This is from a book called "Ultimate Diet Secrets" by Dr.
Gregory Ellis. He details a study by T. R. E. Pilkington
that discredits the Kekwick & Pawan studies.
~~~~~~~~~~~~~~~~~~~~
Atkins' Heroes: Drs. Kekwick and Pawan
As we saw in another chapter in this book, Atkins had been
blasted by the scientific community for his claims that the
calorie theory was a myth and for his notions about the so-
called "metabolic advantage" of the low carbohydrate diet.
Atkins relied primarily for the development of his theory
about metabolic advantage on the research published in the
mid-1950's by two British researchers, Kekwick and Pawan.
The basis of Atkins' 1972 book, it seems, was their
research. He continued to base his 1992 and 1999
publications on this research, now some 45-years old.
Atkins tells us in painstaking detail the specifics of the
Kekwick and Pawan research. He used their research as the
basis of developing his beliefs about weight loss. Kekwick
and Pawan supported the carbohydrate-restricted diet but
also hedged their statements because they weren't completely
convinced about the validity of their own research findings.
I'll quote, here, some statements of Kekwick and Pawan that
weren't publicized by Atkins. First, "Many different types
of diets have been successfully used to reduce weight in
those considered obese. The principle on which most of them
are constructed is to effect a reduction of calorie intake
below the theoretical calorie needs of the body. Experience
with these patients has suggested, however, that this
conception may be too rigid. Many of them state that a very
slight departure from the strict diet that can hardly affect
calorie intake, results in them failing to lose weight for a
time. Though it is realized that evidence from such patients
is notoriously inaccurate owing to their approach to this
particular condition, it is a too constant belief among them
to be entirely discarded."
Of course, my response to this statement is that, in fact,
the belief posited by the overweight should be entirely
discarded, not heeded at all. We know that mis-reporting of
food intake increases with rising levels of obesity.
Therefore, this patient base is, in fact, the most notorious
in mis-reporting food intake, wholly unreliable.
Second, Kekwick and Pawan write: "In such a study the
difficulties are formidable. The first and main hazard was
that many of these patients had inadequate personalities. At
worst they would cheat and lie, obtaining food from
visitors, from trolleys touring the wards, and from
neighboring patients. (Some required almost complete
isolation.) At best they cooperated fully but a few found
the diet so trying that they could not eat the whole of
their meals. When this happened the rejected part was
weighed, and the equivalent calories and foodstuffs were
added to a meal later in the day. The results we report are
selected (emphasis mine), a considerable number of known
failures in discipline being discarded."
So, this is the type of scientific study that is the basis
for Atkins' rejection of the Laws of Thermodynamics and the
Energy Balance Equation.
Kekwick and Pawan also reported considerable difficulty
from the retention and loss of water associated with the
menstrual cycle in their women subjects. Changes in the
water content of the body, particularly during the first
10 days of any dietary changes, mask considerably an
accurate determination of body fat loss (not bodyweight
loss because water is a considerable portion of the
bodyweight that is lost in the early days of dieting). We
must always remember that bodyweight loss and body fat
loss are not one and the same.
It must be realized that both Kekwick's and Pawan's interest
in a carbohydrate-restricted diet arose from the writings of
A. W. Pennington, the Wilmington, Delaware, Dupont Company
medical doctor. Pennington rejected the calorie theory for
reasons unknown to us, stating that the usual treatment for
obesity, calorie restriction, has no scientific basis.
Pennington, (a medical doctor and not a scientist [medical
doctors are not scientists]) obviously, must have failed to
perform much research because, as I've said, the application
of the Laws of Thermodynamics to human nutrition had already
been established by the late 1800's.
Pennington was the first to present the idea that obesity
was a defect in the body's ability to burn carbohydrates. To
Pennington, this notion of a defect in carbohydrate
metabolism overrode the calorie theory and the Energy
Balance Equation, if he was aware of them. Pennington was
the first to propose the idea of eating an unrestricted
amount of protein and fat.
An interesting aside, the understanding of the basic
biochemistry to confirm Pennington's theory was not yet
available to him, although it was beginning to appear in
publications. We know, today, that, in fact, the body does
convert carbohydrates into fat thereby stopping them from
being burned, as we saw when we learned about energy-
partitioning. This, of course, is not a defect as
Pennington, and later Atkins, claimed, but is a function of
the body's basic biochemistry (for all bodies), its normal
regulation of food fuels. So, Pennington was not far off in
tinkering with the idea that something related to
carbohydrates might underlie weight control problems. His
problem, of course, was that he allowed the idea of a defect
in carbohydrate metabolism to take precedence in his theory
of obesity over the well-established calorie theory, the
Laws of Thermodynamics.
Atkins Lashes Back
The publications of Kekwick and Pawan unleashed a scientific
counterattack against their theory that one could lose more
weight faster on a carbohydrate-restricted diet that was
higher in calories than a noncarbohydrate-restricted diet.
The problem, then and now, has always been the tendency, by
all persons, both lay and scientific, to equate bodyweight
loss as a measure of fat loss, as if every pound of
bodyweight loss was accounted for by the loss of fat, a
critical mistake in analyzing the effectiveness of any
bodyweight control program.
Atkins based his 1972 book on the research of Kekwick and
Pawan and took it upon himself to defend them against all
criticism. He launched his first attack against T. R. E.
Pilkington and colleagues. Atkins' primary criticism of the
"Pilkingtonians," as he calls them, was that they discarded
the first 12 days of weight change that occurred in the
subjects who followed the low carbohydrate diet, a 12-day
period in which there were larger and more rapid losses of
bodyweight in subjects following a low-carbohydrate diet.
There was a sound reason, unaccepted by Atkins, why the
"Pilkingtonians" did not report the first 12-days' weight
loss. The facts are that the study by Pilkington spanned
several months, in comparison with the short studies of
several days, performed by Kekwick and Pawan. The shortness
of the Kekwick and Pawan studies was, indeed, the main
argument against the validity of their conclusions.
Pilkington added an interesting twist to his design study in
that he alternated subjects between low- and high-
carbohydrate diets. The low carbohydrate subjects always
lost more bodyweight during the first ten days of their diet
than the subjects on the high-carbohydrate diet. But, after
the first ten days on either diet, the study's subjects lost
weight equally; neither diet was more effective than the
other as to bodyweight loss. However, when subjects switched
diets, from a low- to a high carbohydrate diet, the group
that had been consuming the low-carbohydrate, 1,000 calorie
diet immediately gained weight when switching to the high
carbohydrate, 1,000 calorie diet. Conversely, when the high-
carbohydrate, 1,000 calorie diet group switched to the low-
carbohydrate, 1,000 calorie diet, they immediately lost
weight. These "swings" in bodyweight lasted up to 10 days,
amounting to almost a six pound difference between groups
with the advantage of increased bodyweight loss going to the
low-carbohydrate groups. The "swings" were the reason that
Pilkington rejected the initial 12-days of bodyweight
changes during his several months' study. Pilkington
observed that the "swings" could be largely explained by
changes in water balance induced by the low-carbohydrate
diet. Atkins' heroes, Kekwick and Pawan, observed the same
response in their study. They, however, attributed the
swings in bodyweight to a characteristic of diet
composition: the notion that, somehow, the low-carbohydrate
diet forced the body "to give up" more of its fat content.
They rejected the idea that the more rapid and larger loss
of bodyweight from eating a low-carbohydrate diet was caused
by water losses.
Interestingly, Kekwick and Pawan measured the patients'
Resting Metabolic Rate and found no differences in patients
who consumed diets of different compositions. They argued,
however, that the test (of Resting Metabolic Rate) hadn't
been sensitive enough to pick up possible energy changes. An
interesting point to this story is that Kekwick and Pawan,
when reflecting upon their writings, were not entirely
willing to reject the calorie theory. Atkins never tells us
this. Further, metabolic rate tests were, and are, easily
able to pick up the differences, if they existed, that would
have explained the increased weight loss had it been truly
associated with increases in metabolism or calorie burning
rather than what they actually were which was a larger and
more rapid loss in body water weight.
Pilkington, as I've stated, concluded that the swings in
bodyweight were the result of variations in water content.
Atkins, of course, denies this conclusion. Kekwick and
Pawan admitted that the method of measuring body water that
they used contained errors that made the accurate
determination of changes in body water impossible to
measure. So, of course, making what was without doubt a
sound scientific decision, Pilkington didn't use the
changes in bodyweight that occurred during the first 12
days after each diet switchover so as to avoid biasing the
results. His groups' observations were so repeatedly
consistent that they realized that the initial rapid
changes in bodyweight during the carbohydrate-restricted
diet resulted from water changes. This conclusion was
unavoidable. Atkins, I believe, doesn't want to acknowledge
any of this because he wants to tell you that you can eat
all that you want. Why wouldn't someone jump onto the "eat-all-you-
want" bandwagon? Hell, I did!
Once Pilkington removed the stumbling block, that of an
initial rapid bodyweight change during diet switchover,
bodyweight losses, thereafter, were observed to be equal
between the two 1,000 calorie diets of different
composition. Therefore, there was no advantage to the low-
carbohydrate diet in respect to bodyweight losses,
definitely a deathblow to Atkins' theory.
~~~~~~~~~~~~~~~~~~~~
[email hidden] (tcomeau) wrote in message
news:<[email hidden]>...
Quoted message said:You know that the principle of calculating volume by
displacement is over 2000 years old and the observations
that led to that principle still applies.
Can you give me one valid study that shows that this study
is wrong?
TC
jmk <[email hidden]> wrote in message news:<2j8n0sFq00etU1@uni-
berlin.de>...
Quoted message said:Thank goodness you are up on the latest research!
The Lancet, July 28, 1956
tcomeau said:********
Calorie Intake in Relation to Body-Weight Changes in
the Obese Reference: Kekwick, A., Pawan, G.L.S.,
"Calorie Intake in Relation to Body-Weight Changes in
the Obese," The Lancet, July 28, 1956, pages 155-161.
Summary: The purpose of this study was to evaluate
whether caloric restriction or alterations in the
proportions of dietary fat, protein and carbohydrate
had a greater effect on changes in body weight. This
study was comprised of three different series. Using
six obese individuals, the first series had all
subjects consume a different diet every 7 to 9 days.
The ratio of carbohydrate (47%), fat (33%), and
protein (20%) was kept constant while varying total
calories (2,000, 1,500, 1,000, 500). Researchers
concluded that the fewer calories subjects consumed,
the greater their weight loss. Half of the weight loss
was attributed to water loss while the remainder was
concluded to be fat tissue. Series 2 examined 14
subjects on three 1,000-calorie diets. On each of the
three diets, 90% of the calories came from one of the
following: protein, fat or carbohydrate. After seven
days, subjects consuming the very-high-protein and the
very-high-fat diets lost 4.2 pounds and 6.3 pounds
respectively. The very-high-carbohydrate group had a
1.2-pound weight gain. In Series 3, five subjects ate
2,000-calorie "mixed diets" for seven days. At the end
of the week, total calories were increased to 2,600,
with more calories coming from dietary fat and protein
and less coming from carbohydrate. During the first
week on the 2,000-calorie "mixed diet," subjects
gained an average of 1.1 pounds. Although eating more
total calories and more fat calories the second week
on the 2,600-calorie "mixed diet," 4 of the 5 subjects
lost weight (an average of 2.8 pounds).
*******
TC
