November 2014 Issue

Farewell come the 3,500-Calorie Rule By Densie Webb, PhD, RD Today"s Dietitian Vol. 26 No. 11 P. 36

Researchers have developed brand-new mathematical formulas RDs can use to more accurately suspect the rate of weight loss in patients.

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If you"ve counseled clients and patients for load loss, you recognize that also the many diligent that dieters eventually will with a weight-loss steady state, a plateau, a stumbling block that have the right to be frustrating for them and dietitians alike. And, unfortunately, a big percentage of those that succeed at shedding weight will get it back over time.

We all recognize the weight-loss rules: eat more calories 보다 you burn and you"ll acquire weight; eat fewer calories 보다 you burn and you"ll lose weight. However, researchers say it"s not that simple. In an initiative to better understand the weight-loss process, researchers have devised one ingenious way to more accurately predict the trajectory of weight loss for individuals via a mathematics formula. The hope is that utilizing it will an outcome in much more realistic expectation for load loss through fewer disappointments along the way, and assist explain when and also why weight-loss plateaus occur, even among seemingly dedicated dieters.

Also in development is a personalized dynamic feedback regulate mechanism the clients can wear to monitor their progress and determine once it"s time for reassessment through a dietitian. It"s additionally a an approach for RDs come predict in advance who"s most likely to succeed at shedding those overabundance pounds longterm.

Conventional Weight-Loss Wisdom Ask any dietitian and he or she most likely will say that cutting food intake by 3,500 calories results in a 1-lb loss. Cut 500 calories every day and that"s 1 lb every week. Over the course of one year, that would equal 52 lbs. That"s what RDs have been and continue to it is in taught, and also it"s promulgated by the united state Surgeon General and also the Academy that Nutrition and also Dietetics, and it"s repeated in number of nutrition textbooks.

It"s been estimated that the 3,500-calorie ascendancy is cited in more than 35,000 education weight-loss sites.1 In September, the Journal the the American medical Association released a patience handout title Healthy weight Loss, in i m sorry the very first sentence states, "A full of 3,500 calories equates to 1 lb of human body fat. This means if girlfriend decrease (or increase) your intake by 500 calorie daily, girlfriend will lose (or gain) 1 lb per week."2 Undoubtedly, the 3,500-calorie dogma tho is gift taught even though it"s been presented that it merely doesn"t job-related this way. So wherein did the 3,500-calorie weight-loss wisdom come from? It originated from researcher Max Wishnofsky, MD, in 1958, that calculated the 1 lb the fat stores roughly 3,500 kcal the energy.3 It was appealingly simple, and it stuck.

"I think this happens regularly when there is a basic rule the thumb," claims Diana Thomas, PhD, director of the facility for Quantitative excessive weight Research at Montclair State University, and one the the researchers connected in occurring the new approaches. "It"s easy to propagate, and there"s resistance to adopting something that"s more complex."

The 3,500-calories-per-pound dominion seemed come make feeling at the time, yet much has emerged in the area of human being nutrition in the last 55 years, consisting of the share of expertise amongst fields. The breakthrough in the knowledge of how and also why weight loss occurs and also predicting the rate at which the does, is the an outcome of experts in nutrition and also mathematics putting their collective heads together, coming up with facility formulas and also then simple them.

Elusive Weight-Loss Success The specialists Today"s Dietitian spoke v agree the while the 3,500-calories-per-pound ascendancy does seem to work relatively well in the quick term and for those who desire to lose only a few pounds, the logic starts to loss apart over the long term, especially for those do the efforts to lose a far-ranging amount that weight. Dietitians know that together an individual loser weight, the body"s power requirements decrease, but the dynamic physiological adaptations that happen never have been quantified or figured into the 3,500-calorie rule.4 The many serious error the the 3,500-calorie dominion is its fail to account for dynamic alters in energy balance the occur during a dieting intervention.5 additionally not taken into account: gender, the truth that eating and exercise habits may readjust over time, and poor compliance, all of which can impact weight loss. Due to the fact that of this, the specialists say, the 3,500-calorie-per-pound method significantly overestimates how much weight people will lose over time, setup them up because that disappointment when weight loss slows or stops altogether.1 In other words, the body adapts and also lifestyles readjust in myriad means that minimization or even eradicate the influence of diminished calorie entry and, till recently, there has been no means to predict exactly how consuming under calories may influence the price of weight loss amongst individuals do the efforts to shed weight, particularly when the score is come lose an ext than simply a couple of pounds.

The new facility weight-loss formulas factor in the fall in metabolic price that occurs with time as human body mass decreases. After using the formulas to individuals, a key conclusion Thomas and also other researchers have attracted isn"t a famous one—that human being generally plateau early in the weight-loss process, not because of a metabolic slowdown, although the does occur, but due to the fact that they don"t adhere to calorie-reduced diet plan consistently long term.4,6

"If a plateau is got to within 6 months, then in every likelihood, the person is no longer strictly adhering to the diet," claims Carson C. Chow, PhD, a an elderly investigator in the mathematics biology section of the national Institutes of health (NIH). Six to ripe months is the common timeline because that dieters to reach the dreaded plateau, yet "given that body weight alters so slowly, it can be extended out come a year," Chow says. The brand-new formulas permit clinicians to check out what realistically have the right to be expected based on the individual"s weight, age, gender, and physical activity, and close monitoring permits for adjustments in the predictive formula.7

Where specifically does exercise fit in? The impact of physical task on the price of weight loss isn"t clear. However, research says that the small amount of weight loss periodically seen in exercise treatment studies isn"t because of exercise"s lack of result on load loss, yet it"s a result of no getting enough exercise prescribed,6 and also that"s compounded by an increase in calorie intake—in other words, not sticking come the prescribed reduced-calorie diet lengthy term.1 The proportion of macronutrents in the diet, specifically the ratio of protein come carbohydrates and fat, has been endorsed together a method to promote weight loss. However, tiny effect has actually been prove in the brief term.

Yet, follow to Kevin Hall, PhD, a senior investigator in the mathematics biology section of the NIH, not sufficient is known around the long-term effects of differing macronutrient diet composition.4 together a result, the proportion of macronutrents in the diet isn"t contained in the new weight-loss forecast formulas.

New Weight-Loss math To access the programs and also apps because that assessing the weight-loss trajectory that clients and also patients, Hall and colleagues in ~ the NIH have arisen the Body weight Simulator, obtainable at www.niddk.nih.gov/research-funding/at-niddk/labs-branches/LBM/integrative-physiology-section/body-weight-simulator/Pages/body-weight-simulator.aspx. At an initial glance, it may not watch that various from various other weight-loss predictors, but a incredible amount of math calculations have gone into its development. Plug in your client"s info (weight, height, task level, goal weight, length of time to with goal) and also it will administer a calorie level for load loss and a calorie level for maintenance. Thomas and also her colleagues at Pennington Biomedical Research center in Baton Rouge, Louisiana, additionally have arisen a solitary Subject Weight readjust Predictor applications for predicting weight loss, which can be discovered at http://pbrc.edu/research-and-faculty/calculators/sswcp. Utilizing the Pennington virtual calculator, a 200-lb male aged 35 who reduced 500 kcal/day from his diet would be supposed to shed 23 lbs in one year vs 23 lbs in 4 months in accordance through the 3,500-calorie-per-pound rule.

Hall and also Thomas agree that while there are several minor distinctions in their models, the predictions are similar. The NIH calculator allows for much more detailed input about physical activity, and also the Pennington model allows users to to compare the recently calculated downward weight-loss trajectory, based on your input, with that that the 3,500-calorie-per-pound rule.

The brand-new mathematical approaches have been validated repeatedly, researcher say. In fact, the 3,500-calorie tip was refuted in a consensus statement issued together by the American culture for Nutrition and the global Life scientific researches Institute in 2012,8 although the math philosophies haven"t to be widely embraced for clinical weight management or supplied to educate policy discussions.4 Still, Hall has high hopes for the new weight-loss math.

"I think our methods could be offered to remotely monitor patients and also detect early on signs of adherence loss that would trigger a counseling session or a reevaluation of weight goals and also the type of intervention," says Hall, who has actually invented the personalized dynamic feedback control device, because that which the NIH has actually filed a patent.9 No native on once or if it will certainly be available, but it looks choose it might be the method of the future.

If clients and also patients favor something much less complex, Chow has broken it down to a basic rule of thumb. "While the 3,500-calorie preeminence has been challenged in the past, us were the an initial to change it through an equally simple, but much more accurate rule, and that is the "every 10 calories every day decrease in calorie intake leads to an ultimate one-pound loss," but it deserve to take 3 years to obtain there," Chow says. In other words, weight loss isn"t a linear event over time, together the 3,500-calorie preeminence suggests. All of this brand-new information reflects that load loss might be slow, even slower 보다 we thought. That renders patience a significant factor in weight-loss success. And because compliance wanes end time, consistency is the other major part of the equation that adds up to successful weight loss.

"Successful weight management is a long-term venture that needs diligence each and every day," says Corby Martin, PhD, director of the Ingestive actions Laboratory in ~ Pennington Biomedical research Center. "It"s critical that patients and dietitians consistently monitor progression and change their treatment strategy accordingly. If a patient"s current treatment regimen isn"t working, it"s command to detect this as beforehand as feasible and employ an ext intensive strategies." Both Chow and Hall think that taking active control that food intake may be compelled to limit the long-term rise in energy intake that commonly occurs, particularly in the face of the dramatic climb in ease of access and marketing of very palatable, convenient, inexpensive, and also energy-dense foods.7

And perhaps many intriguing is the brand-new research supposed to be released this year by Thomas and also colleagues. "We have a file under review around a way to do it straightforward for dietitians to identify, from temporary data, who"s most likely to be successful at losing weight over the lengthy term."

Counseling recommendations The 3,500-calorie-per-pound preeminence is dead, or it should be. In its ar are new online devices to assist RDs much better predict just how much weight clients and patients realistically can expect to lose over time. In addition, young name believes the brand-new mathematical formulas have the right to inform dietitians when it"s time come reevaluate your clients" or patients" progression and help them decision what realistic adjustments are needed. If weight-loss milestones haven"t to be reached, then it may be time come reassess what the customer is or isn"t doing. Martin recommends weekly or biweekly check-ins to see exactly how clients space doing. Much more thorough reviews of progress, he says, should happen every three to six months.

While the new online tools most likely will predict lot slower development than anyone would certainly like, dietitians have the right to use lock to help clients and also patients set an ext realistic goals and let them recognize that progress most likely will it is in slow and unsteady. Furthermore, if they"ve to be reading around weight loss virtual or in diet books, inform them the the thinking has adjusted dramatically and also the 3,500 calories-per-pound ascendancy no much longer applies.

— Densie Webb, PhD, RD, is a freelance writer, editor, and industry consultant based in Austin, Texas.

References 1. Cutting board DM, young name CK, Lettieri S, et al. Can a weight loss the one lb a mainly be achieved with a 3500-kcal deficit? commentary on a typically accepted rule. Int J Obes (Lond). 2013;37(12):1611-1613.

2. Guth E. JAMA patience page: healthy and balanced weight loss. JAMA. 2014;312(9):974.

3. Wishnofsky M. Caloric equivalents of gained or lost weight. Am J Clin Nutr. 1958;6(5):542-546.

4. Hall KD, Sacks G, Chandramohan D, et al. Quantification of the effect of energy imbalance top top bodyweight. Lancet. 2011;378(9793):826-837.

5. Hall KD, Chow CC. Why is the 3500 kcal every pound weight loss dominion wrong? Int J Obes (Lond). 2013;37(12):1614.

6. Cutting board DM, Bouchard C, Church T, et al. Why do individuals not lose much more weight from an exercise treatment at a identified dose? An energy balance analysis. Obes Rev. 2012;13(10):835-847.

7. Chow CC, room KD. Short and long-term power intake patterns and their effects for person body load regulation. Physiol Behav. 2014;134:60-65.

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8. Hall KD, Heymsfield SB, Kemnitz JW, Klein S, Schoeller DA, Speakman JR. Energy balance and its components: implications for body weight regulation. Am J Clin Nutr. 2012;95(4):989-994.

9. Personalized dynamic feedback control of human body weight: United says patent application us 20130198214 A1. Google Patents website. Http://www.google.com/patents/US20130198214. Accessed September 4, 2014.