shedding pounds.

  Why do we all eat more than we realize?
We know quite well that eating too much will make us fat. But we also have a very strong and understandable desire to comfort ourselves with food. Food tastes good. Food triggers soothing brain chemicals. But, above all else, eating is one of the most basic, primal ways to feel loved. When the road gets rocky … we've been turned down for a job, our lover doesn't call, we've been snubbed by a friend … that chocolate bar or plate of pasta will always be there for us, faithful, rewarding, and soothing.

So in order to be comforted by food and still maintain the illusion that we are eating moderately, we hide our food intake from our conscious minds.

There are a multitude of ways to keep from knowing how much we are eating. For example, many of us judge our food intake by how much we eat at sit-down meals when other people are present. So, we eat by ourselves. We eat standing up. We nibble while we are cooking dinner and cleaning up. We keep food in our desk drawers, glove compartments, and purses. We eat in the living room while the TV drains away our attention.

Portion size is another way we fool ourselves. We eat three huge slices of pizza and convince ourselves we've eaten just one serving. We gobble down mega-portions at restaurants and tell ourselves we've eaten normal-sized meals. We keep adding small spoonfuls of food to our plates at the dinner table and pretend we're not going back for seconds.

We cling to these strategies because they allow us to eat for comfort, yet hold on to the fantasy that we're trying to lose weight. It helps us have our cake and "diet" too.

The problem with this nearly universal strategy is that calories do count. Eat just 350 calories a day more than the body uses as energy, and ten days from now we’ll have gained a pound. A year from now we’ll have gained 36 pounds. Continue on and after three years or so, we’ll weigh 100 pounds more than today. Our private eating eventually shows up under our chins, around our bellies, and displayed on our behinds. Even if we remain in denial of our overeating, the resulting fat is there for everyone to see. 

 When we count calories by consistently logging our food into a computer food journal for a long time, we can become aware of ways in which we fool ourselves about the amount of calories that are ACTUALLY in our food-intake.

Our mistakes in accurately measuring the amounts of food we eat, together with the labeling mistakes of manufactured food can lead us to believe we have extremely low metabolisms.

However, the Truth is that no matter HOW consistently and how accurately we record our calories, we will make errors, and almost always those errors are overestimations. We judge the calories in our food to be lower than they really are. Eating one extra potato chip per day for a year can add up to a 1 lb gain. No matter what the number of our daily calorie average, if we carry excess weight and ... Over Time ... we are not losing weight, then we are eating more calories than our own individual body needs to sustain a normal weight.

All the expert’s charts and metabolic formulas are complied as AVERAGES. The way to find out how many calories any single individual needs to sustain any specified individual weight is by carefully and consistently recording one’s own calorie intake for a long period of time. 


 The solution? Be Honest with ourselves.
Although this may be a rude awakening, it can bring great rewards. In a one study, Kaiser Permanente enrolled 2037 overweight people in a year-long weight loss program. All the volunteers were advised to eat 500 fewer calories a day and exercise for 30 minutes. But in addition, some of the volunteers were asked to count calories as well, either once a week, 2-3 days a week, 3-4 days a week, or 5 days a week.

As you can see by the graph below, counting calories made a difference in how people fared on the program. (The higher the line, the more people lost.)

After a full year of dieting and exercising, the people who did not count calories at all (represented by the orange line on the graph) weighed more than they had at the beginning of the study.. This is the fate of most people who "go on a diet" but continue on with mindless, unacknowledged eating.

The people who counted calories only one day a week (the green line) ended up about where they had started. Those who counted calories three to four days a week (the pink line) did better and lost an average of about ten pounds. Those who counted calories five or more days a week (the black line) shed an average of 23 pounds.

Why was counting calories the key to success? It left the dieters no place to hide. They had to acknowledge that the extra piece of bread at breakfast and the three o'clock candy bar had racked up 450 calories. That left them only 400 calories for dinner. They would have to forgo the buttered roll and take a smaller helping of the main dish. Because they had the information they needed to stay within their caloric limits, they began losing weight. Losing weight made them willing to stay on the program. Because they kept on the program, they kept losing weight.

The Bottom line is: Whether we count calories or not, the amount of calories we eat matters. This is a Universal Fact of Life which always holds true… irrespective of the types of individual macronutrients (protein, fat, carbs) that exist in the foods we choose to eat. See more about this by reading some of my previous articles on this subject.

DietHobby has many previous articles about counting calories. A few of these are:

More About Calories

Do Calories Matter?

Calorie Detective – Lying Food Labels

 

Here is a recent Quote by a member of a forum that I frequent.

(The article posted below) “supports what some say, and I contend,
about dieting for MOST--not all --. And by dieting I mean a purposeful restriction of foods and amounts to match a target low intake and weight goal.

It certainly doesn't mean that reducing the number of calories won't result in some weight loss. It will. The point is that as a strategy it has not been shown to change permanent habits in most who try it. Worse, it distorts the process so that weight gain statistically follows.

You can argue until you're blue in the face that it will work, but if it thwarts the natural process for most, I call that a strategy meant for the few. And the stats show it. Not for those who make it- for those who don't. Which is most.”

My response to this quote, and to the Article I've posted below is:

Everything that has to do with eating or not eating food is a Diet.

Eating LESS than the body uses as energy is a “weight-loss diet”
Eating the SAME food that the body uses as energy is a “maintenance” diet.
Eating MORE food than the body uses as energy is a “weight-gain” diet.

Some Diets are more easily incorporated into the lifestyles of Some People than other Diets.
Labeling any type of eating (but especially a plan to eat less) "not a diet"
or a “non diet” is just a Semantic Game.

No matter what the "Diet"... "eating plan" .... "way-of-eating" .... "lifestyle",
it is difficult to lose weight, and even more difficult to maintain weight-loss.

I've been saying this here at DietHobby and other online places for quite some time,
and the article below supports this.  

This is my personal experience, and
I've been researching and writing about this for quite some time.
Some of the writings that support this principle can be found at the Links below:

Rethinking Thin: The New Science of Weight Loss---and the Myths and Realities of Dieting (2008) by Gina Kolata.

No Cure

Effort Shock

Science Has Failed

The Fat Trap

The Fat Trap - Follow-up

The Chubby Side of Normal

Set Point

Do Diets Work?

The only "conventional wisdom" that's really "changed"
in the 6 years since the writing of this 2007 article posted below,
is that recent studies have indicated that exercise does very little to help one lose weight;
that exercise might be helpful in maintaining weight-loss;
however, that exercise leads to better physical and mental health.

Dieting Does Not Work, UCLA Researchers Report
                    by Stuart Wolpert - April 03, 2007 - UCLA News

Will you lose weight and keep it off if you diet? No, probably not, UCLA researchers report in the April issue of American Psychologist, the journal of the American Psychological Association.

"You can initially lose 5 to 10 percent of your weight on any number of diets, but then the weight comes back," said Traci Mann, UCLA associate professor of psychology and lead author of the study. "We found that the majority of people regained all the weight, plus more. Sustained weight loss was found only in a small minority of participants, while complete weight regain was found in the majority. Diets do not lead to sustained weight loss or health benefits for the majority of people."

Mann and her co-authors conducted the most comprehensive and rigorous analysis of diet studies, analyzing 31 long-term studies.

"What happens to people on diets in the long run?" Mann asked. "Would they have been better off to not go on a diet at all? We decided to dig up and analyze every study that followed people on diets for two to five years. We concluded most of them would have been better off not going on the diet at all. Their weight would be pretty much the same, and their bodies would not suffer the wear and tear from losing weight and gaining it all back."

People on diets typically lose 5 to 10 percent of their starting weight in the first six months, the researchers found. However, at least one-third to two-thirds of people on diets regain more weight than they lost within four or five years, and the true number may well be significantly higher, they said.

"Although the findings reported give a bleak picture of the effectiveness of diets, there are reasons why the actual effectiveness of diets is even worse," Mann said.

Mann said that certain factors biased the diet studies to make them appear more effective than they really were. For one, many participants self-reported their weight by phone or mail rather than having their weight measured on a scale by an impartial source. Also, the studies have very low follow-up rates — eight of the studies had follow-up rates lower than 50 percent, and those who responded may not have been representative of the entire group, since people who gain back large amounts of weight are generally unlikely to show up for follow-up tests, Mann said.

"Several studies indicate that dieting is actually a consistent predictor of future weight gain," said Janet Tomiyama, a UCLA graduate student of psychology and co-author of the study. One study found that both men and women who participated in formal weight-loss programs gained significantly more weight over a two-year period than those who had not participated in a weight-loss program, she said.

Another study, which examined a variety of lifestyle factors and their relationship to changes in weight in more than 19,000 healthy older men over a four-year period, found that "one of the best predictors of weight gain over the four years was having lost weight on a diet at some point during the years before the study started," Tomiyama said. In several studies, people in control groups who did not diet were not that much worse off — and in many cases were better off — than those who did diet, she said.

If dieting doesn't work, what does?

"Eating in moderation is a good idea for everybody, and so is regular exercise," Mann said. "That is not what we looked at in this study. Exercise may well be the key factor leading to sustained weight loss. Studies consistently find that people who reported the most exercise also had the most weight loss."

Diet studies of less than two years are too short to show whether dieters have regained the weight they lost, Mann said.

"Even when you follow dieters four years, they're still regaining weight," she said.

One study of dieting obese patients followed them for varying lengths of time. Among those who were followed for fewer than two years, 23 percent gained back more weight than they had lost, while of those who were followed for at least two years, 83 percent gained back more weight than they had lost, Mann said. One study found that 50 percent of dieters weighed more than 11 pounds over their starting weight five years after the diet, she said.

Evidence suggests that repeatedly losing and gaining weight is linked to cardiovascular disease, stroke, diabetes and altered immune function. Mann and Tomiyama recommend that more research be conducted on the health effects of losing and gaining weight, noting that scientists do not fully understand how such weight cycling leads to adverse health effects.

Mann notes that her mother has tried different diets, and has not succeeded in keeping the weight off. "My mother has been on diets and says what we are saying is obvious," she said.

While the researchers analyzed 31 dieting studies, they have not evaluated specific diets.
Medicare raised the issue of whether obesity is an illness, deleting the words "Obesity is not considered an illness" from its coverage regulations in 2004. The move may open the door for Medicare to consider funding treatments for obesity, Mann noted.

"Diets are not effective in treating obesity," said Mann. "We are recommending that Medicare should not fund weight-loss programs as a treatment for obesity. The benefits of dieting are too small and the potential harm is too large for dieting to be recommended as a safe, effective treatment for obesity."

From 1980 to 2000, the percentage of Americans who were obese more than doubled, from 15 percent to 31 percent of the population, Mann noted.

A social psychologist, Mann, taught a UCLA graduate seminar on the psychology of eating four years ago. She and her students continued the research when the course ended. Mann's co-authors are Erika Westling, Ann-Marie Lew, Barbra Samuels and Jason Chatman.

"We asked what evidence is there that dieting works in the long term, and found that the evidence shows the opposite" Tomiyama said.

The research was partially supported by the National Institute of Mental Health.

In future research, Mann is interested in studying whether a combination of diet and exercise is more effective than exercise alone.

UCLA is California's largest university, with an enrollment of nearly 37,000 undergraduate and graduate students. The UCLA College of Letters and Science and the university's 11 professional schools feature renowned faculty and offer more than 300 degree programs and majors. UCLA is a national and international leader in the breadth and quality of its academic, research, health care, cultural, continuing education and athletic programs. Four alumni and five faculty have been awarded the Nobel Prize.

Before drawing a conclusion that Diets are negative because they cause Weight-Gain,
it is important to remember that there is a Difference between Causation and Correlation.
See Linked article.

Just because Fat People and Dieting are Associated,
doesn’t mean that Dieting Causes People to be fat.