Low-fat, high-carb diet does not cause weight gain in post-menopausal women

Last Updated: 2006-01-03 16:00:47 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Replacing fat in the diet with vegetables, fruits, and whole grains does not lead to increased body weight in postmenopausal women, according to results of the Women's Health Initiative Dietary Modification Trial.

Some proponents of popular diets have low-fat and high-carb diets for the increased prevalence of obesity in the US over the past several decades, Dr. Barbara V. Howard and her associates note in their report, published in this week's Journal of the American Medical Association.

To assess this premise, Howard, from MedStar Research institute in Washington, DC, and her colleagues evaluated long-term weight changes among nearly 49,000 women ages 50 to 79 enrolled between 1993 and 1998 in the WHI trial.

Abut a third of the women were randomly assigned to participate in group and individual sessions that promoted a reduction in total dietary fat to 20%, at least five servings daily of fruits and vegetables, and six servings of grains, but no restriction in calories. The other women received diet- and health-related educational materials only.

During the first year, mean weight decreased significantly in the intervention group by 2.2 kg (p < 0.001), but not in the control group. Although average weight in the intervention group tended to increase over time, it remained below baseline and significantly lower by 0.5 kg than the comparison group for nine years.

"A low-fat dietary pattern may help attenuate the tendency for weight gain commonly observed in postmenopausal women," Howard's team concludes.

However, editorialists from Tufts University, Dr. Michael L. Dansinger and Dr. Ernst J. Schaefer, call the study's findings on long-term weight change "underwhelming," and suggest that the intervention should have also included advice on caloric restriction for participants who were overweight or obese.

They reported in 2005 that cutting calories resulted in weight loss and heart disease risk factor reduction, regardless of diet type.

"Much more work needs to be done on the obesity front," the Boston-based writers advise, "including a concerted collective effort focused on developing reliable methods of facilitating high long-term adherence levels to substantial lifestyle efforts -- specifically calorie-reduced eating patterns and much more exercise."

SOURCE: Journal of the American Medical Association, January 4, 2006.


http://www.reutershealth.com/archiv...0103elin023.htm


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Underwhelming, indeed. The average difference in weight between the 'healthy eaters' and the control group was 1.1 pounds. And they call this difference 'significant'????
The headline states "does not cause weight gain" however above, they state that while weight in the intervention group tended to increase over time (read: they gained weight) it was lower than the other group by 1.1 pound.



In English: The intervention group lost almost 5 pounds in the first year and then gained roughly 4 of them back while the other group pretty much stayed the same. End result, neither group saw any significant changes in weight over the duration of the study.

Michael Dansinger is now a big hotshot expert in the diet field because of his equally underwhelming comparison study of Atkins, Ornish, Zone and WW diets. One of the crummiest studies I've ever seen. But it got him on TV and in a bunch of "popular" magazines.

Ditto on "underwhelming." In addition, their study may have had a serious confound. The article is not clear, but it looks like the control group women were handed a bunch of brochures and sent home. The controlled-diet group women received a lot more attention - either individual or group sessions. They also got on-going reinforcement to think about their food intake with the specific, daily diet regimen.

It reminds me of an early famous social psych study about how to increase productivity of factory-line workers. I don't remember the exact details, but the researchers tried painting the walls one colour and productivity went up. Then they tried a different colour and productivity went up again. They tried new lighting and... you get the picture. Every time they changed something, productivity went up. It finally dawned on the researchers that the workers were responding to change per se - that the workers felt better because they felt like management was paying attention to them. A classic confound.

If the doctors cited in the diet study had been doing this research, they would have trumpeted the result that "painting walls yellow" increases work effort.

AP's take....bold is mine:

This is an important observation. Even though these women finished up the study at a lower weight (even if it was only slightly lower), they ended up with a waist that was larger, so their bodies were beginning to store fat in the 'apple' pattern. Guess who's developing insulin resistance even on the 'healthier' diet?

This is an important observation. Even though these women finished up the study at a lower weight (even if it was only slightly lower), they ended up with a waist that was larger, so their bodies were beginning to store fat in the 'apple' pattern. Guess who's developing insulin resistance even on the 'healthier' diet?

Excellent point.

you can get the full text (or download a pdf) here: http://jama.ama-assn.org/cgi/content/full/295/1/39

here's one revealing piece of information that the authors surely won't be trumpeting. the participants in the intervention group lost an average of only 0.4kg after seven years on a diet in which they reported eating more than 300 calories less/day than when they began the intervention (baseline 1788 calories/follow up 1445 calories). 1445 calories/day for 7 years and a measely 0.4 kgs to show for all my hard work? 1445 calories/day on a high carb diet = starving. this tells me that either a) people won't lose weight on a low-fat diet even if they're eating far fewer calores, or b) participants in the intervention group reported eating what they thought they were supposed to be eating (i.e. underreporting or misreporting de facto nutrient/calorie intake), or some combination of the two.

here's a look at one of the pertinent tables:

Not only did the low fat group eat less over the period studied, but they increased their weekly physical activity by 10%. Adding the extra kcals burned from extra physical activity to the equation, and they likely would have even gained weight if measured on food intake alone.

really, how so? since neither those in the intervention nor those in the control group (who were supposed to maintain their normal eating habits) gained weight, how does this aid our understanding of anything? according to these results no one should be gaining any weight, which we know, unfortunately, is far from the case.

and does it makes sense to extrapolate results attained in a study of post-menupausal women to an entire population?

This study was discussed on the local news tonight, along with clips of interviews with the author of the study. She said high carb but then carefully explained that she meant vegetables, fruits and whole grains. Sounds like controlled carb to me. I think it's all in the language. "Low carb" is out, but it looks like starchy carbs and sugar are starting to be down played, IMO. Hopefully, soon everyone will meet in the middle and all will benefit by being encouraged to eat a whole foods diet.

the dietary modification component of the women's health initiative was not devised for the purposes of comparing weight loss regimes. here's how it's described on whi's website:
i'm guessing that the low-fat, high fruit, vegetable and grain diet yielded no positive results in regards to the prevention of breast and colorectal cancer or heart disease, so the authors are desperately searching for something meaningful to report after spending 15 years and millions of taxpayer dollars .

considering the results presented thus far, i found it interesting that the waist circumference of women in the intervention group increased despite their very modest weight lost. i wonder how the authors are digesting this in light of the fact that they were hoping to reduce the risk of colorectal cancer, but...

Wow,

It's really disturbing the way society is.
Does the media work for the Devil ? wtf ?

Why does no one look at this stuff except us ?

Stop the planet, I wanna get off!

Thanks for the link to the original article, eepobee.

Unfortunately (citation): "the database available for the analyses in this article did not allow the separation of carbohydrate intake into the percentage of sugar or simple vs complex carbohydrates."

Another citation: "Financial Disclosures: Dr Howard has been a consultant for Merck, the Egg Nutrition Council, and General Mills; has received research support from Pfizer, Merck, and Schering-Plough; and has lectured for Schering-Plough."

Merck & Co., Inc. is a pharmaceutical company. Here is a list ( http://www.cogforlife.org/merckproducts.htm ) of their drugs treating or preventing for example: Clots after certain cardiac events, Blood Pressure, Nepropathy in diabetics, high cholesterol levels, Stroke.
Pfizer Inc is the world's largest pharmaceutical company and Schering-Plough is another large pharmaceutical company.

General Mills, according to themselves "markets some of the most trusted and respected food brands around the world". Products are highly processed foods, including: Cereals, potato mixes, soups, frozen pizza, snacks, cakes and deserts, soy products, meal, partially baked and fully baked dough products, etc etc ( http://www.generalmills.com/corpora...y/overview.aspx ).

But scaring people away from fats has of course nothing to do with consumption of processed carbohydrates and drugs… ???