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​Satiety Per Calorie: A Conversation with the MD Who Founded Diet Doctor

​Satiety Per Calorie: A Conversation with the MD Who Founded Diet Doctor

Posted by Chris S. Cornell on 29th Jul 2023

Dr. Andreas Eenfeldt explains how Hava app will leverage satiety to improve health

Dr. Andreas Eenfeldt, an authority in medical and nutritional science, is revolutionizing our understanding of satiety, which he believes is a critical factor in modern health crises. Dr. Eenfeldt, a prominent advocate for nutritious eating and critic of our obesity-inducing food environment, is applying his two decades of experience in promoting healthier relationships with food as he works to transform our relationship with food.

As the founder and CEO of Diet Doctor and best-selling author, Dr. Eenfeldt is behind the innovative Hava app to be launched later this year, and will adopt the Satiety per Calorie principle to foster a transformative approach to health and wellness. We recently got the opportunity to engage in an in-depth discussion with Dr. Eenfeldt about satiety and the new Hava app.

Dr. Eenfeldt is no stranger to the perils of the global metabolic health crisis. After a successful career in family medicine, where he witnessed first-hand the power of low-carb, high-fat diets in treating obesity and type 2 diabetes, he made a bold decision. In 2015, he stepped away from clinical practice to establish Diet Doctor, determined to combat the increasing wave of metabolic diseases at its source: our dietary habits.

"I believe we can make the world a better place,” Dr. Eenfeldt shared during a recent conversation. “While it may sound cliché, I truly think the greatest health problem we face is metabolic health, driving the major chronic diseases and impacting quality of life. And the food environment we live in is the principal cause of this problem."

Indeed, the link between our food environment and the escalating obesity epidemic is undeniable. "The food industry is stuck in this endless cycle of making ever more obesogenic foods because that's where the profit is," explained Dr. Eenfeldt. "Unless someone stops it or finds a way to turn this around, it's just going to get worse every year, forever."

Redefining Satiety: A Key to Transforming Health and Well-being

In light of such a grim prognosis, Dr. Eenfeldt aims to guide us towards a more promising path by redefining our understanding of satiety. 

"To me, satiety is the opposite of hunger and cravings; it's being satisfied and content to the point where food is not what you’re seeking. With satiety, if you get bored, you're not going to start eating out of emotion; instead, you're going to engage in other activities. When you experience satiety, food is no longer on your mind," Dr. Eenfeldt explained.

Dr. Eenfeldt, together with his team that includes Dr. Ted Naiman, the author of The P:E Diet book, are preparing to launch the Hava app. The app will seek to guide users towards foods that provide higher satiety per calorie. 

The promise of Hava is bold: empower individuals to make food choices that naturally lead to satiety, reducing the likelihood of overeating and breaking the cycle of obesogenic eating habits.

The Power of Satiety: Breaking the Cycle of Obesogenic Eating Habits

“We have to recognize the importance of satiety and how it can radically affect our food choices and our health,” said Dr. Eenfeldt. “The food industry has optimized food for maximal obesity, and the sad part is they've been tremendously successful. But we believe if we can instead optimize for satiety, we can turn this around.”

These realizations about the state of our food environment led Dr. Eenfeldt to focus on satiety, rather than exclusively focusing on low-carb diets, as his Diet Doctor site typically does.

The Satiety Index was created to rate foods based on their ability to quell hunger. According to Dr. Eenfeldt, foods high on the Satiety Index can keep you full for longer, leading to a reduction in calorie intake. "It's not about depriving yourself but about nourishment. You don't need to eat less, but better. Foods like lean meats, eggs, fish, legumes, and vegetables are excellent for promoting a feeling of fullness. They are nutrient-rich and provide all the essential nutrients your body needs," Dr. Eenfeldt clarified.

Satiety per Calorie: A Revolutionary Approach to Nutrition and Health

A common misconception, according to Dr. Eenfeldt, is that we need to be constantly eating to fuel our bodies. “That's simply not true,” he said. “Our bodies are incredibly efficient at storing and utilizing energy. So if we eat foods that are high in nutrients and promote satiety, we can easily go for several hours without feeling the need to eat. This not only helps in weight management but also gives our bodies the time to rest and regenerate.”

Dr. Eenfeldt pointed out that the food industry, and to some extent, conventional wisdom, has promoted the idea of constant snacking, which not only increases our total caloric intake but also keeps our bodies in a constant state of digestion, without allowing time to rest and repair. Snacking, especially on ultra-processed foods, he said, is one of the main contributors to the obesity epidemic.

“I believe the best strategy is to choose whole, nutrient-dense foods that promote satiety and regulate our hunger signals,” said Dr. Eenfeldt. “And for most people, that means eating a diet that's rich in protein and fiber, while limiting our intake of ultra-processed foods and added sugars. It's a simple concept, but one that can have a profound impact on our health and well-being. It's not about dieting or restriction, but about nourishing our bodies and respecting our natural hunger cues.”

In the long term, Dr. Eenfeldt believes this approach can lead to better weight management, improved metabolic health, and a lower risk of lifestyle-related diseases.

“It's a sustainable, achievable approach to nutrition and health that doesn't rely on willpower or deprivation but respects our body's natural instincts and needs. And it's an approach I believe can transform our lives and our world. We just need to rethink our relationship with food and focus on nourishing our bodies, rather than merely feeding them.”

What is Satiety per Calorie?

"Satiety per Calorie" refers to the extent of fullness or satisfaction derived from the intake of a certain amount of calories. According to Dr. Eenfeldt, four primary qualities determine the satiety per calorie of foods:

  1. Protein content - in general, foods with a greater percentage of protein will provide greater satiety per calorie, according to the SPC model that will guide the Hava app. Studies have consistently found that diets higher in protein lead to greater satiety, resulting in consuming fewer calories. This is supported by the "protein leverage" theory, suggesting that humans and animals keep eating until they achieve adequate protein intake. Consequently, increasing dietary protein can naturally decrease overall caloric intake, facilitating healthier weight management. Furthermore, protein-rich whole foods supply essential micronutrients, with their deficiency potentially leading to adverse health effects or increased food cravings. An additional benefit of protein consumption is the release of satiety hormones that convey the feeling of fullness to the brain, reducing the urge for further food intake.
  2. Energy density - foods with high energy density, like most highly processed junk foods, pack a large amount of calories into a small quantity of food and tend to provide less satiety per calorie. Conversely, foods with low energy density, like green vegetables, provide significantly fewer calories for the same quantity, meaning that one would need to consume a substantial volume of these foods to ingest a high number of calories.
  3. Fiber content - evidence suggests that naturally high fiber levels in foods contribute to short-term satiety. Fiber, which is abundant in fruits and vegetables, adds bulk to the food even during digestion, thereby contributing to feelings of fullness and signaling the body to cease eating. This impact on satiety helps curb overeating, thus enhancing the effectiveness of caloric intake.
  4. Hedonic factor - a food’s satiety per calorie is significantly affected by its hedonic factor, a measure of how much specific foods drive one to eat despite an absence of traditional hunger. The level of food processing and the combined content of fats and carbohydrates largely contribute to a food's hedonic factor. Other ingredients, such as sugar or salt, are commonly included in foods specifically to make them more appealing.

Dr. Eenfeldt discussed satiety, particularly Satiety Per Calorie, in depth earlier this year at Low Carb Denver 2023 in a presentation aptly titled "Satiety: the secret to eating better?" While there will always be individual nuances, Dr. Eenfeldt clarified that the satiety per calorie approach is a guiding principle, a tool that can be applied in a variety of contexts. 

“It's not a rigid rule but rather a flexible and adaptable method to help you make better choices, thus leading to a healthier lifestyle,” he said.

And importantly, Dr. Eenfeldt explains the satiety per calorie concept is not about denying pleasure from food.

“It's about finding those choices that not only keep you satiated but also fit your personal preferences,” he said. “We believe that any sustainable diet should be enjoyable. A diet that feels like punishment is unlikely to be maintained long-term. Therefore, with this approach, the aim is to find that sweet spot where health, satiety, and pleasure meet.”

How Does the Satiety Scoring System Work?

The Hava app will provide users with satiety per calorie scores for a wide variety of foods. The scoring ranges from 0 (foods least likely to satiate, leading to potential weight gain and metabolic disease, such as donuts) to 100 (foods that discourage overeating, like green leafy vegetables and lean proteins). The aim is to balance food intake around a moderate value.

Dr. Eenfeld, in a recent tweet, said there are three important considerations to keep in mind when using the Satiety Index:

  • First, everyone will eat a mix of higher or lower-satiety foods. What we predict matters most is the average score over a day, week, or year. That’s what’s going to influence you the most.
  • Secondly, we predict that eating very low satiety on average (e.g., 20) may result in obesity and metabolic disease. On the other hand, eating at an average of 50 or a bit higher may result in a lean, strong physique and solid metabolic health.
  • Finally, the goal is not to stay at 100 on average. This is too high, too effective. You would be likely to become too lean compared to what your body prefers, resulting in eventually – after days or weeks – getting tired, miserable, and depressed. The food would also be very boring.

The goal is instead to find the level that delivers the results you are seeking, he said.

“For some, an average score of 40 may be a good start, for others, 50, and for the over-achievers, maybe 60,” he said.

“Another point I'd like to emphasize is the iterative nature of this concept. Our scoring system has been evolving based on the best available evidence and will continue to do so. We are committed to refining and improving it, integrating new research findings, and adjusting the algorithm as needed. Our goal is to make this tool as effective and user-friendly as possible, and that requires a constant process of learning and adaptation.”

Ultimately, Dr.Eenfeldt said he envisions the satiety per calorie approach as a gateway to a healthier lifestyle for a wide range of people.

“Whether you're trying to lose weight, improve your metabolic health, enhance your athletic performance, or simply wish to maintain a healthy diet, this approach offers a practical and flexible tool. And by making it simple and accessible, we hope to contribute to the broader mission of promoting health and well-being.”

The application of the Satiety per Calorie model in the Hava app is designed to help people make gradual changes to their diet rather than enforce a sudden, drastic shift.

“The goal is to provide guidance towards healthier versions of the foods people already love and consume, thus customizing a dietary approach that fits individual preferences, budget, and lifestyle.”

While this approach, like any first version of an innovative tool, may have room for improvement, Dr. Eenfeldt and his team believe it's a significant step in the right direction.

Resources:

Hava website - https://www.hava.co/

The science of satiety per calorie - https://www.dietdoctor.com/satiety/science

The best high-satiety foods - https://www.dietdoctor.com/satiety/foods

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