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Old 09-06-2014, 05:17 AM   #1
David Meverden
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More evidence for low carb for weight loss

This one's been getting a lot of press but I didn't see a thread on it. More evidence that low carb produces superior weight loss results in both ease of weight loss (how hard it is to lose weight without counting calories) and quality of weight lost (losing fat while minimizing lean tissue loss).

The study was published in the Annals of Internal Medicine and was funded by the National Institutes of Health.

SETUP: 148 participants for 1 year; either carbohydrates or fats were restricted, but not overall calories. Low carb group was told to focus on unsaturated fats.

THE LOW CARBOHYDRATE GROUP:
-lost 3x more weight (12 lbs to 4 lbs)
-lost 6x more fat (−2.6% to −0.4%). The low fat group lost some muscle mass, the low carb actually had some improvement in muscle mass. Both sides were told not to change physical activity levels.
-had much greater triglyceride drop and larger HDL increase. Blood pressure, total cholesterol, and LDL stayed about the same for both groups.

LINK TO STUDY:
http://annals.org/article.aspx?articleid=1900694

LINK TO A COUPLE OF WRITEUPS:
http://www.nytimes.com/2014/09/02/he...diet.html?_r=0
http://www.foxnews.com/health/2014/0...-heart-health/
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Old 09-06-2014, 06:36 AM   #2
Luke Sirakos
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Re: More evidence for low carb for weight loss

It was an interesting study but unfortunately it is very misleading and has very little value in promoting low carb diets as superior to any other form of diet.

Here is one of the better analysis I have read on the study, while I think there are things to be learned from it, the sensational headlines are not that. The best diet is one you can stick to.

http://examine.com/blog/is-low-carb-...ght-loss-diet/ (wfs)
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Old 09-06-2014, 07:54 AM   #3
David Meverden
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Re: More evidence for low carb for weight loss

I'll agree with the headlines being a little sensational, but I disagree with your hasty dismissal of the study.

Except for criticizing the use of electrical impedance, the analysis you linked agrees that the low carb intervention worked better. Their only real point is that the study doesn't prove WHY focusing on reducing carbohydrates worked better than focusing on reducing fat. That's true, but that doesn't make the result less significant.

The lack of certainty for cause and effect comes largely from the fact that the study didn't happen in a sequestered laboratory. People largely cooked their own food, decided on their own portions, and adapted the diets they were taught about somewhat to be more feasible in real life. That's a big CON if you are trying to isolate with great certainty one variable, but it's a huge PRO if you want to know "what can I tell people to do that will help them in the real world". It's regarding the latter point that this study is useful.
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Old 09-06-2014, 08:32 AM   #4
Luke Sirakos
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Re: More evidence for low carb for weight loss

I think if your only options are:

1) Tell people to decrease their fat intake
2) Tell people to decrease their carb intake

Then the second option will definitely result in more weight loss but I don't think it is due to either decreasing fat intake or decreasing carb intake. It is much more likely to be the protein levels. If you take exactly what you eat now and your only goal is to reduce fat intake you are likely to replace those calories with carbs and maybe some protein, if your goal is to reduce carbs then you will likely replace those calories with more protein than the before mentioned scenario. Being that protein is the most thermogenic of the macronutrients and it is more satiating it would stand to reason that a diet with higher protein levels would be more suited for fat loss. That is because you wouldn't be as hungry thus reducing cravings and it would also increase your TDEE.

Also, intake controlled studies with equal protein levels have shown that there is not a metabolic advantage to low carb or low fat, it is the lower calories that causes the weight loss. Instead of the two options above it would be more prudent to suggest hitting a protein target and then focusing on a carb/fat intake that would put you in a caloric deficit. I have no idea why this idea does not get more run in the media, I am assuming it is due to the fact that it isn't sexy and won't sell books but it is the method that has stood rigorous scientific testing.

It is worth noting that by the end of the study the low carb group was not eating low carb anymore, likely because it is difficult to adhere to a low carb diet in the real world over the long term. Also, I think the statement below from the link I previously posted sums it up well:

Quote:
Considering the similarity in waist circumference reduction and both groups eating similar amounts of calories by the end, coupled with the increase in protein by the low carb group and water weight lost when reducing carbohydrates, it would be disingenuous to state that “low carb is superior to low fat for long term weight loss”.
Flexible dieting > Excluding foods for completely arbitrary reasons
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Old 09-06-2014, 10:12 AM   #5
Michael Lennox
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Re: More evidence for low carb for weight loss

Yeah, I think low carb is the way to go, but not necessarily high fat
Adjust the carbohydrates to a comfortable level around activity and then decrease from there. I hate that Low fat foods labeled foods mislead people to buying them thinking they are healthy but they really just replace the fat with sugar and then call it "light and fit ”...
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Old 09-06-2014, 11:57 AM   #6
Darryl Shaw
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Re: More evidence for low carb for weight loss

Quote:
Originally Posted by David Meverden View Post
This one's been getting a lot of press but I didn't see a thread on it. More evidence that low carb produces superior weight loss results in both ease of weight loss (how hard it is to lose weight without counting calories) and quality of weight lost (losing fat while minimizing lean tissue loss).

The study was published in the Annals of Internal Medicine and was funded by the National Institutes of Health.

SETUP: 148 participants for 1 year; either carbohydrates or fats were restricted, but not overall calories. Low carb group was told to focus on unsaturated fats.

THE LOW CARBOHYDRATE GROUP:
-lost 3x more weight (12 lbs to 4 lbs)
-lost 6x more fat (−2.6% to −0.4%). The low fat group lost some muscle mass, the low carb actually had some improvement in muscle mass. Both sides were told not to change physical activity levels.
-had much greater triglyceride drop and larger HDL increase. Blood pressure, total cholesterol, and LDL stayed about the same for both groups.

LINK TO STUDY:
http://annals.org/article.aspx?articleid=1900694

LINK TO A COUPLE OF WRITEUPS:
http://www.nytimes.com/2014/09/02/he...diet.html?_r=0
http://www.foxnews.com/health/2014/0...-heart-health/
Did you read the Full Text? (wfs)

From it's misleading title, to the study design, the lousy dietary interventions*, poor compliance, and predictable, possibly rigged, outcome, it's just bad science. All we really learn from it is calories count, because the group that ate the least lost the most weight and saw the greatest improvement in overall health.

* See table 2. Why no increase in fibre intake in the "low-fat" group? Could it be that the meal plan they were provided with included a lot of energy dense refined/processed carbohydrates, instead of the whole grains, legumes, fruit and veggies recommended by Dr's McDougall, Esselstyn, Ornish, Barnard et al?

Edited to add this article by Dr David Katz -

http://www.huffingtonpost.com/david-...healthy-living (wfs)

Last edited by Darryl Shaw : 09-06-2014 at 12:22 PM. Reason: Added link.
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Old 09-07-2014, 11:05 AM   #7
David Meverden
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Re: More evidence for low carb for weight loss

Yes, the group that ate less lost more weight, as in past studies, but this was NOT a calorie controlled study. People choose how much to eat. The significance here is "which advice was better at getting people to eat less?"

When they were counseled to reduce fats they didn't lose much weight and when counseled to reduce carbohydrates they lost weight more easily.

The study wasn't small, wasn't short, it looked at people in the real world, and your criticism of the dietary intervention is largely speculation. The HuffPo article paints it as extreme low carb vs just ordinary diet, but that's a fairly weak claim. The low fat group wasn't super low-fat, like you'd find in the Ornish diet, but it's recommendation for the low fat group were right out of the American Heart Association guidelines and people were right on target. The low carb group was counseled to eat <40 g/day, which is extreme, but what they actually ate was 90-120 grams/day. It wasn't a year of extreme ketogenic eating. And why not more fiber? Because people didn't choose to eat more: 25 g/day was recommended for both groups; both groups only bothered to eat about 16.

I do agree with a lot of the sentiment of the HuffPo article--that the question of one broad macronutrient vs another broad macronutrient is an oversimplification that often distracts us--but I don't want that to get supplanted by other oversimplifications, such as the idea that it doesn't matter what you eat as long as your calorie count is right. Different foods absolutely have different effects on the body and one's diet should supports one's goals properly.
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Old 09-08-2014, 11:49 AM   #8
Darryl Shaw
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Re: More evidence for low carb for weight loss

Quote:
Originally Posted by David Meverden View Post
Yes, the group that ate less lost more weight, as in past studies, but this was NOT a calorie controlled study. People choose how much to eat. The significance here is "which advice was better at getting people to eat less?"

When they were counseled to reduce fats they didn't lose much weight and when counseled to reduce carbohydrates they lost weight more easily.

The study wasn't small, wasn't short, it looked at people in the real world, and your criticism of the dietary intervention is largely speculation. The HuffPo article paints it as extreme low carb vs just ordinary diet, but that's a fairly weak claim. The low fat group wasn't super low-fat, like you'd find in the Ornish diet, but it's recommendation for the low fat group were right out of the American Heart Association guidelines and people were right on target. The low carb group was counseled to eat <40 g/day, which is extreme, but what they actually ate was 90-120 grams/day. It wasn't a year of extreme ketogenic eating. And why not more fiber? Because people didn't choose to eat more: 25 g/day was recommended for both groups; both groups only bothered to eat about 16.

I do agree with a lot of the sentiment of the HuffPo article--that the question of one broad macronutrient vs another broad macronutrient is an oversimplification that often distracts us--but I don't want that to get supplanted by other oversimplifications, such as the idea that it doesn't matter what you eat as long as your calorie count is right. Different foods absolutely have different effects on the body and one's diet should supports one's goals properly.
This study did not compare a low-carb diet with a low-fat diet. It compared a slightly modified version of the Standard American Diet (SAD) with a more restrictive diet. Predictably the more restrictive diet came out on top, proving that calories count (which we already knew). And since the authors chose not to include specific details of either diet it can not be argued that the source of those calories had a significant effect on the results.

The whole thing was just bad science from start to finish and a complete waste of everybody's time.
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