The low-fat/low-carb wars continue this week with a new publication in the Annals of Internal Medicine (1). Headlines are inflaming the conversation, much like the headline from MedPage Today stating: "Breaking News: Low Carb Beats Low Fat for Weight Loss, CV Risk"
Let's take a look at the study and see what it says:
Let's take a look at the study and see what it says:
I've detailed the study at the bottom half of this post. For a quick summary, the study was a free-living 12month long trial (in no way whatsoever a metabolic ward trial), that included 148 mostly female individuals, with about half being black, who were randomly assigned to follow one of 2 diets: a low fat ( less than 30% of kcals from fat, 7% from saturated fat, 55% carb - followed NCEP guidelines) and a low carb (less than 40 total net carbs per day). Neither diet was instructed to reduced calories, and they were also told to maintain physical activity levels. Both diets were told to consume 25g/day of fiber, and they received a lot of education, starting off with individualized appointments at first, dwindling down to sessions every week and finally every month. They also both received one meal replacement a day, a low-fat and low-carb version for the respective group. They had a number of biochemical panels (lipids, blood glu/press,ketones), anthropometrics and body composition measurements taken, and 8 days of dietary recalls, spread across baseline, 3,6, and 12mo visits.
So for starters, a lot was going on here. They weren't really isolating one thing - effects could be due to how the assigned diets were followed, the meal replacement bars, or the education (the dietitians weren't blind to the study design).
Let's look at what was found:
1. Low Carb (LC) lost more weight on average than the Low Fat (LF) group (5.3kg vs 1.8kg). This means after 12months of dieting, they lost less than 12 and 4lbs.
2. LC had more fat loss and an increase in lean body mass, as measured by bioelectrical impedance
3. Both groups report reducing calories significantly, with the LC group consistently reporting low kcal intake across the baseline, 3mo, 6mo, and 12mo points.
4. Both groups saw significant reductions in waist circumference (note: neither group reached recommended ranges or dropped out of the risk range)
5.Both groups saw reductions in LDL and TGs (LC dropped to below 100mg/dL, LF fell to 117 - both of these measures are in 'normal' ranges, and don't approach the lower end of borderline high of 150 listed by NCEP - see here) and increases in HDL (greater for LC - both still above 45mg/dL). LC also saw a better non-HDL cholesterol
6. LF saw greater decreases in plasma glucose (leaving LF under 5mmol/L and LC at 5mmol/L) and serum insulin (showed an interesting trend, with LC across the 12 months going from a reduction of 25pmol/L to 13.9, and LF going from 18.8 to 24.3) - difference not statistically significant
7. LF saw an increase in CRP, LC saw a decrease (these changes did not put either group near levels of risk)
8. 10-y Framingham risk scores of the LF group increased by .4% and reduced by 1% for LC.
There are a few pertinent things to discuss here:
Quality of Reported data: As per usual, the quality of the dietary recalls is rather poor. At the 12 month point, the low-carbohydrate individuals report consuming 550kcals less/day than at baseline. At the 3month point and the 6month point, they report 600-700 calories fewer than baseline. For some quick math, there are 3500 kcals/pound of body fat. The science of weight loss doesn't quite happen as exactly as reported here, as lean mass/protein and glycogen are also utilized for fuel as well as body fat, adipose tissue is also some water and protein, and adaptations to lower BMR and reduced body weight reduce calorie needs. Kevin Hall has developed an equation to predict weight loss that incorporates these into the model (2). However, the simulator that's available doesn't allow us to model what their weight loss should have been. The 3500 kcal rule of thumb works decently for individuals with an initial body fat above 30kg so I'm gonna be super unscientific here and just use that (3).
Considering the LC's 550kcal/d reduction (being modest here since they report even greater kcal reductions at the 3 and 6mo points), they 'should' have lost about 57lbs. The individuals actually lost about 12lbs. Even in the most conservative estimates of how much weight they 'should' have lost given this number, none would match the 12lbs of actual weight loss observed. The same follows for the low-fat group. There is no way that this recall data is accurate.
Body Composition Measurements: The use of BIA can give rather unreliable results (a really great review of its limitations from Weightology can be read here), with ethnicity being a factor contributing to variability (this sample was mostly African American) (4). Unfortunately, the paper gives us little information about how the BIA was done, which leaves us wondering very important questions like: were they overnight fasted? what was their hydration status? I normally don't entirely toss out BIA if its done in a supine position after an overnight fast. My personal opinion is that if you're going to use BIA, you should also be using skin-fold measurements, to at least have some other measurement to compare to. The fact that we're seeing similar changes in waist circumference, a pretty strong predictor of CVD risk (5), between both groups, makes me question the relevance of the BIA data. It's also unfortunate because some weight loss associated with low-carbohydrate diets is water weight due to reductions in glycogen - i'm not sure how applicable that is here since the individuals consumed a lot more carbs than a typical low-carb diet, and our knowledge of their carbohydrate intake is limited by self-reported data - one can only speculate..
Protein - I've seen several people note that the low-carb group increased their protein intake. This is, however, not true. They saw an increase in their percentage of calories coming from protein, increasing from about 17% to 24% by the 12month point, but this was while reducing their total kcal intake. The LC's raw intake (not listed in the study) initially was 86.4g of protein at baseline, and by the 12mo point report eating 85.4g (this would've been slightly higher at the 3 and 6mo points). The LC group actually kept their protein intake about the same. What happened actually, was that the LF group, which kept their percentage of kcals from protein pretty constant through out, significantly reduced their intake of protein from baseline - something that could've affected the diet's overall satiety and retention of lean muscle mass during weight loss. If you ask me, the study's title could also read "Effects of reducing protein intake during weight loss".
Fiber - All of the groups did not reach their fiber goal of 25g. By the end they both consumed about 15g of fiber. This is pretty indicative of how well they were following the directions of the study. I think an important component to this number is the meal replacements that they received - the study lists it as being a bar or shake. I've never seen a bar or shake that is a meal replacement that doesn't often add at least 3g of fiber to it. I'm not against getting some fiber from these sorts of things, but I think it at least indicates to us how many fruits and vegetables they were likely consuming.. It also gives us a lot of insight (hint: they weren't) whether the LF group was eating predominantly whole grains, legumes, and tubers, much like the dietary guidelines suggest (and the original reasoning for a LF diet).
BetaCarotene and Vitamin C- I would guess they used these values to measure how many fruits/vegetables they were eating. The diets didn't affect their intake of Vitamin C very significantly (you see a dip in LC at the 3month point but it increases back to baseline levels at the 6 and 12mo points). Oddly, they list the median beta-carotene levels, and not the mean. They also give us the interquartile ranges, that show a huge variability in beta-carotene intake. I'm not sure what to make of this because we're not sure if the meal replacement shake was fortified (likely) or whether that was included into these measurements. Regardless, by the end, their vitamin C intake is listed as LF-82.5mg and LC-72.5mg. In one cup of oranges (85kcals) there are 95.8mg of vitamin C. Translation: neither group was eating a significant amount of fruits/vegetables per/day.
UPDATE**: Weight Loss Component - I was chatting on Twitter with Evelyn over at Carbsane, and she further pointed out the absurdity of this trial's design when considering the weight loss differences between groups. Individuals from both groups were not told to reduce calorie intake, but the treatment for the Low-Fat dieters was inherently based on their calorie intake, whereas the low-carb diet treatment was not. The low fat-treatment of a diet containing less than 30% fat could mean a huge difference in total grams of fat depending on how many total calories someone is eating. The low-carbohydrate component was based on a very specific total grams of carbs. The treatment of 40g for the low-carb group was significantly less than their baseline carb intake of about 240g. The low-carb group, essentially, was told to remove 800 calories (net reduction of 200g of carbs), and then see if they would replace that with low-carb food calories, whereas the low-fat group was told to reduce their fat intake from a baseline of about 35% of total kcals to just less than 30% - from their baseline 2000 calorie diet, this equates to a reduction of just over 100kcals to adhere to the treatment. With such a drastic change for the low-carb'ers, and a minimal change for the low-fat'ers, should we be surprised that the low-carb diets lost more weight?
Things I find weird about the study:
1. Why measure ketones and not give us ketone data? That would've been a much better marker of adherence for the low-carb group
2. It is some crazy random chance that the BIA data shows that both groups had on avg the same baseline body fat and lean mass percentages, with the same standard deviations.
3. They listed total grams of carbohydrates and fat, as well as percentage of calories coming from these macronutrients. What they did not do, however, was list the total protein grams, but did list % protein. Listing percent protein makes it seem like protein didn't significantly change, but percentage kcals not changing while kcals drops indicates a huge change. Why not put protein in grams? Because that would show that the intervention effect may be due to reduced protein intake?
4. Why no mention of the limitations of BIA? I think they should have at least said something along the lines of ''using DXA or a BodPod would've been better'', and note the limitations that BIA.
5. Why not give us the nutrition facts on the bar/shake supplements? If they were provided, we should know the nutrition facts. Not giving it to us leaves us to wonder what constitutes a meal replacement...
6. The authors defend their use of dietary recall, and nowhere in the limitations mention that it is physically impossible that the data reported is accurate.
Take Aways:
1. The study gives us an idea that if you're counseling an individual on diet, one that is low-carb may be an easier approach to enabling individuals to reduce their energy intake. It's much easier to say "look at one thing(carbs), and keep it less than 40". It's another thing to say "keep less than 30% of your kcals from fat, less than 7% from saturated fat". Not to mention that low-fat foods have come to mean refined flours and sugar, not legumes and whole grains. What I take from this study is that if you send individuals out into a food environment dominated by poor choices, many of which are characterized by a high calorie load, due to the presence of minimally nutritious carbs (refined flour/sugar), telling someone to eat low-carb will lead to slightly better results than telling someone to eat low-fat. Saying "eat low carb" wipes out a lot of the junk food that was created by guidelines that stated "eat low fat". Reductionism fails us, as per usual.
2. This research is underwhelming, for both LC and LF fans. For those that are pro-low-carb, why would you quote this? It wasn't even that low-carb, and they really didn't lose much weight. It faired only a bit better than the low-fat. All of the individuals in this group very likely had poor diet quality from the vitamin C/beta carotene and fiber levels reported.
3. Do the diet that works best for you, that you can adhere to best, and that sees the best changes in your biomarkers for disease. I can't tell you the number of times i've heard the anecdote-wars of "well I went on low-carb and saw my LDL soar" vs "well I went on low-carb and my triglycerides dropped" - they get us nowhere. Do what works for you.
What you can't say based on this study:
1. A calorie isn't a calorie - It's not a highly controlled metabolic ward study or an inpatient study, and individuals weren't even instructed to count calories, so you can't say a calorie isn't a calorie. We have plenty of highly controlled studies (6,7,8, 9) and they largely demonstrate that calories count (The more scholarly questions relates to how macronutrient metabolism affects body composition - much more research is needed here).
2. National Guidelines are Wrong - The participants, just based on reported fiber intakes, did nothing to follow the standard dietary guidelines, or the NCEP guidelines, so saying those are wrong is horribly misrepresenting this data.
3. Low-fat Individuals have worse cardiovascular health - There were no actual CVD endpoints that were looked at, just a series of biomarkers, so you really can't say that they'll have fewer CVD events. Looking at something like carotid-intima media thickness (CIMT) would be a much stronger biomarker. Based on their average waist circumferences, both groups have a long way to go.
4. These results translate to the greater population - You really can't make this statement because the individuals in this study received extensive counseling by RDs, in individual and/or group settings across a year's length of time. Even with this, the weight loss wasn't something that I'm super excited about. The everyday overweight individual who is not regularly meeting with a healthcare professional may not see the same results, have the same level of motivation, and access to knowledgable individuals who can guide them throughout this process. Adequate dietary counseling (whether it be low carb/fat, high protein, etc) cannot occur during the 15minutes that you're actually talking to your doctor. We, as a society, really need to do something about our access to dietitians and physicians with regards to weight loss.
5. Low-fat diets can't help you lose weight in the long-term. In fact, the National Weight Control Registry largely shows that those who lose weight (avg 33kg) and keep it off for more than 5 years are following a low-calorie, low-fat diet (10)
As a small request, for the love of Darwin can we please stop attacking each other over what macronutrient paradigm we follow and recommend. If your ego and pride are dependent upon macronutrient distributions, I can suggest some productive hobbies.
Study Details:
Participants: 148 participants without CVD/diabetes, BMI of 30-45 and aged 22-75. Their mean age was 46.8 years, and 88% were female, 51% were black.
Trial Length: 12 months
Design: 73 randomly assigned to low-fat, 75 randomly assigned to low-carb
What they say they ate:
So what did they find?
1. http://annals.org/article.aspx?articleid=1900694
6. http://www.ncbi.nlm.nih.gov/pubmed/1734671
7. http://www.ncbi.nlm.nih.gov/pubmed/14127686
8.http://www.ncbi.nlm.nih.gov/pubmed/1734671
9. http://ajcn.nutrition.org/content/63/2/174.abstract
10. http://ajcn.nutrition.org/content/82/1/222S.long
Quality of Reported data: As per usual, the quality of the dietary recalls is rather poor. At the 12 month point, the low-carbohydrate individuals report consuming 550kcals less/day than at baseline. At the 3month point and the 6month point, they report 600-700 calories fewer than baseline. For some quick math, there are 3500 kcals/pound of body fat. The science of weight loss doesn't quite happen as exactly as reported here, as lean mass/protein and glycogen are also utilized for fuel as well as body fat, adipose tissue is also some water and protein, and adaptations to lower BMR and reduced body weight reduce calorie needs. Kevin Hall has developed an equation to predict weight loss that incorporates these into the model (2). However, the simulator that's available doesn't allow us to model what their weight loss should have been. The 3500 kcal rule of thumb works decently for individuals with an initial body fat above 30kg so I'm gonna be super unscientific here and just use that (3).
Considering the LC's 550kcal/d reduction (being modest here since they report even greater kcal reductions at the 3 and 6mo points), they 'should' have lost about 57lbs. The individuals actually lost about 12lbs. Even in the most conservative estimates of how much weight they 'should' have lost given this number, none would match the 12lbs of actual weight loss observed. The same follows for the low-fat group. There is no way that this recall data is accurate.
Body Composition Measurements: The use of BIA can give rather unreliable results (a really great review of its limitations from Weightology can be read here), with ethnicity being a factor contributing to variability (this sample was mostly African American) (4). Unfortunately, the paper gives us little information about how the BIA was done, which leaves us wondering very important questions like: were they overnight fasted? what was their hydration status? I normally don't entirely toss out BIA if its done in a supine position after an overnight fast. My personal opinion is that if you're going to use BIA, you should also be using skin-fold measurements, to at least have some other measurement to compare to. The fact that we're seeing similar changes in waist circumference, a pretty strong predictor of CVD risk (5), between both groups, makes me question the relevance of the BIA data. It's also unfortunate because some weight loss associated with low-carbohydrate diets is water weight due to reductions in glycogen - i'm not sure how applicable that is here since the individuals consumed a lot more carbs than a typical low-carb diet, and our knowledge of their carbohydrate intake is limited by self-reported data - one can only speculate..
Protein - I've seen several people note that the low-carb group increased their protein intake. This is, however, not true. They saw an increase in their percentage of calories coming from protein, increasing from about 17% to 24% by the 12month point, but this was while reducing their total kcal intake. The LC's raw intake (not listed in the study) initially was 86.4g of protein at baseline, and by the 12mo point report eating 85.4g (this would've been slightly higher at the 3 and 6mo points). The LC group actually kept their protein intake about the same. What happened actually, was that the LF group, which kept their percentage of kcals from protein pretty constant through out, significantly reduced their intake of protein from baseline - something that could've affected the diet's overall satiety and retention of lean muscle mass during weight loss. If you ask me, the study's title could also read "Effects of reducing protein intake during weight loss".
Fiber - All of the groups did not reach their fiber goal of 25g. By the end they both consumed about 15g of fiber. This is pretty indicative of how well they were following the directions of the study. I think an important component to this number is the meal replacements that they received - the study lists it as being a bar or shake. I've never seen a bar or shake that is a meal replacement that doesn't often add at least 3g of fiber to it. I'm not against getting some fiber from these sorts of things, but I think it at least indicates to us how many fruits and vegetables they were likely consuming.. It also gives us a lot of insight (hint: they weren't) whether the LF group was eating predominantly whole grains, legumes, and tubers, much like the dietary guidelines suggest (and the original reasoning for a LF diet).
BetaCarotene and Vitamin C- I would guess they used these values to measure how many fruits/vegetables they were eating. The diets didn't affect their intake of Vitamin C very significantly (you see a dip in LC at the 3month point but it increases back to baseline levels at the 6 and 12mo points). Oddly, they list the median beta-carotene levels, and not the mean. They also give us the interquartile ranges, that show a huge variability in beta-carotene intake. I'm not sure what to make of this because we're not sure if the meal replacement shake was fortified (likely) or whether that was included into these measurements. Regardless, by the end, their vitamin C intake is listed as LF-82.5mg and LC-72.5mg. In one cup of oranges (85kcals) there are 95.8mg of vitamin C. Translation: neither group was eating a significant amount of fruits/vegetables per/day.
UPDATE**: Weight Loss Component - I was chatting on Twitter with Evelyn over at Carbsane, and she further pointed out the absurdity of this trial's design when considering the weight loss differences between groups. Individuals from both groups were not told to reduce calorie intake, but the treatment for the Low-Fat dieters was inherently based on their calorie intake, whereas the low-carb diet treatment was not. The low fat-treatment of a diet containing less than 30% fat could mean a huge difference in total grams of fat depending on how many total calories someone is eating. The low-carbohydrate component was based on a very specific total grams of carbs. The treatment of 40g for the low-carb group was significantly less than their baseline carb intake of about 240g. The low-carb group, essentially, was told to remove 800 calories (net reduction of 200g of carbs), and then see if they would replace that with low-carb food calories, whereas the low-fat group was told to reduce their fat intake from a baseline of about 35% of total kcals to just less than 30% - from their baseline 2000 calorie diet, this equates to a reduction of just over 100kcals to adhere to the treatment. With such a drastic change for the low-carb'ers, and a minimal change for the low-fat'ers, should we be surprised that the low-carb diets lost more weight?
Things I find weird about the study:
1. Why measure ketones and not give us ketone data? That would've been a much better marker of adherence for the low-carb group
2. It is some crazy random chance that the BIA data shows that both groups had on avg the same baseline body fat and lean mass percentages, with the same standard deviations.
3. They listed total grams of carbohydrates and fat, as well as percentage of calories coming from these macronutrients. What they did not do, however, was list the total protein grams, but did list % protein. Listing percent protein makes it seem like protein didn't significantly change, but percentage kcals not changing while kcals drops indicates a huge change. Why not put protein in grams? Because that would show that the intervention effect may be due to reduced protein intake?
4. Why no mention of the limitations of BIA? I think they should have at least said something along the lines of ''using DXA or a BodPod would've been better'', and note the limitations that BIA.
5. Why not give us the nutrition facts on the bar/shake supplements? If they were provided, we should know the nutrition facts. Not giving it to us leaves us to wonder what constitutes a meal replacement...
6. The authors defend their use of dietary recall, and nowhere in the limitations mention that it is physically impossible that the data reported is accurate.
Take Aways:
1. The study gives us an idea that if you're counseling an individual on diet, one that is low-carb may be an easier approach to enabling individuals to reduce their energy intake. It's much easier to say "look at one thing(carbs), and keep it less than 40". It's another thing to say "keep less than 30% of your kcals from fat, less than 7% from saturated fat". Not to mention that low-fat foods have come to mean refined flours and sugar, not legumes and whole grains. What I take from this study is that if you send individuals out into a food environment dominated by poor choices, many of which are characterized by a high calorie load, due to the presence of minimally nutritious carbs (refined flour/sugar), telling someone to eat low-carb will lead to slightly better results than telling someone to eat low-fat. Saying "eat low carb" wipes out a lot of the junk food that was created by guidelines that stated "eat low fat". Reductionism fails us, as per usual.
2. This research is underwhelming, for both LC and LF fans. For those that are pro-low-carb, why would you quote this? It wasn't even that low-carb, and they really didn't lose much weight. It faired only a bit better than the low-fat. All of the individuals in this group very likely had poor diet quality from the vitamin C/beta carotene and fiber levels reported.
3. Do the diet that works best for you, that you can adhere to best, and that sees the best changes in your biomarkers for disease. I can't tell you the number of times i've heard the anecdote-wars of "well I went on low-carb and saw my LDL soar" vs "well I went on low-carb and my triglycerides dropped" - they get us nowhere. Do what works for you.
What you can't say based on this study:
1. A calorie isn't a calorie - It's not a highly controlled metabolic ward study or an inpatient study, and individuals weren't even instructed to count calories, so you can't say a calorie isn't a calorie. We have plenty of highly controlled studies (6,7,8, 9) and they largely demonstrate that calories count (The more scholarly questions relates to how macronutrient metabolism affects body composition - much more research is needed here).
2. National Guidelines are Wrong - The participants, just based on reported fiber intakes, did nothing to follow the standard dietary guidelines, or the NCEP guidelines, so saying those are wrong is horribly misrepresenting this data.
3. Low-fat Individuals have worse cardiovascular health - There were no actual CVD endpoints that were looked at, just a series of biomarkers, so you really can't say that they'll have fewer CVD events. Looking at something like carotid-intima media thickness (CIMT) would be a much stronger biomarker. Based on their average waist circumferences, both groups have a long way to go.
4. These results translate to the greater population - You really can't make this statement because the individuals in this study received extensive counseling by RDs, in individual and/or group settings across a year's length of time. Even with this, the weight loss wasn't something that I'm super excited about. The everyday overweight individual who is not regularly meeting with a healthcare professional may not see the same results, have the same level of motivation, and access to knowledgable individuals who can guide them throughout this process. Adequate dietary counseling (whether it be low carb/fat, high protein, etc) cannot occur during the 15minutes that you're actually talking to your doctor. We, as a society, really need to do something about our access to dietitians and physicians with regards to weight loss.
5. Low-fat diets can't help you lose weight in the long-term. In fact, the National Weight Control Registry largely shows that those who lose weight (avg 33kg) and keep it off for more than 5 years are following a low-calorie, low-fat diet (10)
As a small request, for the love of Darwin can we please stop attacking each other over what macronutrient paradigm we follow and recommend. If your ego and pride are dependent upon macronutrient distributions, I can suggest some productive hobbies.
Study Details:
Participants: 148 participants without CVD/diabetes, BMI of 30-45 and aged 22-75. Their mean age was 46.8 years, and 88% were female, 51% were black.
Trial Length: 12 months
Design: 73 randomly assigned to low-fat, 75 randomly assigned to low-carb
- Low Carb: instructed to maintain an intake of less than 40 net carbs (total-fiber)
- Low Fat: less than 30% of energy from Fat (less than 7% from SFAs), and 55% from carbs, in line with the NCEP guidelines
- Both Diets:
- were not instructed to reduce calories
- were asked not to change their physical activity levels
- were given a handbook containing recipes/sample menus that instructed them on how to count macronutrients and read labels
- Each individual received 1 low-carb and 1 low-fat meal replacement per day.
- Each participant met with a RD weekly for the first 4 weeks
- After first 4 weeks, group sessions were held every other week for the next 5 months, and monthly for the last 6 months
- All participants were taught to eat 25g/d of fiber, and were taught about the benefits of MUFAs/to eliminate trans fats
What they say they ate:
| Baseline | 12months | Difference | ||||
| Low Fat | Low Carb | Low Fat | Low Carb | Low Fat | Low Carb | |
| Total Kcal | 2034 | 1998 | 1527 | 1448 | 507 | 550 |
| Carbs(g) | 242 | 242 | 198 | 127 | 44 | 115 |
| Fiber(g) | 16.7 | 18.5 | 15.6 | 15.1 | 1.1 | 3.4 |
| Fat(g) | 80.7 | 75.6 | 52.4 | 69 | 28.3 | 6.6 |
| Vitamin C (mg) | 78.4 | 88.6 | 82.5 | 72.5 | -4.1 | 16.1 |
| Beta Carotene (mg) | 0.75 | 0.49 | 1 | 0.42 | -0.25 | 0.07 |
So what did they find?
- Weight Lost (kg):
- LC: 5.3 (4.9-6.5)
- LF: 1.8 (.3-3.3)
- Waist Reduction:
- LC: 6.7cm
- LF: 5cm
- Body Composition:
- LC: Lean mass increased by 1.3%, Fat Mass decreased by 1.2%
- LF: Lean mass decreased by .4%, Fat Mass increased by .3%
- Lipids
- HDL: increased for both LC (.24mmol/L) and LF (.06mmol/L)
- LDL: decreased for both LC (.08mmol/L) and LF(.05mmol/L)
- TGs: decreased for both LC (.23mmol/L) and LF (.07mmol/L)
- Glucose
- LF: decreased by .1 mmol/L
- LC: increased by .02mmol/L
- Insulin
- LF: decreased by 24.3pmol/L
- LC: decreased by 13.9pmol/L
- CRP
- LF: increased by 8.6nmol/L
- LC: decreased by 6.7nmol/L
- 10yr Framingham
- LF: increased by .4%
- LC: decreased by 1%
Adverse Events: the low fat group reported more headaches at 3 months than the low carb group
1. http://annals.org/article.aspx?articleid=1900694
2. http://www.niddk.nih.gov/research-funding/at-niddk/labs-branches/LBM/integrative-physiology-section/body-weight-simulator/Pages/body-weight-simulator.aspx OR http://www.ncbi.nlm.nih.gov/pubmed?term=Quantification%20of%20the%20effect%20of%20energy%20imbalance%20on%20bodyweight
3. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2376744/
4. http://www.nutritionj.com/content/7/1/26
5. http://www.medscape.com/viewarticle/7783824. http://www.nutritionj.com/content/7/1/26
6. http://www.ncbi.nlm.nih.gov/pubmed/1734671
7. http://www.ncbi.nlm.nih.gov/pubmed/14127686
8.http://www.ncbi.nlm.nih.gov/pubmed/1734671
9. http://ajcn.nutrition.org/content/63/2/174.abstract
10. http://ajcn.nutrition.org/content/82/1/222S.long
Excellent post, as always! Unfortunately most people seem to want to hear what they want to hear not what they need to. I actually find something more "sinister" going on. There seems to be a gradual shift in our society to make everything "easier & more convenient" even at the expense of the truth or our well being. This study is almost "dumbing us down" with a watered down approach to weight loss, IMO.
ReplyDeleteInstead of simply stating that being too sedentary, eating too much processed refined junk foodstuffs, not managing stress properly, & that exercising CORRECTLY & eating mostly real whole foods prepared & cooked correctly with a heavier emphasis on plants is what we need, we have opted to find complex answers to "understand" our current health challenges.
It seems to me that the problem is mostly one of attitude & improper outlook than dietary. Just because the right answer for some may be hard to follow does not make that answer invalid. Finding another answer is admirable but in this case it has proven to be a fiasco at the expense of our health & sanity! Eat mostly plant based foods, enjoy it, exercise correctly, manage stress better, get enough rest, splurge once in awhile & enjoy the ride!
Thanks! I agree that there seems to be a need to make things more complicated than they actually are. Religious lines of thinking in science are quite problematic nowadays
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