The article, written by Dr Hermann W. Børg, MD, was published in the winter edition of the Journal of American Physicians and Surgeons. The journal is published by the American Association of Physicians and Surgeons, which is an organization dedicated to access to medical care sans any form of rationing that might be imposed by governmental bodies or insurance carriers, according the organization’s head, Dr Jane Orient, MD.
Wrong tool for the job
Dr Børg, who is associated with the University of North Carolina School of Medicine in Chapel Hill, laid out his premise in an article titled “Exercise and Diet: Different Tools for Different Jobs.”
Dr Børg cited a number of what he considers fallacies in the weight control debate. Among these are what he considers to be the “Paleo Myth.” In this line of thinking, modern obesity is the result of the ease of modern life, which does not marry well with underlying human physiology. That physiology evolved to help the species survive in a hunter/gathering scenario in the African savanna.
The assumptions are that a typical hunter gatherer expended far more calories per day in gathering food and securing shelter than do most modern humans living in an urban setting with many labor saving devices. Proponents of exercise as a weight control mechanism tie their recommendations to this idea. Homo sapiens are designed to expend a certain amount of calories a day via exercise, or so the thinking goes.
Energy expenditure remains constant
Dr Børg cited a number of studies which he maintains refute this notion. Prime among them are studies that have been conducted on the Hadza people of Tanzania, many of whom still live a lifestyle resembling what anthropologists conceive of as a representative hunter-gatherer lifestyle. In a paper published in 2012 on research conduced on the Hadza, the authors found that even though the Hadza did exercise more than Western counterparts, they did not burn more calories in a day.
“The total energy expenditure (TEE) of Paleolithic-like people is not different from 21st century city dwellers, because energy expenditure is constrained. While the daily level of active exertion of hunters-gatherers from the Hadza tribe was much higher than that of Westerners, this was compensated by the lowering of their basic metabolic rate (BMR) and non-exercise activity thermogenesis (NEAT). In result, Hadzas, despite being more physically active than modern Americans, burned exactly the same number of calories,” Dr Børg wrote.
Role of sugar
The high amount of simple sugars in the modern American diet is another often cited obesity bogeyman. Paleolithic humans didn’t have refined sugar, and having easy access to it naturally packs on the pounds, or so the argument goes.
This is, too, a misconception, Dr Børg maintains, which is borne out by studies on the Hadza. Citing a 2014 study, he wrote, “The Paleolithic diet is not low in sugar. Paleolithic health theorists have overlooked the role of honey. Bees are as prevalent in the areas inhabited by Hadzas as they were in the Paleolithic period. Foraging honey is much simpler for hunter-gatherers than hunting. For Hadzas, honey is one of the staples of their diet.”
These studies have been corroborated by studies done on remote tribes in South America, Dr Børg wrote.
Exercise can help, but is no panacea
Exercise has many important benefits, Dr Børg admits. These include lower incidence of heart disease and of some kinds of cancer. It also had benefits in ameliorating sarcopenia in older adults, and has proven cognitive support benefits.
But as for losing weight and keeping it off, it has not been demonstrated to be effective, Dr Børg maintains.The Hadza and other peoples living that lifestyle are slender because they eat less than to modern Americans, not because they exercise more. Exercise can help, but is not a weight management panacea.
“While exercise is a helpful adjuvant to weight control and a part of lifestyle modification strategies to improve general health, strict compliance with a calorie-restrictive diet—not vigorous exercise—should be the mainstay of obesity management,” he concluded.
Source: Journal of American Physicians and Surgeons
Volume 23 Number 4 Winter 2018
“Exercise and Diet: Different Tools for Different Jobs”
Author: Børg HW
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