The Ice Diet
Many excess pounds ago, when I was determined to lose weight, I resolved to change my eating habits and exercise regime. One of the first changes I made was to give up my beloved ice cream. As an accommodation, I substituted Italian ices. I would typically enjoy the ices sold at the supermarket, sold in 6 ounce cups. These cups characteristically list their calorie content as 100 calories. That number is calculated by knowing the number of grams of carbohydrate in the container, multiplied by the known calories per gram. One evening, earlier this year, in a burst of insight, I realized that this was incorrect. The manufacturer of the ices did not calculate the energy required to melt the ice, and did not deduct this from the calorie calculation.
After spending some time reviewing the Internet, the medical and clinical dietary literature, I found that no one has clearly identified this oversight. I could not locate references to considerations of the implications of the energy content of ice as food. I discussed this in detail with my son, Alex, an engineering student at Rutgers. He reviewed and agreed with my rough calculations.
I wrote up this observation, and the editors of the Annals of Internal Medicine were kind enough to publish this in a letter to the editor, in their August 17, 2010 edition [Weiner BC, Weiner AC. Ann Intern Med. The Ice Diet. 2010;153:279]. The Annals is published by the American College of Physicians.
I believe that this observation may have significant importance to persons trying to lose weight.
At this point, I also want to make two disclaimers. As a clinical gastroenterologist, I speak to patients all day long about what they eat. For most patients, their problem was not in the details of food selection, but in the management of their illness. Most of my work, therefore, was in the management of illness. It is ironic that I am now making detailed food recommendations. As a second disclaimer, I have long prided myself on being a scientifically trained physician. I would usually cringe when patients brought up the weight loss diet of the day, usually some poorly documented and improbable strategy. I never thought I would be actively promoting and discussing weight loss diets. I earnestly hope not to get lumped in with the counter-productive fad diet [snake oil] promoters.
Up until August 17, 2010, if you wanted to lose weight, you needed to: 1. comply with a calorie deficient diet; 2. increase your level of exercise; or, 3. both. With regard to calorie deficient diets, there are many proposed strategies of modulating the diet, several active drugs and several surgical procedures. Some weight loss drugs act to increase the basal metabolic rate and increase the burning of calories. These drugs are controversial, because of concerns about side effects and addiction. Rimonibant, a cannabanoid receptor antagonist, had been used in Europe as an appetite suppressant that resulted in significant weight loss. My practice, Marlboro Gastroenterology, was selected as a site for US studies of this drug, in the treatment of NASH [non-alcoholic steatohepatitis], thought to be a potentially serious side effect of obesity. This drug was recently removed from the overseas market because of concern about psychiatric side effects. As a consequence, this ground-breaking US study was cancelled.
The Ice Diet is a proposed new weight loss treatment choice with a unique mechanism. It exploits the error in the calculation of calorie content of frozen foods. The Ice Diet works by increasing the basal metabolic rate. When ingesting clinically significant amounts of ice, the body must burn energy to warm the ice to body temperature. The ingestion of ice would also provide some level of satiety. The ingestion of 1 liter of ice [equals 1.06 quart] would burn about 160 calories, the amount of energy used in running one mile. This approach has the paradoxical potential to cause weight loss while actually consuming food [realizing the Don Quixote quest equivalent of the bariatric world]. Ingesting ice at this level should not have any obvious adverse consequence in otherwise healthy persons.
By the way, in the case of the six ounce cup of ices, noted to have 100 calories on the label, you are actually only consuming 72 calories or icals [“Icals” are my term for the corrected caloric content of an ice containing food product, adjusted for the energy required to melt the ice].
Brian C. Weiner, M.D., M.S., F.A.C.P., A.G.A.F
Clinical Assistant Professor, Medicine
Marlboro Gastroenterology PC
50 Franklin Lane, Suite 201
Manalapan, NJ 07726
The More You Drink, The More You Lose!