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Global Translational Medicine Mass balance

equipment). The assumption is that such results would the same distance within the same amount of time (e.g.,
violate the Law of Conservation of Energy. As has been 0.5 h) but with a lower heart rate. His body has adapted
discussed before, this is not the case (see 2. The energy to this cardiovascular stress physiologically, biochemically,
balance theory is a flawed paradigm). In studies where low- and even anatomically in the long run, thus becoming a
carbohydrate diets have not been more effective in terms of more efficient fuel utilizer; his body is able to achieve the
fat loss, EBT-based calculation formulas have been used, same running average speed (5 km/0.5 h = 10 km/h), while
which yielded incorrect results (e.g., Hall et al. and a utilizing less fuel. However, every time his body oxidizes
[11]
reanalysis in Manninen ). Therefore, it is important to 1 g of glucose while running, the heat released by his body
[12]
consider these points when reading such reports. continues to be ∼4 kcals, which will not change as he ages
The real “acid test” of every theory is how good results or as a function of his genome, epigenome, or proteome.
can be obtained in practice based on the theory. How 22. The Coca-Cola Company and their
effective have EBT-based obesity treatment interventions insidious marketing arms
been? As of 2021, 19 US states and territories have at least
35% of their residents living with obesity, which is more The Global Energy Balance Network (GEBN) was a
than double the number in 2018 . Therefore, it is clearly US-based marketing arm of The Coca-Cola Company
[40]
impossible to even talk about effective interventions. (hereinafter referred to as Coke), claiming to fund research
Anyone would think that this upsurge would finally raise on the causes of obesity . GEBN’s core message was that
[43]
concerns. However, in my opinion, wasting time and the primary cause of obesity is physical inactivity, not a
money on research conducted within the EBT paradigm poor diet [44-46] . In plain language, their message was that
should be stopped immediately. people can continue to enjoy high-carbohydrate junk food,
including Coke’s drinks, as long as they exercise enough to
20. Other applications of the mass balance remain in “energy balance.”
approach
With around 1.4 billion inhabitants, China is the
Although this review focuses on the macronutrient world’s most populous country, so Coke has naturally
distribution of diet, the mass balance approach has many taken interest in China’s market. In Greenhalgh’s article,
other practical applications. For example, anti-obesity she covered this topic [46] , and her findings were as
drugs or dietary supplements that affect satiety should follows:
reduce the consumption of carbohydrates instead of fats. (i) Coke’s main vehicle for influencing obesity science
Other applications will be covered in the updates to this in China was the International Life Sciences Institute
article.
(ILSI), a Coke-sponsored marketing organization that
21. The mass balance approach has nothing masqueraded as a scientific organization and whose
to do with the metabolic advantage founding president Alex Malaspina was concurrently
the vice president of Coke; a few years ago, the ILSI
hypothesis and Coke were practically synonymous;
Contrary to what some have thought, the mass balance (ii) ILSI’s website emphatically spotlights their long
approach has nothing to do with the metabolic advantage commitment to scientific integrity, but as pointed
hypothesis . Proponents of this hypothesis postulate that by Greenhalgh, “[a] close examination of how the
[41]
low-carbohydrate diets lead to faster body mass and fat organization [ILSI] works in practice reveals a
mass loss than isocaloric high-carbohydrate diets because different picture” ;
[46]
“energetic inefficiency, substrate cycling, and demands of (iii) Coke, working through ILSI-Global and ILSI-China,
gluconeogenesis support observed advantages for weight succeeded in redirecting China’s obesity science and
[and fat] loss” . Unlike energy, mass has no efficiency. policy to emphasize physical activity over dietary
[42]
The amount of mass that is taken in always comes out modifications.
in exactly the same amount. It is worth noting that the In addition to GEBN and ILSI, Coke leveraged the
metabolic advantage hypothesis operates within the EBT. authority of countless health organizations to spread
With all due respect, it would seem that the proponents this message. In Spain, for example, at least 74 health
of the metabolic advantage hypothesis have not taken organizations were sponsored by Coke from 2010 to 2016,
notice that efficiency is not related to incomplete substrate with a total investment above 6 million euros . The main
[47]
oxidation but to how the body uses the available fuel message was the same as with GEBN: “The most prevalent
resources. Consider the following example: a man starts to strategy was to focus on physical activity and sedentary
run 5 km every day and soon discovers that he can complete behaviors as key obesogenic risk factors” . Rey-López
[47]

Volume 2 Issue 1 (2023) 12 https://doi.org/10.36922/gtm.222