Low-carb better than low-fat in several ways

[MeSci]

from Physician's First Watch today, NB relating to obese people:

Low-Carb Diet Linked to Greater Weight Loss Than Low-Fat Diet
By Kelly Young
Edited by
- David G. Fairchild, MD, MPH, and
- Jaye Elizabeth Hefner, MD

A low-carbohydrate diet is associated with greater weight reduction than a low-fat diet among obese adults, according to an Annals of Internal Medicine study.

Roughly 150 obese adults who were otherwise healthy were randomized to eat either a low-fat (<30% fat) or low-carbohydrate (<40 g/day of digestible carbohydrates) diet. Participants were provided diet-specific handbooks with recipes and meal-planning tips in addition to a daily meal-replacement shake or bar.

At 12 months, the low-carb group had lost 3.5 kilograms more than the low-fat group, even though caloric intakes were similar. The low-carb group also saw greater improvements in body composition, CRP levels, HDL cholesterol, and triglycerides.

NEJM Journal Watch Cardiology editor-in-chief Harlan Krumholz comments: "This study, a welcome trial in an area where we need them, supports the new conventional wisdom that low carb is better than low fat for losing weight -- what we do not yet know is which diet is better for lowering risk. That information will require larger trials with much longer follow-up -- but we desperately need that information."

Link(s):
Annals of Internal Medicine article (Free abstract) http://click.jwatch.org/cts/click?q=227;68054938;pNsWhQOpkLcYBAMpIp6E+soatJFWKYYw0JyKNQzQkLo=
Background: NEJM Journal Watch Cardiology summary on long-term consequences of low-carb diet (Free) http://click.jwatch.org

/cts/click?q=227%3B68054938%3BpNsWhQOpkLcYBAMpIp6E%2BmxMNmKi6zH20JyKNQzQkLo%3D

 

[alex3619]

Its been known since about the 1930s that high carb, high fat and high protein diets have different effects. Which is the most effective for weight loss? Given equal calories, high fat always wins. We optimize fat burning by eating fat, a trick that arctic and antarctic explorers know well. The real question that is unanswered, though we are beginning to get answers, is which is safer and healthier over the longer term. High fat has been demonized since about the 1950s. Maybe that's the right attitude ... or maybe it isn't. That's the point of science, to figure these things out.

I suspect though that the very question is wrong. Its more about which diets are better in which circumstance. I will bet peanuts to M&Ms (joking) that the optimal diet for someone in tropical Africa would not resemble the optimal diet for someone in Siberia, and that is before looking at genetic confounds.

 

[Wayne]

That's the point of science, to figure these things out.

Alex, that "should" be the point of science. l've noticed all too often science is cited in clever/devious ways to manipulate facts and maximize profits. I've heard that when scientific evidence first started coming out in the 1950's about the dangers of trans fats, margarine companies immediately saw the danger to their profits, and began a concerted effort to demonize saturated fats to divert attention. Don't know if it's true or not, but it seems to have at least a certain amount of credence.

I read up recently on the best ways to optimize teeth and bone health. Turns out it's a diet high in saturated fats like fish oils, and other fats, including coconut, olive, butter, etc. (NO trans fats). I recently read the book "Grain Brain", which focuses on brain health. Interestingly, he thinks the greatest danger to the brain is a low-fat, higher carbohydrate diet. His diet recommendations for brain health were nearly identical to those I read months ago as the optimal diet for teeth and bone health. Both authors also dispute the whole low-cholesterol diet, which they consider to be dangerous. Results consistently show that those with dementia and other degenerative brain diseases have LOW cholesterol levels.

Best, Wayne

 

[alex3619]

Recent studies are in the process of possibly debunking the idea that saturated fats are bad. Trans fats probably still are considered bad, and for good reason. I know someone who used to work in a margarine factory. The managers never ate it.

I consider that only in extreme cases is lowering cholesterol important. Triglycerides seem to be a worse factor, as is the often overlooked homocysteine. Cholesterol lowering drugs often lower essential fat soluble nutrients.

Science is topsy turvy if its going right. When its dominated by special interests groups from a financial, ideological or poltiical agenda, then its called Zombie Science. Dead science can keep walking through the voodoo powers of vested interests.

 

[MeSci]

Science is topsy turvy if its going right. When its dominated by special interests groups from a financial, ideological or poltiical agenda, then its called Zombie Science. Dead science can keep walking through the voodoo powers of vested interests.

I think you will like this new thread about flawed science, although 'like' is perhaps inappropriate in the context.

 

[jimells]

I saw this story on some TV news program. It was immediately followed by an ad for some no-fat over-processed yogurt. It will take years and years, maybe decades, for this new science to be widely accepted and acted upon.

I'm amazed that doctors continue to promote the no-fat, high-exercise cure for obesity even though it almost never works. I guess they've been well trained not to think for themselves.

 

[alex3619]

I saw this story on some TV news program. It was immediately followed by an ad for some no-fat over-processed yogurt. It will take years and years, maybe decades, for this new science to be widely accepted and acted upon.

I'm amazed that doctors continue to promote the no-fat, high-exercise cure for obesity even though it almost never works. I guess they've been well trained not to think for themselves.

The thing is there is good data that if eating a high carb diet you want to go low fat. Yet is choosing high carb the right choice? Exercise helps too, but not everyone can cope - and not everyone responds the same way, even ignoring ME. So within a narrow range of options I think low fat still makes sense ... its the options themselves that should have been questioned.

Evidence has been growing for a long time that high carb diets are dangerous. The science is still incomplete though, and so there is room for lots of controversy.

 

[MeSci]

Of course there continue to be studies that say that low-fat diets help:

Popular Diets Similar in Terms of Weight Loss, Meta-Analysis Finds
By Amy Orciari Herman
Edited by
- David G. Fairchild, MD, MPH, and
- Lorenzo Di Francesco, MD, FACP, FHM

Popular branded low-carbohydrate and low-fat diets lead to significant weight loss, with little difference between the two approaches, according to a network meta-analysis in JAMA.

Researchers examined data from 48 randomized trials that studied various popular diets among roughly 7300 overweight or obese adults. They found that all diets were superior to no intervention. In particular, low-carb programs (e.g., Atkins) and low-fat approaches (e.g., Ornish) yielded the greatest weight loss at 6 months (roughly 8 kg versus no diet), with minimal differences among the individual diets. Weight loss at 6 months was somewhat lower with moderate macronutrient diets (e.g., Weight Watchers), at just under 7 kg.

The authors say their analysis "supports the practice of recommending any diet that a patient will adhere to in order to lose weight."

Link(s):
JAMA article (Free abstract) http://click.jwatch.org/cts/click?q=227;68055272;vLO/MHt5lsrlJ8NAs+twfAGoRSi8GBuNOznX1EEBFsU=
JAMA editorial (Subscription required) http://click.jwatch.org/cts/click?q=227;68055272;vLO/MHt5lsrlJ8NAs+twfBgIHFg8iLvGOznX1EEBFsU=
Background: Physician's First Watch coverage of Annals of Internal Medicine study earlier this week showing superiority of a low-carb diet (Free) http://click.jwatch.org/cts/click?q=227;68055272;vLO/MHt5lsrlJ8NAs+twfFVii9rohWzDOznX1EEBFsU=

but I would be interested in longer-term follow-up on both weight loss and whether people stick to the diets or revert to old habits.

Personally I tried lots of diets in the 1970s and before. Drastic calorie reduction plus a lot of activity reduced my weight in my mid-teens but of course I couldn't stick to it. Otherwise I tried meal replacement (all high-carb), low-calorie versions of things like bread (I recall eating a whole loaf of low-calorie bread slathered with butter, cheese, etc! I was SO hungry), and other things. Even used to subscribe to a slimming magazine and read it avidly.

Lowish-carb is the only thing that has worked easily and sustainably for me. The appetite stabilisation is a crucial element.

 

[alex3619]

With locusts they eat until they have enough critical nutrients. So low nutrient food makes them eat more. I keep wondering if that is the case with people. We are not locusts, but our bodies are not stupid. It might be the case that the real key is nutrient dense food, and by that I mean micronutrients and essential amino acids, not calories. People also tend to forget there are essential fats as well ... and essential carbs. These often get missed in debate.

I too lost weight on high carb, but I was eating a lot of vegetables, and was even vegetarian for years.

Its important to realize that high carb nutrient dense food is not the same as high carb processed till the nutrients are gone food. Not all carbs, proteins and fats are equal.

 

[MeSci]

With locusts they eat until they have enough critical nutrients. So low nutrient food makes them eat more. I keep wondering if that is the case with people. We are not locusts, but our bodies are not stupid. It might be the case that the real key is nutrient dense food, and by that I mean micronutrients and essential amino acids, not calories. People also tend to forget there are essential fats as well ... and essential carbs. These often get missed in debate.

I too lost weight on high carb, but I was eating a lot of vegetables, and was even vegetarian for years.

Its important to realize that high carb nutrient dense food is not the same as high carb processed till the nutrients are gone food. Not all carbs, proteins and fats are equal.

It's of course especially important for people with reduced mobility to avoid 'empty calories' as they/we can't burn them off and they just get turned into body fat.

At least (good) fats serve a range of essential physiological purposes, unlike simple carbs.

 

[alex3619]

It's of course especially important for people with reduced mobility to avoid 'empty calories' as they/we can't burn them off and they just get turned into body fat.

At least (good) fats serve a range of essential physiological purposes, unlike simple carbs.

Pentose sugars are essential. We really need them in the diet. However most carbs are laden with hexose sugars, and these are easily made and interconverted by the body.

 

[MeSci]

Pentose sugars are essential. We really need them in the diet. However most carbs are laden with hexose sugars, and these are easily made and interconverted by the body.

I wasn't familiar with pentoses so did some searching. This paper suggests that I get plenty in my vegan diet.

 

[alex3619]

Yes, can be lots in vegetarian diet, but can be lacking on other specialized diets. We don't need a lot, but high starch foods are high hexose foods.