1. Calories in, calories out is the golden rule.
2. The vast majority of calories come from carbohydrates.
3. Carbohydrates activate addictive dopaminergic pathways (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2235907/pdf/nih...)
People overeat because food is easy to access, and it provides a short-term, immediate chemical reward. External rewards often need to be introduced to break this vicious cycle. Hobbies, relationships, career achievements, etc. can function as alternative rewards. Perhaps there is a way for technology to provide short-term rewards in lieu of eating?
Also, hilarious adventure I went on once: I ate 4000 calories of bacon a day and nothing else for a month... ended up cutting it off a little early because I was losing weight too quickly.
Your second and third points however are scientifically supported, but do not confuse this with "obesity is complicated." It is not how many calories you eat, it is where they come from.
I used to weigh 340 pounds, I went strictly Paleo, did not increase caloric burn, did not decrease caloric intake in any meaningful way, hit 214 in a year, and then continued dropping; roughly 2000 calories a day and not a lot of exercise (was afraid of joint damage due to weighing so much).
Also, Paleo, like any similar structured diet, is just a trick to get you to ingest fewer calories.
And I'm going to piggy back on the [citation needed] about calories in/out being scientifically disproven.
[1] https://mytdee.com/#gender=male&yr=30&cm=182.9&kg=154.2&bfp=...
That's an extreme statement you definitely need to provide source for. I read a lot of scientific journals on the subject and have never heard anything like that.
While admitting the rest of this thread is bonkers, I'll explicitly list the formula you should follow right now (science is always evolving): Change in Body Stores = (Actual Calories In - Calories Not Absorbed) - (Resting Metabolic Rate + Thermic Effect of Eating + Physical Activity + Non-Exercise Activity Thermogenesis)
This is the more nuanced formula of calories in, calories out. Changing one variable in that equation can have an effect on the rest of the equation, which is why it appears calories is not equal to calories out. You can read about each variable here: http://www.precisionnutrition.com/metabolic-damage.
I should note that this program is published in scientific journals: http://www.invent-journal.com/article/S2214-7829(16)30006-9/... http://link.springer.com/article/10.1007/s11764-016-0582-z http://onlinelibrary.wiley.com/doi/10.1002/osp4.98/abstract
However, if you eat 1000 calories or less, it's impossible not to lose weight. Unless you know someone who can synthesize energy to live and move out of thin air......
[Citation Needed]
You'd think that if it has been scientifically proven false, it'd be one of the biggest discoveries of the century - The Human Body, A Perpetual Motion Machine! Energy from Nothing!
Citation, please.
I had a soccer teammate in college do something similar. He was a central mid and was constantly getting beat by guys faster than him. He felt he was too fat and needed to drop a few pounds so he could compete better.
He went on what he called a "beer" diet. He would wake up and drink a beer to curb his appetite in the AM. Then at lunch, he would have a 12" subway sandwich, chips and pop. Once he got hungry again, he would drink another beer to curb his appetite until practice. After practice, he would have another beer. He would still drink water throughout the day to stay hydrated.
He dropped some 25lbs in like 45 days.
After he lost the weight, he realized that while he did lose the weight, he also suffered a ton of muscle loss. Before he was getting beat because he was slow, now he was getting beat because he was too weak to either fend off other players, or not strong enough to slow other players down, even though now he could keep up with them.
Afterwards he said he wouldn't do again, and started doing more weight training and interval cardio to maintain a healthier weight. After another six months, he said he finally found a happy median between being fast and being strong and stable on his feet.
I am glad it worked for you. However, most people need to start with a basic rule and go from there.
I think it is mainly calories in / calories out. While there seems to be evidence that the source of calories and diet composition do play some role in weight loss, that is what I would call "expert mode".
You can't exercise away a bad diet. One hour of very hard cardio, can burn up to 1,000 calories, depending on your weight and exercise intensity. A big mac meal with a medium drink and fries is more or less that as well. Exercise is great, and is an excellent supplement to a diet, but if you don't watch what you eat, it will be difficult to exercise away the extra calories.
The base rule is you have to watch what you eat. You can play with the composition, but concentrate on the calories. I can not say this enough. If you have extra pounds that you want to lose, and you have not yet found a way to do it, stay away from gimmicks.
Losing weight involves eating less, not eating more.
Regarding different types of calories, it's important to note that fats, proteins, sugars, and carbohydrates are digested in different ways. If you ingest 500 calories worth of sugar your body will be able to use almost all of that for its energy needs. Meanwhile, digesting protein is more complicated, and your body will be able to extract fewer of those 500 calories for its own needs.
Or is it just the caloric measurement you think is irrelevant for human energy intake? While obviously imperfect, I'm skeptical it could be an order of magnitude off for example.
Calories in, calories out is not the golden rule, and this has been scientifically proven false.
It is not how many calories you eat, it is where they come from.
About the best we can do with current science is (a better worded version of): How many calories you consume is important, and so is the nature of those calories, and when you consume them. Also something in there about calories being reductive, and other things matter.
In fact you can (and man do) do much worse for advice than Michael Pollans' summary: "Eat food. Not too much. Mostly plants.[1]" - but "food" is doing extra work here and human health is not the only consideration.
Still, that's a pretty epic diet, and could be very popular in developer circles. You should maybe consider patenting it.
A human body is a mechanical system.
Fuel + air in --> Work done + waste out.
That's it. Any other argument is literally disputing the laws of thermodynamics.
That sounds like an extreme form of a ketogenic diet [1], or Atkins diet [2]. Very effective, but with only bacon you'll miss some important micronutrients.
The mystery would be if you gained weight over a long period of time while consuming food at a calorie deficit. People do make this argument against calorie counting...
The fundamental lesson of calories in calories out is that someone who wishes to lose weight should seek to reduce their calorie intake to a level where it happens. It probably isn't all that useful a lesson, estimating calories consumed is hard, as is reducing them.
Quite the opposite actually. See thermodynamics for reference: https://en.wikipedia.org/wiki/Laws_of_thermodynamics
No. If the laws of thermodynamics had been proven false, we would have heard of it.
I have problems with my weight and my wife is anorexic. We live day-to-day with the fight against obesity (for years) and that's hardly a rule, much less golden.
The only constant I see on this whole food/nutrition industry is how little information is accurate. Millions of diets and nutrition "experts" saying whatever they hear works without testing anything. The classic "worked for me, must work for everyone".
I agree the obesity problem is there to be solved, but don't oversimplify it to 3 bullet points. That's irresponsible to say the least.
I've since maintained (and gained more visible abs :D ) with careful tracking on MyFitnessPal. I also find that if I do not track and weigh the food I eat (I get lazy and just "eyeball" the weight), I very rapidly get out of practice and put on weight. It turns out humans are terrible measuring tools.
And the best part is this doesn't only work for me. Everyone I know who has followed me into methodically measuring food (sample size of 6 friends, and a couple has PCOS and one has hypothyroidism but is taking pills) has had their data analysed by me and the results agree with one another - CICO IS true. I should really write up the analyses one fine day.
of course it's not a simple addition. age, genetics and a lot of other factors come in.
what is dangerously wrong is thinking that changing your calorie intake is easy. it may be very difficult to gain or lose weight depending on which side you are, because changing the way you eat durably is freaking difficult.
You don't see a lot of overweight people in famine prone areas. Calories out - calories in = your weight curve. That's the easy part for losing weight.
Sport does not burn a lot of calories. So it is better to cut on the intake. Which is the hard part: food can be a comfort drug which is easily available. Worse when your entourage is full of overweight people as crab mentality can set-in and they'll try to sabotage your weight loss.
They ALWAYS say they did through calorie restriction.
Yes. Sugar is the enemy. It's ironic that so many substances are regulated or flat-out prohibited and not sugar or sodas. HFCS should be outlawed, and sodas regulated like alcohol (no sales to minors, bulk sales limited, etc.)
Also, the obsession with fats and the whole industry of low-fat food needs to be dealt with, as, obviously, when the proportion of fat decreases, the proportions of the other components rise.
The problem is over-consumption of refined sugars. This is a problem because the results of sugar metabolism (particularly fructose) are highly reactive (which is why they are so easy to metabolize), and can mess up your biochemistry by reacting with proteins and other macromolecules. The phytochemicals in plant sugar sources seem to reduce the biochemical side reactions of sugar metabolism which is probably why the plants synthesize many of them in the first place.
Refined sugars tend to spike the concentration of sugar in your body, leading to more possibility for reactions. Secondly, without the phytochemical stabilizers, the incidence of side-reactions is greater.
The body is a complex system, we need to stop trying to analyze it as if it were linear and reducible.
The theory that the problem is sugar – and not fat – does line up pretty well with available evidence.
So my question is why isnt obesity prevalent in this part of the world?
I love the SV mindset: Let's not get to the reasons of something, let's just build an app and everything will be good.
Please don't post uncharitable generalizations about entire groups here. It's just a rhetorical device and reliably degrades discussion.
Your comment would be just fine if you'd omitted that swipe.
To address a couple of the things you mentioned:
Better education: It's true -- when it comes to health and nutrition, there's a lot of misinformation out there and a general lack of knowledge of even the basics. Most people are not great at determining how many calories are in a meal, whether something is good for them, or even just remembering what they've eaten on a given day. There's a huge opportunity for technology to help people figure this stuff out and learn to make better choices (full disclosure: I work on an app in this space [1]).
Taxing unhealthy food: While we can't levy taxes, there are ways to provide similar incentives, for example by automatically giving people cash rebates when they purchase healthy food [2].
Can the tech industry solve obesity on its own? Maybe not. But I'd argue that trying to address what we can is a better option than throwing up our hands and saying it's a social problem.
Why not, for example, a drug that suppresses appetite? We have many already. Technology has an endless supply of solutions.
Yes, but I'd argue it's not a very helpful rule. As it has been said before, it's pretty much like saying that the golden rule to get rich is "money in vs. money out". Correct, but not very helpful.
Are you saying you need more specifics?
If you want to improve your financial position, either earn more money (get a side job, take a higher paying job with more responsibility), or spend less money (buy beans and rice in bulk, prepare your own meals, sell your luxury car to get rid of the payments and drive a paid-for beater, take public transit and read a book on your commute instead of driving a car).
Similarly, to lose unhealthy weight, either reduce calories in (stop drinking sweet sodas and eating candy bars, order 500-800 calorie items from appetizer menus instead of 2000 calorie entrees) or increase calories out (exercise, take the stairs instead of the elevator, walk instead of ride, lift weights to improve resting calorie burning.)
But it's hard to come up with specifics that apply to everyone, since everyone is different. That's why we just say the general rule, instead of assuming people have an expensive car to sell or go through a 2 liter of Coke a day.
If you go into a caloric deficit your body will give a hormonal response. This response determines if your body will start using your fat reserves, your muscles or will just shut down. This hormonal response is dependent not only on how much you eat, but also on what you eat.
Eating a diet low in carbs enables your body to use up stored fat more easily and will leave you less hungry then a low fat diet. This makes it MUCH easier to stick to your diet.
As someone who works out daily; the point at which I was in the best shape of my life was when I was consuming large amounts of fats. Peanut butter, olive oil, etc. I also find it really really hard to believe that protein would cause obesity; I've heard the exact opposite.
People have been posting similar studies of Indian and Asian countries, basing their recommendations for everyone off that subset of the population, and then completely discount that of traditional European, African, and American diets.
I am shocked by the amount of effort going into fixing health problems post-hoc relative to efforts aimed at improving the foods we eat. In fact, we seem to be going backwards. The intellectual vanguard is pushing organic + non-GMO produce, heirloom foodstuffs, artisan food practices, and other regressive (if high-quality) patterns that won't encourage nutritional improvement for the majority of people.
We should be applying ourselves to improving food. It's completely overlooked because it's seen as a solved problem. I can completely understand why, but I think it's pretty clear, given the health problems in the west, that there is more to be done.
Health and medicine startups are really difficult. Not impossible, but the forces are all stacked against you. I hope and pray some startups can succeed, but the system in the US is set up to perpetuate the broken healthcare system. Sometimes, I feel efficiency and health are almost not a goal.
I realize this is vague, but I've learned this lesson the hard way. I'm on year-3 of a health startup full-time. We actually moved overseas to trail the product in a single-payer nation. The single-payer system offers incentives generally aligned across all parties. In the US, many incentives are antagonistic, making it difficult to sell products. Please the insurer and you piss off the hospital. Please the hospital and you piss off the doctor. Lower costs and you piss off the hospital and doctor. Ect, etc.
It is easy to make products, but difficult to find buyers even when there is obvious value. Perhaps this will change with ACOs. Most successful startups in healthcare I've seen operate on the periphery or actually mold to ease the broken system itself (e.g., Castlight Health)
The problem is very much political with a move away from highways design focusing on strategic mobility, the movement of people and goods over long distances, to sustainable mobility, the movement of people over short distances (0-5 miles) and the provision of systematically safe infrastructure https://www.youtube.com/watch?v=5aNtsWvNYKE
It's a really really hard political problem to solve as the impacts are measured in decades but the returns are huge.
From a technology point of view, the solution is the bicycle.
The key problem however always comes down to the perception that the roads are too dangerous and this is a political in nature usually requiring the re-allocation of road space from parking.
The next (or after the next) Microsoft-Google-Apple-Facebook size tech company will be a healthcare company.
There is no reason access to healthcare can't be as streamlined and cheap as calling an Uber. In addition to diagnosis AI should be able to strip out nearly all of the administrative & clerical layer. Self driving vehicles + drones can reduce the need for large complex hospitals. All of this could not just be a convenience, but mandatory in a post-antibiotic world.
Because of regulatory issues, while this may be an American company, it would be available for Americans for quite some time.
It is like that old joke about taking cold shower every morning for 100 years.
You know that cheesecake is not very good for you, but what is the alternative? You eat that celery stalk but where does it get you?
The best case scenario - raw food eating Jack Lalanne dead at 96. His death heavily shook my belief in healthy eating.
Worst case scenario his brother Norman Lalanne and everyones favorite Jeanne Clement neither of which were much for exercise and Jeanne indulged in smokes and chocolate.
Sure those are anecdotes but we do not have any healthy 150 year olds.
Obesity kills, but non-obesity kills just slightly slower. Slower I define as 10-70 years slower.
We need meaningful progress with other aspects of aging (telomere shortenings, cancers etc) before we can tackle obesity.
Hobbies involving exercise may be an exception, but when you're already overweight, these often aren't so much "hobbies" as ordeals, and unlikely to function as any kind of reward.
As someone in the market, it'd help quite a bit if there were healthier and tasty alternatives. Unfortunately, the current offers seem to be expensive and hard to get (if you have to order a whole box over the 'net, forget it).
To be able to eat healthier requires weaning yourself off high salt/sugar foods to get reacclimitized to food that has those substances in proportions that we've evolved to handle.
We're currently developing a mobile app + clinician dashboard combo working towards a preventive health solution. Our main focus is diabetes right now but cardiovascular disease, prediabetes, and type 2 diabetes are all in our sights here early on.
Many of the apps functions revolve around simple dietary and exercise solutions to combat these illnesses. We also plan on using IBM's Watson to improve suggestions for the patient and the doctor.
We're still early, but check us out at https://kingfit.org
Props for using Shopify!
One thing people can do in a case like this is email us at hn@ycombinator.com to let us know that the top subthread has veered off-topic. We intervene when we see that but we need your help to see everything.
I'm not obese in the meaning that I am very unhealthy. I am mostly okay but I can definitely lose 15kg and feel much better (done it before).
But when I tried using some tech, what happened? Yes, sure, scour an app full of thousands of meals to say what exactly I am eating every time? Sure! (Especially having in mind it's not at all tuned to Bulgarian cuisine.) It's comical and it's so bad. Motivational reminder apps? Gosh, I want to smash the head of the people who thought this was a good idea. I guess they work for many others, definitely not for me and a whole large group of humans though. It's annoying and corny and nothing else.
If I can put a bracelet on my wrist and it can track my pulse, sleep and maybe scan my veins for the chemicals coursing through my body, and if I get a smartphone app that can photograph my food and do precise automatic calorie counting, then I am in. (Also if the bracelet can detect my workouts.)
Before that, forget it. It turns something that you should feel good about, into a series of awful menial chores. The current state of affairs is, as I mentioned in the start, straight out hilarious. The tech is primitive.
Can't speak to your calories comments, but I do think that hobbies and distractions and habits and apps can help move people in the right direction.
but how is this an untapped opportunity when there are already tons of products and companies trying to solve it? short of building an app that evaporates body fat?
some of these apps do work. i know a lot of people who had success counting calories with MyFitnessPal. but you cant force everybody to count calories. you cant force people to count their steps. so i just dont understand what opportunity you see here.
Yes, decreasing caloric intake can cause weight gain - I want to know what the most effective ones to cut are, and replace them with less potently delivered ones.
IMO the general aproach to maximize money is broken as it incentiveses crminal behavior (banks, volkswagen come to mind immediately). This problem would be really interesting to solve, but I don't think that's doable by a single startup as it is a political or social problem.
The main cause of cardiovascular disease is hypertension, which is 100% treatable at very low cost and with very high safety. I haven't checked the numbers lately, but it's not too far off to note that only 50% of hypertension is diagnosed and only 50% of patients take their medications.
So, the lapse is not in medical science -- we know what to do -- but in healthcare delivery.
Yes people can exercise as its own thing too, but realistically it's way easier to get most people consistently exercising if it's something they're doing as a part of their regular daily activities.
Lot's of folks have rebutted with the various ways this is an oversimplification, I won't recap them here.
I will however add another overlooked factor that most folks don't know about: Our gut bacteria is responsible for a lot of pre-processing, and their efficiency varies a lot depending on the mix of strains you happen to have.
So, identical twins, with identical lifestyles and diets, can still have very different experiences with weight gain and loss.
Fortunately, this is actually something that (once the mechanisms are better understood) can be fixed quite simply with a fecal transplant.
That might be the best thing to do right now, for startups - how can you build technology such that it improves the science behind obesity research?
Secondly, exercise can help promote weight loss, but it seems to work best when combined with a lower calorie eating plan. If people don’t curb their calories, however, they likely need to exercise for long periods of time or at a high intensity to lose weight.
For some people eating is even more addictive than Facebook or Candy Crush.