Does this mean we are doomed? Actually, no: It is not solely about willpower. Changing diet composition is more important.
In my clinical experience, increasing the quality of food has a tremendous impact. Foods that are the most micronutrient dense rather than those that are solely focused on macronutrient density, such as protein, carbohydrates and fats, tend to be the most satisfying.
In a week to a few months, one of the first things patients notice is a significant reduction in their cravings. But don’t take my word for it. Let’s look at the evidence.
Effect of refined carbohydrates
By this point, many of us know that refined carbohydrates are not beneficial. Well, there is a randomized controlled trial (RCT), the gold standard of studies, with results that show refined carbohydrates may cause food addiction.
There are certain sections of the brain involved in cravings and reward that are affected by high-glycemic (sugar) foods, as shown by MRI scans of participants.
The participants consumed a 500-calorie shake with either a high-glycemic index or with a low-glycemic index. The participants were unaware as to which they were drinking.
The ones who drank the high-glycemic shake had higher levels of glucose in their blood initially, followed by a significant decline in glucose levels and increased hunger four hours later. In fact, the region of the brain that is related to addiction, the nucleus accumbens, showed a spike in activity with the high-glycemic intake.
According to the authors, this effect may occur regardless of the number or quantity of calories consumed. Granted, this was a very small study, but it was well designed.
High-glycemic foods include carbohydrates, such as white flour, sugar and white potatoes. The conclusion: Everyone, but especially those trying to lose weight, should avoid refined carbohydrates. The composition of calories matters.
We tend to focus on macronutrients when looking at diets. These include protein, carbohydrates and fats, but are these the elements that have the most impact on weight loss?
In an RCT, when comparing different macronutrient combinations, there was very little difference among groups, nor was there much success in helping obese patients reduce their weight. In fact, only 15 percent of patients achieved a 10 percent reduction in weight after two years.
Impact of obesity
In an epidemiological study looking at National Health and Nutrition Examination Survey data, results demonstrate that those who are overweight and obese tend to be lacking in micronutrients. The authors surmise that it may have to do with the change in metabolic activity associated with more fat tissue.
These micronutrients include carotenoids, such as lutein, zeaxanthin, beta-carotene, alpha-carotene and beta-cryptoxanthin, as well as vitamin B12, folate and vitamins C, E and D.
However, supplements don’t compensate; micronutrients from supplements are not the same as those from foods.
The good news is that once people lose weight, they may be able to continue to keep the weight off. In a forward-looking study, results show that once obese patients lose weight, the levels of cortisol metabolite excretion decreases significantly.
Why is this important? Cortisol is a glucocorticoid, which means it raises the level of glucose and is involved in mediating visceral or belly fat.
This type of fat has been thought to coat internal organs, such as the liver, and result in nonalcoholic fatty liver disease. This is an encouraging preliminary, yet small, study involving women.
Controlling or losing weight is not solely about willpower. While calories may have an impact, the nutrient density of the food may be more important. Thus, those foods high in micronutrients may also play a significant role in reducing cravings, ultimately helping to manage weight.