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  #1   ^
Old Wed, Feb-25-09, 20:21
Judynyc's Avatar
Judynyc Judynyc is offline
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Default Counting calories, not carbs or fat, matters most, study says.

Counting calories, not carbs or fat, matters most, study says.

In the long run, it's the calories -- not the fat nor protein nor carbs -- that matter, according to a new study comparing diets.

Weight-conscious Americans snap up the latest diets, from the low-fat Dean Ornish approach, to the high-protein Atkins plan, to the compromise called South Beach. But scientific studies evaluating the diets' effectiveness have had mixed results, though, frustrating consumers who struggle to shed pounds.

A team led by Dr. Frank M. Sacks of the Harvard School of Public Health designed a clinical trial that randomly assigned 811 men and women to eat one of four reduced-calorie, heart-healthy diets with different levels of fat, protein, and carbohydrates for two years. The dieters were asked to exercise for a total of 90 minutes each week and they were invited to attend regular group sessions, in addition to receiving periodic individual counseling.

"What we found is that the most important thing for people to lose weight is to choose a heart-healthy diet and to keep the amounts down," Sacks, lead author of the article appearing in the New England Journal of Medicine,said in an interview. "It's not so important whether they eat higher carbohydrates or higher protein or lower carbohydrates or lower protein. What really matters is just plain, simple old quantity: how much people eat."

All the diets worked the same when measured by lost pounds and reduced waist circumference, regardless of the nutrients they emphasized. The 80 percent of participants who stuck with the diets until the end lost an average of 13 pounds in the first six months and kept about 9 pounds off after two years. Dieters who had the best record of attending counseling sessions lost 22 pounds. Waistlines shrank by about 2 inches throughout all groups.

In the end it was the calories they didn't eat that made the difference. All four diets cut out 750 calories a day, the researchers said, prescribing a minimum intake of 1,200 calories per day.

"It's just the calories that count," Sacks said. "It does really make sense [if] how you gain weight is by eating more calories than you burn, you lose weight by eating less."

Cholesterol, blood pressure, and triglyceride levels also improved modestly across the groups.

"These results show that, as long as people follow a heart-healthy, reduced-calories diet, there is more than one nutritional approach to achieving and maintaining a healthy weight," Dr. Elizabeth G. Nabel, director of the National Heart, Lung, and Blood Institute, said in a statement. The institute funded the study.

The participants, who were classified as overweight or obese based on body mass index scores from 25 to 49, agreed to eat diets high in whole grains, fruits, and vegetables. They recorded what they ate or drank in a web-based program that tracked their progress.

Most participants had trouble meeting their assigned targets for fat, protein, or carbohydrate, the study authors noted. That was especially true for the high-protein and low-fat groups, but the differences between what the four groups ate were bigger than in previous studies, so still large enough to draw conclusions, they said.

"The further diet is from a person's customary intake, the harder it is to stick with it in the long term," Sacks said, adding that the study's conclusion that calories matter most will make it easier to follow than more restrictive diets.

Susan B. Roberts, a professor at the Friedman School of Nutrition Science and Policy at Tufts University, was troubled by the limited success participants had in staying on the diets. If they ate similar amounts of protein, she said, it's not surprising that their weight loss was similar.

"I think these large studies that fail to cause much change in diet and produce minimal weight loss don't really help us move forward because they don't tell us what does work," she said in an e-mail interview. "There are four generally recognized ways to reduce hunger and increase satiety based on detailed clinical studies - high protein, high fiber, high volume (i.e., low energy density) and also low glycemic index carbs. What I would really like to see is more focus on these factors rather than just fat, carbs and protein."

An editorial also appearing in the Journal said focusing on diet components might be less important than the behavior of the dieters and the environment around them.

"Even these highly motivated, intelligent participants who were coached by expert professionals could not achieve weight losses needed to reverse the obesity epidemic," Martijn B. Katan of the Institute of Health Sciences at VU University in Amsterdam writes. "We do not need another diet trial; we need a change of paradigm."

http://www.boston.com/news/health/b...ing_hold_t.html
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  #2   ^
Old Wed, Feb-25-09, 20:45
NrgQuest's Avatar
NrgQuest NrgQuest is offline
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Quote:
Originally Posted by Judynyc
A team led by Dr. Frank M. Sacks of the Harvard School of Public Health designed a clinical trial that randomly assigned 811 men and women to eat one of four reduced-calorie, heart-healthy diets with different levels of fat, protein, and carbohydrates for two years. The dieters were asked to exercise for a total of 90 minutes each week and they were invited to attend regular group sessions, in addition to receiving periodic individual counseling.




I am noting the terms heart healthy and noting that these people got individual counselling.

Quote:

"Even these highly motivated, intelligent participants who were coached by expert professionals could not achieve weight losses needed to reverse the obesity epidemic," Martijn B. Katan of the Institute of Health Sciences at VU University in Amsterdam writes. "We do not need another diet trial; we need a change of paradigm.


It seems even the people who conducted the study know that it is insanity to keep pushing heart healthy diets that do not work. I think that this is a tip off that the none of the four diets were actual low carb diets, just some were lower than others.
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  #3   ^
Old Wed, Feb-25-09, 21:02
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Rosebud Rosebud is offline
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I found some more info about this study here: http://www.hsph.harvard.edu/news/pr...rotein-fat.html

Quote:
The trial included 811 men and women who were randomly divided into four diet groups with different target nutrient compositions:

* Low-fat, average protein: 20% of calories from fat, 15% of calories from protein, 65% of calories from carbohydrate

* Low-fat, high-protein: 20% fat, 25% protein, 55% carbohydrate

* High-fat, average protein: 40% fat, 15% protein, 45% carbohydrate

* High-fat, high-protein: 40% fat, 25% protein, 35% carbohydrate

They call 40% fat "high fat." That's low fat in my eyes. But of course they designed it to be "heart healthy." *eyes rolling right outta my head onto the floor*

In other words, folks, nothing to see here, just the usual crapola. What a damn shame they didn't have the guts to actually put someone on a real low carb diet. I can guarantee their results would have been remarkably different.
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  #4   ^
Old Thu, Feb-26-09, 00:23
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folkshot folkshot is offline
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Well, this is just retarded. Why bother to have all the studies be low calorie, and then go on to say that low calorie works? Where is the control group? If they really wanted to do a study trying to prove low cal is best, then they should have had four separate groups. This is just a shoddy study in general.
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  #5   ^
Old Thu, Feb-26-09, 01:38
Demi's Avatar
Demi Demi is offline
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From the Telegraph
London, UK
26 February, 2009-02-26

Diets that count calories work just as well as Atkins, shows research

Low carbohydrate diets, such as Atkins, do not work any better than old fashioned calorie counting, researchers have found.


Doctors found that diets where the amount of starchy carbohydrates, such as potatoes and pasta, were restricted worked no better than diets with no carb restrictions.

A team from Harvard School of Public Health randomly assigned 811 overweight adults to one of four diets that contained different amounts of fat, protein and carbohydrate for two years.

The article continues here: http://www.telegraph.co.uk/health/h...s-research.html




From The New England Journal of Medicine:


Comparison of Weight-Loss Diets with Different Compositions of Fat, Protein, and Carbohydrates

Read the abstract here: http://content.nejm.org/cgi/content/full/360/9/859
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  #6   ^
Old Thu, Feb-26-09, 05:16
Hutchinson's Avatar
Hutchinson Hutchinson is offline
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Comparison of Weight-Loss Diets with Different Compositions of Fat, Protein, and Carbohydrates Full text of research online. Edit Sorry Demi beat me to it and I hadn't noticed.

the diets should include 8% or less of saturated fat, at least 20 g of dietary fiber per day, and 150 mg or less of cholesterol per 1000 kcal. Carbohydrate-rich foods with a low glycemic index were recommended in each diet. I think most of us find that using NATURAL FAT works better.

The diet sheets are set out here.
This is the low carb analysis
high fat, high protein diet (n = 201)
40% Fat, 25% Prot, 35% Carb

How many people here think 35% of energy from carbs is low carbing?

Last edited by Hutchinson : Thu, Feb-26-09 at 05:36.
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  #7   ^
Old Thu, Feb-26-09, 06:14
Hairballz's Avatar
Hairballz Hairballz is offline
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Quote:
Originally Posted by Rosebud
I found some more info about this study here: http://www.hsph.harvard.edu/news/pr...rotein-fat.html


They call 40% fat "high fat." That's low fat in my eyes. But of course they designed it to be "heart healthy." *eyes rolling right outta my head onto the floor*

In other words, folks, nothing to see here, just the usual crapola. What a damn shame they didn't have the guts to actually put someone on a real low carb diet. I can guarantee their results would have been remarkably different.



Totally agree with Rosebud. I don't think you can honestly come out and say we did a fair comparison including a Low Carb version when it doesn't actually match any lc diet I've ever seen - not enough protein OR fat.

I saw this "breaking story" on the news last night and just groaned - more of the same "junk science" promoted as "startling new insight." Yawn.
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  #8   ^
Old Thu, Feb-26-09, 06:30
steve41 steve41 is offline
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Look on the bright side.... at least they are slowly getting away from demonizing fat. Baby steps, folks.
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  #9   ^
Old Thu, Feb-26-09, 07:40
Aria07 Aria07 is offline
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Quote:
Originally Posted by Rosebud
I found some more info about this study here: http://www.hsph.harvard.edu/news/pr...rotein-fat.html


They call 40% fat "high fat." That's low fat in my eyes. But of course they designed it to be "heart healthy." *eyes rolling right outta my head onto the floor*

In other words, folks, nothing to see here, just the usual crapola. What a damn shame they didn't have the guts to actually put someone on a real low carb diet. I can guarantee their results would have been remarkably different.



But none of those diets are specifically "low carb," right? In fact, it sound like all of them were just low calorie diets, w/some variations in macronutrient content. The "high fat" diet still allowed 35% carbs & only 40% fat. It also only allowed 8% saturated fat & 150 mg of cholesterol. All of the diets cut the participants' calories by 750 calories a day. Basically, they're all low-calorie diets, so of course the results will show the results from cutting calories. And across the board, the results were pretty dismal.

I'm on CALP, which is less strict than Atkins, & Fitday still shows that over 75% of my calories come from fat. Atkins & Gary Taubes have both spoken against low-calorie diets, which they say do not work. This was not a low-carb diet & it sort of bugs that the article talks about Atkins & South Beach as if the study refutes those diets, when it does not. I don't understand why there was so little variation of macronutrient content. If they really wanted to do it, I'd be curious to see a study that allowed 80% carbs, or 80% fat, etc. to see the difference.


It's also sort of amazing to me how *unsuccessful* all of these diets were. An average 3-4 k.g. weight loss after two years? And that's even w/free, intensive counseling, exercise, etc. And that's not even counting or including the 200+ people (out of 800) who dropped out before the study was completed. I bet if their "final" results were included in the average, there would probably be a net *gain* for all the participants after two years. That's consistent w/the overall 98% failure rate of diets. If any experiment showed such poor results, the method would be dismissed out of hand. Yet doctors prescribe diet after diet, even though studies consistently show that they do not work. There's got to be another answer.

Last edited by Aria07 : Thu, Feb-26-09 at 07:55.
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  #10   ^
Old Thu, Feb-26-09, 08:37
KarenJ's Avatar
KarenJ KarenJ is offline
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I just read the study, and also read the 39 comments. There was only one comment that noted the fact that there was no low carb diet represented in the study. I believe that was from "Jenny Ruhl". Name sounds familiar.
There was one other Paleo doc from my home town & University... but the rest of the comments were pro "energy in= energy out".
Very sad.
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  #11   ^
Old Thu, Feb-26-09, 10:20
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MizKitty MizKitty is offline
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Jenny Ruhl is owner of Diabetes Update blog http://diabetesupdate.blogspot.com/
and author of the book What They Don't Tell You About Diabetes. Her name here is Lottadata.

Quote:
Well, this is just retarded. Why bother to have all the studies be low calorie, and then go on to say that low calorie works? Where is the control group?


I couldn't agree more. They were all over this study on the Today show this morning, too. I wanted to know, if every participant was asked to exercise 1 hour a day, how does that prove exercise caused weight loss, as they claimed they proved? Where were the participants that lowered their calories and did not exercise?

Worthless study indeed. But unfortunately getting lots of media coverage.

OH... and had to edit to add: I think it was Matt Laur on the Today show this morning who turned to the "Dr. expert" and said something like, so the best diet is a program like Weight Watchers... to which the Dr expert jumped all over in agreement - made me wonder if WW was paying. But then again, a lot of the "news stories" on the Today show sound like paid endorsements to me.

Last edited by MizKitty : Thu, Feb-26-09 at 10:28.
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  #12   ^
Old Thu, Feb-26-09, 10:39
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brobin brobin is offline
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They always miss the point.

Let me concede that I agree that lowering calories is the key factor in a diet. (ignore exercise).

The point is, which diet choice leads to lower calories.

The low fat approach hypothesized that lowering Fat helps because you get less calories per gram in carbs and protein, so you could eat more and get less calories. Period. Unfortunately, while that is indeed true in terms of food weight, they missed the fact that carbs cause hormonal changes (insulin) which lead to increased hunger. Therefore, in the real world, a low fat diet drives one to a higher calorie diet.

Atkins took the approach that while Fat may have more calories, eliminating carbs causes a hormonal response (in most people) of feeling less hungry, and therefore consuming less calories.

So if you ignore all the crap about which one is healthy, the answer for a given individual comes down to which diet makes them consume less calories, with minimal effort to do so (ie.. over a long period of time).

I do know people who love salad so much, they eat is constantly and avoid fat. They lost weight and keep it off. I doubt they have a strong insulin reaction to carbs, but I notice they don't eat a lot of crap carbs either.

I did that too, but I felt hungry and I could not maintain the constant willpower needed to eat less then I wanted. I switched to low carb and found that I like the foods I can eat on low carb and I naturally consume less calories because I am rarely hungry.

I have always believed if that substance known as FAT was called something else (gorf), then people would have not jumped to the easy, yet false assumption that it was the problem. ie.. eating gorf makes you fat doesn't sound anymore plausible then eating protein makes you fat. They were biased to think eating fat makes you fat .. you are what you eat.. and set out to prove it.

The other depressing thing is why so many so called scientists have no clue how to design an experiment. The number of crap studies I see with obvious holes in them is shocking. Most of this crap wouldn't make it to the regional science fair, let alone published.
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  #13   ^
Old Thu, Feb-26-09, 10:57
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Dodger Dodger is offline
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Quote:
The participants, who were classified as overweight or obese based on body mass index scores from 25 to 49, agreed to eat diets high in whole grains, fruits, and vegetables.
Diets that are high in whole grains are not low-carb.
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  #14   ^
Old Thu, Feb-26-09, 11:13
Hutchinson's Avatar
Hutchinson Hutchinson is offline
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Quote:
Originally Posted by Dodger
Diets that are high in whole grains are not low-carb.
Remember also that diets that are high in fibre reduce further the half life of 25(OH)D and make you even more vitamin d deficient than you are currently and that has a further impact on your insulin sensitivity and glucose metabolism.

It is also the case that Fructose increases leptin resistance and in doing so further deprives your body of the ability to metabolize vitamin d.
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  #15   ^
Old Thu, Feb-26-09, 11:17
Wye Wye is offline
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These "studies" are reported so gleefully in the media that I begin to think something more is going on that simply informing people about the "healthy" way to eat.

There's an agenda behind the low-fat diet, I just don't know what it is.
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