CNN Reports: Low-carb diets work quicker
 

WASHINGTON (Reuters) -- Low-carbohydrate diets help people lose weight in the short term but work no better than other diets after a year, researchers reported on Monday.

Two studies of the popular diets that limit sugar and processed starches show they can work faster than some low-fat diets.

Both studies published in the Annals of Internal Medicine showed that after six months, the low-carb dieters lost more weight than the low-fat group.

But one of the studies showed that after 12 months, both groups had lost about the same amount of weight.

In one study, a team at the Veterans Affairs Medical Center in Philadelphia followed 132 obese adults who were assigned randomly either to a low-carbohydrate diet with intake of less than 30 grams of carbs a day, or a low-calorie diet that kept fat intake at a moderate 30 percent of calories from fat.

Volunteers with diabetes had better control of blood sugar on the low-carb diet, the researchers reported.

The low-carb group lost weight faster, but the low-fat dieters caught up.

A year later, both groups had lost about the same amount of weight -- 11 to 19 pounds (5 to 9 kg) for the low-carb group and 7 to 19 pounds (3 to 9 kg) for the low-fat group.

Dr. Linda Stern, who led the study, said it confirmed that any diet that cuts calories will work.

"Americans are overweight because we're eating too much food and ingesting too many calories," she said in a statement.

But most people tend to overindulge in high-carbohydrate foods. "I think a low-carbohydrate diet is a good choice because much of our overeating has to do with consumption of too many carbohydrates," she added.

In the second study, a team from Duke University followed 120 overweight people and found those on the low-carb diet who also took a variety of vitamins and supplements lost an average of 26 pounds (12 kg), compared to an average of 14 pounds (6 kg) on a low-fat diet after six months.

However, the low-fat dieters lowered their cholesterol levels more, reducing their risk of heart disease.

"We can no longer dismiss very-low-carbohydrate diets," Dr. Walter Willett of the Harvard School of Public Health wrote in a commentary. But researchers said more study was needed to show whether low-carb diets are safe in the long term.

"Patients should focus on finding ways to eat that they can maintain indefinitely rather than seeking diets that promote rapid weight loss," Willet added.

http://www.cnn.com/2004/HEALTH/diet...reut/index.html

Hmm... in every other article I read on these studies, they always mentioned that the low carb dieters had better lipid profiles.

Is this a typo?

My thoughts exactly, MyJourney.

Good point
 

You bring up an interesting point Journey... I copied the article exactly as it was written and pasted it here. I'd always heard the opposite too.

"Both studies published in the Annals of Internal Medicine showed that after six months, the low-carb dieters lost more weight than the low-fat group.

But one of the studies showed that after 12 months, both groups had lost about the same amount of weight."


Ok, I lost 40 pounds doing Atkins in about 5 months. This got me to where I wanted to be. If another person, who needed to lose say, 50 pounds, lost those 50 pounds in one year following a low fat diet. Does this mean the low fat diet worked better than my low carb diet? After one year, the low fat dieter lost more weight, right? This is just one way people can be misled. Another thing that NEVER gets mentioned is that Dr. Atkins purposely tries to slow down your weight loss as you progress through OWL into pre-maintenance.

That's interesting how people tend to really stall out after 6 months though. I wonder what is happening with that. That certainly was my problem too. So I started counting calories and the weightloss began again. Hmmm... Maybe the body just gets more efficient at turning fat to fuel after about 6 months.

JL, the graph I saw showed that the low carbers had a faster initial weight loss then they climbed up a little after 6 months, or stalled, while the low fat dieters had a continuous loss. I'd bet the low fat folks were counting calories and the low carb folks weren't. Maybe the ketosis induced anorexia wears off, I think it did on me and people are just eating more or perhaps there's something else happening.

What drives me nuts on some of these articles is they gloss over or leave out entirely the appetite suppressing aspect of the low carb diet. So even if it is all about calories and in the long run they do come out the same, if I'm miserable on the low fat diet because of hunger cravings but satisfied on the low carb which diet do you think I will fall off of sooner?

Something else that a lot of these articles leave out is that after a year, the low carbers had better cardiac profiles, specifically lower triglycerides and higher HDL, than the low fat dieters. Even if the weight loss is approximately equal, the health benefits (not to mention the lack of hunger) seem to be better with low carb making it a winner in my estimation. :)

and something else they leave out is the benefits the low-carb diet has on diabetic people. I have eliminated all medications, three to be exact, insulin, glucophage and actos and my blood sugars are normal. They don't want to emphasize this because then the drug companies will sue. I was never able to lose enough on low-fat because I was allways hungry, something that does not happens on low-carb. So far I have lost 70 lbs but I am stalling. Need to lose another 60.

I am wondering about drop out rates, did they mention it? The articles from last fall all showed huge drop out rates although on Atkins the drop out was non-significantly lower in some. Drop out rate is important if you propose for the population. Even if Atkins and low fat end up the same in weight loss after 12 month, these studies always have people drop out, and the researchers don't count them in the results, the ones who couldn't stick to the diet for the full 12 month. My impression is that it is easier for people to stick to low carb than to low fat, so that point is more important than how many pounds lost.

Interesting that the researchers point out the speed is less important than finding a diet you can stick to... duh.

re the lipid profile, that seems to be a YMMV thing. I have seen studies that show, as several here indicate, that the lipid profile is fine on average on Atkins, but several in this forum have joined South Beach after Atkins because of sky rocketing lipid values prohibited them from continuing. I think there is genes and diet somehow interacting in some but not all people.

The drop out rate was a little higher for the low-fat dieters.

Something else about the dropout rate; the dieters were randomly assigned to a diet and didn't get to choose which one they would prefer. This doesn't reflect real life where the dieter chooses which program they wish to use and would therefore have a higher liklihood of picking something that suits them and they can commit/stick to.
IIRC, there was also very little education or support offered to the test subjects as well which would also contribute to the contrition rate. They were handed a diet sheet told to read and follow it and sent on their way.

You really have a point. But the solution is very very hard to control - it is a matter of how to do design a study properly. When studies compared drugs to psychoanalysis, the same argument comes that if you hate talking to a shrink, it won't be as successful as drugs.

I believe that there are a number of honest researchers who really want to find this out. But to design studies properly isn't easy. For example, if at this moment you would tell people what the diets are, and let them choose, you would have a huge socio-economic and educational confound - people who are educated would be curious to try low carb, they would go online to inform themselves and thus would have more support etc. How would you take that into account? I think the US is doing a giant trial if really 10% or so of the population is trying low carb. We will know the long term consequences in 10 years.

Another thing to keep in mind on the drop-out rate is that they probably didn't give the dieters a choice as to which program they wanted to follow. So the drop-out rate in the study might be higher than normal for both plans because the people did not have the motivation they might have had if they had been able to choose their own plan.

edit: Sorry Lisa, I didn't read your comment before I posted this. ;)

What you would get is a pretty good picture of how things work in the real world and not within the carefully controlled confines of a lab or clinical setting. Of course, it also depends on what you are trying to study. If the goal of the study was to see which diet was easier to stick to, they would have been better off allowing people to pick the plan that most appealed to them since sticking with something you find distasteful is not going to work very well. But...since (I believe), the goal of the study was to see which diet was more effective (and being able to stick with the plan is a big part of that), I can see where they might have felt it better to randomly assign dieters even if it doesn't match "real life" experience. I just happen to think it was flawed since being able to stick with your plan plays a big part in how effective it will be for you.
In the real world, people pick the diet that they want to try. In the real world, they get as much (or little) information as they are willing to look or ask for.
Since there is an addictive/emotional component to sweet/carby foods, giving someone a diet sheet and telling them to go forth and lose weight is about as effective as giving someone an instruction sheet on alcoholism and telling them to go get dry. As we see daily here on the forum, support and accurate information are vital to success. Quite honestly, I'm a bit surprised that the dropout rate wasn't higher in these studies on either side; on the low carb side due to lack of support and/or information and on the low fat side just due to sheer hunger or on either side from being matched with a plan that was unappealing to the dieter. :rolleyes:

some more info on the two studies from atkins:

A Study from Duke Researchers

A Year-Long Study in Philadelphia

Also, when you look at total weight loss, what about the size of the person at the end of the year?

When I weighed 150 on low fat, I was a full size larger. My new, lower size has got to be worth 10-15 pounds, right?

"But one of the studies showed that after 12 months, both groups had lost about the same amount of weight. "

What about the second study ?? Since it was ignored I will assume that at the end of 1 year low carb was much better.

danny

I agree. When I lost my first 30 pounds, I dropped many more sizes than I "should" have from past experience. In these studies, I wish they would measure body fat percentage instead of simply measuring weight on the scales.

Saw this one on Netscape today;I will comment within the quote in bold.


I already suspect the statements are skewed to produce a pre-ordained outcome showing yet again the agenda of the low-fat "big sugar" people.

Two studies of the popular diets that limit sugar and processed starches show they can work faster than some low-fat diets.

A pointless statement since we are trying to rid the world of the notion of "quick fix" rather than lifestyle. Any quick-acting diet might be taken as a "cure" instead of a regimen, thus paradoxically, working faster will lead to abandonment for many who aren't being told the more important truth: You have to stay on the regimen because once having corrected the problem, you can do even *more* damage by going back to the bad habits that led you to change them in the first place!

OTOH, for some who are more in despair, seeing some good results gives them hope, since likely they have been exposed to so many *true* fad diets that really don't work that they are disheartened already even before trying LC or even worse, "toying" with LC, meaning attempting it but ultimately incorrectly with predictable negative results.

I also have a problem with the term "processed starches" since this is an attempt to mislead as well: A naive reader may well come to the conclusion that "unprocessed starches" were somehow good for you!

Both studies published in the Annals of Internal Medicine showed that after six months, the low-carb dieters lost more weight than the low-fat group.

Perhaps a little more realistic, but again, we have to avoid the idea that LC is a "prison sentence" needed to get thinner only to then follow it up with a "get out of jail free" attitude. The purpose of LC is to produce a life-long result, so this whole notion of "timing studies" of diets is bogus.

But one of the studies showed that after 12 months, both groups had lost about the same amount of weight.

A deliberate attempt to oversimplify the problem. No discussion of health benefits/changes in the body good or bad, no discussion of how much of the weight lost was lean tissue versus muscle mass, etc.

In one study, a team at the Veterans Affairs Medical Center in Philadelphia followed 132 obese adults who were assigned randomly either to a low-carbohydrate diet with intake of less than 30 grams of carbs a day, or a low-calorie diet that kept fat intake at a moderate 30 percent of calories from fat.

Interesting that value-judgements are so simply placed here. 30 grams of carbs is low while 30 percent fat is moderate. Many studies show that 30 percent fat may be low and 15 percent may best be described as inadequate to support proper health.

Volunteers with diabetes had better control of blood sugar on the low-carb diet, the researchers reported.

Finally something that stands on its own as useful fact!

The low-carb group lost weight faster, but the low-fat dieters caught up.

Race horses, not human beings! This fails to be realistic as all LC dieters know a "plateau" when they see it. Merely ignoring a plateau has predictable lame results, as apparently was done in this study. It is true that LF diets generally don't have this effect as profoundly as LC, thus catching-up is irrelevantly true if you aren't doing anything to keep the LC diet in the "lead".

However, a properly monitored LC diet has to be tweaked as necessary to always be effective. Plateau-busting may involve lots of changes such as a 3-day carb-high "heresy" period followed by strict induction phase which could be far lower than the 30 grams they suggest in their study, or going on the Stillman LC and LF diet for a short time [or fasting], planning for a temporary high-exercise program then reverting to a more moderate one that is perhaps still higher than was being done before, increased dosages of various vitra-nuitrients such as Chromium or L-carnitine, etc.

A year later, both groups had lost about the same amount of weight -- 11 to 19 pounds (5 to 9 kg) for the low-carb group and 7 to 19 pounds (3 to 9 kg) for the low-fat group.

Be wary of undefined statistics here! No statistical profile is offered as to what the trends are in the two groups. How many people lost the LC 11 and how many people lost the LF 7 for example? Is this a group weight loss thus this is just putting the groups on a collective scale?

Dr. Linda Stern, who led the study, said it confirmed that any diet that cuts calories will work.

Sounds like a politically-correct statement made to avoid ruffling feathers of the various agenda groups. But it muddies the waters where they need to be most clear. A recent US government-funded [NOT ATKINS!] study found that eating more calories in a LC diet inducing ketosis causes more weight loss of fat-only tissue than a lower calorie diet consisting of too much carbs to causes ketosis.

Moreover, what about the various positive and negative side effects that likely suggest the LF diets are deficient in all the other ways that really count, such as not helping diabetic control, not lowering LDL while raising HDL, not lowering triglycerides, etc. Still wanna take this "it doesn't really matter" stance?

"Americans are overweight because we're eating too much food and ingesting too many calories," she said in a statement.

Why make that blatantly oversimplified misleading statement? A better, more honest statement could be "Americans are overweight because we as a nation have been mislead for decades about the supposed advantages of low-fat foods which are killing us because in actuality it causes us to crave combinations of sugars and fats that are in fact unhealthy. We likely cannot curb the apetites of people, but at least we can tell them that if they eat sufficiently lowered carb quantities that they wind up in ketosis, they can eat all they want of protein and fat and actually wind up less obese and more healthy. And if they also want to lower their weight even more, then they have to somewhat lower their total intake of food and exercise as well."

But most people tend to overindulge in high-carbohydrate foods. "I think a low-carbohydrate diet is a good choice because much of our overeating has to do with consumption of too many carbohydrates," she added.

This is an MD speaking, but why does it have to sound so naive? My point is that the presence of a doctor in a study implies to some that the study is somehow scientific. But if the doctor isn't trained to understand how to conduct the study in the best way, what relevance is there to it?

My read of this study is that despite heavy pressure from "Big-Sugar", this doctor agreed to perform a somewhat misguided study comparing a typical LF diet (which requires far less tweaking) to a poorly-adjusted LC one in the hopes of proving LC people wrong. But even lamely implemented, LC won out in some ways, and the results, even spun towards LF mindset, can't deny that LC needs to be in the picture, etc.

In the second study, a team from Duke University followed 120 overweight people and found those on the low-carb diet who also took a variety of vitamins and supplements lost an average of 26 pounds (12 kg), compared to an average of 14 pounds (6 kg) on a low-fat diet after six months.

Clearly this shows that LC diets managed properly with vita-nutrient tweaking outperforms LF. And thus largely invalidates the other study!

However, to be fair, it doesn't point out what happens after the six months. Many of us who know how to tweak the diet could demonstrate that the results would continue comparably, or at least not imply the plateau effect reported in the other study. Notice that someone who insists that LF is better will point this out and just say that the continued results *must* be in-line with the other study because the other study was longer. This is of course absurd because you are comparing a study result to a conjecture.

However, the low-fat dieters lowered their cholesterol levels more, reducing their risk of heart disease.

This has to be wrong! Or at least is spun using irrelevant statistics. Remember, it may be true that total cholestrol levels could drop in certain LF diets, but that's not even a useful factoid unless you are some carb-company's marketroid. There is widespread belief in the HDL/LDL ratio factor and almost no belief in the total level as heart risk predictors, and in some circles, LDL is itself not a monolith. Thus raising HDL and the "good" component of LDL while lowering the "bad" component of LDL, lowering overall triglyceride levels, and ignoring total cholesterol levels [unless they severely *drop*!] is the statistic we need to hear. The LC dieters likely did this, thus reducing their risk of heart disease. I would really like the writer of the article to back up the claim made!

"We can no longer dismiss very-low-carbohydrate diets," Dr. Walter Willett of the Harvard School of Public Health wrote in a commentary. But researchers said more study was needed to show whether low-carb diets are safe in the long term.

The standard BS rears its ugly head! LF is shown to be bad for you long-term but no one complains about it. LC shows that it's better, so the status quo people suggest it might not be safe simply because they have no data to confirm or deny any such notion.

I think we need to fund a study on the long-term effects of carb-selling companies on the deleterious effects of their practices on curtailing scientific studies!

"Patients should focus on finding ways to eat that they can maintain indefinitely rather than seeking diets that promote rapid weight loss," Willet added.

A good point that totally undermines the reasoning the other study is trying to use. There is a real danger that the led-by-the-nose public will never understand this, since the larger problem is the notion of a diet versus a WOL. We live in a society quite poisoned by the notion of instant gratification on too many levels. No wonder the carb-companies can manipulate so much!

Moreover, we have this relatively new bandwagon of "LC-friendy" food purveyors that are in actuality trying to make us eat too many carbs while wrapping the Atkins flag around themselves falsely. The main point missed is that merely a little less carbs doesn't accomplish much at all. Only severely restricting carbs works, and you have to count *all* of them, not this "net" carb crap! Thus, this is the carb-companies wolves in LC sheep's clothing as usual manipulating us.

[url]http://www.cnn.com/2004/HEALTH/diet.fitness/05/17/health.diet.reut/index.html[/url

cjl (Is it me or is the count of carb obfuscation articles getting published dramatically rising?)

You know, that's a really good point. It is very likely the low-fatters caught up by losing lean tissue. It would have been nice to see what the change in body composition was rather than flat weight loss.

Hmmm. Some other poster quoted an expanded version of the article different from the one I saw on Netscape.

It appears that Time-Warner/AOL/Netscape's editorial people have deliberatly skewed the article by leaving some things out!

In my previous post I complained about what relevance the weight ranges cited were, asking for a trend and not the range points of weight loss. The quoted article said 7-19 on LF and 11-19 on LC.

But in the larger quote, it shows that the average for LF was only 8 and the average for LC was 11 which paints quite a different picture. You get to see that the low side was more typical in LF's lower low-side than in the low-side of LC, meaning it was less effective at the least.

cjl (don't quote ME out of context!)

Actually, I think that the low-fatters "caught up" because the low-carbers were gaining muscle weight, which slowed their downward trend on the scales, in addition to the low-fatters losing muscle weight. Most all of us have noticed that our muscle mass (strength) increases with low-carbing -- sometimes even without much or any exercise depending on the shape we were in when we started.

Body Composition:

In the 6-months study by Yancy et al., the low carbers lost 9.4 kilos of fat mass, and 3.3 k of fat free mass. The low fatters lost 4.8k of fat mass, and 2.4k of fat free mass.

What this shows in percentages is that of the total weight lost, 35% of it was lean mass for the low carbers, but 50% of it was lean mass for the low fat group. :eek: They weren't catching up at all; they were losing ground (and lean mass) and a faster rate than the low carb group.

That'd be 25% lean for lowcarbers, 33% lean for lowfatters. Approximately.

But the main finding of that, the fact that low fatters were losing ground compared to lowcarbers in more ways than one (weight loss speed AND weight loss composition) remains valid.

Actually, in the one-year study, the low-carbers leveled out at one year because they gradually STARTED EATING MORE CARBS.

"A look at the dietary composition data shows why the low-carb diet produced such a lacklustre result in weight loss during the last six months of the study; by 12 months, most of the subjects were no longer following a low-carb diet! Average carb intake was 120g, while protein had declined from baseline, from 84g to an anaemic 73g. Compliance with the diet, evidently, was poor."

Actually, I should mention that that quote came from Anthony Colpo at

http://www.theomnivore.com/index.html

One thing you have to remember with ANY study is you have to garner 3 or 4 other articles to reach a hypothesis. This is a cardinal rule when writing a paper in University. There are MANY flaws in one paper. First you have to determine many factors before reaching a preliminary conclusion, 1) see how many subjects (people) who are participating in the study AND how they were selected. 2)You have to consider the ages, sex and weights of each of the subjects. 3)Lenght od the study - does the study review the results after one year etc. 4)How did the study monitor each of the subjects?

There are many inidicators that go unanswered in this ONE article that no one should be led to feel frustrated that their low-carb efforts are for nought. I think if you have found a diet that works for you is the one you should stay on. Where you are getting solid results and are maintaining optimal health.

I, for one, am encouraged to see articles that condone the low carb diet and it's overall health benefits. Let's face it being fat is dangerous at least we are all trying to do something to about it.

Love and Peace