
Obesity: Drink till you drop - jsyedidia
http://www.economist.com/node/16881791
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Maciek416
I'd like to know how much obesity is caused by a structural "finish everything
on your plate" problem. By this I mean the tendency of certain folks to finish
everything that is served, no matter what their hunger level is. Also, I've
heard it said that people who eat from smaller plates will consume fewer
calories over time.

In the study, the group given water also had their food portions slashed by a
substantial amount. What happens if the portions stay the same size? How many
people will read or see re-hashed versions of this study in their daily papers
or news and simply prefix a large glass of water before their dinners, only to
find that it has made no difference?

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jacquesm
Plenty of it, but that's also because typically people will prepare (or expect
to be prepared for them in restaurants) unbelievable amounts of food.

I weigh about 70 Kg and a _half_ portion in any US restaurant is more than
enough for me. I always feel bad about sending food back to the kitchen but
I'd feel even worse for overeating.

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sliverstorm
I find this is somewhat dependent on the restaurant I'm at. I'm a stable
60-65Kg, but I hungrily consume almost anything in front of me, except at the
most excessive of restaurants.

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jacquesm
High metabolism?

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sliverstorm
Or something like that

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shrikant
Me and the significant other have known this for quite a while. Frankly, I'm
REALLY surprised that this wasn't an established scientific result.

The way it works IMHO is not too obscure - water fills you up and gives you
the impression of being 'full' earlier, so you tend to reduce your regular
food intake. Feeling 'fuller' equates to being satiated for a lot of people
(including me), so the tendency to chow out at random times during the day is
highly reduced/eliminated.

I used to be 90+ kg in the middle of 2009. Once I decided to drink copious
amounts of water during the day, by Jan 2010 I had come to about 60ish kg and
lost 4 inches around the waist. My other breakfast/lunch/dinner eating habits
remained the same, and the water meant I cut down on snacking between meals.

Seriously, isn't there any research showing water fills you up?

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brownleej
In the study, they controlled for caloric intake by giving everyone a limit.
This would seem to point toward an effect other than the fact that water makes
you eat less. It's possible that the group drinking water actually stayed
below their caloric limit, but I didn't see that mentioned in the article.

~~~
lars512
I imagine it's hard to enforce caloric intake limits effectively. Perhaps
people who drank water simply had more success staying within (or close to)
the allocated limit.

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SoftwareMaven
I was wondering if it altered the quality of calories taken in. The article
mentioned that it wasn't just dropping calories from drinks, since they were
counted as part of the allocated amount.

On the other hand, if people were eating (for instance) more proteins in place
of the simple sugars of fizzy drinks, they would drastically alter how their
body was interacting with those 1800 calories.

I was disappointed by the apparent attitude in the article that every calorie
was equal, regardless of source. I really believe calories are to the
nutrition industry what counting lines of code is to software: a number that
is just too easy to calculate but absolutely meaningless in measuring
anything.

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roel_v
"...absolutely meaningless in measuring anything."

This is not true, not for calories nor for lines of code. Both are not
_sufficient_ measures when used on their own, and both need context to be
interpreted in, but outright dismissing any measurement of them is just as
wrong as blindly relying on them.

Apart from this, this study was done by professional nutritional researchers -
the article may have dumbed down their word a bit but I'd be hard-pressed to
believe that they didn't account for things like that.

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SoftwareMaven
I'm curious (please don't take this combatively, it's not meant that way)
where you've seen value in measuring lines of code. What is the context that
makes the measurement valuable?

I ask because in the many years I've developed software or managed the
development of software, I've never found it a useful metric to study because
there are too many variables that impact it. However, if I'm missing something
there, I'd like to know.

~~~
roel_v
When you have a team of people who do the same work, if there is one person
who consistently writes half as much code as the rest that could be a reason
to look deepen into that person's performance. When you have for example a new
project, you split up all task to be done in several-hour long chunks and you
assign those chunks to all team member in a way so that the work is comparable
(roughly equal parts GUI, algorithm implementation etc.), it's reasonable to
expect that everybody would product about the same amount of code (or checkins
or similar). If someone is 2 or 3 standard deviations from the median, that
says something. Maybe it says something about that person, maybe about the way
tasks are allocated, either way it says something.

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tommizzle
While I completely agree with the gist of the article, Dr Davys counter-
argument is terrible:

"It is possible that the water displaced sugary drinks in the hydrated group,
but this does not explain the weight loss because the calories associated with
any fizzy drinks consumed by the other group had to fall within the daily
limits."

There is such a thing as good calories and bad calories - obviously getting
your calories from healthy fats such as olive oil and avacados is going to be
a lot more beneficial to your weight in the long run than getting your
calories from sugary fizzy drinks such as coca-cola.

Still, nice article.

~~~
WilliamLP
> obviously getting your calories from healthy fats such as olive oil and
> avacados is going to be a lot more beneficial to your weight in the long run
> than getting your calories from sugary fizzy drinks such as coca-cola.

It may be "obvious", but I'm not sure if that's true!

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tommizzle
I would say it's pretty common knowledge in the fitness world. I think this
quote explains the concept nicely:

"The second rule of fat loss is that healthy fat does not make you fat. Excess
calories, in particular excess from the wrong calories makes you fat. This is
a very hard concept to get across. People still believe that fat makes you fat
and will argue without you to the grave while they eat a gallon of low fat ice
cream that has the power to make you fat over night.

...

Lets get back to fat. Low fat diets equal low testosterone and low
progesterone production. Both are necessary for men and women for optimal fat
loss and well-being.

Without adequate levels of fat in your diet (30% of calories), you will not
have adequate levels of testosterone. Without adequate levels of testosterone
you will not be able to build muscle. Building muscle is the most effective
way to get rid of fat and keep it off. " - Mike Mahler

~~~
WilliamLP
You're preaching to the choir here. What you're not going to be able to
demonstrate is that, in laboratory controlled conditions where literally every
calorie is counted by a scientist, and all variables are taken into account
(e.g. hyrdation levels) that one kind of calorie leads to a "metabolic
advantage" over another and lead to more or less fat loss or gain _given
adequate protein_. This would be a kind of holy grail discovery.

What is undeniable is that any study where people self-count their caloric
intake has a ton of potential problems which have been demonstrated over and
over again. People are notoriously terrible at counting calories in what they
eat.

It is true that sugars have certain metabolic effects, for example with
insulin, that will make you hungrier and crave more. This makes it true that
they should be avoided. Basically I think we're on the same page if you're
willing to scratch the "obviously".

Another point is that the amount that doing weight training raises your
metabolism is extremely overrated. I don't have the hard data in front of me
but I think if you look up how many more calories you burn by gaining a pound
of muscle, you will be shocked that it isn't that much. This is one of those
"everybody knows" facts about fitness that everyone believes but isn't really
backed up very well.

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count
This covers some of that very well:
<http://www.youtube.com/watch?v=dBnniua6-oM>

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tommizzle
Cliff notes?

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count
Due to the way the body processes fructose and glucose, fructose leads more
directly to being 'fat', as it's stored as adipose tissue more readily/rapidly
than glucose. Fructose, in HFCS and other solutions, is becoming extremely
common in food where it did not used to be - this is leading to the huge
increase in metabolic syndrome/etc. tl;dr: sugar makes you fat, but different
sugars do it at different rates.

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hswolff
I just started doing this myself a few days ago. I've found that I've bloated
up a little bit at first (as water is prone to cause) but at every meal I am
feeling 'full' earlier and not eating as much. My body seems to be enjoying it
as well. I definitely say give it a try, the most painful outcome being an
increased number of trips to the bathroom - the bladder can only hold so much
liquid.

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evanchen
The problem with "solutions" like this is that they don't really fix the
problem where it lies. Weight gain is attributed to caloric surplus, there's
no two ways about it.

Drinking water before a meal will help you feel a little fuller and
ultimately, eat less. People ignorant to nutrition will begin to use this as a
free pass to eating even more poorly.

If you really take a step back and look at this, what they are suggesting is
filling up with less calorie dense foods (water being the ultimate example),
preferably with a high satiety index (here's a list:
<http://www.mendosa.com/satiety.htm>).

~~~
rdtsc
> People ignorant to nutrition will begin to use this as a free pass to eating
> even more poorly.

One danger would be that they would wash out too many useful substances out of
their body by drinking to much liquid.

I would also imagine so much liquid dilutes the stomach juices and the food
doesn't digest properly. I don't have any scientific basis for this btw, just
a hunch.

> ... what they are suggesting is filling up with less calorie dense foods

Another way to accomplish the same thing (for me at least) is to eat spicier,
more flavorful foods.

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hugh3
_I would also imagine so much liquid dilutes the stomach juices and the food
doesn't digest properly. I don't have any scientific basis for this btw, just
a hunch._

I've never heard of that happening, or anything like it. There is such a
thing, supposedly, as water intoxication though:
<http://en.wikipedia.org/wiki/Water_intoxication>

It's not a serious concern for anyone not running marathon distances or taking
part in a water-drinking competition, though.

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pbhjpbhj
>There is such a thing, supposedly, as water intoxication

Why do you doubt that water intoxication exists? Exertional Hyponatremia for
example doesn't seem to have any gross reasons to doubt.

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elptacek
The advice I read (somewhere, so long ago I don't remember) is that sometimes
when you think you're hungry or craving something, you're really thirsty. This
has worked well for me for many years, and usually means I don't end up eating
anything at all. Too bad it doesn't help with anxiety.

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rmanocha
Not sure about the "science" behind this, but this technique has definitely
worked for me. I've been drinking ~3 litres of water daily for the last year -
and along with other changes in my lifestyle, have lost ~65lbs in that time.

If for no other reason, drinking that water reduces my urges for fizzy drinks
- which helps a lot. Additionally, as others have said - reducing the amount
you eat, in whatever way that works for you, has helped a lot.

~~~
carbocation
The "science" behind this is a randomized, controlled trial. Why the scare
quotes?

~~~
WilliamLP
For one thing, though scientific, any conclusion is going to be rather soft if
it's drawn from one study where human beings self-report calories, and where
the difference in weight (2kg) is within the variance of how much our weight
can vary within a single day.

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jules
Heck, if I go cycling in the morning and don't drink enough I can be 4kg
heavier after dinner that day than right after cycling.

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malkia
Could that be related somehow with people drinking less and less tap water (I
live in US, but also seeing this in my home country Bulgaria)?

I mean nowadays you have to buy your water most places, you might as well get
something "better" for that money, and that won't be water - some some kind of
beverage, soft drink, etc.

So you would be drinking less, simply because you have to pay (yes, you pay
for tap-water too, but that's done as part of all your water usage bill, and
it's done at the end of the month usually, and probably way cheaper than
bottled water).

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b3b0p
It would be interesting if restaurants cut the portion sizes in half, kept the
same prices, but used higher quality products and better care in preparing.

I guess it's wishful thinking.

~~~
mgkimsal
Just a random anecdote here on portion sizes:

Piper's in Raleigh has a really good fish n chips plate - my wife loves it.
However, it's an insanely huge portion. $13.95, but it's _more_ than enough
for two people (she split it with a friend last time and they couldn't finish
it). Dropping the sizes in half and making it $10.95 would still be a good
value (well, in line with the rest of their portions, FWICT). The waitress has
said that most people don't finish the fish because it's too much - it just
ends up being thrown out. You can't easily reheat fried fish the next day as a
leftover (well, _I_ can't - any tips?)

Getting Chinese takeaway always felt a bit expensive (for the good stuff
around us). However, we've cut back on portion sizes, and my wife's dinner is
enough for dinner, then lunch, then usually another dinner, all from an $11
menu item. In those terms, it's a good deal. But if you tried to eat it all in
one sitting, it's too much.

I just do not understand restaurant portion sizings.

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iuytrfghj
>I just do not understand restaurant portion sizings.

The food is a very small part of their costs. They can double the amount of
food for a cost of $1, charge an extra $2 AND have many more customers for
their great value!

It's like selling home PCs with a 1Tb drive, most users don't need it but it
only costs them $5 more than a 500Gb drive.

~~~
rdtsc
Why don't European restaurants do it. Is food more expensive there or is it
just considered bad form or somehow un-sophisticated to serve giant portions.

I would also guess that it depends on the type of food. High quality, fresh
organic produce is a lot more expensive, so perhaps for some food items it
really is about the price. For example the fish in fish and chips could be
some really expensive fish. Doubling the portion would be a lot more than
adding another $1 to the cost.

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Retric
Culturally food quality is considered more important than quality. Also,
higher quality ingredients cost significantly more. So basically it costs them
more to do so, and their customers don't care.

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njharman
I drink upwards of a gallon of water a day, maybe only 3/4 gal in winter. I'm
very easily dehydrated. I weigh ~350lbs.

Just a reminder that studies may find a typical or probable result. They do
not find cause -> effect for everyone.

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c00p3r
s/water/beer/g and get the exactly opposite effect. ^_^

