Dr. David Ludwig in the News: 2019 – 2021
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Challenging Dietary Dogma on Weight Gain
Introduction to Podcast (Starts at 6:10): Our guests are challenging the dietary dogma on weight gain, that we put on weight because we eat too much and move too little. Read More >>
"We’ve Had it Backwards" - New Model Explains Weight Gain and Obesity
November 9, 2021: Intro to Video: “A paper just released in the American Journal of Clinical Nutrition challenges really challenges conventional thinking about nutrition, weight gain, and what has caused the very rapid and profound increase in obesity rates over the last 50 years. This is a landmark paper by any standard and saying that will raise eyebrows is an understatement. The papers authored by a number of distinguished nutrition scientists. The lead author is Dr. David Ludwig from Harvard University.”
Stimulated Secretion Predicts Changes in Body Composition Following Weight Loss in Adults with High BMI
SEPTEMBER 29, 2021: CONCLUSIONS: Baseline insulin dynamics predict substantial individual differences in body composition following weight loss. These findings may inform understanding of the pathophysiological basis for weight regain and the design of more effective obesity treatment.
Effects of a low-carbohydrate diet on insulin-resistant dyslipoproteinemia—a randomized controlled feeding trial
SEPTEMBER 28, 2021: “Conclusion: A low-carbohydrate diet, high in saturated fat, improved insulin-resistant dyslipoproteinemia and lipoprotein(a), without adverse effect on LDL cholesterol. Carbohydrate restriction might lower CVD risk independently of body weight, a possibility that warrants study in major multicentered trials powered on hard outcomes.”
The carbohydrate-insulin model: a physiological perspective on the obesity pandemic
SEPTEMBER 13, 2021: “According to a commonly held view, the obesity pandemic is caused by overconsumption of modern, highly palatable, energy-dense processed foods, exacerbated by a sedentary lifestyle. However, obesity rates remain at historic highs, despite a persistent focus on eating less and moving more, as guided by the energy balance model (EBM). This public health failure may arise from a fundamental limitation of the EBM itself. ”
CAN A LOW-CARB DIET HELP YOUR HEART HEALTH?
OP-ED: DO WE REALLY KNOW WHAT MAKES US FAT?
(SEPTEMBER 26, 2021): “We’re familiar with the pattern by now: Every few years, a new study emerges with new obesity statistics. The numbers seem shockingly high, almost impossibly high, until the next study comes along with numbers that are higher still. In the 1970s, approximately 15% of American adults met the obesity criteria. By the end of the 1980s, that 15% had grown to more than 20%. By the year 2000, we had reached 30%. Today, 42% of American adults are classified as obese, and an additional 30% are considered overweight. Whatever is happening, it is happening to a remarkable number of us.”
Do Lower-Carbohydrate Diets Increase Total Energy Expenditure?
DECEMBER 3, 2020: “Conclusion: Lower-carbohydrate diets transiently reduce TEE, with a larger increase after ∼2.5 wk. These findings highlight the importance of longer trials to understand chronic macronutrient effects and suggest a mechanism whereby lower-carbohydrate diets may facilitate weight loss.”
Effects of Sugar‐Sweetened, Artificially Sweetened, and Unsweetened Beverages on Cardiometabolic Risk Factors...
JULY 22, 2020: A 2018 American Heart Association science advisory indicated that, pending further research, artificially sweetened beverages (ASBs) may be an appropriate initial replacement for sugar‐sweetened beverages (SSBs) during transition to unsweetened beverages (USBs).
Effects of Dietary Carbohydrate Content on Circulating Metabolic Fuel Availability in the Postprandial State
MAY 26, 2020: “According to the carbohydrate-insulin model of obesity, an elevated insulin-to-glucagon ratio in response to a high-carbohydrate diet directs metabolic fuels toward storage, resulting in lower circulating energy.”
Milk and Health
FEBRUARY 13, 2020: This review summarizes the evidence for the benefits and possible risks associated with consumption of cow’s milk. The authors describe the relationship of milk consumption to the risks of fracture, obesity, cardiovascular disease, allergies, and various cancers.
The Ketogenic Diet: Evidence for Optimism but High-Quality Research Needed
DECEMBER 11, 2019: “For >50 y, dietary guidelines in the United States have focused on reducing intakes of saturated and total fat. However, rates of obesity and diabetes rose markedly throughout this period, with potentially catastrophic implications for public health and the economy. Recently, ketogenic diets have received substantial attention from the general public and nutrition research community. These very-low-carbohydrate diets, with fat comprising >70% of calories, have been dismissed as fads. However, they have a long history in clinical medicine and human evolution. Ketogenic diets appear to be more effective than low-fat diets for treatment of obesity and diabetes.”
WHY DIET RESEARCH IS SO SPECTACULARLY THIN
NOVEMBER 2019 – Most diet trials in the best journals fail even the most basic of quality control measures. That’s the finding of a study by us to be published today in JAMA Network Open.
DISCREPANCIES IN THE REGISTRIES OF DIET VS DRUG TRIALS
NOVEMBER 13 2019 – ClinicalTrials.gov was established in 2000 in response to the Food and Drug Administration Modernization Act of 1997, which called for registration of trials of investigational new drugs for serious diseases. Subsequently, the scope of ClinicalTrials.gov expanded to all interventional studies, including diet trials.
Improving the Quality of Dietary Research
AUGUST 12, 2019: “Compared with pharmaceutical research, studies evaluating diet or dietary interventions for chronic diseases like obesity (to be distinguished from micronutrient deficiency syndromes like scurvy or rickets) have far greater challenges in terms of consistency, quality control, confounding, and interpretation.”
Management of Type 1 Diabetes With a Very Low–Carbohydrate Diet
CONCLUSIONS: Exceptional glycemic control of T1DM with low rates of adverse events was reported by a community of children and adults who consume a VLCD. The generalizability of these findings requires further studies, including high-quality randomized controlled trials.
Dr. David Ludwig in the News: 2016 – 2018
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EFFECTS OF A LOW CARBOHYDRATE DIET ON ENERGY EXPENDITURE DURING WEIGHT LOSS MAINTENANCE: RANDOMIZED TRIAL
The BMJ (2018): Conclusions Consistent with the carbohydrate-insulin model, lowering dietary carbohydrate increased energy expenditure during weight loss maintenance. This metabolic effect may improve the success of obesity treatment, especially among those with high insulin secretion.
Management of Type 1 Diabetes With a Very Low–Carbohydrate Diet
(JUNE 2018): CONCLUSIONS: Exceptional glycemic control of T1DM with low rates of adverse events was reported by a community of children and adults who consume a VLCD. The generalizability of these findings requires further studies, including high-quality randomized controlled trials.
HOW A LOW-CARB DIET MIGHT HELP YOU MAINTAIN A HEALTHY WEIGHT
New York Times (November 2018): It has been a fundamental tenet of nutrition: When it comes to weight loss, all calories are created equal. Regardless of what you eat, the key is to track your calories and burn more than you consume.
But a large new study published on Wednesday in the journal BMJ challenges the conventional wisdom.
THE CASE AGAINST CARBOHYDRATES GETS STRONGER
Los Angeles Times (November 14, 2018): As anyone who’s gone on a diet knows, once you lose some weight, it gets harder to lose more. The “eat less, move more” mantra, as simple as it sounds, doesn’t help us deal with our bodies’ metabolic reality: As we shed pounds, we get even hungrier and our metabolism slows down.
DIETARY FAT: FROM FOE TO FRIEND?
Science Magazine (November 2018): For decades, dietary advice was based on the premise that high intakes of fat cause obesity, diabetes, heart disease, and possibly cancer. Recently, evidence for the adverse metabolic effects of processed carbohydrate has led to a resurgence in interest in lower-carbohydrate and ketogenic diets.
WHY CALORIE COUNTING DOESN’T WORK—AND WHAT TO DO INSTEAD
Clean Plates (June 2018): Calories in vs. calories out—i.e., eating fewer calories than you burn off—has been an accepted weight loss formula for decades. And on its face, it seems to make sense. But a growing body of research is proving what frustrated dieters have already discovered: It’s just not that simple.
HURRAH! IT’S THE STEAK AND CHOCOLATE DIET – WHICH IS EASIER TO KEEP TO BECAUSE IT HAS ENOUGH FAT
Daily Mail (January 2, 2016): Year dieters should ditch the celery and salads and tuck in to shepherd’s pie and steak instead – and even indulge in cream on their dessert – according to a leading academic.
CUT FAT OR CARBS? THE WAY TO SHED POUNDS MAY BE NEITHER
Seattle Times (February 24, 2016): Always hungry? Not losing weight? According to Dr. David Ludwig, professor at Harvard’s School of Public Health, you can calm your cravings and get your body back on track with a balance of healthy, natural carbs and fats, rather than faddish eating plans.
ARE YOU EATING THE RIGHT KIND OF CARBS?
Telegraph (February 22, 2016): In polite company, it is more acceptable these days to admit that you’re in AA than to order a pasta dish or to dip into the bread basket. Because carbohydrates are evil, aren’t they?
HUNGRY NO MORE
Experience Life (January/February 2016): Weight-loss wisdom has long focused on one thing: Consume fewer calories than you burn. There’s just one problem. It doesn’t work — at least not over the long term, for most people. Obesity rates remain at historic highs, despite a 40-year focus on low-calorie, low-fat diets. While an obsession with counting calories rarely produces lasting weight loss, it regularly causes suffering and shame.
BEST-SELLING DIET BOOK SAYS NO TO CALORIE-COUNTING, YES TO HEALTHY FATS
Chicago Tribune (February 3, 2016): In the mid-1990s, when the low-fat diet was king, a young obesity researcher began to have his doubts.
Why, Dr. David Ludwig wondered, did his patients almost invariably gain weight on state-of-the-art diets? Why was he himself gaining weight?
“ALWAYS HUNGRY?” BOOK CHALLENGES THINKING ON CALORIES, WEIGHT LOSS
CBS News (February 10, 2016): A new book challenges the long-standing belief that when it comes to weight loss, calories are what count.
In Dr. David Ludwig’s book “Always Hungry?” (Grand Central Life & Style, 2016), he argues that the type of foods you eat — not just the number of calories in those foods — ultimately affects the number of calories you burn.
IS YOUR LOW-FAT, LOW-CAL DIET WORKING AGAINST YOU?
US News (August 15, 2016): Heather Reyes has spent the better part of the last decade struggling to lose the 40 extra pounds she gained in her early 20s and the weight she put on during her pregnancies. The Aurora, Illinois, mother of two counted calories ad nauseum, at one point losing 30 pounds during a stint on Weight Watchers. But inevitably her willpower would fade. As soon as she strayed from her diet, she says, “the floodgates would open,” and the pounds would creep back on.
RETHINKING WEIGHT LOSS AND THE REASONS WE’RE ‘ALWAYS HUNGRY’
New York Times (January 7, 2016): LUDWIG often uses an analogy when he talks about weight loss: Human beings are not toaster ovens. If we were, then the types of calories we consumed would not matter, and calorie counting would be the most effective way to lose weight.
EAT FAT, LOSE WEIGHT: THE ANTI-HUNGER DIET
Daily Burn (February 18, 2016): Eat less, move more. That’s the theme behind most diets these days. If we just consume fewer calories and put in more hours at the gym, we’ll shed pounds, right?
According to David Ludwig, MD, PhD, leading obesity researcher and professor of nutrition at Harvard University, our time and energy might be better spent paying more attention to what we eat rather than how much we eat. In fact, our diet has the capacity to actually retrain our fat cells to burn more calories, Dr. Ludwig says.
IF DAVID LUDWIG IS RIGHT, EVERYTHING WE THOUGHT WE KNEW ABOUT OBESITY—AND LOW-FAT DIETS—IS WRONG
Boston Magazine (January 2016): In the late 1990s, David Ludwig brought 12 obese teenage boys into his clinic for the day, and fed them each prescribed meals. It was a simple experiment: The meals all had the same number of calories, but contained different kinds of food.
EAT FAT, LOSE WEIGHT: THE ANTI-HUNGER DIET
The Daily Beast (March 20, 2016): Eat less, move more. That’s the theme behind most diets these days. If we just consume fewer calories and put in more hours at the gym, we’ll shed pounds, right?
HOW TO LOSE WEIGHT: 9 STRATEGIES TO TRY
New York Times (March 18, 2016): THERE’S more than one way to lose weight — and recommendations are constantly evolving. Here are some we’ve highlighted recently.
THE 15 ABSOLUTE BEST WAYS TO LOSE BELLY FAT
February 17, 2016 – If you’re one of the 32 percent of Americans who want to lose belly fat for good, but have no idea what actually works anymore, you’re not alone. A recent survey found that 76 percent of people didn’t follow a diet or workout plan last year because, well, there seems to be a fad diet popping up every day and nobody knows what’s what. So let’s cut through the clutter—these are the 15 out-of-the-box strategies that are guaranteed to give you results.
YOU ASKED: WHAT’S THE BEST WAY TO LOSE WEIGHT?
January 27, 2016 – Eat less, move more, and you may lose weight—though probably not for long.
If you’re hoping to drop a few pounds for an upcoming vacation, the old “calories in, calories out” method can be effective. Combine a meager diet with lots of exercise, and in the short term your body will plunder its fat stores in search of energy.
WILL THE ‘ALWAYS HUNGRY’ DIET REVOLUTIONIZE WEIGHT LOSS? A Q&A WITH THE AUTHOR, DR. DAVID LUDWIG
Forbes (January 5, 2016): Nearly $60 billion is spent annually on the U.S. weight loss market, yet two-thirds of adults and one-third of children and teens are overweight or obese. Dieters who can sustain their weight loss are the “rare exception, rather than the rule” according to a 2007 analysis by researchers at the University of California at Los Angeles.
STRUGGLING TO LOSE WEIGHT? EXPERT REVEALS THE 7 REAL REASONS YOU AREN’T SHEDDING THE POUNDS
Daily Mail (July 6, 2016): Forget everything you’ve been taught about dieting. Many struggle to lose weight and often wonder why they can’t get their desired body in time for the summer. But now an expert believes he may know the reason why – and it lies within our eating habits.
BEYOND THE BINGE: ERIC DIETZIUS’S SUCCESS STORY
Experience Life (October 2016): One man’s journey to move beyond poor health habits — and overcome an undiagnosed eating disorder.
“When our first child was born in 2007, I had an awakening. Carrying 285 pounds on my 5-foot-11-inch frame, I was completely out of shape. I had become a self-indulgent person, and it was time to start living for my family…”
BEST DIETS 2016: FROM FASTEST WEIGHT LOSS TO CONQUERING CRAVINGS
NPR (January 5, 2016): It comes to dieting, losing weight fast holds some appeal. Perhaps that’s why U.S. News & World Report has added a Fast Weight-Loss Diet category to its annual rankings of best diet plans. And one of the diets that comes out on top is the Health Management Resources program.
I READ A BOOK TO SEE IF IT COULD STOP ME FROM BEING HUNGRY ALL THE TIME
Elle.com (January 6, 2016): I am always hungry. Okay, maybe not always, but the idea of food always sounds good—and it’s hard to differentiate the two. Meanwhile, my dresses are increasingly strained across my hips.
7 TIPS FOR BREAKING YOUR ADDICTION TO SUGAR
Money Talks News (February 17, 2016): Sugar is an often invisible, but ever-present part of American life. We all know it’s in cookies, candy, soda pop and pastries, but it’s also present in surprising amounts in other foods — spaghetti sauce, catsup, salad dressing, soups, yogurt, coffee drinks, sports drinks and juice, cereals and protein bars, for instance.
7 HACKS FOR CONQUERING YOUR FOOD CRAVINGS
New York Post (February 17, 2016): It’s the third week of February and the midwinter blues have settled in. As New Year’s resolutions fall by the wayside, there’s a fair chance you’re battling cravings for unhealthy foods, leading to weight gain and sluggishness.
Dr. David Ludwig in the News: 2014-2015
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WHY IS THE FEDERAL GOVERNMENT AFRAID OF FAT?
The New York Times (July 9, 2015): BOSTON — Since the publication of the federal government’s 1980 Dietary Guidelines, dietary policy has focused on reducing total fat in the American diet — specifically, to no more than 30 percent of a person’s daily calories. This fear of fat has had far-reaching impacts, from consumer preferences to the billions of dollars spent by the military, government-run hospitals and school districts on food.
ALWAYS HUNGRY? HERE’S WHY
The New York Times (May 16, 2014): For most of the last century, our understanding of the cause of obesity has been based on immutable physical law. Specifically, it’s the first law of thermodynamics, which dictates that energy can neither be created nor destroyed. When it comes to body weight, this means that calorie intake minus calorie expenditure equals calories stored. Surrounded by tempting foods, we overeat, consuming more calories than we can burn off, and the excess is deposited as fat.
EFFECT OF LOW-FAT DIET INTERVENTIONS VERSUS OTHER DIET INTERVENTIONS ON LONG-TERM WEIGHT CHANGE IN ADULTS: A SYSTEMATIC REVIEW AND META-ANALYSIS
The Lancet Diabetes and Endocrinology (2015): Interpretation: These findings suggest that the long-term effect of low-fat diet intervention on bodyweight depends on the intensity of the intervention in the comparison group. When compared with dietary interventions of similar intensity, evidence from RCTs does not support low-fat diets over other dietary interventions for long-term weight loss.
THE 2015 US DIETARY GUIDELINES: LIFTING THE BAN ON TOTAL DIETARY FAT
“In the new DGAC report, one widely noticed revision was the dropping of dietary cholesterol as a “nutrient of concern.” This surprised the public, but is concordant with scientific evidence demonstrating no appreciable relationship between dietary cholesterol and serum cholesterol1 or clinical cardiovascular events in general populations.2 The DGAC should be commended for this evidence-based change.”
THE REAL COST OF FOOD: CAN TAXES AND SUBSIDIES IMPROVE PUBLIC HEALTH?(JAMA 2014)
“Suboptimal diet quality is among the leading factors associated with death and disability in the United States1 and globally.2 Strategies to address suboptimal diet focus on nutrition education through dietary guidelines and food package labeling. However, this approach places responsibility for healthier diets on an individual’s ability to make informed choices rather than addressing the complex, powerful environmental determinants of dietary habits. Not surprisingly, this strategy has fallen short, as demonstrated by the increasing rates of obesity, diabetes, and other diet-related illness.”
Dr. David Ludwig in the News: 2010-2013
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EFFECTS OF DIETARY GLYCEMIC INDEX ON BRAIN REGIONS RELATED TO REWARD AND CRAVING IN MEN
The American Journal of Clinical Nutrition (2013): Conclusions: Compared with an isocaloric low-GI meal, a high-GI meal decreased plasma glucose, increased hunger, and selectively stimulated brain regions associated with reward and craving in the late postprandial period, which is a time with special significance to eating behavior at the next meal.
EFFECTS OF A LOW-GLYCEMIC LOAD DIET IN OVERWEIGHT AND OBESE PREGNANT WOMEN: A PILOT RANDOMIZED CONTROLLED TRIAL
The American Journal of Clinical Nutrition (2010): Conclusions: A low-GL diet resulted in longer pregnancy duration, greater infant head circumference, and improved maternal cardiovascular risk factors. Large-scale studies are warranted to evaluate whether dietary intervention during pregnancy aimed at lowering GL may be useful in the prevention of prematurity and other adverse maternal and infant outcomes.
EFFECTS OF DIET COMPOSITION ON POSTPRANDIAL ENERGY AVAILABILITY DURING WEIGHT LOSS MAINTENANCE
PLoS Medicine (2013): The major circulating metabolic fuels regulate hunger, and each is affected by dietary composition. An integrated measure of postprandial energy availability from circulating metabolic fuels may help inform dietary recommendations for weight maintenance after weight loss.
EFFECTS OF DIETARY COMPOSITION ON ENERGY EXPENDITURE DURING WEIGHT-LOSS MAINTENANCE
JAMA (2012): Conclusion: Among overweight and obese young adults compared with pre-weight-loss energy expenditure, isocaloric feeding following 10% to 15% weight loss resulted in decreases in REE and TEE that were greatest with the low-fat diet, intermediate with the low-glycemic index diet, and least with the very low-carbohydrate diet.
HOW EARLY SHOULD OBESITY PREVENTION START?(The New England Journal of Medicine 2013)
“Obesity has pervaded the United States and is spreading throughout the world. Following in its wake is type 2 diabetes, which will affect at least half a billion people worldwide by 2030.”
THREE DAILY SERVINGS OF REDUCED-FAT MILK: AN EVIDENCE-BASED RECOMMENDATION? (JAMA Pediatrics 2013)
“In light of research linking sugar-sweetened beverage consumption to obesity, the US Department of Agriculture, the American Academy of Pediatrics, and other organizations have formulated recommendations on healthy beverages. These guidelines consistently recommend limiting consumption of all calorie-containing liquids, except reduced-fat milk, of which people in most age groups are encouraged to consume 3 cups daily. This article questions the scientific rationale for promoting reduced-fat milk consumption at these levels in children and adults and reconsiders the role of cow’s milk in human nutrition.”
OPPORTUNITIES TO REDUCE CHILDHOOD HUNGER AND OBESITY: RESTRUCTURING THE SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (THE FOOD STAMP PROGRAM)(JAMA 2012).
“Childhood is a time of substantial nutritional needs. However, many children in low-income families do not consume adequate amounts of nutritious foods for optimal physical development, cognitive performance, and psychological well-being. The pending reauthorization of the Supplemental Nutrition Assistance Program (SNAP, formerly known as the Food Stamp Program), a $75 billion annual federal food assistance program, provides a critical opportunity to improve the nutritional health of its 46.6 million recipients, nearly half of whom are children.1“
SURGICAL VS. LIFESTYLE TREATMENT FOR TYPE 2 DIABETES (JAMA 2012)
“Recent clinical trials have reported that substantially more weight loss and greater likelihood of diabetes remission occur following bariatric surgery compared with medical therapy,1 leading to calls for earlier consideration of surgery in the treatment of this obesity-related metabolic disease. Although these studies demonstrate the lack of efficacy of conventional practices, they do not prove the inherent superiority of surgery to lifestyle change. This Viewpoint considers the limitations of published research and highlights the need for clinical trials with improved design.”
WEIGHT LOSS STRATEGIES FOR ADOLESCENTS: A 14-YEAR-OLD STRUGGLING TO LOSE WEIGHT (JAMA 2012)
“A key parenting practice applicable to children of all ages is to create a protective environment in the home, substituting nutritious foods for unhealthful ones and facilitating physical activities instead of sedentary pursuits. Other behaviors that may promote successful long-term weight management include good sleep hygiene, stress reduction, and mindfulness.”
THE 2010 DIETARY GUIDELINES - THE BEST RECIPE FOR HEALTH? (The New England Journal of Medicine 2011)
“The new U.S. dietary guidelines may have limited direct educational influence, but they will affect Americans’ diets through federal food policies and food-assistance programs. The new guidelines represent a mix of progress and lost opportunities.”
THE SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM, SODA, AND USDA POLICY: WHO BENEFITS? (JAMA 2011)
“In a controversial decision dated August 19, 2011, the US Department of Agriculture (USDA) denied a request by New York state to conduct a pilot project with New York city that would have eliminated Supplemental Nutrition Assistance Program (SNAP, formerly known as food stamps) benefits for sugar-sweetened beverages.1 California, Nebraska, Illinois, Pennsylvania, Minnesota, Michigan, Vermont, and Texas have either requested such permission or urged Congress to grant states more flexibility to set standards for what can and cannot be purchased with SNAP benefits, but thus far no such request has been granted.”
TECHNOLOGY, DIET, AND THE BURDEN OF CHRONIC DISEASE (JAMA 2011)
“From an evolutionary perspective, food is either difficult to get or difficult to eat. Humans lack the strength and speed of large carnivores and the specialized digestive track of herbivores. Indeed, the diet of early hominids was mostly limited to fruits and insects. For this reason, humans have long strived to develop technologies to improve food availability, digestibility, safety, transportability, and storage life. However, the rate of change in food technology has greatly accelerated, with major implications to human nutrition and health.”
WEIGHT-LOSS MAINTENANCE - MIND OVER MATTER?(The New England Journal of Medicine 2010)
“Many people can lose weight in the short term by reducing their intake of calories with the use of a variety of diets, ranging from low-fat to very-low-carbohydrate. However, few people successfully maintain their weight loss.1 One explanation for the poor efficacy of conventional diets relates to psychological factors, since the motivation to adhere to restrictive regimens diminishes with time, especially in an environment with virtually instantaneous availability of food.”
DIETARY GUIDELINES IN THE 21ST CENTURY - A TIME FOR FOOD (JAMA 2010)
“The discovery of specific dietary insufficiencies as the cause of human disease played a central role in the development of modern nutritional science. In 1753, one of the first clinical trials showed that citrus fruit could prevent scurvy in sailors, leading to the identification of vitamin C as essential for health. By the mid-20th century, protective effects of many nutrients for deficiency diseases had been shown, including thiamine (beriberi), niacin (pellagra), vitamin D (rickets), vitamin A (night blindness), iron (anemia), and iodine (goiter).”
THE ASSOCIATION BETWEEN PREGNANCY WEIGHT GAIN AND BIRTHWEIGHT: A WITHIN-FAMILY COMPARISON
“Maternal weight gain during pregnancy increases birthweight independently of genetic factors. In view of the apparent association between birthweight and adult weight, obesity prevention efforts targeted at women during pregnancy might be beneficial for offspring.”
BRING BACK HOME ECONOMICS EDUCATION (JAMA 2010)
“Home economics, otherwise known as domestic education, was a fixture in secondary schools through the 1960s, at least for girls. The underlying concept was that future homemakers should be educated in the care and feeding of their families. This idea now seems quaint, but in the midst of a pediatric obesity epidemic and concerns about the poor diet quality of adolescents in the United States, instruction in basic food preparation and meal planning skills needs to be part of any long-term solution.”
PERSONAL RESPONSIBILITY AND OBESITY: A CONSTRUCTIVE APPROACH TO A CONTROVERSIAL ISSUE (Health Affairs 2010).
“Personal responsibility can be embraced as a value by placing priority on legislative and regulatory actions such as improving school nutrition, menu labeling, altering industry marketing practices, and even such controversial measures as the use of food taxes that create healthier defaults, thus supporting responsible behavior and bridging the divide between views based on individualistic versus collective responsibility.”
FRONT-OF-PACKAGE FOOD LABELS: PUBLIC HEALTH OR PROPAGANDA? (JAMA 2010)
“At no point in US history have food products displayed so many symbols and statements proclaiming nutrition and health benefits. Front-of-package claims, often used in violation of Food and Drug Administration (FDA) labeling regulations, have become ubiquitous in food marketing.1,2 Recently, the FDA embarked on an initiative to review front-of-package labeling and asked the Institute of Medicine to consider eventual recommendation of a single, standardized guidance system. Front-of-package labels may so thoroughly mislead the public that another option deserves consideration—eliminate all nutrition and health claims from the front of processed food packages while strengthening the Nutrition Facts Panel.”
EXTRA CALORIES CAUSE WEIGHT GAIN - BUT HOW MUCH? (JAMA 2010)
“How much weight would an individual gain by eating an extra chocolate chip cookie every day for life? One approach to answering this question, frequently used in textbooks1 and scientific articles, is based on the assumption that a pound (454 g) of fat tissue has about 3500 kilocalories (kcal). Thus, a daily 60-kcal cookie would be expected to produce 0.2 kg (0.5 lb) weight gain in a month, 2.7 kg (6 lb) in a year, 27 kg (60 lb) in a decade, and many hundreds of pounds in a lifetime. This of course does not happen. In this article, the physiology of weight gain and loss is reviewed, and the amount of reduction of caloric intake necessary to avoid becoming overweight or obese is estimated.”
Dr. David Ludwig in the News: Earlier than 2010
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EFFECTS OF DIETARY GLYCEMIC INDEX ON BRAIN REGIONS RELATED TO REWARD AND CRAVING IN MEN
The American Journal of Clinical Nutrition (2013): Conclusions: Compared with an isocaloric low-GI meal, a high-GI meal decreased plasma glucose, increased hunger, and selectively stimulated brain regions associated with reward and craving in the late postprandial period, which is a time with special significance to eating behavior at the next meal.
EFFECTS OF A LOW-GLYCEMIC LOAD DIET IN OVERWEIGHT AND OBESE PREGNANT WOMEN: A PILOT RANDOMIZED CONTROLLED TRIAL
The American Journal of Clinical Nutrition (2010): Conclusions: A low-GL diet resulted in longer pregnancy duration, greater infant head circumference, and improved maternal cardiovascular risk factors. Large-scale studies are warranted to evaluate whether dietary intervention during pregnancy aimed at lowering GL may be useful in the prevention of prematurity and other adverse maternal and infant outcomes.
ACUTE EFFECTS OF DIETARY GLYCEMIC INFEX ON ANTIOXIDANT CAPACITY IN A NUTRIENT-CONTROLLED FEEDING STUDY
JAMA (2009): Oxidative stress, caused by an imbalance between antioxidant capacity and reactive oxygen species, may be an early event in a metabolic cascade elicited by a high glycemic index (GI) diet, ultimately increasing the risk for cardiovascular disease and diabetes.
EFFECTS OF A LOW-GLYCEMIC LOAD VS LOW-FAT DIET IN OBESE YOUNG ADULTS: A RANDOMIZED TRIAL
JAMA (2007): Conclusions: Variability in dietary weight loss trials may be partially attributable to differences in hormonal response. Reducing glycemic load may be especially important to achieve weight loss among individuals with high insulin secretion. Regardless of insulin secretion, a low-glycemic load diet has beneficial effects on high-density lipoprotein cholesterol and triglyceride concentrations but not on low-density lipoprotein cholesterol concentration.
EFFECTS OF DIETARY GLYCEMIC INDEX ON ADIPOSITY, GLUCOSE HOMEOSTASIS, AND PLASMA LIPIDS IN ANIMALS
Lancet (2004): Clinical studies suggest a role for dietary glycaemic index (GI) in bodyweight regulation and diabetes risk. However, partly because manipulation of GI can produce changes in potentially confounding dietary factors such as fibre content, palatability, and energy density, its relevance to human health remains controversial. This study examined the independent effects of GI in animals.
EFFECTS OF AN AD LIBITUM LOW-GLYCEMIC LOAD DIET ON CARDIOVASCULAR DISEASE RISK FACTORS IN OBESE YOUNG ADULTS
The American Journal of Clinical Nutrition (2005): Conclusion: An ad libitum low-glycemic load diet may be more efficacious than a conventional, energy-restricted, low-fat diet in reducing cardiovascular disease risk.
EFFECTS OF A LOW-GLYCEMIC LOAD DIET ON RESTING ENERGY EXPENDITURE AND HEART DISEASE RISK FACTORS DURING WEIGHT LOSS
JAMA (2004): Conclusions: Changes in dietary composition within prevailing norms can affect physiological adaptations that defend body weight. Reduction in glycemic load may aid in the prevention or treatment of obesity, cardiovascular disease, and diabetes mellitus
ARTIFICIALLY SWEETENED BEVERAGES: CAUSE FOR CONCERN (JAMA 2009)
“The taste receptor for sweetness, T1R2/R1R3,1 can detect sugar at a concentration as low as about 1 part in 200, whereas some bitter substances can be detected in the range of a few parts per million, perhaps explaining why most individuals prefer foods with high sugar content but little bitterness. However, this innate preference for sweetness does not necessarily lead to obesity or other diet-related diseases because sugar-containing foods in their natural form tend to be highly nutritious. For instance, an 8-oz apple contains beneficial vitamins, minerals, and phytochemicals but fewer calories than a 2-oz portion of bread. Most fruits elicit a high level of satiety relative to calories ingested due to their low-energy density, high-fiber content, and low glycemic index.”
THE PUBLIC HEALTH AND ECONOMIC BENEFITS OF TAXING SUGAR-SWEETENED BEVERAGES (JAMA 2009)
“Consumption of sugar-sweetened beverages (SSBs) has been linked to risks of obesity, diabetes, and heart disease,1–3 making a compelling case for reduced consumption. SSBs are beverages which contain added naturally-derived caloric sweeteners such as sucrose (table sugar), high-fructose corn syrup, or fruit juice concentrates, all of which have similar metabolic effects.”
OBESITY AND THE ECONOMY: FROM CRISIS TO OPPORTUNITY (JAMA 2009)
“The onset of a major recession places the economic correlates of obesity into sharp relief. Even in good economic times, obesity imposes great financial burden on society in the form of higher medical costs and lower worker productivity. The economic downturn can be expected to reduce nutrition quality and physical activity, worsening obesity prevalence when society is least able to bear the escalating financial burden.”
THE IMPORTANCE OF BIODIVERSITY TO MEDICINE (JAMA 2008)
“In the past 12 months alone, more than 1000 new species were identified.1 Some were found in Earth’s most remote locations, such as the Weddell Sea off Antarctica or central Australia’s Simpson Desert, where 3 species of carnivorous sponges and a new microbat species were found, respectively. In addition, nearly 100 previously unknown species of bacteria were found to be inhabiting human epidermis. When it comes to biodiversity—a term that describes the variety of life on the planet—the more scientists look, the more they find. But these discoveries represent far more than just novelty. In them can be found a major engine of advancement for medicine and biomedical research and a new lens with which to look on human health and disease.”
CAN THE FOOD INDUSTRY PLAY A CONSTRUCTIVE ROLE IN THE OBESITY EPIDEMIC? (JAMA 2008)
“In response to increasing rates of obesity, many food companies have announced policies of corporate responsibility. McDonald’s claims, “[we] empower individuals to make informed choices about how to maintain the essential balance between energy intake (calories consumed as food) and energy expenditure (calories burned in physical activity).”1 Coca-Cola states, “we have launched new broad-based physical and nutrition education programs that reach even the least athletic students.”2 PepsiCo says, “we can play an important role in helping kids lead healthier lives by offering healthy product choices in schools, by developing healthy products that appeal to kids and by promoting programs that encourage kids to lead active lives.”3 Kraft says, “helping children and their families make heal thy food choices while encouraging physical activity has become part of how Kraft gives back to communities.”4 In light of such statements, should the food industry be welcomed as a constructive partner in the campaign against obesity?”
STORM OVER STATINS - THE CONTROVERSY SURROUNDING PHARMACOLOGIC TREATMENT OF CHILDREN (The New England Journal of Medicine 2008)
“In July of this year, the American Academy of Pediatrics (AAP) released revised recommendations for the management of hypercholesterolemia in children (see table).1 Within days after publication, the new policy statement had elicited a firestorm of controversy — including hundreds of print and broadcast news stories, editorials in the New York Times and the Boston Globe, and thousands of Internet postings — that took many members of the pediatrics community by surprise. The AAP and the National Cholesterol Education Program have advocated targeted screening and pharmacologic treatment for nearly two decades. What sparked this sudden flurry of media attention?”
MINDFULNESS IN MEDICINE (JAMA 2008)
“Mindfulness refers to a meditation practice that cultivates present moment awareness. In the past 30 years, interest in the therapeutic uses of mindfulness has increased, with more than 70 scientific articles on the topic published in 2007. Meditation practices, including mindfulness, have come to the attention of neuroscientists investigating consciousness and affect regulation through mental training and to psychotherapists interested in personal development and interpersonal relationships. In this Commentary, we define mindfulness, consider possible mechanisms, explore clinical applications, and identify challenges to the field.”
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