The $12M NuSI/Ludwig Study ~ Part V: Intake, REE and TEE Measures

This post should maybe have come first, but it’s taken some time to look deeply at the data for the main outcome — total energy expenditure measured by doubly labeled water — and associated results of intake and resting energy expenditure.
In this study, all participants were paid to participate, AND provided free meals for ~8 months.  Said food was professionally and prepped, weighed, measured, individualized to supply some exact level and macronutrient composition to each subject.  The evaluation phase (in other words, the analysis appropriate ) involved maintaining a consistent weight (to within ±2 kg), for a substantial length of time:  20 weeks, assessed at the midpoint and the end.

A roughly 300 growth in TEE was detected during 4 months of isocaloric feeding, producing no fat loss.  This was basically dismissed as”not enough time to show weight loss”  paraphrase….  So in the present study, the average change in TEE masks the often wild swings of up to 2000 calories per day involving 10 week care time points.   If this increase (or decrease) in expenditure is truly real, the subjects would HAVE to have adjusted intake accordingly over the course of several weeks in order to maintain consistent weight.  

This post is about the massive discrepancies between intake and TEE information (also compared with REE), and the inexcusable near-dismissal of those discrepancies in the journal article.
Either the DLW-TEE information is (for reasons that can be discussed) unreliable/inaccurate, or the intake data is unreliable. If the TEE information is problematic, how do there be of a difference of means of 250 cal/day a consequence justifiably defended as significant/meaningful, when we see no difference in intake? If the intake data is problematic, then how can we conclude anything from a”diet comparison”, because significant deviations in caloric consumption would render the strict macro compositions totally insignificant. 
Either way, the investigators failed to address this glaring issue with the results study.  Further, the discrepancies in both of these data sets are so egregious that it is impossible that both can be considered accurate and reliable.  It must be one or another.  Based on the data for Resting Energy Expenditure (REE), the needle points to the intake data as the more reliable measure.



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