Drowning in Information and Starving for Wisdom

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"Busting Conventional Wisdom"

 An irony of America’s overweight problem is despite all the diet books, food-pyramid images, nutritional guidelines and the broad publicity about the problem, we keep piling on the pounds.

As Albert Einstein once observed, the significant problems we face cannot be solved at the same level of thinking we were at when we created them. That we’d have to shift to a new level, a deeper level of thinking, to solve them.

 Healthy Bytes offers a novel Systems Thinking perspective of personal health regulation and weight management—in a form that’s accessible to the general reader. The book aims to challenge deeply ingrained assumptions about weight/energy regulation and provides readers with the conceptual understanding (and tools) to more effectively manage weight loss. After reading Healthy Bytes, readers will better understand how the human energy and weight regulation system works, why it works that way, and how to better manage it.

 

Two Essential Skills

Effective regulation of any complex system—whether it is the energy regulation of our bodies or the energy regulation of an atomic reactor—requires that we do two things well: (1) understand how and why the system (our body) behaves the way it does; and (2) predict how it will behave in the future (e.g., in response to our interventions).

Understanding is terribly important in managing personal health. For example, understanding the built-in asymmetries in human energy regulation—favoring over-consumption rather than under-consumption—would help people realize that in our current food-rich activity-poor environment we may be all at risk. This, in turn, could help alleviate a heretofore significant impediment to prevention efforts—the “it won’t happen to me” illusion that instills in many people a false sense of invulnerability.

Understanding alone is not enough, however. Understanding without a capability to predict the body’s behavior—e.g., when devising treatment strategies and/or to assess treatment outcomes—is of little practical utility. In personal health regulation, effective prediction of treatment outcomes (e.g., pounds lost from a diet) is critically important because people’s expectations about treatment and the degree to which they are met (or not met) can affect their self-efficacy and long-term commitment.

Unfortunately, when dealing with a complex adaptive system such as the human body, reliable prediction is surprisingly challenging... and problematic.

A good (bad!) example: the ubiquitous 3,500 kcal per pound rule that remains to be the staple energy calculus by which most dieters (as well as many health care professionals) explain weight gain and predict treatment outcomes. It goes something like this: a 3,500 kcal energy deficit per week causes a loss of one pound per week, two pounds in two weeks, and so on for a month of dieting, a year, forever.

It is a simplistic one-size-fits-all calculus that overlooks the important fact that the overweight are not a homogeneous lot and that response to weight-loss intervention can vary greatly between people. The outcome of a caloric deficit depends, for example, on differences in body composition which vaies widely among dieters. (That’s because the composition of tissue lost during weight reduction depends on the initial body fat content of the subject. And because fat and non-fat tissue types have different energy densities, such differences translate into differences in the amount of weight lost.) It also erroneously treats energy as though it were a single currency—assumes a 1,000 kcal caloric deficit has the same effect irrespective of how it is induced through dieting (energy input) or exercising (energy expenditure). In reality, how an energy deficit is created does matter… and energy is not a single currency.

 Reliance on simplistic one-size-fits-all tools such as the 3,500 kcal per pound rule—justifiable perhaps in the pre-Internet ages when we were computationally poor—is a bankrupt strategy that must be abandoned in favor of more intimate tools that actually fit. Today we can do better… we should do better.

People need personalized “intimate” tools that fit them and that reflect their lifestyle preferences (dieting versus exercise) not the one-size-fits-all calculation that is applied en masse. As consumers, we’ve come to expect customization in more and more of the things we buy, and now it needs to happen in health.

 

In Part III of Healthy Bytes, a suite of new generation tools that support interaction and customization for personal weight management is presented. They include:

      o   Mi Model—an “intimate” energy balance calculator that is more accurate (because it does capture individual differences such as body composition and lifestyle preferences—dieting versus exercising).

      o   Mi Volumetrics—a tool to help dieters compose optimized meal plans that maximize meal weight (and thus satiety) while abiding by other dietary constraints (e.g., caloric ceiling, macronutrient composition, the amount of calories from fat, etc.).

      o   Mi Energy Density Polar Plot—a nutritional “map” to help dieters: (1) visualize where they are nutritionally; and (2) chart promising directions for improvement. It is a compact graphic that integrates the key determinants of a proper diet—energy density, total meal weight (which is the key to what makes us feel satisfied) and total calories (the driver of weight loss/gain).