Effect of Low-Fat vs. Low-Carb Diet on 12-Month Weight Loss in Overweight Adults

https://jamanetwork.com/journals/jama/article-abstract/2673150

by nradov • 8 years ago

56 64 8 years ago

adadad3442• 8 years ago

Unsurprising results- calories intake & expenditure defines weight loss/gain, not other nutrition information like fat, carbs, vitamins, etc.

JohnJamesRambo• 8 years ago

I'm actually relieved by the result. It makes things make sense again a little more.

geowwy• 8 years ago

It is surprising if you believe the insulin-obesity hypothesis. A lot of people do these days.

callesgg• 8 years ago

I my mind the point of these special diets is to alter the food habits making it so that you take in less total energy. By essentially forcing you to think more about your food.

Not that one diet wound automatically burn more energy than the other.

pesfandiar• 8 years ago

True; however, they may be very different practically. Few people are going to measure calories for every single thing they eat. Most will rely on the sense of hunger and urge to eat certain things. I wouldn't be surprised if low-carb diets outperform low-fat ones in that department, since carbs tend to keep people urging for more through rapid blood sugar fluctuation.

wnevets2• 8 years ago

I wouldn't be surprised if low-carb diets outperform low-fat ones in that department, since carbs tend to keep people urging for more through rapid blood sugar fluctuation.

This is exactly why low carb has works so well for me. My cravings for snacks become virtually disappear.

kasey_junk2• 8 years ago

That result is literally what this study is saying they didn’t find.

Perhaps you can make the argument that the study is flawed statistically or that 12 month weight loss is not long term enough or that the diet sessions caused the lack of difference?

beager• 8 years ago

This has been my experience, and I wonder if part of the efficacy of macronutrient-centric dieting is about cultivating self-control. That would be an activity that would be hard to measure in a study where the participants know they’re participating and have a sense of duty to remain committed. Healthy low fat vs healthy low carb will yield the same results, roughly, with the same caloric intake. Any macro combination will, really. But carbohydrate restriction is something I’ve personally found to be a good way to stay on the rails.

20180201• 8 years ago

calorie intake and expenditure is a description not a prescription. this is about as useful as saying "make more money than you spend" in order to become wealthy. sure, that's true, but it won't help you make $10 million. how do you eliminate the desire to waste time and money on useless pursuits? that is the analogy we need to use to reframe this discussion. yes, there is a certain level of maturity and self-control involved, but you need to know what NOT to do first.

what is causing people the intense desire to overeat, and the intense lethargy that follows? probably insulin-spiking processed carbs and sugar. have you seen anyone in the throes of a carb addiction/crash cycle? it's damn near supernatural the amount of power these foods have over people.

at this point i consider them about the same level as cigarettes or alcohol. cheap, widely availabe, intensely addictive, and people who don't have a problem just telling you to "use less", "it's so easy". okay. sure.

"how do i graduate college?" "take more credits than it requires to graduate."

try telling this to the person who got sucked into the for-profit university and is $50k in debt.

the world is not as cut and dry as it seems, especially if you are burdened with a low IQ like the people who most easily fall for these schemes.

bobdole1234• 8 years ago

I'd say it's harder to quit eating badly than it is to quit cigarettes: You can live a long life without ever touching a cigarette again. But you won't get far with going cold turkey on food.

_red• 8 years ago

Good points, but there is something else going on.

If you travel alot you start to see that every culture is heavy on carbs: Rice, pasta, potatoes, noodles, bread. They are ubiquitous.

Find a frenchmen that isn't eating bread from first meal to last...or an asian with rice / noodles. Or an Italian with pasta / bread, etc.

There is something else wrong here. I don't pretend to know what it is, but it seems like its almost a "food culture" problem. The most immediate things you notice are: (a) Americans portion size is double the rest of the world, and (b) Americans eat very very fast.

cageface8• 8 years ago

Meat and animal protein is actually more insulinogenic than many common carbohydrates.

https://www.drcarney.com/blog/entry/low-carb-theory-regardin...

Pretty much everybody agrees that eating a lot of sugar or processed simple carbs is a bad idea but the demonization of high fiber, complex carbs has no basis in science.

RachelF• 8 years ago

Exactly. The good old "eat less" diet works, but is not as sexy as all the fad ones.

headsoup5• 8 years ago

So I can eat just cardboard, so long as I don't eat so much of it that I can't expend the energy?

It's nowhere near as simple as that.

daxfohl2• 8 years ago

It's a bit surprising that the number of degrees burning your food will raise the temperature of water is related to weight gain. I find it more surprising that this simple relation has withstood the test of time.

sokoloff• 8 years ago

Can’t tell if sarcastic or not. Burning food to release chemically stored energy therein seems like it would correlate naturally to the chemical energy an organism could extract.

megaman22• 8 years ago

For me, the easiest way to eat less calories is to eat a low-carb diet. The reason is this: my typical meal consists of three parts; meat, vegetable, and starch. The least healthy and highest calorie part is the starch. Cut the starch, cut most of the caloric intake.

Besides, if I cut enough carbs, I get into ketosis, and then I stop being hungry.

forkLding• 8 years ago

I'm guessing they used a random sample to study the diets hopefully and also this would generally mean I believe that any general diet low in fat or carbs can lose weight because they listed that participants still lost 5 to 6 kg no matter the diet?

dieterrams• 8 years ago

Missing from the title is the qualifier "healthy", as in "healthy low-fat" diet vs "healthy low-carb" diet. What does "healthy" mean, here? It's not defined in the abstract.

fredrik-j• 8 years ago

The closest I got to definition of "healthy low X" was a general description of the approach in the paper:

"Briefly, the main goals were to achieve maximal differentiation in intake of fats and carbohydrates between the 2 diet groups while otherwise maintaining equal treatment intensity and an emphasis on high-quality foods and beverages.

Thus, participants were instructed to reduce intake of total fat or digestible carbohydrates to 20 g/d during the first 8 weeks. Higher priorities for reduction were given to specific foods and food groups that derived their energy content pri- marily from fats or carbohydrates. For example, the reduction of edible oils, fatty meats, whole-fat dairy, and nuts was prioritized for the healthy low-fat group, whereas the reduction of cereals, grains, rice, starchy vegetables, and legumes was prioritized for the healthy low-carbohydrate group.

Then individuals slowly added fats or carbohydrates back to their diets in increments of 5 to 15 g/d per week until they reached the lowest level of intake they believed could be maintained indefinitely. No explicit instructions for energy (kilocalories) restriction were given. Both diet groups were instructed to (1) maximize vegetable intake; (2) minimize intake of added sugars, refined flours, and trans fats; and (3) focus on whole foods that were minimally processed, nutrient dense, and prepared at home whenever possible."

I find the last sentence interesting, reminds me of Michael Pollan's quip: "Eat food. Not too much. Mostly plants."

lokopodium• 8 years ago

I wonder which of the two is easier to keep. Feeling hungry most of the time is little joy and leads to relapses.

Pokepokalypse• 8 years ago

Oh but. . . "weak willpower", and "immorality", and "fat people deserve their misery and shame". . . we really need to maintain our comfortable mindset.

enraged_camel• 8 years ago

>In the HLF vs HLC diets, respectively, the mean 12-month macronutrient distributions were 48% vs 30% for carbohydrates, 29% vs 45% for fat, and 21% vs 23% for protein.

30% carbs is hardly "low-carb".

Indeed, most low-carb diets suggest 50g or less carbs per day - 200 calories or less.

https://www.dietdoctor.com/how-low-carb-is-low-carb

edit: why am I being downvoted?

coding123• 8 years ago

That's exactly what I was thinking. Also, to do this across 12 months definitely means that 90% have dropped out after 30 days and shouldn't be counted. Those that treat it as a short term diet are bound to rebound. In the end you need to see this as your permanent way of eating.

wnevets2• 8 years ago

I've found even 50g still too high.

lowdest• 8 years ago

30% of a 2000-calorie diet is going to be 150g of carbohydrates per day. Not very low carb at all.

aYsY4dDQ2NrcNzA• 8 years ago

30% of a 2000-calorie diet is going to be 150g of carbohydrates per day.

600g

ClassyJacket• 8 years ago

50g is still high. Most people in low-carb communities talk about "low carb" as being under 20 grams per day.

tunabee• 8 years ago

Ketogenic is under 20g per day; low-carb is usually <100g.

firasd2• 8 years ago

Low-Carb proponents don't necessarily disagree that 'a calorie is a calorie' in the physics sense. We just feel there's no need to be hungry when you can eat to satiation and still lose weight, and that unnecessarily high glucose in the bloodstream is not good for you anyway.

cageface8• 8 years ago

Complex carbs like potatoes are some of the most satiating and nutritious foods you can eat:

https://scottabelfitness.com/potato-and-the-satiety-index/

High fat diets can also be satiating but there are a lot of downsides to eating saturated fats, which make up most of the fats in the typical keto/paleo high fat diet.

https://nutritionfacts.org/video/the-saturated-fat-studies-s...

firasd2• 8 years ago

I guess it depends on how a potato is prepared. The guy in the link eats baked potatoes which I suppose would be pretty filling. Personally I've found most 'filling' foods I eat when (trying to get back to) low-carbing are: cauliflower, eggs, paneer (a type of Desi cheese), coconut, and beans/legumes.

euler_• 8 years ago

Ketosis can apparently lead to more weight loss because ketones are less efficient vehicles of energy in general. Additionally, unused ketones can be eliminated through sweat, urine, and breath.

kasey_junk2• 8 years ago

Apparent to what evidence?

will_brown• 8 years ago

The Krebs Cycle I am guessing.

gwern• 8 years ago

Fulltext: https://www.dropbox.com/s/cbpt3bw8ql310kr/2018-gardner.pdf?d...

Worth noting that the genetics here was just 3 SNPs based on a 2010 candidate-gene study of apparently n=133 (it was never published, it's just a conference talk, based on the citation & description of the work in https://www.wsj.com/articles/SB10001424052748703862704575099... ), which made the absolutely crazy claim that "those with a genetic predisposition to benefit from a low-carbohydrate diet lost 2 1/2 times as much weight as those on the same diet without the predisposition". So unfortunately, their total failure is exactly what you would predict from a non-GWAS-derived set of SNPs and the result is meaningless. This tells you nothing about whether SNPs can predict or cause more/less weight loss, be used to optimize diet choice, or have any cross-racial differences, despite people apparently interpreting it that way.

jobu• 8 years ago

The key thing for these diets is the ratios of Carb/Fat/Protien :

In the HLF vs HLC diets, respectively, the mean 12-month macronutrient distributions were 48% vs 30% for carbohydrates, 29% vs 45% for fat, and 21% vs 23% for protein.

Both of those diets seem fairly balanced. A typical ketogenic diet (high-fat, low-carb) is usually < 10% calories from carbohydrates, 20-30% from protein (depending on exercise) and 60-75% fat calories. It seems unlikely any of the HLC participants would have gotten into ketosis, so I don't see this study as being relevant to the current debate over the efficacy of ketogenic diets.

markdown• 8 years ago

I'm not sharing this because it doesn't confirm my self-tested and proven beliefs. #NoCarbsForLife

lucidguppy2• 8 years ago

29% cal from fat isn't really low fat. It would be interesting to see a study on lower fat diets.

testuser312• 8 years ago

Also, 30% of calories from carbs (on the so-called low-carb diet) is not really low-carb. As mentioned in another comment, for a 2,000 calorie diet, that's 600 calories from carbs! Most low-carb diets aim way lower than that because they aim at reaching a state of ketosis, where your body is essentially burning fat instead of sugar for energy. This might be something like 20-50 grams per day, depending on a lot of factors like specific carbs consumed, etc. This is the stage where a lot of the health benefits including increased energy, no afternoon crash, weight loss, etc. come in.

I realized recently that I was getting fat (4 inches of waist size increase in just a couple years), so for the past couple months, I've tried restricting my calories. At first, I tried cutting out things that are just ridiculous like beer and bread. In the past week or so, I've gotten more 'restrictive' and have been trying to eat almost exclusively meat. I'm not counting calories or anything like that, I just eat until I'm full and then I stop. I have lost 20 lbs in the past two months, and I feel much better overall. I have way more energy than I did before and I fart a lot less.

I can understand if it sounds extreme, but look at the standard American diet. Since the food pyramid was introduced, with a base of grains, people have gotten nothing but fatter, more diabetic, more heart attacks and stokes, etc. While there are essential fats and proteins, there are NO essential carbohydrates. I'm not sure if I'm going to stay on this diet forever, but it doesn't seem like the mainstream diet is very healthy, so I'm going to listen to what my body tells me and use reason to try to get out of this mess.

lucidguppy2• 8 years ago

I've done both keto and whole-foods-plant-based diets.

Both lose weight - but I feel a lot more energy on a starch based diet. Whole plant foods contain the right amount of fat (10%). Who cares about farts when I never get constipated. With a little exercise and a starch based diet I was able to lose 80lbs. When I started introducing fats and added refined sugars - the weight came back. The fat you eat is the fat you wear.

Long term ketosis is not optimal health.

https://www.ncbi.nlm.nih.gov/pubmed/22850317

https://www.ncbi.nlm.nih.gov/pubmed/11108325

Look at cheese consumption and it tracks national weight gain. We're taking in way more fat today than long ago.

http://www.pcrm.org/images/media/blog/cheese_consumption.jpg

But we're taking more calories overall - so people get to blame whatever they want.

Starches powered all civilizations up to the 20th century. Only when we started consuming lots of meat and purified sugars and white flour did we really gain weight.

jewei• 8 years ago

Conclusions: In this 12-month weight loss diet study, there was no significant difference in weight change between a healthy low-fat diet vs a healthy low-carbohydrate diet, and neither genotype pattern nor baseline insulin secretion was associated with the dietary effects on weight loss. In the context of these 2 common weight loss diet approaches, neither of the 2 hypothesized predisposing factors was helpful in identifying which diet was better for whom.

Effect of Low-Fat vs. Low-Carb Diet on 12-Month Weight Loss in Overweight Adults

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