[media id="PRD__4cc0986927de15_87049863" title="Male Doctor Sitting with Woman"] The diet section in your local bookstore has shelves crammed with books that promise they can help you lose weight. Every diet seems to have a different “ground-breaking” approach to how many total calories we should eat in a day, and what percentage of those calories should come from specific nutrient groups.  When you pick up several different diet books, the recommendations in one book completely contradict the recommendations in the next book- one books says we’ll be healthier and lose more weight when we eat more whole grains, and the next book says we should avoid grains all together. Each approach is supported by excited claims that “it worked for me!” It makes us stop and wonder- if it worked for them, is it going to work for us, too? Is this just the latest fad diet, or is the solution we’ve been searching for?

Dr. James O. Hill, one of the leading obesity researchers in the U.S., suggests that to find a solution for our expanding waistlines, we need to take an evidence-based approach to health and wellness. Dr. Hill is professor of pediatrics and medicine and executive director of the Anschutz Health and Wellness Center at the University of Denver Medical Campus. Dr. Hill is the co-founder of the National Weight Control Registry, a research project that is tracking over 1,000 participants who have more than 30 pounds and have kept it off for one year or longer. I recently had the privilege to meet Dr. Hill and his colleague Dr. Holly Wyatt at the 2012 Fitness and Health Bloggers Conference, hosted by the Anschutz Wellness Center.

Dr. Hill’s research suggests that the usual advice we hear about what it takes to lose weight- “Eat Less and Move More”- is misguided. Being overweight or obese is a natural result of an environment that causes us to eat more and be less active. However, since the typical approach to weight loss begins with calorie restriction, this sets people up for failure. Following the calorie-restriction approach, people need to restrict their calorie levels more and more to match their sedentary activity levels. According to Dr. Hill, anything under 1,2,00-1,400 calories per day is an unsatisfying diet for most people, and people usually cannot maintain that level of eating for longer than 6 months. Dr. Hill argues the human metabolism is most efficient “on high.”  This means that we should exercise more so that we can eat more - expending more calories through exercise means that we can eat a satisfying diet.

At the most basic level, weight loss works the same way for everyone- the goal is to create a negative energy balance by reducing energy intake below your energy expenditure requirements. To lose weight, we need to burn about 500 calories more per day than we eat. Exercise is one necessary component, but for most people, physical activity alone does not result in a large amount of weight loss. No matter how much we exercise, we will never be able to out-exercise a poor diet. Dr. Wyatt suggests that people find it easier to eliminate 500 calories during the day than to burn 500 calories during exercise.  It’s easier to give up eating one Big Mac than it is to run 5 ½ miles, even though both will create a deficit of about 550 calories. Dr. Wyatt suggests an even better long-term solution: eat 250 fewer calories and burn 250 calories by walking for 30-45 minutes.

Given the dizzying array of choices available, which diet should we choose? One key to success is to avoid diets that make fantastic claims. Dr. Hill cautions, “If anybody tells you that losing weight is easy, don’t walk, RUN the other way.” Beyond that, Dr. Hill and Dr. Wyatt believe that, as long as it creates a negative energy balance, any diet will work. Let me say that again: it doesn’t matter which diet you choose- as long as you have a negative energy balance, any diet will work. For example, one research study showed that the macronutrient composition of various diets didn’t determine which diet was more successful than others. All of the diets that were compared in the study performed about the same over the long run.  What mattered more than the macronutrient composition of the diet was an individual’s adherence to the diet. In other words, it almost doesn’t matter whether you choose low-carb, low-sugar, high-protein, all-organic, Paleo, gluten-free, or any other diet that tells you it’s the latest “sure-fire way” to weight loss. According to Dr. Hill and Dr. Wyatt, “the best diet is the one you will stick with.”

(To see the stunning graph from this research, check my FB page:
https://www.facebook.com/notes/your-path-personal-training-lisa-bradley-sharecare-fitness-expert/move-more-eat-smarter-for-long-term-weight-loss/396915610367005)

It is true that some certain people respond better to certain diets. However, Dr. Wyatt’s research shows that it’s not possible to predict which diet will work better for any individual person. Examine the various options that are available until you can find the diet you can stick with.

Beyond diet, research from the National Weight Control Registry has identified some common behaviors of successful losers. These participants in the NWCR have not only lost a significant amount of weight, but they have kept it off for a year or more. Most report that they maintain a low calorie, low fat diet and engage in high levels of activity. In addition,

•78% eat breakfast every day.

•75% weigh themselves at least once a week.

•62% watch less than 10 hours of TV per week.

•90% exercise, on average, about 1 hour per day.

Dr. Hill tells us that instead of our old idea- “Eat Less, Move More”- the research suggests that we should “Move More, Eat Smarter.” When people ask Dr. Hill whether diet or exercise is more important to long-term weight loss- his answer is “Yes.” Diet is more important for weight loss, but physical activity is more important for keeping the weight off. Dr. Hill summarizes the research bluntly: “You don’t have to exercise if you want to lose weight, as long as you want to lose it temporarily.”

For more information:

•Hill, James O. & colleagues. “Why current strategies for fighting obesity are not working.” Article review published in Science Daily, July 3 2012. Available online:
http://www.sciencedaily.com/releases/2012/07/120703162706.htm

•National Weight Control Registry.  http://www.nwcr.ws/

•”Expert Q&A: Getting started with a weight loss plan.” Interview with Dr. James Hill on WebMD:
http://www.webmd.com/diet/features/expert-qa-starting-weight-loss-plan-james-o-hill

•Interview with James O. Hill, for PBS “Frontline” program “Diet Wars.” Available online: http://www.pbs.org/wgbh/pages/frontline/shows/diet/interviews/hill.html

•Dr Hill and Dr. Wyatt are directors of the Anschutz Health and Wellness Center at the University of Colorado Medical Campus: 
http://www.anschutzwellness.com/