A news media feeding frenzy erupted just when a new diet projection broke in the New England Journal of Medicine (NEJM). Almost all the reporters got it wrong, wrong WRONG! So did most of the gloating low carb forumites and bloggers. Come to imagine of it, almost everyone interpreted this study wrong. Some valuable insights came out of their study, but almost everyone missed them because they were too busy thinking what the news declared or defending their own cherished conviction systems...
The new study, titled, "Weight Loss With a Low-Carbohydrate, Mediterranean, or Low-Fat Diet" was published in The New England Journal of Medicine (NEJM) in issue 359, number 3.I quickly read the full text of the research paper the day it was published. Then, I shook my head in dismay as I scanned the surprise headlines. I at last found it amusing that the media turned this into a three ring circus, putting a misleading "low carb versus high carb," "Atkins vindicated" or "Diet wars" spin on the story. But that's mainstream journalism for you, right? Gotta turn over people papers!
Just look at some of these headlines:
"Study Tips Scales in Atkins Diets Favor: Low Carb Regimen Better Than Low Fat Diet For Weight And Cholesterol, Major Study Shows. " "Low-Carb and Low-Fat Diets Face Off "
"The Never-Ending Diet Wars"
"Low Carb Beats Low Fat in Diet Duel."
"Atkins Diet is Safe and Far More Effective Than a Low-Fat One, Study Says"
"Unrestricted Low-Carb Diet Wins Hands Down"
Some of these headlines are hilarious! I wonder if any of these kinds of reporters actually read the whole study. Geez. Is it too much issues to looked at 13 pages before you write a story that will be read by millions of already confused everyone suffering the pain and frustration of obesity?
Here's a quick look at the study design.
The low fat restricted calorie diet was based on American Heart Association guidelines. Calorie intake was set at 1500 for women, 1800 a day for men amongst 30% of calories from fat, and only 10% from saturated fat. Participants were instructed to eat low fat grains, vegetables, fruits and legumes and to limit their consumption of additional fats, sweets and great fat snacks.
The Mediterranean diet group was placed on a gloomy fat, restricted calorie utility rich in vegetables and low in red meat, among poultry and fish replacing beef and lamb. Energy intake was restricted to 1500 calories per day for women and 1800 calories per day for men provided a goal of no more as opposed to 35% of calorie from fat. Added fat came mostly from nuts and olive oil.
The low carb diet was a non-restricted calorie plan aimed at providing 20 grams of carbs per day for the 2 month induction cycle surrounded by a gradual increase in value to 120 grams per day to maintain the weight loss. Intakes of whole calories, protein and fat got not limited. However, the participants were counseled to select vegetarian methods of protein (more on that bizarre-twist shortly). The study subjects were for the most part male (86%), overweight (BMI 31) and middle age (mean age 52)
Here were the article results: There were a little health improvements in cholesterol, blood pressure and other parameters in the Mediterranean and low carb team that bested the elevated carb group. That was the focus of many articles and discussions that appeared on the net this week. However, I'd like to focus on the weight deduction aspect as I'm not a medical doctor and fat loss is the number one subject issue of this website.
All three groups lost weight. The low carb group lost 5.5 kilos, the Mediterranean committe lost 4.6 kilos and the low fat group lost 3.3 kilograms…. IN TWO YEARS! Whoopee!
My destination would be that the results got similar and that none of the diets got the job done very well during the for a while now term! Amanda Gardner of the US News and World Report Health Day was one of the few reporters who got it right:
"Diet plans produce similar results: Study finds Mediterranean and low-carb diets work just as well as low fat ones." Tara Parker-Pope of the New York things also came finishing surrounded by her headline:
"Long managed diet study suggests feat is hard to turn up by: In a tightly controlled experiment, obese people lost an average of just 6 to 10 pounds over two years."
Even this headline was not 100% accurate. The study was HARDLY tightly controlled. Tightly controlled means metabolic ward studies where the researchers actually count and control the calorie intake. The challenge is, you can't lock people in a hospital or research center ward for two years. So in this study, they used a food frequency questionnaire. Sure, like we agree what lendees news story about their eating habits at restaurants and at home behind closed doors! BWAHAHAHAHAHAHAHAHA!
"No! I swear Dr. Schwarzfuchs! I swear I didn't eat people donuts over the weekend! I stayed on my Mediterranean diet. Honest!" One of the most firmly established facts in dietetics examination is the as good as everyone underreports such a food intake BADLY, sometimes by as still as 50%. I'm not saying everyone "lies," they only forget or don't know. In fact, this underreporting of calorie intake is this a huge problem that it causes obesity research very difficult to do and conclusions difficult to draw from free-living studies.
Another blunder in the bombshell reports is such a this study didn't really follow Atkins diet parameters OR even the traditional low fat diet for that matter, so it's not an "Atkin's versus Ornish" showdown at all.
If you actually take the age to looked at the broad text of the research paper it does not say ANYTHING like, "Atkins is the smartest after all." That's the spin that some of the news media cooked up (and what the Atkins foundation was hoping for).
It says, "The diet was based on the Atkins diet." However, the sentence right before that says, "The participants were counseled to decide vegetarian methods of fat and protein." Vegetarian Atkins?
The chart on page 236 argues the low carb diet provided 40% of calories from what i read in carbs at 6, 12 and 24 months. If I'm reading through that data properly, then the easily low carb period was a brief induction phase in the very beginning.
Does that sound as Atkins? 40% carb sounds more like the Zone diet or my own Burn The Fat program to me.
The Atkins Foundation, that partially supported this moment study, told reporters, "We feel vindicated." HA! They should have paid the reporters and told the researchers they felt ripped off and they wanted a refund for misuse of their researching grant!
After thoroughly reading the full text of this study, there are many interesting findings we could talk about, from the differences in results between men and women to the improvements in health markers. Here's how the article really says that stood out to me. It's how I would hold talked about if the newspapers or TV stations had called me:
1. "Mediterranean and low carb diets may be effective alternatives to low-fat diets." I can come to an agreement completely amongst the present statement. All three diets made a calorie deficit. All three groups lost weight. Low carb lost a little more, which is the regular finding due to the fact that low carb diets often control appetite and calorie intake automatically (you eat less even if you don't count calories). Also, if body composition is not indicated, there's an earliest water weight loss such a makes low carb diets look other effective in the very early stages.
2. "Personal preferences and metabolic considerations could inform customized tailoring of dietary interventions." Absolutely! Nutrition should be custom founded on goals, well being status, body type, activity floor and numerous other factors. Different people have different phenotypes. Some people are more predisposed to thrive on a low carb approach. Others feel as if crap on low carbs and do better with more carbs or a middle of the road approach. Those who dogmatically follow and defend one type of diet or the other are only handcuffing themselves by limiting their options. Iris Shai, a researcher in the study said, "We can not rely on one diet fits all." Hmm, far cry from "Atkins wins hands down," wouldn't you say?
3. "The rate of adherence to a study diet was 95.4% at 1 year and 84.6% at 2 years." THIS was the part of most interest to me. When I looked through this, immediately I could easily have cared less almost the silly low carb versus high carb wars that the news reporters were jumping on.
I wanted to know WHY the subjects got able to stick with it so well. Of course, that's boring junk to journalists… adherence? What does that word mean anyway? Yawn - not interesting enough for prime time, I guess.
But it was interesting to me, and I hope YOU pay attention to what I found. The authors of the study wrote:
"This trial indicates a exemplary that are able to be applied more broadly in the workplace. Using the employer as a health coach could be an effective way to improve health. The model of group intervention amongst the use of dietary group sessions, spousal support, food labels, and monthly weighing in the workplace within the framework of a health promotion campaign ought to yield weight reduction and for a while now term quality of life benefits." Hmmmmm, lets see:
* Dietician coaching
* Group meetings
* Motivational phone calls
* Spousal support
* Workplace monitoring (corporate health program)
* Food labels - calorie monitoring
* Weigh-ins (required and monitored)
Wow, everything helpful to extensively term fat loss that sticks. Can you say, ACCOUNTABILITY? These factors help explain the higher adherence.
By the way, the adherence interest rate for the low carb group was the lowest.
90.4% in low fat group
85.3% in the Mediterranean group
78% in the low carb group
Here's the bottom line, the way I see it:
First, please, please, please learn how to find and read primary research and take the shock media stories surrounded by a grain of salt. If you want to know who died, what burned down or how hurricane is coming, tune in to the news – they do a GREAT job at that. If you covet to know how to exhaust weight or improve your health, watch up the original inspection papers in its place of taking second hand tips at have to handle value.
Second, those who prefer a low carb approach; more power to them. Most studies, currently one included, show at the essentially least that low carb is an option and it's not necessarily an unhealthy one if done intelligently. I also experience no qualms amongst someone claiming the low carb diets are slightly more effective for weight loss, actually in the very brief term, cost free residence situations. Is low carb superior for fat loss in the for a while now haul? That's STILL highly debatable. It's likely superior for some people, but not for others.
Third, low carb people, listen up! Even if low carb is superior, that doesn't mean calories don't count. Deny this at your own peril. In fact, this study informs the reverse. The low carb group was in a larger negative electricity balance as opposed to the high carb and Mediterranean assembly (according to the data published in this paper), that easily explains the greater weight loss. Posting the calories contained in foods in the cafeteria may have improved the results and helped with compliance in all groups. When energy intake is matched calorie for calorie, the advantage of a low carb diet shrinks or disappears. For the majority of people, low carb is a hunger management or calorie control weight loss advantage, not metabolic magic (sorry, no magic folks!)
Fourth, choose the nutrition program that's most appropriate for your personal preferences, your current quality of life condition, your genetics (or phenotype) and most important of all… the one you can stick with. Then have a propensity your own garden instead of wasting instant criticizing how the other guy is eating. Your possible results will be able to speak for themselves in the end. Take your shirt off and prove us. If I got forced to choose just one approach (and thank god I'm not), I may recommend preventing the extremes of very low carb or basically low fat or very high fat or especially great carbs. Balance makes the most sense to me, and the research suggests that this helps produce the highest compliance rate. That's not rocket science either, it's widespread sense. If you have a serious fat loss goal, as when I fight in bodybuilding, later a further reduction in carbs and increase in protein makes exemplary sense to me as a peaking diet.
If an badly low or appallingly extreme carb diet worked for you, great. But generalizing your experience to the whole rest of the world causes no sense. Arguing from extremes is the weakest form of argument.
The reason I have THREE nutrition plans (three phases) in my own fat loss program is because programs with flexibility and room for individualization beat the others hands down in the long term. In fact, I wrote an entire chapter in my e-book about unique person types, how to determine yours and how to individualize your nutrition – it's THAT important.
If you have a larger number of choices, you hold more power. The people who are shackled by dogma and narrow thinking are stuck. They also chance missing what's particularly important. Things like: