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Old 10-23-2009, 06:02 AM   #1
Darryl Shaw
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Weight loss - a calorie really is a calorie.

This study might be of interest to those who believe that altering the macronutrient ratio of your diet has some effect on weight loss independent of calories.

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Comparison of Weight-Loss Diets with Different Compositions of Fat, Protein, and Carbohydrates

ABSTRACT


Background: The possible advantage for weight loss of a diet that emphasizes protein, fat, or carbohydrates has not been established, and there are few studies that extend beyond 1 year.

Methods: We randomly assigned 811 overweight adults to one of four diets; the targeted percentages of energy derived from fat, protein, and carbohydrates in the four diets were 20, 15, and 65%; 20, 25, and 55%; 40, 15, and 45%; and 40, 25, and 35%. The diets consisted of similar foods and met guidelines for cardiovascular health. The participants were offered group and individual instructional sessions for 2 years. The primary outcome was the change in body weight after 2 years in two-by-two factorial comparisons of low fat versus high fat and average protein versus high protein and in the comparison of highest and lowest carbohydrate content.

Results: At 6 months, participants assigned to each diet had lost an average of 6 kg, which represented 7% of their initial weight; they began to regain weight after 12 months. By 2 years, weight loss remained similar in those who were assigned to a diet with 15% protein and those assigned to a diet with 25% protein (3.0 and 3.6 kg, respectively); in those assigned to a diet with 20% fat and those assigned to a diet with 40% fat (3.3 kg for both groups); and in those assigned to a diet with 65% carbohydrates and those assigned to a diet with 35% carbohydrates (2.9 and 3.4 kg, respectively) (P>0.20 for all comparisons). Among the 80% of participants who completed the trial, the average weight loss was 4 kg; 14 to 15% of the participants had a reduction of at least 10% of their initial body weight. Satiety, hunger, satisfaction with the diet, and attendance at group sessions were similar for all diets; attendance was strongly associated with weight loss (0.2 kg per session attended). The diets improved lipid-related risk factors and fasting insulin levels.

Conclusions: Reduced-calorie diets result in clinically meaningful weight loss regardless of which macronutrients they emphasize.
http://content.nejm.org/cgi/content/full/360/9/859 (wfs)
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Old 10-23-2009, 06:13 AM   #2
Laura Kurth
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Re: Weight loss - a calorie really is a calorie.

But they just trusted the participants to follow the diet right? Hmmm. doens't really mean much.

also they should have had one control group on a ketogenic diet, the lowest carb was 35 %, not really 'low carb'

I mean, I already know that calories are what matters, but I don't think this study would convince anybody who doesn't.
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Old 10-23-2009, 06:27 AM   #3
Kevin Thomas
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Re: Weight loss - a calorie really is a calorie.

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Originally Posted by Laura Kurth View Post
But they just trusted the participants to follow the diet right? Hmmm. doens't really mean much.
Sounds like they covered that with the observation that "attendance was strongly associated with weight loss (0.2 kg per session attended)" Meaning, if you pick a reduced calorie diet and follow it, you will likely have pretty good results.
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Old 10-23-2009, 06:31 AM   #4
Eric Montgomery
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Re: Weight loss - a calorie really is a calorie.

Any details about types of foods to make up those proportions? If the protein is all from tofu and the carbs and fat are all from ice cream, that would create less than successful results at any of those ratios.

And yes, 35% carbs is hardly "low-carb."
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Old 10-23-2009, 06:53 AM   #5
Darryl Shaw
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Re: Weight loss - a calorie really is a calorie.

Quote:
Originally Posted by Laura Kurth View Post
But they just trusted the participants to follow the diet right? Hmmm. doesn't really mean much.

also they should have had one control group on a ketogenic diet, the lowest carb was 35 %, not really 'low carb'

I mean, I already know that calories are what matters, but I don't think this study would convince anybody who doesn't.
The participants were counseled quite thoroughly on their respective diets but short of locking them all in a metabolic ward for two years you're going to have some cheating and the low carb diet was based on the Atkins Diet and allowed only 20g/d for the first two months and 120g/d thereafter so in effect it would have been a ketogenic diet.
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Old 10-23-2009, 06:56 AM   #6
Darryl Shaw
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Re: Weight loss - a calorie really is a calorie.

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Originally Posted by Eric Montgomery View Post
Any details about types of foods to make up those proportions? If the protein is all from tofu and the carbs and fat are all from ice cream, that would create less than successful results at any of those ratios.

And yes, 35% carbs is hardly "low-carb."
The specifics of each diet are included in supplementary appendix 1 and 2.
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Old 10-23-2009, 06:57 AM   #7
Steven Novick
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Re: Weight loss - a calorie really is a calorie.

Read "Good Calories, Bad Calories" by Gary Taubes, which summarizes decades worth of research on diet, weight loss and health. You will see that all calories are not equal. Why is it not obvious that the body would handle protein, fat and carbohydrate differently? The book also points out flaws in some of the "energy balance" diet studies, some of which are along the lines of those already pointed out in this thread.
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Old 10-23-2009, 07:09 AM   #8
Benjamin Wheeler
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Re: Weight loss - a calorie really is a calorie.

Low-carb diet kicks ***!

http://www.proteinpower.com/drmike/k...he-mainstream/ (WFS)
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Old 10-23-2009, 07:09 AM   #9
Laura Kurth
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Re: Weight loss - a calorie really is a calorie.

Quote:
Originally Posted by Darryl Shaw View Post
The participants were counseled quite thoroughly on their respective diets but short of locking them all in a metabolic ward for two years you're going to have some cheating and the low carb diet was based on the Atkins Diet and allowed only 20g/d for the first two months and 120g/d thereafter so in effect it would have been a ketogenic diet.
Yes, true.

I was just pointing out that trying to convince people here of this is futile. I mean, even if they WERE locked in a metabolic ward for two years and every calorie was accounted for.... people would still say "Read Good Calories Bad Calories"
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Old 10-23-2009, 07:16 AM   #10
Jamie J. Skibicki
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Re: Weight loss - a calorie really is a calorie.

the type of calories in affect how calories out. It's not a linear system.
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