It’s easier than you think to improve metabolic scores

In medicine, it's almost axiomatic that for those who are overweight or obese, losing weight will improve metabolic scores such as blood pressures, cholesterol scores, and glucose or insulin scores. This weight loss is usually effected by cutting overall calories, regardless of whether the diet plan is Mediterranean-style, ketogenic, Paleo, or DASH diet.

Way back in 2006 we reported on a study that assessed the effects on the hearts of those following a significantly calorie-restricted diet of about 1,600 calories per day with those following a more usual Western diet at about 2,400 calories per day. The authors found a greater decline in diastolic heart function in those consuming more calories, even though the levels of macronutrients in both diets were largely the same.

Today's research takes a broader look at the effects of calorie restriction and metabolic scores (Lancet 2019; http://dx.doi.org/10.1016/S2213-8587). The authors designed a controlled trial that lasted for two years: they randomly assigned two-thirds of 218 adult, non-obese men and women to a reduced-calorie diet while the other third continued on their usual diet.

Those assigned to the reduced-calorie condition received weekly group and individual counseling sessions for the first 24 weeks and were also provided with a variety of eating plans to help them plan their meals. The authors' goal was for those in the reduced-calorie condition to cut their caloric intake by 25%.

As you might expect, the actual number of calories the reduced-calorie group managed to cut from their diet was a little less than half of what the researchers planned for: about 12% over the course of the two years, not the more ambitious 25%. To put this into perspective, those on a 1,500-calorie per day diet had been expected to cut out 300 calories per day, while those on a 2,000 calorie per day diet were expected to cut their intake by 400 calories per day.

As it turned out, those cutting calories reduced their intake by about 165 and 220 calories per day, on average, respectively.

The participants underwent blood and glucose testing at the start and end of the study to assess their metabolic scores, including blood pressures, cholesterol scores, and glucose tolerance scores. Despite them falling short of the researchers' caloric restriction goals, those cutting calories still lost about 7.5 kg (about 16.5 pounds), while those who continued on their usual diets gained about 0.1 kg (a little less than 1/4 pound). They also improved their triglycerides, their insulin sensitivity, and significantly improved blood pressures, both systolic and diastolic.

What this means for you

You do not have to lose significant amounts of weight in order to improve your metabolic scores: most people only need to consume about 1,500 calories per day and the participants removed the equivalent of a candy bar in the number of calories they consumed each day. The key here is to sustain that change, If you'd like to effect lifestyle change, choose something small that you can live with: you'll be surprised at how effective it can be.

First posted: July 17, 2019