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Health

‘Reverse Dieting’ Is Not a Weight Loss Cheat Code

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Photo: Lolostock (Shutterstock)

To hear the TikTok girlies tell it, there’s a hack that will let you EAT MORE FOOD! While NOT GAINING WEIGHT! And it’s great if you are SICK OF DIETING! Never mind that one can achieve all those goals by a simple trick called “not dieting anymore.” No, it needs a name and a strict protocol: reverse dieting.

The basic idea of reverse dieting is that you slowly add a few more calories to your diet every week. So s you normally maintain your weight on 2,000 calories per day, but you’ve been eating 1,500 calories to lose weight. You might then “reverse diet” by eating 1,600 calories a day next week, 1,700 calories a day the week after that, and so on. Eventually you’ll be back up to 2,000 calories, or maybe even more.

This is not a trend that originated on TikTok. The term seems to have come from bodybuilders, whose sport requires that they engage in extreme cycles of bulking (gaining weight to gain muscle mass) and cutting (losing as much fat as possible before stepping on a stage). While the process can create dazzling physiques, it also fucks with your metabolism and overall health.

Reverse dieting is one approach for transitioning from an extreme cut, to maintenance or bulking: Instead of just pigging out the day after your bodybuilding show, you might rather slowly increase the amount of food you eat as you find your maintenance calories again.

This idea spawned the current trend of influencers pitching reverse dieting as the cure for all your diet-related complaints. But it doesn’t work that way.

The science behind reverse dieting

Some of the claims you’ll hear from thin women flexing their abs on TikTok, and from the bodybuilders saying to just trust them, bro, are true. Among them:

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  • Your metabolism adapts to dieting, so over time you have to eat less and less food to keep losing weight (this is a known thing).
  • After dieting a long time, you may be eating a miserably low number of calories.
  • Eating more food will allow your body to stop being so stingy with the calories, and can increase the number of calories your body burns.
  • After increasing your calories, someday you may be able to lose weight again while eating more food than when you were in the depths of your diet.

There are also a number of untruths and half-truths that come up. You may hear that increasing your calories too fast after a diet will make your body pack on fat, or that you can add 1,000 calories and still be losing weight, or something something hormones something cortisol. (Scroll long enough on fitness TikTok and somebody will explain that all your problems are due to cortisol. Take a drink.)

In any case, this is where “reverse dieting” comes in. Supposedly the cure to all of these ills is simply that you need to add 50 to 100 calories to your diet each week. The process is slow and requires patience, but stick to it and you too could look like this girl (imagine me moving my head to point at the before-and-after photos I’ve greenscreened behind me) on 2,400 calories instead of 1,200.

So what’s actually true about reverse dieting, and why is everybody so into it? Let’s take a closer look.

When it goes right, “reverse dieting” is just “not dieting” but with more rules

After reading all of those bullet points above, you might think, OK, so why not just stop dieting? You’ll get to eat more food, your body will burn more calories, and from there you can either diet again or—crazy idea here—just not diet anymore. Heck, you could give gaining weight a try.

And that is, in fact, the real answer. Just stop dieting. The world will not end. You can eat food again, and you will be fine. So why reverse diet?

As Eric Trexler, a nutrition and metabolism researcher, puts it here, the original reverse dieters’ goal was to smoothly transition from a calorie deficit, to maintenance, to their first bulk after a bodybuilding contest without gaining any more fat than they needed to. One problem with this approach is that after bodybuilders diet that hard, they need to regain fat. You can’t stay dangerously lean forever, and that’s true whether you’re a meathead or a TikTok girlie.

On social media, reverse dieting is often described as a way of continuing to diet while eating more calories. It’s true that if you’re in a 500 calorie deficit and you’re only adding 50 calories a week, you’ll continue to be in a deficit for a very long time—10 weeks, at that rate. Trexler notes that “this would serve only to delay even the most basic and immediate aspects of recovery, and make [the dieter’s] life unnecessarily difficult.”

Reverse dieting is not a cure for chronic dieting

There are two things going on here, I think. One is relatively harmless. Let’s say you’ve been on a diet and you’re ready to start gaining weight. Instead of eating an extra 1000 calories each day (to go from a 500 calorie deficit to a 500 calorie surplus), you can eat an extra few hundred this week, and add a few hundred more next week, and so on. You’ll be less surprised by changes in your weight (eating more food means there’s more food in your belly, so the scale might tick up a bit just from that) and it may be easier to figure out approximately how many calories you should eat going forward.

But that’s not how it’s being described on social media. Thin women are telling chronic dieters that they can eat more food while continuing to be very thin, if only they follow a strict reverse dieting protocol. But the strictness and the expectations can be damaging on their own.

For an extreme example, check out this video from a registered dietitian and eating disorder specialist. She describes a woman who was getting help for eating disorder recovery. The woman had such a low body weight, with associated health issues, that the dietitian says she “need[ed] to gain weight immediately.” But instead of following guidance from her care team that would have her gaining a pound a week, she secretly put herself on a reverse diet protocol. By adding just 50 calories each week to the too-low amount she was already eating, it took her three months to gain a whole pound of body mass—basically delaying her recovery by three months.

And here’s where I think we need to take a closer look at why reverse dieting posts are so popular in corners of social media that are focused on weight loss. While eating more sounds healthier—it’s a good start!—following a strict reverse diet is just another way of restricting.

Reverse dieting is sometimes just a way to restrict more

Let’s say, as in many of the examples on TikTok, that you are somebody currently eating 1,200 calories (officially a starvation diet) and no longer losing weight. Even if you are a small woman who never exercises—maybe because you don’t have the energy?—a healthy amount of daily calories will likely be 1,600 or more. So you’re supposed to eat 1,250 next week? And then 1,300 the week after that? At that rate, it would take eight weeks to get you up to the number that should be mere maintenance for you. Even if you don’t have an eating disorder, you’re creating the same problem for yourself as the ED patient in the dietitian’s case study.

What’s even more concerning to me is that 50 or even 100 calories is an extremely precise amount. If I’m aiming to eat 2,000 calories a day, maybe some days I’ll have 1,950 and some days I’ll have 2,100. Over time it balances out. But if you’re trying to hit exactly 1,850 and not 1,900 (because 1,900 is next week’s target) you’ll have to track your food meticulously. This is the kind of lifestyle where you’ll be weighing your toast before and after you spread the peanut butter, and you won’t want to eat at a restaurant, because how many calories are in each menu item? What if they’re heavy handed with the sauce?

In my scroll through #reversedieting TikTok, I found women saying that they had to miss out on family meals and deal with concern from their friends during their reverse diet. Clearly, they have not taken a step very far out of diet-land. For these folks, it actually seems like the “reverse” is essentially a way of extending their diet. You could be eating at maintenance for those eight weeks, but you’re restricting instead. And then what? Reverse dieting is often described as a way of increasing your calorie burn so you can diet again.

Even when the influencers show themselves gaining muscle and eating genuinely healthy numbers of calories (assuming that the numbers they cite are true), it’s still all couched in language around leanness and thinness, and features photos of their abs. Prioritizing leanness even while gaining muscle is some backwards-ass shit. It’s okay to not be able to see your abs while you are trying to make yourself bigger. As strongman JF Caron famously put it, “abs is not a thing of power. Is just a sign you don’t eat enough.”

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Health

Ultraprocessed foods linked to ovarian and other cancer deaths, study finds

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Eating more ultraprocessed foods raises the risk of developing and dying from cancer, especially ovarian cancer, according to a new study of over 197,000 people in the United Kingdom, over half of whom were women.

Overly processed foods include prepackaged soups, sauces, frozen pizza and ready-to-eat meals, as well as hot dogs, sausages, french fries, sodas, store-bought cookies, cakes, candies, doughnuts, ice cream and many more.

“Ultra-processed foods are produced with industrially derived ingredients and often use food additives to adjust colour, flavour, consistency, texture, or extend shelf life,” said first author Dr. Kiara Chang, a National Institute for Health and Care Research fellow at Imperial College London’s School of Public Health, in a statement.

“Our bodies may not react the same way to these ultra-processed ingredients and additives as they do to fresh and nutritious minimally processed foods,” Chang said.

However, people who eat more ultra-processed foods also tend to “drink more fizzy drinks and less tea and coffee, as well as less vegetables and other foods associated with a healthy dietary pattern,” said Duane Mellor, a registered dietitian and senior teaching fellow at Aston Medical School in Birmingham, UK, in an email.

“This could mean that it may not be an effect specifically of the ultra-processed foods themselves, but instead reflect the impact of a lower intake of healthier food,” said Mellor, who was not involved in the study.

The study, published Tuesday in the journal eClinicalMedicine, looked at the association between eating ultraprocessed foods and 34 different types of cancer over a 10-year period.

Researchers examined information on the eating habits of 197,426 people who were part of the UK Biobank, a large biomedical database and research resource that followed residents from 2006 to 2010.

The amount of ultraprocessed foods consumed by people in the study ranged from a low of 9.1% to a high of 41.4% of their diet, the study found.

Eating patterns were then compared with medical records that listed both diagnoses and deaths from cancer.

Each 10% increase in ultraprocessed food consumption was associated with a 2% increase in developing any cancer, and a 19% increased risk for being diagnosed with ovarian cancer, according to a statement issued by Imperial College London.

Deaths from cancers also increased, the study found. For each additional 10% increase in ultraprocessed food consumption, the risk of dying from any cancer increased by 6%, while the risk of dying from ovarian cancer rose by 30%, according to the statement.

“These associations persisted after adjustment for a range of socio-demographic, smoking status, physical activity, and key dietary factors,” the authors wrote.

When it comes to death from cancer among women, ovarian cancer is ranked fifth, “accounting for more deaths than any other cancer of the female reproductive system,” noted the American Cancer Society.

“The findings add to previous studies showing an association between a greater proportion of ultra-processed foods (UPFs) in the diet and a higher risk of obesity, heart attacks, stroke, and type 2 diabetes,” said Simon Steenson, a nutrition scientist at the British Nutrition Foundation, a charity partially supported by food producers and manufacturers. Steenson was not involved in the new study.

“However, an important limitation of these previous studies and the new analysis published today is that the findings are observational and so do not provide evidence of a clear causal link between UPFs and cancer, or the risk of other diseases,” Steenson said in an email.

People who ate the most ultraprocessed foods “were younger and less likely to have a family history of cancer,” Chang and her colleagues wrote.

High consumers of ultraprocessed foods were less likely to do physical activity and more likely to be classified as obese. These people were also likely to have lower household incomes and education and live in the most underprivileged communities, the study found.

“This study adds to the growing evidence that ultra-processed foods are likely to negatively impact our health including our risk for cancer,” said Dr. Eszter Vamos, the study’s lead author and a clinical senior lecturer at Imperial College London’s School of Public Health in a statement.

This latest research is not the first to show an association between a high intake of ultraprocessed foods and cancer.

A 2022 study examined the diets of over 200,000 men and women in the United States for up to 28 years and found a link between ultraprocessed foods and colorectal cancer — the third most diagnosed cancer in the United States — in men, but not women.

And there are “literally hundreds of studies (that) link ultraprocessed foods to obesity, cancer, cardiovascular disease, and overall mortality,” Marion Nestle, the Paulette Goddard professor emerita of nutrition, food studies and public health at New York University told CNN previously.

While the new UK-based study cannot prove causation, only an association, “other available evidence shows that reducing ultra-processed foods in our diet could provide important health benefits,” Vamos said.

“Further research is needed to confirm these findings and understand the best public health strategies to reduce the widespread presence and harms of ultra-processed foods in our diet,” she added.

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Health

‘Bad’ foods like cheese and chocolate could be good for you

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Feeling guilty about already ditching your New Year’s resolution to give up chocolate or cheese?

Fear not. Many foods we assume to be bad for us — including cheddar and candy bars — can actually provide our bodies with significant health benefits.

“We tend to view food as either good or bad for us,” Lisa Young, a registered dietitian at New York University and the author of “Finally Full, Finally Slim,” told The Post.

However, she said, such thinking isn’t necessarily useful — or, well, healthy.

“Generally, a small portion of [any] food is OK,” she said.

And many of our favorite bites, it turns out, are a great deal more than OK —they’re packed with vital nutrients. Have a look.

White potatoes

Young says there are benefits to including white potatoes in your diet.
Getty Images/iStockphoto

“They get a bad rap because of French fries, which is a form of white potato,” Young told The Post. “But white potatoes themselves [aren’t bad].”

“A baked potato has tons of fiber and potassium,” she continued. Plus each one is a single unit, making portion control simple.

Just beware of going overboard on indulgent toppings. Instead of the usual sour cream and chives, substitute protein-packed Greek yogurt and fresh veggies, such as chopped tomatoes or spinach.

Cheese


Maybe say yes to that cheeseboard next time it’s sitting in front of you.
Getty Images/Image Source

Sure, the beloved pre-dinner snack is high in calories, but that doesn’t mean you shouldn’t ever say “cheese.”

It “provides protein [and] calcium, so there is definitely a place in the diet for cheese,” Young said.

Harder cheeses such as cheddar, Swiss and parmesan and blue cheeses are typically healthier than soft cheeses, such as brie, because they contain more calcium.

Plus, aged cheeses have been identified as helping to aid digestion and boost immunity.

“Both raw and pasteurized cheeses contain good bacteria that can be beneficial to human gut microbiota,” Adam Brock, vice president of food safety, quality and regulatory compliance for Dairy Farmers of Wisconsin, told The Washington Post.

Those who consume cheese and full-fat dairy have also been found to lower their likelihood of developing diabetes or hypertension. A 2020 study — which surveyed more than 145,000 people in 21 countries — found consuming two daily servings of dairy of any kind reduced the risk posed by either condition by 11% to 24%.

Peanut butter


As long as there’s no additives, peanut butter has been given the thumbs up by Dr. Young.
Getty Images/iStockphoto

If you opt for a nutty spread that’s all peanuts — and doesn’t have additives such as salt, sugar or kernel or palm oil — it’s a great snack.

“Natural peanut butter is one of the healthiest foods for you,” Young said. “[Nuts] are high in polyunsaturated fat — so they’re good for you.”

According to the American Heart Association, polyunsaturated fat can help reduce bad cholesterol levels, which can lower your risk of heart disease and stroke.

A scoop of PB is also known to satisfy and suppress your appetite, and is a fairly balanced energy source, containing all three major macronutrients: carbohydrates, fat and protein, all of which your body needs to remain healthy.

Chocolate


Chocolate containing more than 70% cocoa or above contains antioxidants — so have a nibble, for health.
Getty Images

“It’s healthy, to allow yourself to indulge in a small portion of a treat every now and then,” said Young.

She noted that dark chocolate that is 70% cocoa or higher has antioxidants, which help to prevent or slow damage to cells in the body caused by free radicals — waste substances that can harm cells and the body’s functioning.

There’s more sweet news. A study published in the journal BMJ Heart in 2017 found that those who consumed chocolate in small amounts — roughly once a week — were less likely to be diagnosed with atrial fibrillation.

Eggs


As long as you don’t have high cholesterol, eggs are a healthy addition to your diet.
Getty Images/iStockphoto

Give ’em a break. Eggs are a great source of protein when consumed in moderation — and ideally without a side of bacon or deep-fried hash browns.

Plus, Young said, “Eggs have lutein [which supports eye and brain health], vitamin E, Choline — there’s a lot of nutrients.” Many of the nutrients are in the yolk, so don’t opt for just the whites.

While the yolks are high in cholesterol, the Mayo Clinic notes that consuming eggs doesn’t seem to raise a person’s cholesterol the way foods high in saturated fat do.

A 2019 review from the Université de Tours in France even found that the peptides eggs contain reduce blood pressure.

Butter


While you shouldn’t be eating a stick of butter, spreading some on a slice of toast is fine.
Getty Images/EyeEm

There’s little harm in spreading a tablespoon or two of the creamy stuff on your toast every morning, Young said.

It can help build calcium and it’s also a good source of vitamin A — which is important for skin health and immune function — and vitamin E, which is important for vision and reproduction, according to the Mayo Clinic.

“[The health benefits of butter come down to] a quantity issue,” Young said. “In moderate amounts [it can be] be totally healthy.”

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These healthy diets were associated with lower risk of death, according to a study of 119,000 people across four decades

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Eat healthy, live longer.

That’s the takeaway from a major study published this month in JAMA Internal Medicine. Scientists led by a team from the Harvard T.H. Chan School of Public Health found that people who most closely adhered to at least one of four healthy eating patterns were less likely to die from cardiovascular disease, cancer or respiratory disease compared with people who did not adhere as closely to these diets. They were also less likely to die of any cause.

“These findings support the recommendations of Dietary Guidelines for Americans that multiple healthy eating patterns can be adapted to individual food traditions and preferences,” the researchers concluded, adding that the results were consistent across different racial and ethnic groups. The eating habits and mortality rates of more than 75,000 women from 1984 to 2020 over 44,000 men from 1986 to 2020 were included in the study.

The four diets studied were the Healthy Eating Index, the Alternate Mediterranean Diet, the Healthful Plant-Based Diet Index and the Alternate Healthy Eating Index. All four share some components, including whole grains, fruits, vegetables, nuts and legumes. But there are also differences: For instance, the Alternate Mediterranean Diet encourages fish consumption, and the Healthful Plant-Based Diet Index discourages eating meat.

The Alternate Mediterranean Diet is adapted from the original Mediterranean Diet, which includes olive oil (which is rich in omega-3 fatty acids), fruits, nuts, cereals, vegetables, legumes and fish. It allows for moderate consumption of alcohol and dairy products but low consumption of sweets and only the occasional serving of red meat. The alternate version, meanwhile, cuts out dairy entirely, only includes whole grains and uses the same alcohol-intake guideline for men and women, JAMA says.

The world’s ‘best diets’ overlap with study results

The Mediterranean Diet consistently ranks No. 1 in the U.S. News and World Report’s Best Diets ranking, which looks at seven criteria: short-term weight loss, long-term weight loss, effectiveness in preventing cardiovascular disease, effectiveness in preventing diabetes, ease of compliance, nutritional completeness and health risks. The 2023 list ranks the top three diets as the Mediterranean Diet, the DASH Diet and the Flexitarian Diet. 

The DASH (Dietary Approaches to Stop Hypertension) Diet recommends fruits, vegetables, nuts, whole grains, poultry, fish and low-fat dairy products and restricts salt, red meat, sweets and sugar-sweetened beverages. The Flexitarian Diet is similar to the other diets in that it’s mainly vegetarian, but it allows the occasional serving of meat or fish. All three diets are associated with improved metabolic health, lower blood pressure and reduced risk of Type 2 diabetes.

Frank Hu, a professor of nutrition and epidemiology at the Harvard School of Public Health and co-author of the latest study, said it’s critical to examine the associations between the U.S. government’s Dietary Guidelines for Americans and long-term health. “Our findings will be valuable for the 2025-2030 Dietary Guidelines Advisory Committee, which is being formed to evaluate current evidence surrounding different eating patterns and health outcomes,” he said.

Reducing salt intake is a good place to start. In 2021, the Food and Drug Administration issued new guidance for restaurants and food manufacturers to, over a two-and-a-half-year period, voluntarily reduce the amount of sodium in their food to help consumers stay under a limit of 3,000 milligrams per day — still higher than the recommended daily allowance. Americans consume around 3,400 milligrams of sodium per day, on average, but the Centers for Disease Control and Prevention recommends that people consume less than 2,300 milligrams each day.

Related: Eating 400 calories a day from these foods could raise your dementia risk by over 20%

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Intermittent fasting may not be as helpful for losing weight as once thought, study finds

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Are snacks before bed your vice? Or do you prefer to wait a few hours after you wake up to eat?

The timing of meals may not have as big an impact on weight as once thought, according to a new study.

The study tracked the portion sizes and eating times of 547 people, in addition to data on their health and weight, over the course of six years. The data showed no association between an interval of the day in which people had their meals and their weight, according to the study published Wednesday in the Journal of the American Heart Association.

Restricting eating times, as seen in diet trends such as intermittent fasting, has been a popular method to try to lose weight in recent years.

But the researchers found no association between restricting eating times and weight loss, said principal investigator of the study Dr. Wendy Bennett, an associate professor of medicine in the division of general internal medicine at Johns Hopkins School of Medicine. That included how long people ate after waking up, how long their window of eating was throughout the day and how close to going to bed they ate, she noted.

Instead, smaller meals were associated with weight loss, she said.

“Based on other studies that have come out, including ours, we are starting to think that timing of meals through the day most likely doesn’t immediately result in weight loss,” Bennett said, adding the caveat that for some people, timing meals may be a useful tool in tracking nutrition.

The results of this study should be taken with a grain of salt, experts cautioned.

There were few racial and ethnic minorities among the participants, noted Dr. Fatima Cody, associate professor of medicine at Harvard Medical School. There are also many social determinants of health, such as stress and people’s environment, that could be added to the data, Cody added.

Those factors could be important for getting a better look at the effects of meal timing, added Alice Lichtenstein, professor of nutrition science and policy at Tufts University.

“I suspect that if they looked more closely at the data, that there would be subgroups (where timing of meals) may have had a significant effect,” Lichtenstein said.

This study was observational, Bennett noted, meaning that they looked at existing patterns for the study instead of making changes to a randomized group. Further work on this topic is underway, she added.

The big takeaways are that there is no one strategy that works for all people when it comes to nutrition, and that quality of the food counts, Lichtenstein said.

“If you make some effort to consume a healthy diet, you make some effort to be physically active, you’re less likely to have diabetes, chronic kidney disease, obstructive pulmonary disease and hypertension,” Lichtenstein said.

It’s the boring stuff no one wants to hear, she added, but there is no getting around eating fruits and vegetables and getting physical activity when it comes to weight management.

For some people, trying intermittent fasting or restricting eating intervals can be a helpful way to take note of personal tendencies, but many people can’t sustain it for enough time to see long-term change — or keep off any weight they lose, Lichtenstein added.

Cody, who is an obesity medicine physician at Boston’s Massachusetts General Hospital Weight Center, doesn’t like to focus too strongly on either calorie restriction or intermittent fasting, she said. Instead, she wants her clients to look at the nutritional value of the food they are eating.

To the body, 100 calories of gummy bears is not the same as 100 calories of oatmeal with fruit and nuts, she added.

But different approaches work better in different lifestyles, and everyone should work with their own doctor and their own body without stress and shame, Cody said.

If a nutrition strategy works for someone else, she said, “it just means someone’s body responded and the other one didn’t. It doesn’t mean you’re flawed. It just means that’s just not what your body needed.”

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Health

The Benefits of Taking Vitamin D Might Depend on Your Weight

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Image: Shutterstock (Shutterstock)

The potential benefits of taking vitamin D supplements may be affected by your weight and height, new research suggests. The study found that overweight and obese people taking these supplements experienced a smaller increase of vitamin levels and other related markers relative to those with a lower body mass index.

The study is a reanalysis of the VITAL trial, a large-scale project that tested whether proactively taking vitamin D or marine omega-3 supplements could reduce older people’s risk of developing cancer and cardiovascular disease. The randomized, placebo-controlled trial was led by researchers from the Brigham and Women’s Hospital in Massachusetts, which is affiliated with Harvard University. It overall found no significant effect from either type of supplementation on these outcomes. But some data also indicated that vitamin D supplementation was associated with benefits in those with a BMI lower than 25 (BMI between 18.5 to 25 is considered “normal”), specifically a smaller risk of developing cancer and autoimmune disease, as well as a lower cancer mortality.

To better understand this link, some of the same researchers decided to study blood samples taken from over 16,000 volunteers over the age of 50 involved in the trial. These samples allowed them to look at people’s total vitamin D levels as well as other biomarkers of vitamin D, like metabolic byproducts and calcium, before the study began. About 2,700 of these volunteers also came back for follow-up blood tests two years later.

The team found that people’s levels of vitamin D and these biomarkers generally increased following supplementation, no matter their BMI. But this increase was significantly less pronounced in those with a BMI over 25, the threshold for overweight and obesity. This dampening effect was also seen in people who had low levels of vitamin D at baseline, meaning those who would experience the greatest benefit from supplementation. The team’s findings were published Tuesday in JAMA Network Open.

“We observed striking differences after two years, indicating a blunted response to vitamin D supplementation with higher BMI,” said study author Deirdre Tobias, an associate epidemiologist in Brigham’s Division of Preventive Medicine, in a statement from Harvard. “This may have implications clinically and potentially explain some of the observed differences in the effectiveness of vitamin D supplementation by obesity status.”

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As for why this may be happening, the researchers point to two possible theories. It’s possible, for instance, that higher levels of body fat may allow more vitamin D—a fat-soluble vitamin—to be pulled away from a person’s blood circulation and stored away. Obesity-related liver problems might also make it harder for people to metabolize vitamin D as effectively.

This is only one study, however, and more research will be needed to confirm the patterns seen here. But the authors say that their findings might eventually lead to a reevaluation of the positives and negatives of vitamin D supplementation and how to improve its use for people across the board. People with higher BMI, for example, may need higher doses of vitamin D to achieve the same benefits seen in those with lower body weight.

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Health

Can Intermittent Fasting Help Combat Youth Obesity?

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Parents and doctors are looking for new strategies to help adolescents with obesity. One controversial approach drawing the interest of some families is intermittent fasting, which limits people to eating for just a part of the day or week. 

Intermittent fasting has gained traction among adults who use it to try to manage weight and improve health. Doctors have largely avoided trying it with adolescents out of concern that introducing a fasting period to their schedules might result in nutritional gaps or trigger eating disorders when teens are rapidly growing and developing.

Now, a small number of doctors and researchers are evaluating types of intermittent fasting in adolescents, searching for solutions as rates of obesity and Type 2 diabetes rise. One pediatric endocrinologist in Los Angeles is launching a clinical trial looking at eating within a set time window in adolescents with obesity. Researchers in Australia are completing a separate trial, the results of which they expect to publish later this year.

Roughly one-fifth of children in the U.S. are considered obese, according to data from the Centers for Disease Control and Prevention. Pediatricians are so concerned that the American Academy of Pediatrics for the first time this month recommended physicians offer weight-loss drugs for children with obesity. 

Any approach that limits when and how an adolescent eats must be handled cautiously, doctors say. 

Families and doctors need to be very careful with any form of intermittent fasting in youth as it can be a slippery slope with a potential risk of eating disorders, says

Jason Nagata,

a pediatrician and eating-disorder specialist at the University of California, San Francisco. Doctors have also raised questions about the potential long-term effects of intermittent fasting on developing bodies.

Courtney Peterson,

an associate professor of nutrition sciences at the University of Alabama at Birmingham who studies intermittent fasting in adults, says she would be worried about adolescents’ getting enough nutrients. “I think it’s worth testing but testing with caution,” she says. 

Her research has found that adults with obesity who ate between 7 a.m. and 3 p.m. lost on average an extra 5 pounds more than a control group eating over 12 hours or more, and adults with prediabetes who ate over a six-hour period starting early in the day showed improvements in blood-sugar levels.

Intermittent fasting is an umbrella term for eating strategies that involve fasting. One such strategy, time-restricted eating, or TRE, limits eating to a set number of hours a day—often eight—with no limitations on what or how much you eat. In the remaining hours, you refrain from eating or drinking except for water. 

Alaina Vidmar,

a pediatric endocrinologist and obesity-medicine specialist at Children’s Hospital Los Angeles, is starting a clinical trial to evaluate whether an eight-hour window of eating, from 11 a.m. to 7 p.m., results in changes in insulin and glucose response for teens with obesity. 

The researchers are also looking at weight loss and body-fat mass, as well as blood pressure and cholesterol. 

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The research stems from conversations Dr. Vidmar had with families of patients with obesity in recent years. Some had asked her about time-restricted eating, or had tried it and said they liked it. She tested the concept in teenagers with obesity to see if setting an eight-hour window of eating was feasible in a pilot study published in the journal Nutrients in 2021.  

“They enjoyed doing it, they felt like their whole family could do it, and over time they were losing weight,” Dr. Vidmar says of the teens. 

Now, her lab is enrolling 100 youth between 12 and 21 years old with Type 2 diabetes and obesity in a 12-week trial. Participants are screened and monitored for any negative eating behaviors, she says. So far, she hasn’t found that time-limited eating “impacts eating behaviors or worsens disordered eating in any way,” she says. 

In Australia, researchers are studying how teens with obesity respond to a different form of fasting called intermittent energy restriction. 

In this approach, for three days a week you eat roughly one-quarter of the calories you normally do, says

Natalie Lister,

a researcher and dietitian at the University of Sydney. On the other four days, you have no calorie limits. 

Dr. Lister says she and colleagues started looking into intermittent fasting in adolescents with obesity a few years ago when patients started asking about it. They conducted a pilot trial with 30 adolescents, published in 2019. Now, the researchers are completing a trial whose results they expect to publish later this year. 

The health team monitors for eating disorders and depression, and the study doesn’t enroll anyone with a high risk of disordered eating, says Dr. Lister. Dietitians provide guidelines to help ensure participants are meeting nutritional requirements.

In adults with obesity, the data on TRE is mixed when it comes to weight loss, but two systematic reviews of the existing research both found a modest weight-loss benefit overall, says Dr. Peterson. Studies have also found that adults experience improvements in measures such as insulin resistance, reducing blood-glucose levels, particularly when their eating window starts early in the day. 

Matthew Muros, a 15-year-old in Carson, Calif., struggles with his weight and prediabetes. Matthew participated in Dr. Vidmar’s pilot studies last year. The first two weeks were challenging, he notes. 

“I did feel really hungry. I just kept on drinking water,” he says.

He says it got easier, and when the study was over he decided to stick with the schedule. He has lost about 30 pounds, and his blood-glucose levels have improved. 

He has also changed his diet, having less soda, fast food and carbohydrates. “I’m trying to eat a little bit more healthy,” he says.

Write to Sumathi Reddy at Sumathi.Reddy@wsj.com

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Health

Here’s how to eat to live longer, new study says

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CNN
 — 

You can reduce your risk of an early death for any reason by nearly 20%, just by eating more foods from your choice of four healthy eating patterns, according to a new study.

People who more carefully followed any of the healthy eating patterns — which all share a focus on consuming more whole grains, fruits, vegetables, nuts and legumes — were also less likely to die from cancer, cardiovascular illness, and respiratory and neurodegenerative disease.

The results of the study, published Monday in the journal JAMA Internal Medicine, show “there is more than one way to eat well and derive the attendant health benefits,” said Dr. David Katz, a lifestyle medicine specialist who was not involved in the study.

People often get bored with one way of eating, study coauthor Dr. Frank Hu said, “so this is good news. It means that we have a lot of flexibility in terms of creating our own healthy dietary patterns that can be tailored to individual food preferences, health conditions and cultures.

“For example, if you are eating healthy Mediterranean, and after a few months you want to try something different, you can switch to a DASH (Dietary Approaches to Stop Hypertension) diet or you can switch to a semi-vegetarian diet,” said Hu, a professor of nutrition and epidemiology and chair of the department of nutrition at the Harvard T.H. Chan School of Public Health. “Or you can follow US dietary guidelines and create your own healthy eating plate.”

The study followed the eating habits of 75,000 women participating in the Nurses’ Health Study and more than 44,000 men in the Health Professionals Follow-up Study over 36 years. None of the men and women had cardiovascular disease at the start of the study, and few were smokers. All filled out eating questionnaires every four years.

“This is one of the largest and longest-running cohort studies to examine recommended dietary patterns and the long-term risk of premature deaths and deaths from major diseases,” Hu said.

Hu and his team scored participants on how closely they followed four healthy eating styles that are in sync with current US dietary guidelines.

One is the Mediterranean diet, which stresses eating fruits, vegetables, whole grains, nuts, legumes, fish and a high amount of olive oil, Hu said. “This dietary pattern emphasizes healthy fats, especially monounsaturated fat, in addition to plant-based foods and moderate alcohol,” he said.

The next is called the healthful plant-based diet, which also focuses on eating more plant products but gives negative points for all animal products and any alcohol.

“It even discourages relatively healthy options, like fish or some dairy products,” Hu said, adding that the eating plan frowns on unhealthy plant-based foods such as potato products.

“So you can imagine that vegetarians are probably on the higher end of this diet score,” he said, “and people who eat a lot of animal products or highly processed carbohydrate foods would be at the lower end of this score.”

The Healthy Eating Index tracks whether people follow basic US nutritional guidelines, which stress healthy, plant-based foods, frown on red and processed meat, and discourage eating added sugar, unhealthy fats and alcohol, Hu said.

The Alternate Healthy Eating Index was developed at Harvard, Hu said, and uses the “best available evidence” to include foods and nutrients most strongly associated with a lower risk of chronic disease.

“We explicitly included nuts, seeds, whole grains and lower consumption of red and processed meats and sugar-sweetened beverages,” he added. “A moderate consumption of alcohol is allowed.”

After each person’s eating pattern was scored, the participants were divided into five groups, or quintiles, from highest to lowest adherence to one or more of the eating patterns.

“The highest quintile of diet quality as compared to the lowest was associated with a roughly 20% reduction in all-cause mortality,” said Katz, president and founder of the nonprofit True Health Initiative, a global coalition of experts dedicated to evidence-based lifestyle medicine.

The study also found reductions in risk of death from certain chronic diseases if people improved their diet over time, Hu said.

Participants who improved the health of their diet by 25% could reduce their risk of dying from cardiovascular disease by a range of 6% to 13% and dying from cancer by 7% to 18%, he said. There was up to a 7% reduction in risk of death by neurodegenerative disease, such as dementia.

“Respiratory disease mortality reduction was actually much greater, reducing risk by 35% to 46%,” Hu said.

The study relied on participants’ self-reports of food preferences and therefore only showed an association, not a direct cause and effect, between eating habits and health outcomes. Still, the fact that the study asked about diets every four years over such a long time frame added weight to the findings, Hu said.

What is the takeaway of this large, long-term study?

“It’s never too late to adopt healthy eating patterns, and the benefits of eating a healthy diet can be substantial in terms of reducing total premature deaths and different causes of premature death,” Hu said.

“People also have a lot of flexibility in terms of creating their own healthy dietary pattern. But the common principles — eating more-plant based foods and fewer servings of red meat, processed meats, added sugar and sodium — should be there, no matter what kind of diet that you want to create.”

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Health

Just one soda a day can increase risk of baldness in men

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One less soda a day could keep your hair loss at bay.

A new study suggests drinking your favorite pop could be raising your odds of going bald.

Researchers from the Tsinghua University in Beijing found that those who indulged in just one soda per day had a 57% higher risk of experiencing male pattern hair loss compared to those who avoided fizzy bevs.

Specifically, they analyzed the consumption of “sugar-sweetened beverages,” referred to as SSBs in the study, and hypothesized the likelihood that any drink high in added sugar could contribute to the condition. With the possible exception of diet sodas, other sugary drinks, including sports drinks, sweetened coffee and tea, should be off the table if you want to keep your hair.

Data show that half of men typically lose their hair by 50, and 25% of bald men see the earliest signs of hair loss before they’re 21, according to the Cleveland Clinic.

Scientists have long searched for an effective hair loss treatment, trialing everything from twice-a-day tablets to old-school Minoxidil, the active ingredient in Keeps and Rogaine. One team of Japanese researchers even grew a hair follicle in a petri dish earlier this year — a first step toward developing a regenerative hair growth treatment.

But recent advances might be for naught if men continue to guzzle down soda. According to the Centers for Disease Control and Prevention, 63% of adults aged 18 years and up drink at least one sugary beverage a day.

This latest study, published in the journal Nutrients, looked for links between sweet drink consumption and male pattern hair loss, in a self-reported survey of 1,028 men, ages 18 to 45, located in China.

Participants answered questions about previous balding, their eating habits and if they experience any mental health problems. They were also asked how often they consumed certain foods and beverages — namely soft drinks and sweetened refreshments.

This revealed a “significant association” between a high sugary drink consumption and hair loss in men.

Investigators saw the highest sweetened beverage intake among the youngest men surveyed, and believed it to be the result of an “unawareness of the harmful effects” of the sugary drinks.

“Chronic diseases and deaths are so vague and distant for young people that they are unwilling to give up the satisfaction brought by SSBs for the sake of long-term health goals,” the authors wrote.

Researchers further concluded that drinking sugary beverages one to three times per week saw an increased risk of hair loss by 21%, while consuming four to seven of the sweet drinks heightened the risk to 26%.

In addition to hair loss, they found a relationship between sweetened beverage intake and psychological health — potentially fueling a vicious cycle of depression and anxiety made worse by hair loss.

In their analysis, researchers found that people who consumed three sodas per day had about a 25% higher risk of depression. They also discovered that the simple sugars in such drinks are associated with heightened anxiety among 45-year-old study participants.

The scientists’ findings are correlative, meaning that they cannot be certain that soda causes hair loss — only that soda drinkers are losing their hair at higher rates.

This potential link between poor diet and balding isn’t the first of its kind, though, as other researchers have analyzed the effects of salt and a receding hair line. Some researchers have touted healthy eating and various vitamins and minerals as the holy grail to preventing hair loss, yet it remains unclear if eating clean is indeed end-all, be-all.

The Beijing researchers didn’t seem to think so. They did not find any protective qualities of eating healthy, but called for more studies to be conducted to confirm their results.

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Technology

This Puck Tess Your Nutrition and Cycle Right From Your Toilet

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You know that extreme paranoia you have about dropping your favorite device in the toilet? Withings wants you to forget all that for its latest health-tracking device, the U-Scan, which is not only specifically designed to be used in a toilet bowl, but to be urinated on as well. Stick with us; it’s not as gross as it sounds.

There’s only so much health information that can be collected from strapping a smartwatch to your wrist, clipping a pulse oximeter to your finger, or wrapping an inflatable blood pressure cuff around your upper arm. That’s why doctors will often order blood samples to be taken or request that patients pee in a cup for detailed urine analysis at a lab before making a diagnosis.

Urine tests that can be performed at home aren’t a new idea, but the info they provide is often limited. Pharmacies sell strips that can be used to test for urinary tract infections, while urine tests remain the cheapest and easiest way to confirm a pregnancy without a trip to the doctor. With the U-Scan, Withings is expanding the health information that can be gleaned from urine without sending it off to a lab, while also making the collection process completely hands-off.

Image: Withings

The hardware is reminiscent of Google’s Chromecast dongle, but instead of plugging into a TV’s HDMI port, you hang it in the front of a toilet bowl, where you then deliberately urinate on it. The U-Scan’s smooth, pebble-shaped design funnels urine along its surface down into a collection inlet at the bottom, where a thermal sensor detects the presence of the fluid and activates a pump, which draws the sample inside and through a “microfluidic circuit.” While a user is urinating, a “low-energy radar sensor embedded into the device” can also recognize and distinguish between several users by detecting their “unique urine stream signature” through a feature Withings calls Stream ID.

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Inside the U-Scan is a replaceable cartridge, good for about three months, filled with dozens of test pods into which urine is injected. Chemical reactions then occur when one or several biomarkers are detected, producing specific colors that are analyzed by an optical sensor. After the test is complete, the remaining fluids are pumped out of the U-Scan and back into the toilet. The device itself is cleaned during every flush, although you still might want to reach for a pair of gloves when swapping cartridges or giving it a charge, which you’ll need to do every three months.

The results of the U-Scan’s tests are shared over wifi to Withings’ private servers and made available through the company’s accompanying mobile apps, which allows the results and each user’s personal health data to be tracked over time. There’s no timeline for when U-Scan will be available in the United States—Withings is still developing it for the US market and it will require FDA clearance first—but the starter kit will go on sale in Europe next year for €499.95 (about US $530) and will include one of two different three-month cartridges, with the option to buy more through a subscription plan or standalone.

Image: Withings

The U-Scan Nutri Balance cartridge and app will provide information on a user’s pH, vitamin C, carb balance, and ketone levels to help “monitor their metabolic intake to optimize their daily hydration and nutrients” and recommend “workouts, dietary suggestions, and recipes to achieve identified goals.”

Image: Withings

The U-Scan Nutri Balance cartridge and app is instead designed specifically for “cycle tracking, coaching, and journaling” and provides information on “cycle predictions and ovulation window based on hormonal detection alongside key hydration and dietary biomarkers.” The user can also document other symptoms the U-Scan can’t detect, including period flow, mood, food and water intake, and cervical fluids. The hope is that, together, the U-Scan and the journaling will provide more accurate predictions and insights into a user cycle than apps that rely on journaling and self-collected data alone.

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