Brink’s Unified Theory of Nutrition For Weight Loss and Muscle Gain

When people hear the term Unified Theory, some times called the Grand Unified Theory, or even “Theory of Everything,” they probably think of it in terms of physics, where a Unified Theory, or single theory capable of defining the nature of the interrelationships among nuclear, electromagnetic, and gravitational forces, would reconcile seemingly incompatible aspects of various field theories to create a single comprehensive set of equations.

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Such a theory could potentially unlock all the secrets of nature and the universe itself,Brink’s Unified Theory of Nutrition For Weight Loss and Muscle Gain Articles or as theoretical physicist Michio Katu, puts it “an equation an inch long that would allow us to read the mind of God.” That’s how important unified theories can be. However, unified theories don’t have to deal with such heady topics as physics or the nature of the universe itself, but can be applied to far more mundane topics, in this case nutrition.

Regardless of the topic, a unified theory, as sated above, seeks to explain seemingly incompatible aspects of various theories. In this article I attempt to unify seemingly incompatible or opposing views regarding nutrition, namely, what is probably the longest running debate in the nutritional sciences: calories vs. macro nutrients.

One school, I would say the ‘old school’ of nutrition, maintains weight loss or weight gain is all about calories, and “a calorie is a calorie,” no matter the source (e.g., carbs, fats, or proteins). They base their position on various lines of evidence to come to that conclusion.

The other school, I would call more the ‘new school’ of thought on the issue, would state that gaining or losing weight is really about where the calories come from (e.g., carbs, fats, and proteins), and that dictates weight loss or weight gain. Meaning, they feel, the “calorie is a calorie” mantra of the old school is wrong. They too come to this conclusion using various lines of evidence.

This has been an ongoing debate between people in the field of nutrition, biology, physiology, and many other disciplines, for decades. The result of which has led to conflicting advice and a great deal of confusion by the general public, not to mention many medical professionals and other groups.

Before I go any further, two key points that are essential to understand about any unified theory:

A good unified theory is simple, concise, and understandable even to lay people. However, underneath, or behind that theory, is often a great deal of information that can take up many volumes of books. So, for me to outline all the information I have used to come to these conclusions, would take a large book, if not several and is far beyond the scope of this article.

A unified theory is often proposed by some theorist before it can even be proven or fully supported by physical evidence. Over time, different lines of evidence, whether it be mathematical, physical, etc., supports the theory and thus solidifies that theory as being correct, or continued lines of evidence shows the theory needs to be revised or is simply incorrect. I feel there is now more than enough evidence at this point to give a unified theory of nutrition and continuing lines of evidence will continue (with some possible revisions) to solidify the theory as fact.
“A calorie is a calorie”

The old school of nutrition, which often includes most nutritionists, is a calorie is a calorie when it comes to gaining or losing weight. That weight loss or weight gain is strictly a matter of “calories in, calories out.” Translated, if you “burn” more calories than you take in, you will lose weight regardless of the calorie source and if you eat more calories than you burn off each day, you will gain weight, regardless of the calorie source.

This long held and accepted view of nutrition is based on the fact that protein and carbs contain approx 4 calories per gram and fat approximately 9 calories per gram and the source of those calories matters not. They base this on the many studies that finds if one reduces calories by X number each day, weight loss is the result and so it goes if you add X number of calories above what you use each day for gaining weight.

However, the “calories in calories out” mantra fails to take into account modern research that finds that fats, carbs, and proteins have very different effects on the metabolism via countless pathways, such as their effects on hormones (e.g., insulin, leptin, glucagon, etc), effects on hunger and appetite, thermic effects (heat production), effects on uncoupling proteins (UCPs), and 1000 other effects that could be mentioned.

Even worse, this school of thought fails to take into account the fact that even within a macro nutrient, they too can have different effects on metabolism. This school of thought ignores the ever mounting volume of studies that have found diets with different macro nutrient ratios with identical calorie intakes have different effects on body composition, cholesterol levels, oxidative stress, etc.

Translated, not only is the mantra “a calorie us a calorie” proven to be false, “all fats are created equal” or “protein is protein” is also incorrect. For example, we no know different fats (e.g. fish oils vs. saturated fats) have vastly different effects on metabolism and health in general, as we now know different carbohydrates have their own effects (e.g. high GI vs. low GI), as we know different proteins can have unique effects.

The “calories don’t matter” school of thought

This school of thought will typically tell you that if you eat large amounts of some particular macro nutrient in their magic ratios, calories don’t matter. For example, followers of ketogenic style diets that consist of high fat intakes and very low carbohydrate intakes (i.e., Atkins, etc.) often maintain calories don’t matter in such a diet.

Others maintain if you eat very high protein intakes with very low fat and carbohydrate intakes, calories don’t matter. Like the old school, this school fails to take into account the effects such diets have on various pathways and ignore the simple realities of human physiology, not to mention the laws of thermodynamics!

The reality is, although it’s clear different macro nutrients in different amounts and ratios have different effects on weight loss, fat loss, and other metabolic effects, calories do matter. They always have and they always will. The data, and real world experience of millions of dieters, is quite clear on that reality.

The truth behind such diets is that they are often quite good at suppressing appetite and thus the person simply ends up eating fewer calories and losing weight. Also, the weight loss from such diets is often from water vs. fat, at least in the first few weeks. That’s not to say people can’t experience meaningful weight loss with some of these diets, but the effect comes from a reduction in calories vs. any magical effects often claimed by proponents of such diets.

Weight loss vs. fat loss!

This is where we get into the crux of the true debate and why the two schools of thought are not actually as far apart from one another as they appear to the untrained eye. What has become abundantly clear from the studies performed and real world evidence is that to lose weight we need to use more calories than we take in (via reducing calorie intake and or increasing exercise), but we know different diets have different effects on the metabolism, appetite, body composition, and other physiological variables…

Brink’s Unified Theory of Nutrition

…Thus, this reality has led me to Brink’s Unified Theory of Nutrition which states:

“Total calories dictates how much weight a person gains or loses; macro nutrient ratios dictates what a person gains or loses”

This seemingly simple statement allows people to understand the differences between the two schools of thought. For example, studies often find that two groups of people put on the same calorie intakes but very different ratios of carbs, fats, and proteins will lose different amounts of bodyfat and or lean body mass (i.e., muscle, bone, etc.).

Some studies find for example people on a higher protein lower carb diet lose approximately the same amount of weight as another group on a high carb lower protein diet, but the group on the higher protein diet lost more actual fat and less lean body mass (muscle). Or, some studies using the same calorie intakes but different macro nutrient intakes often find the higher protein diet may lose less actual weight than the higher carb lower protein diets, but the actual fat loss is higher in the higher protein low carb diets. This effect has also been seen in some studies that compared high fat/low carb vs. high carb/low fat diets. The e

Healthcare Reform Checklist

Health systems often require tweaking, fine-tuning, and even reconstruction.

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GENERAL
Healthcare legislation in countries in transition,Healthcare Reform Checklist Articles emerging economies, and developing countries should permit – and use economic incentives to encourage – a structural reform of the sector, including its partial privatization.

KEY ISSUES

· Universal healthcare vs. selective provision, coverage, and delivery (for instance, means-tested, or demographically-adjusted)

· Health Insurance Fund: Internal, streamlined market vs. external market competition

· Centralized system – or devolved? The role of local government in healthcare.

· Ministry of Health: Stewardship or Micromanagement?

· Customer (Patient) as Stakeholder

· Imbalances: overstaffing (MDs), understaffing (nurses), geographical distribution (rural vs. urban), service type (overuse of secondary and tertiary healthcare vs. primary healthcare)

AIMS

· To amend existing laws and introduce new legislation to allow for changes to take place.

· To effect a transition from individualized medicine to population medicine, with an emphasis on the overall welfare and needs of the community

Hopefully, the new legal environment will:

· Foster entrepreneurship;

· Alter patterns of purchasing, provision, and contracting;

· Introduce constructive competition into the marketplace;

· Prevent market failures;

· Transform healthcare from an under-financed and under-invested public good into a thriving sector with (more) satisfied customers and (more) profitable providers.

· Transition to Patient-centred care: respect for patients’ values, preferences, and expressed needs in regard to coordination and integration of care, information, communication and education, physical comfort, emotional support and alleviation of fear and anxiety, involvement of family and friends, transition and continuity.

The Law and regulatory framework should explicitly allow for the following:

I. PURCHASING and PURCHASERS

(I1) Private health insurance plans (Germany, CzechRepublic, Netherlands), including franchises of overseas insurance plans, subject to rigorous procedures of inspection and to satisfying financial and governance requirements. Insured/beneficiaries will have the right to apply contributions to chosen purchaser and to switch insurers annually.

Private healthcare plans can be established by large firms; guilds (chambers of commerce and other professional or sectoral associations); and regions (see the subchapter on devolution under VI. Stewardship).

Private insurers: must provide universal coverage; offer similar care packages; apply the same rate of premium, unrelated to the risk of the subscriber; cannot turn applicants down; must adhere to national-level rules about packages and co-payments; compete on equality and efficiency standards.

(I11) Breakup of statutory Health Insurance Fund to 2-3 competing insurance plans (possibly on a regional basis, as is the case in France) on equal footing with private entrants.

Regional funds will be responsible for purchasing health services (including from hospitals) and making payments to providers. They will be not-for-profit organizations with their own boards and managerial autonomy.

(I12) Board of directors and supervisory boards of health insurance funds to include:

– Two non-executive, lay (not from the medical professions and not politicians) members of the public. These will represent the patients and will be elected by a Council of the Insured, (as is the practice in the Netherlands)

– Municipal representatives;

– Representatives of stakeholders (doctors, nurses, employees of the funds, etc.).

(I13) The funds will be granted autonomy regarding matters of human resources (personnel hiring and firing); budgeting; financial incentives (bonuses and penalties); and contracting.

The funds will be bound by rules of public disclosure about what services were purchased from which providers and at what cost.

Citizen juries and citizen panels will be used to assist with rationing and priority-setting decisions (United Kingdom).

(I2) Procurement of medicines to be done by an autonomous central purchasing agency, supervised by a public committee (drug regulatory authority) aided by outside auditors.

All procurement of drugs and medications will be done via international tenders.

The agency will submit its reimbursement rates for drugs on the PLD to external audit in order to accurately reflect pharmacists’ overhead costs. At the same time, the profit margins on all drugs, whether on the PLD or not, will be regulated.

This agency should be separate from the Health Insurance Fund and the Ministry of Health. This agency will also maintain national drug registries. It will secure volume discounts for bulk purchasing and transparent, arm’s-length pricing.

(I21) Use of reference prices for medicines. If the actual price exceeds the reference price, the price difference has to be met by the patient.

(I3) The Approved (Positive) List of Medicines will be recomposed to include generic drugs whenever possible and to exclude expensive brands where generics exist. This should be a requirement in the law. Separately, an Essential Drug List will be drawn up.

(I31) Encourage rational drug prescribing by instituting a mixture of GP and PHC incentives and penalties, or a fundholding system: budgets will be allocated to each GP for the purchase of drugs and medications. If the GP exceeds his/her budget, s/he is penalized. The GP gets to keep a percentage of budget savings. Prescription decisions will be medically reviewed to avoid under-provision.

(I4) Payments and Contracting

Payment to providers should combine, in a mixed formula:

BLOCK CONTRACTS

Capitation – A fixed fee for a list of services to be provided to a single patient in a given period, payable even if the services were not consumed, adjusted for the patients’ demographic data and reimbursement for fee-for-service items.

Inflation-adjusted Global budgeting (hospitals) and block (lump sum) grants (municipalities)

COST and VOLUME CONTRACTS

Provide incentives and reward marketing efforts which result in an increase in
demand/referral beyond the limit set in a block contract.

COST PER CASE CONTRACTS

Apply Diagnosis Related Group (DRG)/ Resource-based Relative Value (RBRV) / Patient Management Categories (PMCs) / Disease Staging/Clinical Pathways

Levels of reimbursement, case-mix adjusted to be decided by external auditors.

Contracts with providers should include:

· Waiting Times Guarantee

· Single Contact Person(“Case Officer”) for the duration of a stay at the hospital

· Hospital benchmarking (individual-level data on costs, diagnoses, and procedures during entire case episodes: inpatient admissions and outpatient visits; cost-effectiveness of services.

· Performance targets in performance agreements with all healthcare facilities, both public and private.

· All payments – wages included – will be tied to these targets and their attainment as well as to healthcare quality as determined by objective measures (internal, external, and functional benchmarking), clinical audits (sampling), as well as customer satisfaction surveys and interviews and discussions with patients.

· Provider and Staff Bonuses and penalties tied to exceeding/under-performing targets and contract variance

· Patients’ rights, including their rights to litigate

Selective contracting will be allowed on all levels (including specialist ambulatory care and hospitals), although all providers, private and public, will be permitted to apply for contracts with health funds and insurers. The funds will choose from among private providers either following a process of deliberation, or via an auction, or public tender (United Kingdom).

(I5) Commissioning preference will be given to the purchase of Primary Healthcare over secondary, or tertiary Healthcare.

II. PROVIDERS

The Law and regulatory framework should explicitly allow for the following:

(II1) Hospital Management

(See separate document)

The law should allow:

I. Co-location of a private wing within or beside a public hospital

II. Outsourcing of non-clinical support services

III. Outsourcing of clinical support services

IV. Outsourcing of specialized clinical services

V. Private management of public hospitals

VI. Private financing, construction, and leaseback of new public hospitals

VII. Private financing, construction, and operation of new public hospitals

VIII. Sale of public hospitals as going concerns

IX. Sale of public hospitals for alternative use

X. Consolidation of redundant public healthcare facilities by merging them or closing down some of them

XI. Privatization of Primary Healthcare (PHC) clinics within medical centers

XII. Healthcare institutions will be granted autonomy regarding matters of human resources (personnel hiring and firing); administering financial incentives or penalties, budgeting; and contracting.

XIII. Privatization pharmacies inside medical centers and hospitals.

(II2) Primary, Ambulatory, and Secondary Care and General Practitioners (GP)

(II21) Limit the number of patients per GP