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Here’s my once a month on the first Sunday Food Matters column for the San Francisco Chronicle, out today:

Nutrition and public policy expert Marion Nestle answers readers’ questions in this column written exclusively for The Chronicle. E-mail your questions to food@sfchronicle.com, with “Marion Nestle” in the subject line.

Q: I’m confused about calories. If I cut calories to lose weight, does it matter what foods I eat? Or are all calories the same?

A: As the co-author of “Why Calories Count: From Science to Politics,” I hear this question all the time.

The short answer: Calories matter for weight. The choice of foods that provide the calories matters a lot for health and may make it easier for you to diet successfully.

To lose weight, reducing calorie intake below expenditure works every time.

To prove this point, a professor at Kansas State University lost 27 pounds in 10 weeks on the Twinkies diet – one Twinkies every three hours with occasional snacks of chips, sugary cereals and cookies. Even so, he cut his usual calorie intake by 800 a day. Anyone would lose weight doing that.

Only four dietary components provide calories: fat (9 per gram), carbohydrate and protein (4 per gram each) – and alcohol (7 per gram).

Does the particular mix of these components make any difference to weight loss? Yes, say proponents of diets low in carbohydrate, especially rapidly absorbable sugars and refined starches.

Low-carbohydrate diets are necessarily high in fat, and somewhat higher in protein. Do people lose weight on them because of the effects of carbohydrates on insulin levels or because low-carbohydrate diets help reduce calories?

This question does not have an easy answer, but not for lack of trying. Weight-loss studies are hard to do. Estimating calorie intake is notoriously inaccurate, and measuring calories is difficult and expensive.

The first measurement study I know of took place in 1964. Investigators from the Oakland Institute for Medical Research studied weight loss in five obese patients in a hospital metabolic ward. They calculated the number of calories needed to induce rapid weight loss in each patient, and fed each of them a liquid formula diet containing that number every day. Every few weeks, they changed the formula to vary the proportions of protein (ranging from 14 percent to 36 percent of calories), fat (12 percent to 83 percent), and carbohydrate (3 percent to 64 percent).

Regardless of the proportions, all patients lost weight at a constant rate. The investigators titled their study “Calories Do Count.”

This study was conducted under rigidly controlled conditions of hospitalization and involved actual measurements – not estimations – of calorie intake and body weight.

But what about weight-loss studies involving people who are not incarcerated? Since the early 2000s, numerous clinical trials have shown low-carbohydrate diets to produce greater weight loss than low-fat diets. Some also have observed improvements in blood pressure, blood glucose levels and blood lipids.

But it is so inaccurate to estimate calorie intake in such studies that most didn’t bother to try. This means they can’t say whether the weight loss was due to composition of the diet or to calorie reduction.

It’s possible that low-carbohydrate, high-fat diets make people less hungry, but the evidence for this is mixed. Most studies of extreme diets of any type report high dropout rates or failure to stick to the diet for more than six months or so. And even though initial weight loss is rapid on low-carbohydrate diets because of water loss, these diets are low in fiber and some vitamins.

One problem with losing weight is that it takes fewer calories to maintain smaller bodies. Dieting also reduces energy expenditure.

One recent study of that problem involved taking detailed measurements for several years, and illustrates the difficulties of obtaining definitive answers to questions about diet composition and energy balance.

The researchers wanted to know whether diet composition affected energy expenditure in very obese people who had just dieted off up to 15 percent of their weight. They found that a low-carbohydrate diet did not slow down energy expenditure nearly as much as a low-fat diet, meaning that low-carbohydrate diets might make it easier for people to maintain weight loss.

On this basis, the investigators said, “The results of our study challenge the notion that a calorie is a calorie from a metabolic perspective.”

Perhaps, but study subjects were fed prepared calorie-controlled diets for only four weeks, and lost and maintained weight under highly controlled conditions. Does diet composition matter for weight maintenance in the real world? Longer-term studies by other investigators show that diet composition makes little difference in the ability to maintain weight loss.

Most reviews of the subject conclude that any diet will lead to weight loss if it cuts calories sufficiently.

Obviously, some diets are better for health than others.

Face it. The greatest challenge in dieting is to figure out how to eat less – and to eat healthfully on a regular basis – in the midst of today’s “eat more” food environment. And that’s a much more important research problem than whether low-carbohydrate or low-fat diets work better for weight loss.

Marion Nestle is an author and a professor in the nutrition, food studies and public health department at New York University. She blogs at foodpolitics.com. E-mail: food@sfchronicle.com

Jason Huffman, the editor of Food Chemical News, sent in a comment a few weeks ago that I thought worth sharing.

Just an observation. Your readers’ comments on these articles about limits on soda sizes are as entertaining as your columns, Marion. Obviously, some very intelligent people read your articles, and with a good balance of viewpoints. I think you might start writing some of your columns as a single line and simply say “discuss.” 🙂

I think so too.

So how about it?  What topics would you like to see me put up as a single line and open for discussion?

Whenever I give a talk, someone in the audience invariably asks how to get involved in food advocacy.  My suggestion is usually to go online and look for local groups working on issues of interest or, if lucky enough to have a nearby Edible magazine, read the ads.

These are still useful starting points and I list them and others in the FAQ section on this site (questions 3 and 4).

More recently, I’ve been asked a more complicated question: Why don’t all those organizations get together?  If they did, they would form a major political force. 

Vivian Wang, an undergraduate at NYU, asked that very question after one of my talks.  She volunteered to start doing some preliminary work by attempting to identify local and national food advocacy groups.

It didn’t take her long to discover the enormity of that task. 

Nevertheless, she created spreadsheet of the groups she was able to find.  She organized her findings by the tabs at the bottom, which she named:

• Long Lists: These are groups with websites that provide information about resources including many other advocacy groups.
• NYC-based: Groups in New York City.  These are also given on different spreadsheets in the other categories
• Advocacy
• Agriculture
• Education
• Hunger
• Local Food
• Organic Food
• Urban Farming
• NYU-based: food and nutrition clubs at New York University

Readers: please take a look at these lists.  Feel free to use them.

How can such lists best be used to help create coalitions willing to work toward common goals? 

Suggestions are most welcome.   

Worried about the potential personal and economic costs of obesity?  Never mind.  It’s time to view obesity as a business opportunity.

As the press release for a new research report from Bank of America Merrill Lynch, Globesity—The Global Fight Against Obesity, points out:

Increasing efforts to tackle obesity over the coming decades will form an important new investment theme for fund managers…Global obesity is a mega-investment theme for the next 25 years and beyond…The report…identifies that efforts to reduce obesity is a “megatrend” with a shelf-life of 25 to 50 years…BofA Merrill Lynch analysts across several sectors have collaborated to identify the sectors and companies developing long-term solutions.

Given the worldwide increase in obesity, its high prospective costs, and the ever-present threat of government regulation, the report identifies more than 50 global stocks that provide investment opportunities for fighting “globesity.”  These fall into four categories:

• Pharmaceuticals and Health Care: companies taking advantage of the FDA’s increased support for obesity drug development; tackling related medical conditions and needs including diabetes, kidney failure, hip and knee implants; making equipment such as patient lifts, bigger beds and wider ambulance doors.
• Food: companies accessing the $663 billion “health and wellness” market and reformulating portfolios to respond to increasing pressure such as “fat taxes” to reduce sugar and fat levels.
• Commercial Weight Loss, Diet Management and Nutrition: companies pursuing dieting, nutrition and behavioral change—a $4 billion market in the U.S. and growing globally.
• Sports Apparel and Equipment: “This is the longer-term play, but we believe that promoting physical activity will become a key priority for more government health policies.”

Well, that’s one way to look at it.  Public health, anyone?  

Now that the Supreme Court says that the Affordable Care Act is constitutional, it’s time to get those pesky menu labeling regulations in place.  That Act, you may recall, included a provision to take menu labeling national.

Late in May, Nation’s Restaurant News reported that pizza restaurant chains were banding together to fight FDA’s forthcoming menu-labeling regulations.

The American Pizza Community (TAPC) represents chains like Domino’s Pizza, Papa John’s Pizza, Little Caesar Enterprises, the International Pizza Hut Franchise Holders Association, Hungry Howie’s and Godfather’s Pizza.

TAPC members want alternatives for menu labeling that “would work for pizza.”

When there are 34 million ways to top a pizza just at Domino’s, it’s easy to understand how the one-size-fits-all situation currently proposed doesn’t work for pizza.

On June 4, Food Chemical News said the pizza industry would be asking Congress for an exemption from the menu labeling final rule.

Two days later, TAPC denied that charge.

On June 19, the Washington Post reported that TAPC met with congressional representatives to push for changes to the menu labeling plan.  What kind of changes?  Could they include exemptions?  Not clear.

TAPC is getting somewhere.  Congressman John Carter (R-TX) has just introduced a bill to weaken the national menu labeling law.  This would exempt supermarkets and convenience stores from having to post calorie information on prepared foods, gives a break to pizza, and allows calories to be listed by serving size.

Also in the meantime, Food Chemical News says the House Appropriations subcommittee told the FDA to narrow the focus of its menu labeling rule.  Translation: leave out movie theaters and, maybe, pizza.

I happen to love pizza, but it is unquestionably a major source of calories in American diets.  A slice of a big thick pizza can easily run 1000 calories.  I’d like to think that some pizza eaters might find that information useful.

I think pizza places should label calories—really, they can figure out how to do it—and that’s what I told  CBS TV on June 20.

Margo Wootan at Center for Science in the Public Interest (CSPI) has an op-ed in The Hill with a good summary of the reasons why menu labeling needs to get moving.  If you agree, CSPI has a model letter you can quickly send to the President, the Secretary of Health and Human Services (the FDA’s parent agency), and the FDA.

What’s holding up the regs?  First, the Supreme Court, but that’s no longer an excuse.  The upcoming election maybe?  That’s no excuse either.

On the eve of the Olympics, The Lancet has published a special issue on physical activity.

Since this is too small to read:

Physical activity:

Worldwide, we estimated that physical inactivity causes 6-10% of the major non-communicable diseases…physical inactivity seems to have an effect similar to that of smoking or obesity.

The issue is packed with carefully researched commentaries and papers on the benefits of physical activity.

But it starts out with a tough editorial,  Chariots of Fries:

The Games should encourage physical activity, promote healthy living, and inspire the next generation to exercise. However, marring this healthy vision has been the choice of junk food and drink giants—McDonald’s, Coca-Cola, and Cadbury’s—as major sponsors of the event

Health campaigners have rightly been dismayed. On June 20, the London Assembly (an elected body that scrutinises the work of the Mayor of London) passed a motion urging the International Olympic Committee (IOC) to adopt strict sponsorship criteria that exclude food and drinks companies strongly associated with high calorie brands and products linked to childhood obesity.

Meanwhile, the UK’s Academy of Medical Royal Colleges has said that the presence of McDonald’s and Coca-Cola at the 2012 Games sends out the wrong message to children.

This morning, I received an e-mail from the Coca-Cola Civic Action Network (CAN), described on its website as

a non-partisan group whose purpose is to provide information to the Coca-Cola family about national, state, and local issues that could affect us.  Whenever an issue comes up that could change our day-to-day lives, CAN goes to work getting important information to its members.

The message lists Coca-Cola’s Olympic actions:

• Olympic Torch Relay
  Integrated Marketing Campaign, Move to the Beat
• Global Anthem, Documentary & Global TV Commercial
• Coca-Cola Presents, Beat TV
• Digital & Mobile Application
• Games-time Refreshment
• Powerade Sports Academy
• Physical Activity Programs
• Legacy in sustainability

The e-mail says:

Coca-Cola will be refreshing and hydrating the 14,000 athletes, 7,000 officials, 20,000 workers and volunteers and more than 6 million spectators that are expected to flock to the Olympic Park. From one product in one size offered at the 1948 Olympic Games, to today’s more than 500 brands at the London 2012 Games, Coca-Cola will provide the widest range of drinks and sizes ever offered at an Olympic or Paralympic Games, to suit every lifestyle and hydration need.

Should soda and fast-food companies be sponsoring the Olympics?  Is this the message we want sent to kids?  I don’t think so.  You?

I was asked by a reporter yesterday for comment on the press release issued by the National Cattlemen’s Beef Association (NCBA) in response to USDA’s announced support of the Meatless Monday campaign.  

What? 

My immediate reaction: It’s pretty unbelievable that USDA would support Meatless Monday. Where’s the USDA statement? [see addition below]

The NCBA press release said:

The U.S. Department of Agriculture’s (USDA) recent announcement that the agency embraces the “Meatless Monday” concept calls into question USDA’s commitment to U.S. farmers and ranchers. USDA stated “one simple way to reduce our environmental impact while dining at our cafeteria is to participate in the “Meatless Monday” initiative.”

NCBA said Meatless Monday “is an animal rights extremist campaign to ultimately end meat consumption” and “NCBA will not remain silent as USDA turns its back on cattlemen and consumers.”

Without having seen what USDA said, I told the reporter:

If USDA is really supporting Meatless Monday, that’s big news. Historically, the USDA has worked hand in glove with the meat industry and has firmly resisted suggestions that it would be healthier for people and the planet to eat less meat.

The meat industry complained that the 2010 dietary guidelines pushed seafood and that meat got lost in protein in MyPlate, so they are supersensitive to this issue. Anyone who has ever been to a feedlot or industrial pig farm knows that the environmental issues are huge. You can smell them from miles away.

And what did the USDA actually say?  Oops.  Mistake.

According to the Boston Globe:

The Agriculture Department says a statement on its website encouraging its employees not to eat meat on Mondays was made without proper clearance.

The posting earlier this week was part of an internal newsletter that discusses how staff can reduce their environmental impact while dining at the agency’s cafeteria.

….USDA spokeswoman Cortney Rowe says the department does not endorse the “Meatless Monday” initiative, which is part of a global public health campaign.

Apparently, the USDA pulled the statement within minutes after the NCBA statement went out. 

How did USDA announce this to the public?  On Twitter!

USDA MT @usdapress: USDA does not endorse Meatless Monday. Statement on USDA site posted w/o proper clearance. It has been removed // @FarmBureau

 Food politics in action!

Addition, June 27: Here’s the original USDA Newsletter that caused all this fuss.  Scroll to page 3.

I’m out of town but learned about the hearing by e-mail and twitter (thanks to senders), and I’ve read the coverage in Huffington Post,  the Christian Science Monitor, and the Toronto Star.

One picture says it all: