0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Editor's Correspondence |

All Calories Are Not Equal

William J. Evans, PhD; Nicholas P. Hays, PhD
Arch Intern Med. 2005;165(9):1069. doi:10.1001/archinte.165.9.1069-a.
Text Size: A A A
Published online

Extract

In response to the letter by Seshadri,1 we agree that emphasis on intake of complex carbohydrates over simple carbohydrates may be preferred in fat-reduced diets owing to their greater effects on satiety2; however, we believe that certain points regarding our article3 and study have been misinterpreted. We examined the effects of an ad libitum high–complex carbohydrate diet on body weight and body composition. The subjects in this study were provided 150% of estimated energy needs, not estimated prestudy energy intake; that is, our goal was to provide a surfeit of food that would not be consumed in its entirety. In this way, we were able to measure actual food intake by weighing all food provided to each subject before and after each day. Assessment of free-living energy intake is difficult due to frequent underreporting,4 and as described in our results, the apparent 1000 kcal/d increase in intake during the intervention compared with baseline in the control subjects was likely due to methodologic differences between the 2 measurement periods (ie, food records vs measured weight of consumed food). The important conclusion of this study was that weight loss was experienced by subjects consuming an ad libitum high-carbohydrate diet with no attempt at energy restriction. Our results also indicated that subjects lost weight with no significant reduction in energy intake. The human body is not a bomb calorimeter, and the notion that all macronutrients are metabolized in an equivalent fashion is untenable. For example, classic studies by Sims and Danforth5 demonstrated that weight gain is accomplished with almost 5-fold fewer kilocalories on a high fat vs mixed diet. The metabolic fate of ingested carbohydrate is glycogen storage and oxidation6 with a trivial amount directed toward de novo lipogenesis, while the storage of dietary fat as fat is remarkably efficient. The data from this study strongly supports the hypothesis7 that fat balance is maintained by fat oxidation and fat consumption. The reduction of fat intake with no change in the rate of fat oxidation can result in the loss of body fat even when total energy intake is unchanged.

Topics

calories

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles
Jobs
brightcove.createExperiences();