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Chasing Immortality, On a Diet

MED’s Caroline Apovian warns “calorie restriction” diets aren’t for everyone

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Caroline Apovian and a patient at BMC’s Nutrition and Weight Management Center. Photo by Frank Curran

In his legendary quest for the fountain of youth, the explorer Ponce de Leon had it wrong. He should have pursued the famine of youth.

So runs the thinking of calorie restriction acolytes, who hold that severely curbing one’s caloric intake to a degree that would leave most people feeling chronically hungry is the ticket to a longer life.

“The data are clear. The most robust way to increase healthy lifespan in a broad variety of organisms is in fact calorie restriction,” biotech businessman Christoph Westphal confidently proclaimed this month in a Boston Globe op-ed. “In other words, it behooves us to cut our calorie intake markedly” while still getting essential nutrients. He’s not the only evangelist: the global Calorie Restriction Society boasts thousands of volunteer guinea pigs testing the theory on themselves.

But is the science really clear? In a country where two-thirds of the population is overweight, thanks to junk food and an aversion to exercise, some calorie restriction is a no-brainer, says Caroline Apovian, who heads the Nutrition and Weight Management Center at Boston Medical Center. Beyond that observation, the facts get murky.

BU Today spoke with Apovian, a School of Medicine associate professor of medicine and pediatrics, about the state of the research.

BU Today: How clear are the data about calorie restriction and longer life?
Apovian:
There is no human data showing that calorie-restricted humans live longer. You have the least risk of dying if your body mass index (BMI) is between 18.5 and 25.5. That’s average. So very, very skinny people, according to these studies, don’t show longevity.

Based on all the data that’s available, if we want to live as long as we can, we need to be physically active and eat a well-balanced, healthy diet, but not overeat.

Hasn’t some research suggested that slightly overweight people live longer than the rest of us?
There is epidemiological research that looks at mortality and BMI. It does suggest that as you get older, it is a benefit for mortality if your BMI is slightly higher, yes.

I think it’s probably a good idea to tell Americans in general to eat 20 percent less, because we’re all gaining weight.


If a person is active, eats healthy, and is fit, would you tell that person to eat 20 percent less?
I’m not sure the data are there to tell them to eat 20 percent less. The data suggest that as you get older, those who have a BMI of 25 live longer than those who have a BMI of 18. That’s supposed to be a measure of body fat. In reality, you can’t use it for people who have a lot of muscle, because it looks like their BMI is high. But they’re all muscle, so they’re actually healthier.

When we talk about calorie-restricted diets, how severe a restriction are we talking?
If somebody came into my clinic who had a BMI of 30—female—I would put them on a 1,200- to 1,500-calorie-a-day diet, and they usually would be eating 2,500. A normal, moderately active female eats 2,000 calories a day, and a male, 2,500.

Would that degree of calorie restriction in most people produce a chronic hunger?
It does, and it’s usually a hunger that people cannot tolerate. That is the reason most diet programs fail.

This idea that if you’re at a normal weight, you should calorie-restrict anyway—the data don’t support that. It could be that, to live longer, you should have as much muscle mass as possible. If [calorie restriction advocates] are exercising strenuously, they need a few more calories to support the muscle function, brain function. I think they’re taking a risk.

Aren’t researchers seeking a drug to fool the body into thinking it’s on a calorie-restricted diet, without the hunger?
Resveratrol is found in wine in minute quantities. Research is giving animals 20 times as much as in a bottle of wine. It looks as if it makes the animals exercise longer, live longer, age more gracefully. Human trials are ongoing. What happens if you take resveratrol every day for 10 years? Nobody knows.

Do you count your calories?
I love fruit and vegetables. I hate crappy food. I exercise like crazy. I can’t tell you that yesterday I had 2,000 calories. But anytime I add in my head how much did I eat—I’m in a weight management center; it does cross my mind once in a while—it’s the average: 2,000 calories, 2,500. But I’m on a masters swim team, I bike, and when I run, I run seven or eight miles.

Rich Barlow can be reached at barlowr@bu.edu.

5 Comments

5 Comments on Chasing Immortality, On a Diet

  • G H on 08.02.2010 at 6:44 am

    So she admits failure?

    What a horrible person to interview for this article. So I want to take weight loss advice from this person?

    “I love fruit and vegetables.”
    “I hate crappy food.”
    “I exercise like crazy.”
    “I’m on a masters swim team”
    “I bike”,
    “when I run, I run seven or eight miles.”

    Well since most people who have problems managing their weight have NOTHING in common with this person, how is she a good conveyor of the message?

    She goes on to give her sage advice on rescuing the obese:

    “I would put them on a 1,200- to 1,500-calorie-a-day diet,… it’s usually a hunger that people cannot tolerate” “That is the reason most diet programs fail.”.

    So she is saying her methods are largely doomed to fail.

    Also this article doesn’t address “Calorie Restriction” diets at all.

    I’m sorry but this is a waste of time to read.

  • Gold Guide on 08.02.2010 at 11:02 am

    Weight & Calories

    I do count my calories but I’m not a freak about it. I think there is a difference between going on a diet to get to a healthy weight and going all the way to being way to skinny. Which is a common issue with younger women. They are too easily influenced by the way models and actresses look.

    I’m a 27 year old male and I had to go on a serious diet about 3 years ago. I’m 5’11 and went up to 225 pounds when I had weighed 160 to 170 most of my adult life. Within a 6 month diet and workout regimen I was able to drop back to 170. If you are curious I used the Abs Diet. The book is a fun read and changes your outlook on your lifestyle.

    I think that once you are able to get to a healthy weight that some calorie counting and healthy eating goes a long way at maintaining that weight and avoiding other heart related risks.

  • Anonymous on 08.02.2010 at 7:59 pm

    Counting Calories

    Being a 23 year old who’s matabolism is slowing down it becomes increasingly more appealing to calorie count. I could just do exercise but I have an exercise block or something I don’t know.

    Seeing the weight just slowly going up is a sadening thought, perticulary if I look at my father who was thin untill his 30s and then his weight exploded.

    I need to do something ¬_¬

  • Anonymous on 08.05.2010 at 12:00 am

    Calorie Restriction

    This article about Calorie Restriction (CR) seemed more like one I would have read 5 years ago. First of all, it asked only about whether one would live longer on CR, not whether one would be healthier. It is true there is no evidence that humans on CR live longer, although there is overwhelming evidence that many other species on CR do live longer.

    The article made no mention of “health span” – does a CR diet lead to a healthier life? There is substantial evidence now that CR quickly leads to many improvements in health – in humans. For instance there is significantly improved cardiovascular function and there is significant decrease in inflammation.

    The following quote from an abstract of a peer-reviewed, scientific paper (http://www.ncbi.nlm.nih.gov/pubmed/19262201?dopt=Abstract) published in 2009 gives a nice summary of the status of CR research:

    “Although it is currently not known if long-term calorie restriction with adequate nutrition extends maximal lifespan in humans, we do know that long-term calorie restriction without malnutrition results in some of the same metabolic and hormonal adaptations related to longevity in calorie restriction rodents. Moreover, calorie restriction with adequate nutrition protects against obesity, type 2 diabetes, hypertension and atherosclerosis, which are leading causes of morbidity, disability and mortality.”

    I have found in the last 7 years that following a CR diet is hard not because you are hungry, but because if you do not track, in detail, the nutritional content of what you eat, you will not be on a CR Diet. That is hard to do.

    I seriously doubt Carolyn Apovian’s statement: “anytime I add in my head how much did I eat—I’m in a weight management center; it does cross my mind once in a while—it’s the average: 2,000 calories, 2,500.” I’ve tried that, and then compared it to what I actually recorded – my estimates are not even close. It is very hard to remember every single thing you ate during the day and assign a calorie value to it. And of course, she has no idea what % of her daily requirement for some 25 or 30 micro-nutrients she consumed.

  • Anonymous on 08.06.2010 at 3:45 pm

    Resveratrol

    Talk about out of context… Resveratrol supplements are unrelated to calorie restricted diets … and how can you talk about Resveratrol multipliers in red wine without mentioning that ‘naturally occuring’ Resveratrol has dropped preciptously in wine over the last two decades….. I suggest sending another writer out to interview Caroline Apovian and see if they can produce a worthwile article.

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