Laparoscopic Associates of San Francisco

Study Highlight: De-bunking the Myth; “A Calorie is a Calorie”

July 13th, 2012 Posted in Bariatric surgery, Eating healthy, News, Nutrition, Protein and calories, Research, Resources, weight loss plan, weight loss surgery

An eye-opening research study was published June 26th in the Journal of American Medical Association. The article proves the theory that many observant dietitians have noticed along the years counseling patients-“a calorie is NOT a calorie”-especially when it comes to weight loss surgery.


The objective of the study out of Boston was to “examine the effects of 3 diets differing widely in macronutrient composition and glycemic load on energy expenditure following weight loss.”


The study participants were split into three different groups and given three different diet interventions after already achieving 10% to 15% weight loss. One group consumed an isocaloric, low-fat diet (60% of energy from carbohydrate, 20% from fat, and 20% protein; high glycemic load), another a low glycemic diet (40% from carbohydrates, 40% from fat, and 20% from protein; moderate glycemic load), and the last a low-carbohydrate diet (10% from carbohydrate, 60% from fat, and 30% from protein; low glycemic load) in random order for 4 weeks.


The results that they found were “compared with the pre-weight-loss baseline, the decrease in REE was greatest with the low-fat diet, intermediate with the low-glycemic index diet, and the least with the very low carbohydrate diet”. The decrease in the TEE showed a similar pattern. “During the isocaloric feeding following weight loss, REE was 67 kcal/d higher with the very low-carbohydrate diet compared with the low fat diet. Also, the TEE differed by approximately 300 kcal/d between these 2 diets, an effect corresponding with the amount of energy typically expended in 1 hr of moderate-intensity physical activity.” These results are huge for those who have lost weight and want to maintain that weight loss and for bariatric patients in the process of weight loss and the maintenance phase.


Many post-weight loss surgery patients that have lost weight may experience weight regain and it is often attributed to a decline in motivation or adherence to diet and exercise, but biology also plays an important role. This study shows how maintaining an intelligent weight loss plan (low carbohydrate diet, and a high protein diet) helps us build and maintain lean muscle mass making a person even at rest burn calories more efficiently than those with an isocaloric diet that is low in fat, or low glycemic.


How to put this study in practice? What should I do to maintain proper muscle mass and weight loss?


For those at maintenance, you should maintain a high protein/low carbohydrate diet even after reaching your weight loss goal. It is recommended to have an intake of at least 1 to 1.5 grams of protein per pound, especially if you are doing high intensity workouts. The average minimum protein intake for all patients should be 90-100 grams per day after the first two weeks of surgery. Remember, not only is protein intake important, but you must also keep an isocaloric diet. Many weight loss surgery patients at maintenance calorie goals should range from 800-1200 calories per day depending on their energy expenditure.


Are you getting enough protein per day?


Reference: Children’s Hospital Boston (2012, June 26). Dieting? Study challenges notion that a calorie is just a calorie. ScienceDaily. Retrieved June 28, 2012, from­ /releases/2012/06/120626163801.htm

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