Four Diet Types Compared

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Ron AKA Posted: Wed, Feb 25 2009 11:28 PM

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Finally a study that makes some sense. They found that it did not matter whether it was low carb, low fat, or .... It just came down to calories. Will not be popular with all the fad diet promoters.

Low Carb? Low Fat? It's the Calories that count!

CNN Version

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nomorecarbs replied on Thu, Feb 26 2009 9:44 AM

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Not surprisingly, I disagree.  This study makes no sense.  They did NOT directly compare the diets.  They didn't even study a low carb diet, the lowest carb content was still 35% carbohydrates, NOT exactly what I'd consider low carb.  The 'study''s authors, simply decided that 'healthy' carbs were required, and saturated fats were to be avoided.  They didn't test this belief, but simply varied the percentage of fat, protein, and carbohydrates a little around their version of a 'healthy' diet emphasizing whole grains, vegetable versus animal fats, etc.

There have been studies pitting true low carbohydrate diets with unlimited calorie intake, versus low fat, calorie restricted diets.  The low carb diets won hands down.  The reason is simple, fats are satiating, carbohydrates are not.

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Madman replied on Thu, Feb 26 2009 10:08 AM

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have to disagree with you on that satiating thing.  I personally find beans and salads to be quite satiating....the fiber makes me feel full quicker.

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nomorecarbs replied on Thu, Feb 26 2009 11:30 AM

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madman,

I can eat a steak, enjoy it, I'm not ravenous for another one.  If I eat a starchy or sugary meal (often it's a high fat meal as well), I'm never quite satiated, or if I am, I'm soon craving more.

My comment was only in pointing out what I thought was obvious:

http://abcnews.go.com/WN/Story?id=5388954&page=1

Many low carb advocates also claim a metabolic advantage.  I'm an agnostic in that regard, I believe the satiating ability of a low carb meal, along with the lower insulin levels, is sufficient to explain the superior results for low carb diets described in the above link.  Any metabolic advantage would just be icing on the cake, so to speak, in a high carb way!

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nora@joslin replied on Thu, Feb 26 2009 2:18 PM

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Dear nomorecarbs:

Many studies have found that the dietary composition of the diet in the short term has an effect on the amount of weight  lost, with low carbohydrate diets and low carbohydrate has not been consistently defined) offering an edge.  Low carbohydrate diets also increase HLD and appear to reduce insulin levels better than diets with higher carbohydrate intake.  However in the long run, weight loss often equals out.  Perhaps the two most interesting conclusions from this study are   that no matter what nutrition approach you take the more contact/intervention between the participant and the "coach" the better the result and that despite the fact that the subjects revered to their original dietary pattern with continued contact, they were able to keep some of the weight off. 

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Ron AKA replied on Thu, Feb 26 2009 4:38 PM

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Here is the original New England Journal of Medicine report:

Comparison of Weight Loss diets...

Some good conclusions:

"Reduced-calorie diets result in clinically meaningful weight loss regardless of which macronutrients they emphasize."

"These results show that, as long as people follow a heart-healthy, reduced-calorie diet, there is more than one nutritional approach to achieving and maintaining a healthy weight."

"This provides people who need to lose weight with the flexibility to choose an approach that they're most likely to sustain -- one that is most suited to their personal preferences and health needs,"

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nomorecarbs replied on Thu, Feb 26 2009 11:12 PM

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Heart healthy?  This study did not address the issue of what diet proved to be heart healthy.  The study's authors began with the belief that low saturated fat, low glycemic carbs were good, and this was the basis for all four diets studied.

What I'd love to see is the 'heart healthy' diet advocated by the establishment, namely low saturated, whole grains, etc. compared to a low carbohydrate, high fat diet.  I'd love to see the total mortality risk over 20 years for such diets, especially for diabetics.

I eat 'heart healthy' fats, namely from animal foods, rather than manufactured fats from plants.  I have failed to find any evidence proving that such fats aren't heart healthy.  Indeed, Harvard's Nurses Study of 82,000 plus women over 20 years couldn't find an association between low carb diets and the risk of heart disease either.  So just how harmful can such diets be?

http://content.nejm.org/cgi/content/abstract/355/19/1991

Indeed, for many type 2 diabetics, the problem being experienced is too many calories being ingested.  What happens to excess carbohydrates?  It doesn't matter what form of 'heart healthy' carb one is eating, the excess is going to be converted to triglycerides, a SATURATED FAT.

Long before Atkins, there were low carb publications and studies.  Dr. Eliott Joslin used the Massachusetts General Hospital low carb diet developed by Dr. Frederick Allen, to treat diabetes, before the discovery of insulin.  This is not a 'fad diet'.  I'd welcome a serious attempt by the authorities to seriously and fairly evaluate the safety of such diets.  We are willing to allow people to take totally artificial chemical concoctions to treat diabetes, and spend billions of dollars researching such treatments, but we seem totally uninterested in studying a totally natural treatment.  One that seems to have already proven itself over eons.  To the best of my knowledge, no peoples on a low carbohydrate, ever experience diabetes until they adopt a Western diet with abundant refined carbohydrates.  Healthy non-diabetics in countries eating unrefined carbohydrates don't develop diabetes either.  So, how about the government funding studies of 'primitive' diet approaches to diabetes, comparing  low carbohydrate versus low fat, low glycemic carbohydrate diets.  I say 'government' because the commercial sponsors of much existing research won't be interested, and non profit organizations such as the ADA, seem to be funded by the same commercial interests.  If I'm right, the country could reduce health care expenditures by billions.  If I'm wrong, many diabetics choosing low carb approaches, would switch to healthier approaches, and the government would save money.  Since one out of four Americans over 65 have diabetes, the issue is not trivial.  Outside of Duke University and Downstate New York Medical School, there doesn't seem to be much interest in doing serious research on the low carb approach, despite it's long history of efficacy.

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donw replied on Fri, Feb 27 2009 8:37 AM

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Again, just one more "scientific" study that, no doubt, will be contradicted within 180 days by another "scientific" study from somewhere else.  Prime example, last year we were all talking about the benefit of a glass of wine with dinner.  Now wine is being demonized as a cancer causing agent in women.    Go figure! 

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Mountain Man replied on Fri, Feb 27 2009 10:00 AM

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Whether we like it or not, the Laws  of Thermodynamics have not been repealed. Energy (calories) in equals energy (calories) out. If not, than the surplus is stored by the body. If less energy is consumed, than the body burns stored fat to make up the differnce.

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Ron AKA replied on Fri, Feb 27 2009 10:21 AM

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Mountain Man:

Whether we like it or not, the Laws  of Thermodynamics have not been repealed. Energy (calories) in equals energy (calories) out. If not, than the surplus is stored by the body. If less energy is consumed, than the body burns stored fat to make up the difference.

Mountain Man (Welcome to the forum!), you have it exactly right. It is no more complicated than that. However, those that sell fad diets and diet schemes do everything they can to avoid this truth, and confuse the matter to the point where they get people to believe the laws can be broken. This study has just reconfirmed the obvious - the Laws are valid.

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nomorecarbs replied on Fri, Feb 27 2009 7:19 PM

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Is a calorie a calorie?

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2129158

Well, I'm not a biochemist, but commonsense tells me that it's not as simple as some would like to make it.  What is a calorie?  Well, a calorie is a unit of energy which has a precise mathmatical value.  But how many calories do we eat?  That is not so precise.  When we scan a food label, we see the calories, fat grams, carb grams, etc.  The calories are determined by burning a sample of the  food in a calorimeter.  Of course, our bodies do not extract energy from food by burning it in a calorimeter.  So we know that the process is different, with somewhat different results, depending upon the current state of our individual metabolic system, as well as the actual carb content of the food we are eating.  Further, how we cook the food, can affect the caloric content.  Cooking can convert fiber into digestible carbohydrate, so whether we eat a food al dente or cooked to a mush, can affect the caloric content.  The calories in food aren't metabolized free of cost.   Metabolizing food  requires energy by our bodies.  The exact amount of energy required may vary from one meal to another and from one day to another and from one individual to another.  Once the food has been digested, what do we do with the final product?  What is an early symptom of type I diabetes?  Isn't sudden, unexplained weight loss even with higher than normal eating, a common symptom?  In this case, it is the absence or deficiency of insulin.  Plenty of calories coming in, not enough being available for energy expenditure or tissue building.  It is certainly not as simple as a 'calorie is a calorie'.

Furthermore, it misses the essential point of low carb diets, that studies already completed, demonstrate that diabetics can benefit from a low carbohydrate diet even with NO caloric restriction.  We can argue over why this is the case, but it is the case.

http://www.nlm.nih.gov/medlineplus/news/fullstory_73453.html

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Mountain Man replied on Fri, Feb 27 2009 10:22 PM

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Please read the third pargraph from the linked article:

"Carbohydrate restriction is at the heart of a diabetic diet. A very low carb diet causes the body to use protein to provide energy, which produces ketones, and it is therefore called a ketogenic diet. Another dietary approach is to use foods with a low glycemic index, ie, that don't cause a rapid rise in blood sugar, and to cut back on calories."

It clearly states that the low glycemic diet must include a reduction in calories. Regardless of how the body utilizes calories, the principal is still the same.

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nomorecarbs replied on Fri, Feb 27 2009 10:47 PM

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Mountain Man,

If you will reread that paragraph, you will see that they are referring to 'ANOTHER' dietary strategy, the low glycemic diet which must include a reduction in calories, that is not true of the very low carb, ketogenic diet, which does NOT require a reduction in calories.  There are studies of both adults and epileptic children that show this to be true.

Again, I will go back to type I diabetics.  Regardless of how much they eat, they will lose weight until they begin insulin treatment.  Similarly, before the discovery of insulin, type I diabetics could have their lives extended by going on fat and alcohol diets, which provide calories not requiring an insulin response.  Unfortunately, without protein in the diet, the patient ultimately wastes away to terminality.

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Ron AKA replied on Fri, Feb 27 2009 10:51 PM

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NMC, what you say is a good example of the smoke blown by the snake oil salesman. The strategy is to take some factual information, but use it in a way to greatly exaggerate the effect (blowing smoke to cloud the facts). It is true that calorie content is determined by a calorimeter, and not all the energy is digested and made available to the person. The most significant example of this is fiber included in the carbohydrate calories. The calorimeter counts it, and it is included on the food label, but it is not digested. The effect is an overestimation of the calories in carbohydrates. This means you can eat more carbohydrates than the label would indicate. Sugar alcohols have a similar effect. However in the scheme of things, this overall effect is quite minor. Further it favours the use of carbs over fat or protein, and not the other way around.

The undiagnosed type 1 diabetic quickly losing weight when food intake increases is a very good example of how the calories in calories out formula works. When calculating the calories out all you have to do is calculate the calorie content (sugar) of the urine and multiply it times the daily volume. This loss is in addition to the normal energy expended.

You can't cheat the laws of thermodynamics. However, you can become confused if you do not know the facts.

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nomorecarbs replied on Sat, Feb 28 2009 6:02 AM

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Ron wrote:

"Mountain Man:

Mountain Man (Welcome to the forum!), you have it exactly right. It is no more complicated than that"

But in his latest post, he adds,

"

The undiagnosed type 1 diabetic quickly losing weight when food intake increases is a very good example of how the calories in calories out formula works. When calculating the calories out all you have to do is calculate the calorie content (sugar) of the urine and multiply it times the daily volume. This loss is in addition to the normal energy expended.

You can't cheat the laws of thermodynamics. However, you can become confused if you do not know the facts"

***************************************************************

Well, if you recognize that energy intake can be excreted rather than stored as fat, you realize that no thermodynamic laws are violated when demonstrating that a low carbohydrate diet can lead to greater weight loss even when the same amount of calories are being consumed.