The energy balance theory: an unsatisfactory model of body composition fluctuations

Abstract

Background & Aims There is an ongoing debate about the role of macronutrient distribution of the diet in weight management and the potential of its modification as an approach to treat obesity. Our aim was to shed light on this highly disputed topic. Methods This computational study utilized the recently proposed mass balance model (MBM) of obesity to simulate the effect of exchanging a high-carbohydrate diet (20% F, 65% C, 15% P; HCD) for an isocaloric very-low-carbohydrate diet (75% F, 10% C, 15% P; VLCD) on body weight in a 70kg person. Furthermore, we investigated whether this model can explain the weight loss associated with the onset of type 1 diabetes. Results Prior any feeding perturbation body weight was stable at ~70kg with a baseline diet of 2 000 kcal (day 0-149). Next this reference diet was exchange by a 2 000 kcal HCD (day 150-400), yet body weight gradually increases to ~73kg. Moreover, after beginning a second isocaloric VLCD (day 400), body weight decreases towards a steady value of ~67.5kg. In addition, it was demonstrated that the MBM can make predictions of body weight loss consistent with the type 1 diabetes treatment during the pre-insulin era. Conclusions The MBM of obesity explains the weight loss advantage of a low-carbohydrate diet over an isocaloric low-fat diet. In addition, this model explains the weight loss associated with the onset of type I diabetes.

Chronic Positive Mass Balance is the Actual Etiology of Obesity: Time for A Paradigm Shift?

“…For further details, please see, including Supplementary Files, [1], [2] and [3]. Please note that only the most important references are listed for this article, as the others can be found in the aforementioned papers.…”

“…variety of feeding experiments, and it seems to provide a highly accurate description of the very best human experimental feeding data (e.g., 1,2,3). For example, we have compared head-to-head the predictions given by the MBM with the EBT-based model of Hall and coworkers, and the MBM seems to be superior to the EBT-based model [1]. And the ranking of such models is determined by their predictive accuracy.…”

“…A highly significant practical application of a mass balance approach is that a low-carbohydrate/high-fat diet leads to a greater body mass and fat mass loss than an isocaloric high-carbohydrate/low-fat diet because it provides less nutrient mass [1,2,3]. When the energy fraction from dietary fat increases, while energy intake is clamped (i.e., fixed), mass intake decreases due to the significantly higher energy density of fat compared with other energy substrates.…”

“…It is possible for an open system, such as the human body, to be at mass balance while the system experiences a persistent energy imbalance. That is, energy balance may be positive (ΔE > 0) or negative (ΔE < 0) yet the mass change that may occur during energy flux is not required by the Law of Conservation of Energy (i.e., the First Law of Thermodynamics) to mirror the energy balance direction [1,2,3].…”

Ketogenic diets, dietary ketosis, diabetic ketoacidosis and energy expenditure

“…I would like to point out that our recent findings indicate that the widely accepted energy balance theory (EBT) is erroneous. 4,5…”