Tue, Feb-27-24, 10:32
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Plan: Muscle Centric
Stats: 238/153/160
BF:
Progress: 109%
Location: UK
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How much do you eat? The diet study where no one can cheat
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How much do you eat? The diet study where no one can cheat
It’s the most detailed research of its kind — and the most exacting for those involved
This month Kevin Elizabeth spent two weeks at a biomedical research centre in Louisiana following a strict meal plan of junk food devised by clinical nutritionists. He ate things like Frosties for breakfast and the abomination that is Tater Tots (fried nuggets of grated potato plus corn flour, dextrose, sodium acid pyrophosphate) for lunch.
His physiological responses were monitored: blood sugar, insulin and heart rate, to name a few. And no cheating was allowed. If his fiancée visited, her bags and pockets were checked to ensure she didn’t smuggle in an apple. Elizabeth wasn’t tempted either.
“I didn’t sneak anything — I didn’t really want to,” the 28-year-old tech worker says. He laughs. “I didn’t want to face the awkwardness of being searched.” Plus, he adds, “You know how serious the work is. You don’t want to put any of that in jeopardy.”
He’s pleased to be part of a project aiming to understand better why broadly healthy eating guidelines don’t work for everyone. The Nutrition for Precision Health (NPH) study, which is funded by the American research agency the National Institutes of Health and is part of its All of Us research programme, involves 10,000 participants over five years, and is assessing individuals’ genetics, gut microbes, metabolism, lifestyle and more, to discover how these variables affect their unique response to various foods. The programme, which launched in May last year, is the largest research initiative of its kind. AI algorithms created from its data will help to predict an individual’s response to certain diet patterns, enabling doctors to tailor nutritional recommendations to optimise the health of each and every one of us.
First, participants answer surveys on lifestyle, health history, mental health, social support and stress levels. Height, weight, body composition, respiratory rate, blood pressure, resting heart rate variability and grip strength (a proxy for physical fitness) are measured. Urine and stool samples are taken.
Assessments cover “potential predictive measures — things that could feed into the algorithms we’re trying to create about predicting how people respond,” the NPH co-ordinator Dr Holly Nicastro says. They also cover actual responses. “We want to see what’s changing in response to what you’re eating and can we predict those?”
Participants are fitted with an accelerometer — “a little more clunky than an Apple Watch but it captures things like physical activity, sedentary time and sleep,” Nicastro says — and a continuous blood glucose monitor. Incretins, blood lipids and resting metabolic rate are also measured.
In the first phase or module of the study, participants stick to their normal diet and routine. Module two (which participants undertake at home) and module three (which is residential and supervised) include three “dietary interventions” — diet A, diet B and diet C — each lasting two weeks, with a fortnight’s break in between.
Diet A sounds similar to the Mediterranean diet — high in fruit, vegetables, whole grains and beans, with moderate amounts of dairy, meat, poultry, eggs, fish, nuts, seeds and vegetable oils, and very low amounts of sugar-sweetened drinks and desserts.
Diet B, meanwhile, is your average junk food diet. It is high in refined grains, meat, poultry, eggs, sugary drinks, sweets, snacks, desserts and processed foods, with a moderate amount of dairy, and low in vegetables, whole grains and fish.
Diet C isn’t far off a low-carb diet, with moderate to high amounts of vegetables, meat, poultry, eggs, fish, nuts, seeds, fats and oils, low amounts of fruits and dairy, and very low amounts of grains and sugars.
But no one’s judging. Nicastro (who declares Tater Tots “very tasty”) says of the research: “It’s not to say which of the three diets is best, or which of the three diets is best for a person. The goal of these three diets is to create as different responses in people as possible. So that’s why you’ll see this variation among the three in levels of things like fat, or saturated fat, sodium, processed foods, fibres, added sugars.” She adds: “We want them to be distinct from one another.” The diets aren’t named so as to avoid prejudicing participants — eg “I’ve heard about this diet — this diet’s garbage!” Nicastro says.
Though she concedes that diet A resembles “a Dash [the heart-healthy Dietary Approaches to Stop Hypertension] eating plan or a Mediterranean eating plan,” she says that diet B “might remind you of a typical American diet, higher in things like added sugars, sodium and saturated fat, and lower in fibre and fresh fruits and vegetables”. And of diet C she says: “Some people might say it looks like a ketogenic diet. Higher in fats, higher in things like avocados and meats, and lower in the carbohydrates, the added sugars, but also lower in pasta, lower in breads.”
Each diet is developed to provide exactly the same amount of calories for every participant, either 1,600, 2,100, 2,600 or 3,200 daily. “We use standard equations based on your age, your sex and your weight to determine how many calories you need in a day,” Nicastro says. That means diet B is not more calorific than diets A and C. They avoid the concept of “dieting”, preferring to talk about “eating patterns”. She adds: “We’re not studying weight loss.”
Elizabeth — who has also completed diet C at the facility and is about to return for diet A — had cravings on the junk food diet, but felt full on the low-carb one. “It was a lot of vegetables, proteins, very little carbs. A lot of cauliflower rice … mashed cauliflower, a lot of dairy, a lot of cheese sticks, a lot, every day.” He adds: “The first three days, it was tough for me — it seemed like a lot of food. The healthier alternative to meet those caloric amounts — the portion size was a bit of a shock to my system.”
His normal diet falls somewhere between diets C and A, he says. He cooks three or four times in the week or eats convenience food such as frozen pizza and has “no rules” at weekends. Breakfast is usually “black coffee, cereal or something simple: yoghurt and granola”. Lunch is “prepared meals or deli sandwiches I make on my own with deli meat” and dinner is “pasta dishes, simple proteins like steak and vegetables, potatoes, rice”.
When he started exercising on the low-carb diet, “I did feel it was fuelling my body a lot better than I was typically accustomed to. I felt a lot more energised.” As for the junk food diet, he says “it took a toll”, making workouts harder. “I felt that sugar crash.”
He liked the routine. Participants in residence can eat breakfast between 7am and 9am, have lunch between 11am and 1pm, and eat dinner between 5pm and 7pm — but they must stick to a regular time. “When people eat does affect how they’re going to respond to foods,” Nicastro says, “so in module 3, that’s one of the many, many, many things we are trying to hold constant.”
They take no chances with resident participants’ willpower. Registered dieticians ensure they get enough food so they’re not constantly hungry. Rules are clarified in advance: “Do you understand, there are no vending machines, you can’t bring food in?”
Even so, Nicastro reveals, “when participants check in, their belongings are searched, to make sure. Visitors also have their bags checked.” Some participants stay in hotels with study staff and are accompanied en route to the facility “just to make sure they’re not swinging into Starbucks on the way”. Exercise is allowed, “but if that exercise involves going for a walk somewhere, they will be accompanied”.
Some participants in every module are also fitted with mini-cameras attached to eyeglasses to assess the exactitude of their self-reporting. This is not for snooping purposes, apparently, and is more a data-gathering aid. “Can they help participants more accurately report on what they’re eating?” Nicastro asks.
For residents they provide a useful comparison — “what do the glasses tell us participants are eating, versus the actual gold-standard data of a human weighing somebody’s food, watching them eat it and then weighing the empty plate to know exactly what crossed that person’s lips?”
Fascinating as this sounds, do we not already have good information on how harmful UPFs are for health? And — spoiler alert — doesn’t diet A, the Mediterranean-ish one, have the most evidence to show that it’s beneficial?
“I will not argue against that,” Nicastro says. “There’s a lot we do know about what makes a healthy diet.” And yet, she adds: “We still don’t see the health in the population we’d like to see, and we do know that there’s no right way of eating for everybody.” Even on the Dash studies, she notes, “some people had their blood pressure increased”.
The Study for Precision Nutrition is learning more about why some people respond differently, Nicastro says. “Our goal is, if we can predict it then we can tailor our dietary advice to people based on whatever these predictive factors are so they can have the health outcomes that they’re looking for.”
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https://www.thetimes.co.uk/article/...-2024-cfw7lv3pw |
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