Transitioning from macro tracking to a more sustainable approach

[UserName]

Hey BBM team,

I thought this would be an interesting topic to discuss and haven't found any previous posts on this.

I've been on a diet and diligently tracking macros for almost 6 months now and will soon be transitioning to a maintenance period of a few weeks before looking to slowly gain weight over time.

I've learned a lot on this journey, mostly building healthy eating habits/dietary patterns that include lots of fruits & vegetables, fiber, a good amount of protein, etc., but I realize that tracking food cannot be a permanent strategy to achieve one's goals for weight management over the long run.

I wanted to get your thoughts on the following:

1. When transitioning from a calorie deficit to a maintenance period and subsequently to a slight surplus, would you continue to track intake initially before tapering towards a more "feeling" approach?
2. How would you go about abandoning tracking food over time? Do you have a few tips that could help for the long run?

Just a few ideas for point 2):

• initially keep a couple of daily staple meals to help gauge
• get a better feel for volume of food in general and slowly switch to portion control by eyeballing
• move to tracking hunger levels instead, provided activity levels stay the same
• keep tracking weight and WC

My objective is to be able to slightly increase weight or maintain weight over a long period of time without having to track food.

In a more general sense, I am hoping this can help myself and others develop the right skills to be able to manage weight over the course of life.

Thank you in advance for your feedback,
Matteo

[Jordan Feigenbaum]

Matteo,

Thanks for the post and nice job here.

For your first question, I think some sort of quantity control is useful long-term and do not think a "feeling" approach is likely to be successful for most. I don't think you have to track daily and/or measure everything with a scale, cups, etc., but I do think using some sort of portion control is going to be necessary for at least the medium term. Using a visual scale, e.g. palm-sized portion of lean protein, tracking every third day, etc. and maintaining accountability for overall energy balance using weight and anthropometry would be my recommendations. Reductions in food variety tend to reduce energy intake variation, so staple meals can be useful, yes. I do not think tracking hunger levels are helpful for increasing adherence or improving outcomes.

For your second question, I don't think I would recommend that unless there was a strong preference for doing so and/or greater risk to tracking than rewards.

Long-term you may stabilize at a weight and body composition you're happy with alongside a health-promoting dietary pattern and a set of skills that allow you to maintain the appropriate energy balance. I don't think this is likely to occur during periods of active weight change, however.

[awe1ss]

“I do not think tracking hunger levels are helpful for increasing adherence or improving outcomes.”

I have little bias here for or against, but do you have any literature for that claim you’d feel comfortable sharing? I value your anecdotal experience with clients, if that applies here.

[UserName]

Thanks for the insights Jordan!

I think I understand the distinction here, where during periods of active weight change paying more attention to (or having more control over) what you are eating is advisable to help achieve the target weight.

[Jordan Feigenbaum]

Yes, precisely.

[Jordan Feigenbaum]

“I do not think tracking hunger levels are helpful for increasing adherence or improving outcomes.”

I have little bias here for or against, but do you have any literature for that claim you’d feel comfortable sharing? I value your anecdotal experience with clients, if that applies here.

Plenty! What have you been able to find so far on the relationship between people rating their hunger as a tool for guiding dietary habits and weight/body composition outcomes?

[awe1ss]

So far, alongside my novice interpretations:

“BMI decreased from 28.7 ± 3.5 to 26.5 ± 3.5 in the trained group. The decrease was significant in comparison to controls (P = 0.004) and in comparison with baseline values of the same group (P = 0.0001). Multivariate analysis of variance showed a significant association between training and both BMI and weight.”

Int J Gen Med. 2013; 6: 465–478.
Published online 2013 Jun 17. doi: 10.2147/IJGM.S40655

Interpretation: high-dropout rate, correlation is present in the given sample. Clinical significance given the rest of the available literature? meh.

“Little evidence suggests that ME and IE interventions influence energy intake or diet quality.”

Grider, Hannah S et al. “The Influence of Mindful Eating and/or Intuitive Eating Approaches on Dietary Intake: A Systematic Review.” Journal of the Academy of Nutrition and Dietetics vol. 121,4 (2021): 709-727.e1. doi:10.1016/j.jand.2020.10.019

Interpretation: 13 studies (of lower quality) analyzed, majority of studies (RCTs) found no meaningful differences between groups for diet quality, nor dietary intake.

I’ve seen some neat cross-sectional (e.g., Géraldine M Camilleri et al., 2016), or pilot studies on “intuitive eating”, but I’m biasing my uninformed opinion slightly towards the meta listed above!

[Jordan Feigenbaum]

Yep, I think you've got a good start there. I do think when reviewing the literature that we should really try to ask specific, answerable questions. In this case, does rating hunger help with weight management? Intuitive and mindful eating are a bit more broad as far as what they include in training their subjects.

With hunger, you have a number of inputs (similar to pain) that don't really correlate to previous or subsequent energy intake independent of food and eating environments. We also don't really see people strictly rate their hunger and then eat less (??) for weight management purposes. Data on hunger ratings and correlations to satiety hormones, ad libitum eating, etc. are plentiful, but interventional studies where people rate their hunger are less numerous, though still available.

I'd like to give you more time to search for this data rather than provide the answer.

[awe1ss]

Thank you for your response. I did take a rather unhelpful broad stroke approach, I completely agree that I should be more specific with my search.

I also appreciate you letting me build a degree of self-efficacy here!

[awe1ss]

Edit: so far, I have found very little quality research concerning rating hunger and significant weight management changes. I unlikely made a dent in the available literature, though.

[Jordan Feigenbaum]

Yea, it is an interesting question.

We see that reducing hunger seems to improve dietary adherence and improve weight management, but there's little data showing that rating hunger regularly improves hunger management. My take is that we don't necessarily need to measure something if it's not going to change what we do or how we do it.

[awe1ss]

Makes sense, thank you again for walking me through this!