Comment by daviross | Hacker News Reader

Comment by daviross | Hacker News Reader

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> protein pacing diet for the remaining five/six days/week (Protein pacing refers to 4–6 meals/day evenly-spaced, where each meal contains 25–40g of protein)

> During fasting days, participants fasting for one day/week were allowed to consume 400 Kcal/day, while participants fasting for two consecutive days were allowed 500 Kcal/day. During non-fasting days the dietary regimen provided 1350 and 1700 kcals/day for women and men, respectively, and a macronutrient distribution consisting of 35% protein, 35% carbohydrate, and 30% fat.

That's somehow more calories/day than I would expect for a "fasting day", and fairly restrictive over-all. I'd be curious to hear how these compare to someone on the 1350/1700 kcal/day diet 7 days a week.

> Extending beyond 4-weeks reduces compliance and may be overly excessive for a caloric restriction and 2 day IF and create undue metabolic, physiologic, hormonal, and psychological stress in the study participants.

Also something I was wondering, the repeated emphasis on short-term benefits has me wonder how the participants did after the trial. Does it do much good if you drop more but it bounces back?

> Isagenix International, LLC (Gilbert, AZ, USA) provided all meal replacement shakes, bars, beverages, and supplements.

> Whole Blend IsaLean® Shakes, Cleanse for Life®, Ionix® Supreme, Collagen Bone Broth, AMPED™ Hydrate, Harvest/Whey Thins™, IsaDelight® Chocolates,

> This study was supported by a grant (IRB#: 1911–859) from Isagenix International, LLC

> P.J.A. (the primary author) is a member of the scientific advisory board at Isagenix International LLC, the study’s sponsor. E.G. and A.E.M. are employed by Isagenix International LLC.

Ok, that reads as very suspect, now.

Assuming 2000 kcal/day is the normal amount blah blah blah.

For men, they are running a 300 kcal deficit for 5 days and 1500 kcal deficit for the other two. For a total of 4500 kcal per week. Or losing about a pound and a half.

Now, seeing as this is for overweight people, it's likely to be even more. As it takes more calories per day to maintain higher weights. So if the person's maintenance is about 3000 kcal/day, that's going to be a deficit of roughly 11,500 kcal per week. Which is close to 4 pounds.

But then again, restricting yourself to just 2000 kcal/day would have you lose about a pound and a half per week.

Because, when you are very overweight, lots of things work.

Study is definitely suspect, but if 400-500 kcal allowed for the benefits of fasting that would be really useful information for some. I have to eat some food for medication in the morning, and have always presumed that made fasting not a viable strategy for me.

1700 kcal a day for male is already pretty high calorie deficit even without any physical activity

On average, sure, but there are plenty of metabolic outliers, and I doubt those seeking weight loss are on the higher end. My weight was surprisingly consistent at 1300kcal/day.

As an outlier more towards the other end, my weight tends to fall if I go below about 2500 kcal/day

Is it that far off? I had a medical last week and was told my resting metabolic rate was around 1750 kcal.

Resting metabolic rate means "sitting on the couch literally all day long".

Even the slightest physical activity (working, moving around the house) will raise that by a few hundred calories.

> Also something I was wondering, the repeated emphasis on short-term benefits has me wonder how the participants did after the trial.

This right here is the first and most important reason to be skeptical of any study on weight loss. None of these things ever turn out to do anything useful on a time horizon that matters.

If you want to know how to lose weight for a few weeks you don't need a peer reviewed journal, just go get a "women's health" magazine and read about several ways that really do probably work to lose weight in that timespan.

And then you gain it back.

Aside from what others have pointed out that it's perfectly okay for a scientific study to have limited scope and not try to solve the entire problem of how to lose weight and keep it off, which inherently requires following and monitoring people for a very long time, even the case you're describing here isn't necessarily all bad.

Given a person undergoes an intervention, succeeds in losing 40 pounds, then gains it all back over the next five years, that sounds like failure in a vacuum, but that means they spent five years not gaining more weight. If the non-intervention counterfactual is they would have ended up 40 pounds even heavier, then intervention is still a win. Yo-yo dieting with lifetime net zero progress is still better than steadily getting fatter for the rest of your life.

Yo-yo dieting can potentially create its own health risks.

> This right here is the first and most important reason to be skeptical of any study on weight loss. None of these things ever turn out to do anything useful on a time horizon that matters.

It's (always) worth skimming the article, or at least the headline. From the subheadline:

> *Given the same energy intake and expenditure*, intermittent fasting two days versus one day per week increases weight loss in overweight men and women

This study isn't saying "2 day IF is a miracle weight-loss cure and you should just do it bada bing bada boom weight loss solved". It's holding everything constant except the number of fasting days, and finding that it's (quite dramatically) more effective in the short-term.

This is a data point, not a weight-loss plan. It doesn't call for "skepticism", just careful reading and limited application (or for a start, reading the article/headline at all).

Nutrition is intensely complicated and devilishly difficult to study. But for scientifically-literate people who take it seriously, data points like this shed light on limited portions of the "solution space". This is crucial to mapping out the space enough to understand how to improve your own diet; it's not amenable to an impatient approach that expects every study to be a magic bullet.

Even ignoring the signal that this provides, the absolute minimum value of this study is that somebody who's already doing a time-limited IF-1 diet can switch to a time-limited IF-2 diet. That's valuable in and of itself.

> If you want to know how to lose weight for a few weeks you don't need a peer reviewed journal, just go get a "women's health" magazine and read about several ways that really do probably work to lose weight in that timespan.

With the same improvement in hunger levels, hormone profile, and cardiometabolic health (all mentioned in the for both the control and treatment)? I highly doubt it. Even assuming that IF isn't sustainable[1], people do have short-term weight loss goals sometimes, and IF provides a path to do so that keeps metabolic and hormonal health in mind relative to traditional crash dieting.

[1] I've been doing it for....five years now? Not only did I lose a reasonable amount of weight early on, it's been helpful for maintaining during a life phase of suddenly-expanding waistlines among my peers. Plus it's trivial to dial it up slightly when I do feel the need to tighten up a little.

If you don't mind sharing, what does your routine look like?

> None of these things ever turn out to do anything useful on a time horizon that matters.

I found IF gave me a tool to help me control my appetite for the rest of my life.

Self control is best method for maintaining weight, as it's free and guaranteed to work if used.

I agree, I'm going on 50 and working hard on a beach body.

Traditional wisdom says that's nearly impossible at my age without "supplements" like "vitamin T".

I've found that IF is the real key for me.

I do one meal per day, and I can see all my nutrients laid out in front of me.

Aside from the other purported benefits of IF, this level of control I think is the main benefit to me.

I think that a lot of people don't realize how disconnected the feeling of hunger is from your actual (very minimal) caloric requirements.

Hunger is mostly a trained response, a production of ghrelin that's mostly a pavlovian response coupled with incredibly complex gut and psychological factors.

The hunger response can be trained away in about a week. I generally don't start getting hungry until around 6pm, when I've trained my body that it's dinner time.

Snacking, IMHO, is the single biggest weight loss killer.

"I think that a lot of people don't realize how disconnected the feeling of hunger is from your actual (very minimal) caloric requirements."

True, this is my observation as well.

"The hunger response can be trained away in about a week."

Unfortunately, it is quite easy to fall off the bandwagon in irregular conditions (holidays, vacations, a visit to an elderly relative who insists on feeding you). The adaptation to IF is, in my case, lost just after a day or two of non-IFing. And once it is gone, I have to undergo the week-long self-training again.

> Hunger is mostly a trained response,

I agree as well.

> ...it is quite easy to fall off the bandwagon in irregular conditions

YES. So, this is where being _committed_ makes the difference.

I have many rules that help me with this one is "feeling hunger is normal" and "being uncomfortable getting back on track is normal". (this rule is less refined, but key to overcoming falling off the wagon) And "admit when you fail, and try again", very key to dealing with getting started, or restarted on a good thing in life.

The self-training you mention was what I signed on for at the beginning, knowing full well this is normal, so it's not so bad when I have to do it.

Likely others have similar experiences.

> Self control is best method for maintaining weight, as it's free and guaranteed to work if used.

Studies done on it do not, as far as I've ever seen, back up the idea that it "works if used" in anything but the most tautological sense (ie. "Anyone who fails clearly didn't actually exert self-control").

If you're aware of any studies that show enduring weight loss in any but a small minority of participants with any regimen that fits your description, please share.

Self control is a fantastic way to quit cigarettes, alcohol, and other addictions, why would food be any different?

Food can't enter your body legally if you don't consent?

Well if you have this self control in the first place, you would not need to quit - if you are addicted, you lost the control over yourself.

So pure self control probably won't cut it for most people. Talking about myself: I can go past just so many sweets till I falter. I didn't got the chocolate bar today but ate the cake at the birthday. I knew it will hurt my progress at the gym but I was just to tired from self control that I just gave in.

And then I am telling me; I must get better at self control. But how?

If you have ever changed anything about yourself, I would start there.

I have had to relearn self change multiple times, because it feels just as hard every time.

I changed from a night person to a morning person by first declaring truthfully to myself "many things will be easier if I was a morning person." (work, sleep, schedules, etc...) When you state something truthful to yourself, and you believe it, then you can't let it go.

Then I go for a single moment of success, the first win. With food, I did it by accident by missing a meal because I was engrossed. Then I realized I was more hungry and enjoyed my dinner more than most I could recall in recent history, because I hadn't snacked, and I skipped lunch. I wanted this feeling again. But the next day, I was hungry again, and it sucked. I was in pain and just wanted to eat.

Eventually I read somewhere that hunger pain is temporary and you just need to be patient through it. I drank coffee, tea, water, hot cocoa, anything to get through hunger pain. And the first time that it worked was eye opening. I found that I (me, not a pill, coach, friend, wife) I successfully fought off hunger pain with reason, practice, environment, tools (drinks) and I made it through the day without snacking or eating a meal until dinner.

I have many stories of changing something about myself, the are all similar in the emotional turmoil you feel trying to take control.

It's not any different, in that it doesn't work for any of those either, on average.

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