How to Switch Off Your Menstrual Cycle W/ Exercise & Dieting - More Than 22% Deficit ➯ Increased Risk of Menstrual Irregularities + Reduced (!) Weight Loss

Messing with your hormones won't help to reveal your abs, ladies!

I have written about this problem previously. Actually the whole SuppVersity "Athlete's Triad"-Series (read it) is remotely related to it: Women working out like hulk and eating like a sparrow. A behavior that leads to hormonal imbalances and amenorrhea very reliably.

So if you are wondering, why your menstrual cycle is messed up. Why you cannot get pregnant or why you simply stopped menstruating, ladies, this article is for you.

Needless to say that the same goes for male and female trainers, obviously, for whom the results of a very recent study from the Pennsylvania State University and the Penn State University College of Medicine (Williams. 2014).

Low T3 syndrome is also a result of dieting and a part of the (Female) Athletes Triad.

Female Athletes' Body Comp Suf- fers From Dieting

Female Athlete's Triad is not ex- clusively female

Female Athlete's Triad - A Vicious Cycle

Female Athlete's Triad - Recovery Part 1/3

Female Athlete's Triad - Recovery Part 2/3

Female Athlete's Triad - Recovery Part 3/3

The study Nancy I. Williams and her colleagues conducted was designed to confirm or refute the that there would be a dose-response relationship between the induction of menstrual disturbances (luteal phase defects, anovulation, and oligomenorrhea) and the magnitude of energy deficiency.

In other words, the researchers expected that higher energy deficits would incur a significantly greater incidence and more severe disturbances of their menstrual cycle disturbances. To evaluate their hypothesis, the researchers conducted a randomized prospective design that employed controlled feeding and supervised laboratory-based exercise over the course of three menstrual cycles in young, untrained, premenopausal, eumenorrheic women.

Table 1: Overview of the experimental procedures; MC=Menstrual Calendar | Note: Mid-study Body composition testing occurred during Intervention Cycle 2 for most subjects, but in some it occurred during Intervention Cycle 3 (Williams. 2014)

"The study was conducted over three years, with yearly cohorts recruited in the fall of the academic year and followed until the end of spring semester. The controlled feeding and exercise training began after the Screening and Baseline periods, each period lasting one menstrual cycle. All phases of the intervention were anchored to subjects’ menstrual cycles, and each study phase consisted of one menstrual cycle (Intervention Cycle 1, Intervention Cycle 2, Intervention Cycle 3). A post study period of one week where diet and exercise remained controlled allowed for post intervention measurements. The study design is illustrated in Table 1.

Group assignments were based on varying levels of energy deficiency created through a combination of caloric restriction and exercise such that one group remained in energy balance and four groups were in different degrees of an energy deficit. Repeated assessments of menstrual status, metabolic status, and body composition were conducted." (Williams. 2014)

The study was conducted with healthy young, weights-stable women, who had not evidence or history of disordered eating were aged 18 – 30 years, weighed 45 – 75kg and had a normal body fat level of 15 – 35%. The women didn't smoke, were not hormones or anti-contraceptives.

So what did the scientists do?

During the Baseline period, subjects were randomly assigned to an experimental group for the Intervention Cycles 1, 2, and 3 of the study. The goal of the subject groupings was to test the impact of varying levels of an energy deficit created by the combination of caloric restriction and exercise on menstrual function.

Most women ignore the risk of bone loss and only few know that the un- wanted "clinical sequelae", i.e. the nasty pathological consequences, of not eating enough and working out like a maniac include sign. increases in cardiovascular risk (O'Donnell. 2004)

The overlooked significance of hormonal imbalances: As Williams et al. point out, "[a] large body of evidence in a variety of mammalian species has demonstrated a causal link between chronic energy deficiency and the suppression of reproductive function involving the central inhibition of gonadotropin releasing hormone (GnRH) pulsatility" (Williams. 2014). In humans, long term energy deficiency can result in functional hypothalamic amenorrhea, (FHA) and therefore, decrease estrogen exposure, diminishing estrogen’s impact on bone, reproductive, and cardiovascular regulation, often resulting in bone loss (Rencken. 1996; Wade. 1996), stress fractures - specifically in athletes (Barrow. 1988; Bennel. 1999; Brukner. 1997), transient infertility, dyslipidemia, and impaired endothelial function (Friday. 1993, Hoch. 2007; O’Donnell. 2004).

Table 2: Baseline demographic characteristics of study subjects categorized by group (top) and energy balance parameters averaged across Intervention Cycles 1-3 for each group (bottom) - directly from Williams (2014)

They were assigned to either a control group that did not exercise and consumed an amount of calories estimated to maintain body weight, a control group that exercised, but received extra food calories to remain in energy balance (exercising controls or EXCON), or one of four groups that exercised and were prescribed reduced energy intake to create varying levels of an energy deficit (energy deficit or ED groups). ED groups were defined by an energy prescription comprised from the quantity of calories provided as food and the quantity of calories expended as exercise. ED groups were prescribed targeted reductions in energy intake (7 days/week) compared to their Baseline energy needs ranging from – 15% to – 30% in combination with prescribed increases in exercise energy expenditure (5 days/week) equivalent in calories to + 15% to + 30% of Baseline energy needs.

Starvation diets will also mess w/ your thyroid | learn more

So, how low can you go? The scientists fount that the estimates of the magnitude of energy deficiency associated with menstrual disturbances ranged from -22% (ED2) to -42% (ED3), reflecting an energy deficit of -470 to -810 kcal per day, respectively. In contrast to the what Williams et al. expected, the severity of menstrual disturbances, was not dependent on the magnitude of energy deficiency and is thus not a gauge to estimate how much more you'd have to eat to become fully functional again.

As the researchers point out, specifically, the initial four energy deficit groups were intended to represent 1) an increase of 15% kcals of exercise (15% deficit), 2) an increase of 30% kcals of exercise (30% deficit), 3) a decrease of 15% in dietary intake, combined with an increase of 15% of exercise, (30% deficit) and 4) a decrease of 30% in dietary intake, combined with an increase of 30% kcals of exercise (60% deficit).

Figure 1: Daily energy deficit (left) and corresponding menstrual irregularities (right) the Pennsylvanian researchers observed during the intervention (Williams. 2014)

As you can see in Figure 1 the plan worked out quite well and the original hypothesis that the severity of the energy deficit would correlate with the risk of overall risk of menstural irregularities. What is interesting, though, is that the overall linear increase was visible mostly for the luteal phase disturbances. Actual unovulatory cycles were observed only in groups ED2 & ED3, but - and this is important - for some women, it was enough to just work out to induce oligomenorrhic cycles, i.e. infrequent (or, in occasional usage, very light) menstruation.


Next to the menstrual irregularities, which were obviously what the scientists were actually interested in, the scientists also observed that the 34 subjects lost weight, 3.8 kg in the ED1 and - listen up ladies! - only 2.8 kg and 2.6 kg in the high(er) energy deficit groups ED2 and ED3 (no significant weight loss occurred in the exercise only, i.e. the EXCON group).

Figure 2: Amount of weight (in kg) the women in the four groups lost over the course of the complete study period (Williams. 2014)

Bottom line: Let me say this right away. It's not unfair, but very clever that nature made sure that starving women cannot become pregnant.

If you look at the "target outcome" of most women's dietary interventions, i.e. the amount of weight they lose (see Figure 2), you will also have to concede that what many women believe would be "unfair" actually protects them from ineffective starvation diets. It was after all not the group with the highest, but the group with the lowest energy deficit that lost the most weight. So, ladies, be sure to remember this and if you are still not convinced that starving yourself is not the magical weight loss solution that will give you the "shape cover model" body you're looking for, take another look at the "9 Rules of Sensible & Effective Dieting" | Comment on Facebook.

References:

• Barrow, Gray W., and Subrata Saha. "Menstrual irregularity and stress fractures in collegiate female distance runners." The American journal of sports medicine 16.3 (1988): 209-216.
• Bennell, Kim, et al. "Risk factors for stress fractures." Sports Medicine 28.2 (1999): 91-122.
• Brukner, Peter, and Kim Bennell. "Stress fractures in female athletes." Sports Medicine 24.6 (1997): 419-429.
• Friday, Karen E., et al. "Elevated plasma low-density lipoprotein and high-density lipoprotein cholesterol levels in amenorrheic athletes: effects of endogenous hormone status and nutrient intake." The Journal of Clinical Endocrinology & Metabolism 77.6 (1993): 1605-1609.
• Hoch, Anne Z., et al. "Athletic amenorrhea and endothelial dysfunction." Wisconsin Medical Journal 106.2 (2007).
• O’Donnell, Emma, and Mary Jane De Souza. "The Cardiovascular Effects of Chronic Hypoestrogenism in Amenorrhoeic Athletes." Sports Medicine 34.9 (2004): 601-627.
• Rencken, Monica L., Charles H. Chesnut, and Barbara L. Drinkwater. "Bone density at multiple skeletal sites in amenorrheic athletes." Jama 276.3 (1996): 238-240.
• Wade, GEORGE N., JILL E. Schneider, and H. Y. Li. "Control of fertility by metabolic cues." American Journal of Physiology-Endocrinology And Metabolism 270.1 (1996): E1-E19.
• Williams, Nancy I., et al. "Magnitude of daily energy deficit predicts frequency but not severity of menstrual disturbances associated with exercise and caloric restriction." American Journal of Physiology-Endocrinology and Metabolism (2014): ajpendo-00386.

Women Can't Go Without Fat, Men Not Without Glucose!? Plus: Could Fat & Glucose Be Created Equal(ly Important)?

Image 1: Are we missing the cacao (=fat) for the chocolate? Study suggests that women do better without glucose than men (img. stern.de)

Ladies, I know I am neglecting you. Testosterone here, bodybuilding there and rarely something about your issues. In the end, it is not fundamentally different with today's news, but the study we are going to look at today is at least food (all pun intended) for thought for both sexes. In fact, Mallory, one of the few women who has not yet been put off by "half naked bodydbuilding types" (if you don't know what I am hinting at, check out the "Biggest Winner" blogpost) and all the hoopla around the "muscle building effects of testosterone", reminded me that I had stashed away a study on the sex-specific reaction to glucose- and lipid-deprivation by scientists from the University of Cincinatti a few weeks ago for "future reference" - a study with quite remarkable results (Sandoval. 2012).

"Gimme those extra sweet twinkies, honey!"

One of the common diet-related clichés is that while men love their greasy barbecue, women just can't live without their chocolate. If we disregard the actual macronutrient content of these foods and go just by their taste, this cliché tells us that women are "carbo-" and men "protein-o-fat-o-holics" - or put simply: Common wisdom would suggest that men are made for low-carbing, while women are going to have a tough time without their sweet treats. The results of the aforementioned study by Sandoval et al. do yet indicate that, from a merely physiological perspective, the exact opposite should be the case... but let's tackle one thing at a time.

Figure 1: Low carb and low fat extreme. By force-feeding the rodents 2-deoxyglucose (2-DG) or mercaptoacetate (MD), the scientists effectively blocked the use of glucose or fatty acids, respectively.

What the scientists did was take a couple of male and female rats and force-fed (IP dosing) the animals with either 80, 250 or 750 mg/kg of 2-deoxyglucose (Figure 1, left) or 115, 200 and 355µmol/kg mercaptoacetate (Figure 1, right). With the former being a "unusable" form of glucose and the latter being a fatty acid that is not susceptible to mitochondrial oxidation, the treatments hamper the use of glucose or fatty acids as a fuel and result in a dose depend glucose or fatty acid deprivation state. In a way this is like jamming the fuel pipe of a car - no matter how much gasoline you put into your tank the engine is not going to be able to use it... similarly, no matter how much carbohydrates, respectively fats the rodents would eat, their "hunger" for glucose of fatty acids would not be satisfied.

No, what would conventional wisdom tell us, should have happened? Right! The female rats would have gone crazy in the 2-DG trial (without their "sweet" glucose) and the male rodents would have gone on one of the infamous "hunter and gatherer" greasy meat binges... but in fact, the exact opposite was the case.

Figure 2: Relative food intake of male and female rats in the 3h after the IP injection of 80, 250 and 750mg 2-deoxyglucose (data adapted from Sandoval. 2012)

As the data in figure 2 shows, the "binge response", i.e. the overeating in response to the artificially induced glucose deprivation, was more pronounced (+170% food intake) and was triggered at lower doses of 2DG (meaning that there was still more glucose available) in male than in female rats. In the mercaptocetate fat deprivation trial, on the other hand, ...

[...] the males significantly increased food intake over saline only in response to the highest dose of MA used [...] In contrast, compared with saline, females had significantly greater
food intake at 115 and 355 µmol/kg, and a strong trend (P < 0.06) at the 200µmol/kg doses of MA.

These findings are not only of interest, because they may shed some (albeit counter-intuitive) light on why men and women tend to "diet" differently, but also because they strongly suggest that we are not dealing with either lipo- or glucostatic controls of energy intake (and probably metabolism), but with both. 

No-carb or no-fat? In the end neither will work

Image 2: Everyone understands that Micheal Phelps seems to understand that he/she cannot eat as many carbs as Michael Phelps (img. Fox), but more and more people fail to realize that they can, ... and for many even, that they must eat more carbs than a sedentary 200lbs overweight type II diabetic.

Despite the fact that he male rats overate "earlier"* to glucose and the female rats "earlier"* to fat deprivation (*earlier means at an overall higher availability of the respective nutrient), when a given threshold was surpassed, both sexes did react with eating everything in sight. In other words, if these results apply to humans as well (2DG studies by Davis et al. would suggest that they do; cf. Davis. 2000), it does not matter if you starve yourself of fat or the ostensibly dispensable and fattening glucose, you still starve and if there is anything everyone should by now have understood, then this: Nothing stalls healthy weightloss more effectively than starvation.

So, don't be a bigoted pighead and acknowledge the value of both, fat and carbohydrates not as mutually exclusive, but as synergistic and with an "optimal" that is in constant flux and will be determined not only by your sex by, but also by your overall, metabolic and endocrine health, by your body composition, by your activity level and the type of activity and many other physiological, psychological, seasonal and environmental parameters that are just as diverse for each of us as our "optimal" macronutrient ratios.

Biggest Winners Lose Their Weight "Slowly" - Losing 6kg of Body Weight in 15 instead of 5 Weeks is 4x More Effective and Ensures that it is Fat You Are Losing, Not Muscle!

Image 1: "How did I let this happen again?", asks Oprah in her own magazine (as a German I am shocked there even is such a thing as an "Oprah Magazine" ;-) - the answer is simple, Oprah! Your "diet" programmed the YoYo effect! It happened not after, but right while you were starving... ah, pardon "dieting"!

From time to time, I am using the Blogspot stats to check where you, my dear readers, are coming from. Aside from the usual suspects, there are sometimes certain posts, which attract a hell lot of visitors from single threads on any of the major or minor bulletin boards. To cut a long story short, about 2 weeks ago, I hit on a forum where one of you (thank you by the way) cited the SuppVersity as a good source of information for all things related to nutrition and exercise... now, the reason I mention this, is not that without comments like this and people spreading the word, the work I put into this blog on a daily basis would hardly be worthwhile, but rather the feedback the person got from the other "residents" of the board: feedback along the lines of "Pah! I am not into looking and half-naked musclemen!" ...

Obviously the lady who posted that, must have followed the link on a Thursday - in fact one of those Thursday's, where Adelfo was raving about how "disgusting" he wants his muscle to look on the day of his competition. And yes, it may be true that - especially the ladies - probably have slightly different concerns than muscles, which do not look disgusting enough, but the results of a recently published study that was conducted by scientists from the University of Sherbrooke in Québec, Canada, show that even the fair sex could learn a lot from the way Adelfo plans and tweaks his contest prep diet - first and foremost that slow and steady and not rapid and abrupt is the way to go, when you want to make sure that you don't just lose weight, but also see the gratifying results in the mirror, as well.

If you want to get lean and stay lean, you better diet down slowly

What is particularly interesting about the trial, the results of which M. Sénéchal et al. describe in their paper (Sénéchal. 2012) is that they have amazing practical value. After all, the only advice the scientists gave the 23 obese women, who participated in the trial, were ...

• reduce the initial body weight by at least 5% and, unfortunately,
   
• eat a "healthy" diet containing 55%, 30% and 15% of the caloric intake from carbohydrates, fats, and proteins, respectively.

While I would agree that the macronutrient ratio may not be exactly optimal, it is still the way most people try to get rid of their superfluous body weight. What is yet even more important that the subjects were free to chose how exactly they would achieve this ends (at least this is how I understand the detailed description of the dietary protocol). The result was that some of the participants lost their ~6kg of body weight within 5-weeks (n = 5), while others took their time and "dieted" for 15 weeks (n = 5) until the 6kg of had fallen off their ribcage, buttocks and who knows whichever other problem areas the ladies had (with 5 women in the rapid and 5 women in the slow weight loss group, this obviously leaves 13 women who were excluded from the analysis, because they did not fit in any of these groups).

Rapid vs. slow - biggest loser vs. leanest winner?

I guess if this study had been part of the Biggest Loser TV show, the ladies in the "slow" weight loss group would already have been voted out before they had made it to the -5% body weight weight-loss limit. After all "fast", "rapid" and "immediate" are what everyone is looking for these days and "slow" and "steady" is for the real, not the "biggest losers" - right?

Figure 1: Prescribed macronutrient composition, identical for all subjects (left), and average caloric deficit (in kcal /day) in the rapid weight loss and slow weight loss groups (right, data based on Sénéchal. 2012)

Well, if you take a closer look at figure 1, this assumption begins to totter. After all, the ladies in the "slow" group had a caloric deficit of only -465kcal/day. Their counterparts in the rapid weight loss group, whose average caloric deficit was -1,338kcal/day, on the other hand, must have literally been starving for 5 weeks straight to achieve their goal - after all, the level of voluntary physical activity remained stable. Exercising the food away, which is a major part of the (idiotic) Biggest Loser regimen, was thusly not part of the equation, the body weight / composition specific results of which I have summarized in figure 2:

Figure 2: Reductions in weight, waist circumference, total and compartmental fat mass expressed relative to daily kcal deficit in the rapid and slow weight loss groups; relative difference in effect sizes slow vs. rapid (in %) are indicated right above the individual bars (data calculated based on Sénéchal. 2012)

As you can see, the negative side effects of the "quick fix"-mentality which gets so many people into a situation, where they have to shed weight, in the first place (fast food, coffee to keep going, sweet treats to get over the day, etc.) are similarly detrimental as the original ones. While you cannot debate that the women in the "rapid" weight loss group lost more than two pounds of body weight per week, this success came at the expense of a highly relevant -2.6kg loss in lean muscle mass (60% less loss in lean mass per calorie by which the subjects reduced their caloric intake compared to baseline) - "metabolic currency", as my friend Carl Lanore likes to say that would not only help them to keep the weight off in the future, but is also a indispensable prerequisite for mobility and health up until the old age. With the data in figure 2 being expressed on a "per kcal-deficit" basis, it becomes even more obvious how wasteful this starvation approach to weight loss actually is - not only in terms of losses in lean mass, but also in "what you get" for the effort (hunger) you invest: more than + 200% more weight loss and reduction in waist circumference per kcal and more than + 400% greater reductions in total, trunk and appendicular (inter-organ) fat speak for themselves - don't they?

Losing slow = losing steady = losing healthy = winning in the long run

If we also take into consideration that the "slow losers" experienced greater reductions in blood pressure and a 4x higher reduction in triglycerides (probably a way better marker of overall health than the likewise reduced levels of total cholesterol), it stands to reason that "starving the fat away" is no viable option, regardless of whether you are obese and trying to get down to a healthier weight, or whether you are a competitive bodybuilder who wants his muscle to shine in all their "disgusting" glory.

Image 2: Regardless of whether you want six-pack abs, like Adelfo or just a "flat tummy" like one of the Shape cover models; starving yourself won't get you there. The tummy wants to be filled appropriately, otherwise it will advice your brain to make sure that the fat under skin and even around the organs won't disappear.

Just a final note: I don't think that it is incidental that this is yet another trial where the "magic no." (although I don't think you should focus too much on that) is ~400-500kcal/day and thusly by no means more than ~30% of the regular total caloric intake, which would be necessary to remain at a stable weight. Anything beyond that, may produce impressive results on the scale... but it will neither result in a continuous nor sustainable reduction in body fat levels and will program you to the ravenousness, about the negative psychological consequences of which Adelfo has written quite extensively in his latest blogpost. It is also becoming increasingly obvious that "hunger and satiety hormones" like GLP-1, CCK, PYY & co exert profound regulatory effects which go way beyond making us raid the fridge: They also make our bodies sacrifice energy consuming muscle tissue and fight for each individual fat-molecule it has stored away over the years... keep that in mind, before you rejoice over another 10lbs you lost within less than 2 weeks | Comment on Facebook!

References:

• Sénéchal, Martin, et al. "Effects of rapid or slow weight loss on body composition and metabolic risk factors in obese postmenopausal women. A pilot study." Appetite 58.3 (2012): 831-834.

Challenging the Special K Challenge: Especially Convenient or Especially Stupid 14-Day Weight Loss "Solution"?

Image 1: Is this really all it takes to lose those unhealthy and unaesthetic pounds? Two servings of a breakfast cereal a day, instead of two of your regular meals? Sounds too "good" (?) to be true, right? A study says it works, but only the SuppVersity will tell you the real costs!

For me, as a German, it is quite surprising that the words "Special K", or rather the reference to the eponymous product comes up pretty often in the health and nutrition blogosphere, when someone wants to point out an e-special-ly (K) unhealthy breakfast. While "low fat", still looms large here in Germany and "diet"-this and "diet"-that stickers (respective products usually carry the label "light", which shall obviously imply "light" as in "lightweight") are attached to an ever-growing number of products in the mainstream supermarkets, my fellow countrymen (I am unfortunately not so sure about the women, though) must yet have had advanced access to the data (not just the abstract - but more about that later) of Patricia K. Shaw's master thesis (Shaw. 2011), which has been peer-reviewed and published only recently, and are thusly mostly avoiding this "healthy whole grain" product from a company with a >13b revenue in 2010.

"Special K Challenge" - What does it challenge? Weight loss or yo-yo-effect?

In the respective 14-day intervention trial 24 subjects (12 men and 12 women) with a mean age of 34.7 years and a pretty chubby physique (BMI 28.6 kg/m², but body fat 28.8% and 40.7% for men and women, respectively) had to follow the "Special K Challenge" (official website), the central idea of which is that you are going to lose weight and get healthier if you replace two of your regular meals by a predefined amount of yummy (and nutritious *rofl*) expensive cornflakes, ah... I mean "Special K"...

Figure 1: Macronutrient composition of the 174kcal Special  K + skim milk "meal replacement" and the Special K Snack Bars (83kcal) and Mini Breaks (99kcal) the participants consumed during the 14-day challenge and the consequent reductions in protein and fat intake relative to baseline (data calculated based on Shaw. 2011)

In view of the fact that everyone appears to be on the lookout for an easy and above all convenient way to lose weight, it was not difficult for Mrs. Shaw to recruit their subjects among the faculty staff and senior students from the University of Limerick, who actually had to do nothing, but adhere to these two "protocols" for 2x14 days:

1. Control phase: Do what you usually do and eat what you usually eat for two weeks, log all your foods and get back to the lab to get another body weight, body water, body fat, lean body mass (the latter two via DXA scans), waist and hip circumference measurement taken.
    
2. Special K Challenge: Keep doing what you usually do, keep eating what you usually eat, but replace 2 of your main dishes with Special K + semi skimmed milk and eat fruit and/or Special K Mini Breaks or Special K Snack Bars between meals (cf. figure 1), log everything you eat and return your hopefully lighter self as well as the logs to the lab in another two weeks.

About as convenient as the average pizza-ordering slacker likes it, right? It is thusly not really surprising that the overall compliance of 83% was above what you usually see in dietary interventions.

"I want my pizza back!"- and "I better completely stop eating to maximize weight loss"-effect

What is similarly unsurprising, is that the overall calorie intake is reduced (avg. energy deficit: 673kcal/day) by a "challenge" , in the course of which two of the main meals (of which most people obviously consume only three) are replaced with a 174kcal "meal replacement" in form of yummy cornflakes with watery skim milk (aside from the "bah, I want my pizza"-effect, I am thinking about the "hyperpalatability hypothesis" here, as well; cf. Guyenet. 2011). That it is so profoundly reduced that at least one male subject had a caloric deficit of 1555kcal per day (!), however, clearly suggests that the end-result of this type of "diet" (or shall we call it a hunger-strike?) is not going to work. It is thus all the more surprising, that, according to the conclusion of the abstract, ...

The results of the present study demonstrate that the Special K Challenge was effective in reducing total energy intake and resulted in a positive, health-related change in body composition. The reduction in total body mass, regional fat mass and waist circumference may act as an effective motivator to long term body mass reduction.

Certainly worth taking a closer look at the data, right? Well, for the first point, i.e. "effective in reducing total energy intake", we already know that this is true. "Effective", by the way, is effectively understated. Now, what about the "positive, health-related change in body composition"? What would that imply? A reduction in body fat and an increase in lean mass, right! And what have we got?

Figure 2: Lean mass and fat mass of 24 overweight  men and women before 2-week accommodation phase (pre) and before (basal) and after (Special K) 14-day "Special K Challenge" (data adapted from Shaw. 2011)

We got a reduction in body fat and a reduction in lean mass - and worst of all, the female study participants, who, with their 40%+ body fat levels already had no muscle to begin with, lost almost twice as much lean mass as body mass. Assuming that they are "scale watchers" (and should read the "How to track your progress on a diet & exercise regimen"), this may in fact have been an "effective motivator", but it is also a profound obstacle to the "long term body mass reduction", unless we want to define that as "starving your muscles away".

"But it does work! So what do you want?"

Even if you are not effected by it yourself, I bet that everyone of you knows someone who has maybe not even gained weight, but has become fatter and fatter with every diet he (or presumably "she") has "done". This study on the "Special K Challenge" shows you exactly what went wrong for him/her/them:

Image 2: Although common wisdom would say so, eating salad is no alternative either... when I come to think about it, it may be an alternative to eating toilette paper, but that won't help with fat (not just weight!) loss either.

• believing in the existence of a "quick fix" and/or "convenient solution" that will work in 1-2 months, let alone weeks and thusly
• going on a diet instead of changing your diet as part of changing your lifestyle 
• not meeting your minimal energy requirements / starving yourself
• not having enough protein and fat with EVERY meal
• snacking, in general, and on processed foods, in particular
• no exercise (in this case), or tons of endurance exercise to exercise your "cheats" away
• using the scale as a measure of success

Taken together, all that programs failure, no matter how "motivating" it may be... or do you really believe the guy with the -1,500kcal/day deficit or his female counterpart with -1,139kcal/day will "stick" to this "diet" for longer than two weeks? I don't! And we both know what happens, when they are sitting with their friends and family at the coffee, next Sunday, right? ... I guess, it is thus unnecessary that I answer the question I raised in the headline, explicitly - Especially Convenient or Especially Stupid? You decide!

Starving Yourself Makes You Fat, Regardless of Whether You Overeat Or Not. Study Finds Obesity Promoting Effects of Ghrelin Unrelated to Orexia.

Image 1: Starving + indulgence, even without
over-indulgence, leads to obesity. (Image from
Hieronymus Bosch's The Seven Deadly Sins
and the Four Last Things)

Do you know that grumbling? This strange feeling you get, when you are "running on empty" - not the appetite or desire you feel when you pass by the ice cream parlor. I am talking about hunger, real physiological hunger, the one where you start towards your fridge and, regardless of what is in there, stuff it down your pie-hole. This ravenous desire for food is the direct psycho-physiological response to surges of the "hunger-hormone" ghrelin.

So, if high ghrelin levels make you eat everything that cannot escape fast enough, it seems quite obvious that this would be the underlying reason for obesity in rats injected with exogenous ghrelin.

This, however, was not the case in a recently conducted study by Perez-Tilve et al. from the Department of Internal Medicine at the University of Cincinnati (Perez-Tilve. 2011).

Figure 1: Food intake of ghrelin injected or control rats on low fat or high fat diets.
(data adapted from Perez-Tilve. 2011)

The scientists had administered intracerebroventricular ghrelin injections to two groups of rats. One group received a low-fat chow, while the other was on the famous high-fat diet scientists use to emulate our modern westernized gluttony (cf. yesterday's news, fig. 1). As expected, the rats that were fed the low-fat chow significantly increased their food intake (cf. Figure 1). Unexpectedly, though, ghrelin failed to statistically significantly increase food intake in the high fat diet group, yet ...

in rats fed the HFD, ghrelin nonetheless increased adiposity [fat mass increase of 14±2 g (ghrelin+HFD) vs. 1±1 g (saline+HFD), P<0.001] up-regulating the gene expression of lipogenic enzymes in white adipose tissue.

These results are of great interest, because they clearly show that your typical "fast", where you diet really hard for a few days (and thus increase your ghrelin levels), until you get so ravenously hungry that you end up (deliberately or not) "refeeding" yourself with pizza and ice-cream set the scene for further undesirable fat gain by setting your body's metabolic switches to fat storage mode.