What is the Best Approach for Weight Loss?

Jennifer O'Donnell-Giles | September 26, 2017

Despite an abundance of weight loss plans, diet books and various theories on ways to live healthfully, Americans continue to get increasingly overweight. While people who are genetically predisposed to be overweight are remaining that way, many people who were lean in their younger years are putting on unhealthy fat mass as they get into their 40s and 50s and beyond.

You have heard the conventional advice a million times: “eat less and exercise more”. This doesn’t always work when we’re constantly hungry and grabbing for the nearest donut as a result.

Perhaps a newer and more realistic approach to weight loss and weight maintenance comes from the Nurses’ Health Study I and II at Harvard University and The New England Journal of Medicine. Researchers set out to find out exactly what foods people who need to lose weight should eat more often and what foods should be eaten less often.

This detailed 20-year long-term study analyzed 120,877 well-educated men and women (nurses, doctors, dentists and veterinarians) to identify the factors that influence weight gain. They were healthy and at normal weights at the start of the study. Every two years, participants filled out a very detailed questionnaire which asked about many health factors, including eating habits, amount of exercise, smoking habits, alcohol intake, sleeping habits, and amount of time spent in front of a TV.

On average, every study participant gained 3.35 pounds every four years, resulting in a total gain of 16.8 pounds in 20 years.

“This study shows that conventional wisdom — to eat everything in moderation, eat fewer calories and avoid fatty foods — isn’t the best approach,” wrote Dr. Dariush Mozaffarian, study author and Harvard University Cardiologist and epidemiologist. “What you eat makes quite a difference. Just counting calories won’t matter much unless you look at the kinds of calories you’re eating.”

Harvard School of Public Health Nutrition Expert, and co-author of this study, Dr. Frank B. Hu said, “In the past, too much emphasis has been put on single factors in the diet. But looking for a magic bullet hasn’t solved the problem of obesity.”

They also believe that the food industry’s claim that there’s no such thing as bad food is a false one.

“There are good foods and bad foods, and the advice should be to eat the good foods more and the bad foods less,” says Mozaffarian. “The notion that it’s O.K. to eat everything in moderation is just an excuse to eat whatever you want.”

Participants who exercised more over the course of the study gained 1.76 fewer pounds than the rest of the participants who exercised less during each 4-year period. They realized that physical activity had the expected benefits for weight control.

The most interesting results revealed that the kinds of foods people ate had a larger effect overall than changes in physical activity did.

“If you are fairly active and ignore diet, you can still gain weight,” said Dr. Walter Willett, Harvard School of Public Health Nutrition Department Chairman and co-author of this study.

So the takeaway message for the rest of us is that it’s the little things that contribute a lot to weight control. None of us become overweight overnight. But it seems that way because, one day, we wake up and nothing in our closets fits anymore! Small increments of weight gain creep up on us and can actually harm our health. Weight gain increases the risk of heart disease, diabetes, stroke and breast cancer for women and the risk of heart disease, diabetes and colon cancer for men.

If we look at this study, we see an average of 20 pounds gained in 20 years. If we take small steps and gradually adopt healthy lifestyle habits, we can avoid that gain and either maintain weight over time or lose weight if needed.

Foods that provide the greatest risk of weight gain:

  • French Fries
  • Potato Chips
  • Sugar-Sweetened Drinks
  • Red Meat
  • Processed Meats
  • Sweets and Desserts
  • Refined Grains
  • Fried Foods
  • Fruit Juice
  • Butter

Foods that assisted in weight maintenance and weight loss:

  • Vegetables (3 or more servings per day)
  • Whole Grains
  • Fruits
  • Yogurt*
  • Nuts
  • Peanut Butter

*Participants who consumed plain yogurt regularly lost on average 0.8 pounds every four years.

Neutral Foods (found not to contribute to weight loss but not to weight gain either)

  • Full-Fat Dairy
  • Low-Fat Dairy

Other habits can influence weight. The study found that participants who slept less than 6 hours a night gained more weight than those who slept more than 6 hours a night. It should also be no surprise to anyone that the more time participants spent watching TV, the more weight they gained. Interestingly enough, light to moderate alcohol consumption (e.g. one glass of wine) had no effect on weight. However, researchers theorized that more alcohol and alcohol in other forms would likely add unwanted pounds. Smokers who quit gained weight during the first 4-year time frame but it then leveled off afterward.

Based on the Harvard study, the best approach to weight loss extends beyond eating less and exercising more. The key to long-term weight loss and weight management is maintaining healthy lifestyle habits such as watching what you eat, staying physically active and getting adequate sleep. So if you’re struggling to lose weight or stay at your normal weight, making these small changes can make all the difference.


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Jennifer O'Donnell-Giles

Jenn Giles, R.D., C.S.S.D. is all about health and wellness. She has over 15 years’ experience, including a dual master’s degree in Nutrition and Exercise Physiology from Columbia University. She is a Registered Dietitian (RD) and a Board Certified Specialist in Sports Dietetics (CSSD). She supplements all of this with her spin instructor certification and USATriathlon Level I Coach Certification.

Jennifer is passionate about (actually, obsessed with) the sport of triathlon. She has been personally participating in triathlons since 2000 and running road races since 1992. She is a two-time Ironman finisher and has completed countless numerous marathons. She has been a member of Power Bar Team Elite since 2006 and competed as a member of the 2006 Aquaphor/Active.com Sponsored Athlete Team. She was ranked as USAT All American Honorable mention in 2006 and 2011. Jennifer does all of this along side of her husband, Patrick, who is an equally accomplished triathlete and runner. They try as hard as they can to do all of their training and racing together.

She will tell you, however, that her most important, most rewarding and most challenging job is as a mother of four. She knows first hand the challenges of maintaining optimal fitness, overall good health and achieving goals while raising a family - of which good nutrition is the cornerstone.

Most importantly, she knows how to motivate, inspire and challenge athletes based on their own abilities, strengths and everyday lifestyles. She believes there is an athlete in everyone - no matter what their abilities are – and if those abilities are manifold, then there is an even better athlete in there!

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