Re: Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet

[Guest guest]

This is being broadcast all over the news: that the “low carb” (i.e. high protein) diet is the best for weight loss. Doesn’t sound like the best for longevity though.......

From: Al Pater <old542000@...>

Reply-< >

Date: Wed, 16 Jul 2008 17:38:40 -0700 (PDT)

< >

Subject: [ ] Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet

It is good, free full-text stuff.

New Engl J Med 359 — July 17, 2008 — Number 3

Article Summaries

Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet

This 2-year trial, which took place in an isolated workplace that facilitated retention in the study, randomly assigned 322 moderately obese subjects to one of three diets: a low-fat, restricted-calorie diet; a Mediterranean, restricted-calorie diet; or a low-carbohydrate, non–restricted-calorie diet. The results suggest that the Mediterranean and low-carbohydrate diets are effective alternatives to low-fat diets and that personal preferences and metabolic considerations might inform individualized tailoring of dietary interventions.

New Engl J Med 359 — July 17, 2008 — Number 3, 229-241

Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet

I. Shai and Others, for the Dietary Intervention Randomized Controlled Trial (DIRECT) Group.

http://content.nejm.org/cgi/content/full/359/3/229

ABSTRACT

Background Trials comparing the effectiveness and safety of weight-loss diets are frequently limited by short follow-up times and high dropout rates.

Methods In this 2-year trial, we randomly assigned 322 moderately obese subjects (mean age, 52 years; mean body-mass index [the weight in kilograms divided by the square of the height in meters], 31; male sex, 86%) to one of three diets: low-fat, restricted-calorie; Mediterranean, restricted-calorie; or low-carbohydrate, non–restricted-calorie.

Results The rate of adherence to a study diet was 95.4% at 1 year and 84.6% at 2 years. The Mediterranean-diet group consumed the largest amounts of dietary fiber and had the highest ratio of monounsaturated to saturated fat (P<0.05 for all comparisons among treatment groups). The low-carbohydrate group consumed the smallest amount of carbohydrates and the largest amounts of fat, protein, and cholesterol and had the highest percentage of participants with detectable urinary ketones (P<0.05 for all comparisons among treatment groups). The mean weight loss was 2.9 kg for the low-fat group, 4.4 kg for the Mediterranean-diet group, and 4.7 kg for the low-carbohydrate group (P<0.001 for the interaction between diet group and time); among the 272 participants who completed the intervention, the mean weight losses were 3.3 kg, 4.6 kg, and 5.5 kg, respectively. The relative reduction in the ratio of total cholesterol to high-density lipoprotein cholesterol was 20% in the low-carbohydrate group and 12% in the low-fat group (P=0.01). Among the 36 subjects with diabetes, changes in fasting plasma glucose and insulin levels were more favorable among those assigned to the Mediterranean diet than among those assigned to the low-fat diet (P<0.001 for the interaction among diabetes and Mediterranean diet and time with respect to fasting glucose levels).

Conclusions Mediterranean and low-carbohydrate diets may be effective alternatives to low-fat diets. The more favorable effects on lipids (with the low-carbohydrate diet) and on glycemic control (with the Mediterranean diet) suggest that personal preferences and metabolic considerations might inform individualized tailoring of dietary interventions.

Supported by the Nuclear Research Center Negev (NRCN), the Dr. C. and Atkins Research Foundation, and the S. Abraham International Center for Health and Nutrition, Ben-Gurion University, Israel.

-- Al Pater, alpater@...

[Guest guest]

Some points..

- i am surprised this made it into the NEJM

- the " low fat " diet was not a " low fat " diet but an American Heart

Association diet that is 30% fat, 10% Saturated fat and been proven to

be ineffective. How did fiber consumption go down in a healthy low fat

diet?

-notice the difference in calories between the groups during the first 6

months of which the main difference in weight occured.

- most of their comments in relation in " lipid & heart health

improvement " is in relation to HDL related numbers ratios. But those are

just bio-markers and not endpoints. I have posted info here on how

changes in HDL on an Atkins diet type may not be healthy but detrimental.

Regards

Jeff

Al Pater wrote:

>

> It is good, free full-text stuff.

>

>

> New Engl J Med 359 — July 17, 2008 — Number 3

> Article Summaries

> Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet

>

> This 2-year trial, which took place in an isolated workplace that

> facilitated retention in the study, randomly assigned 322 moderately

> obese subjects to one of three diets: a low-fat, restricted-calorie

> diet; a Mediterranean, restricted-calorie diet; or a low-carbohydrate,

> non–restricted-calorie diet. The results suggest that the

> Mediterranean and low-carbohydrate diets are effective alternatives to

> low-fat diets and that personal preferences and metabolic

> considerations might inform individualized tailoring of dietary

> interventions.

>

>

> New Engl J Med 359 — July 17, 2008 — Number 3, 229-241

> Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet

> I. Shai and Others, for the Dietary Intervention Randomized Controlled

> Trial (DIRECT) Group.

> http://content.nejm.org/cgi/content/full/359/3/229

> <http://content.nejm.org/cgi/content/full/359/3/229>

>

> ABSTRACT

>

> Background Trials comparing the effectiveness and safety of

> weight-loss diets are frequently limited by short follow-up times and

> high dropout rates.

>

> Methods In this 2-year trial, we randomly assigned 322 moderately

> obese subjects (mean age, 52 years; mean body-mass index [the weight

> in kilograms divided by the square of the height in meters], 31; male

> sex, 86%) to one of three diets: low-fat, restricted-calorie;

> Mediterranean, restricted-calorie; or low-carbohydrate,

> non–restricted-calorie.

>

> Results The rate of adherence to a study diet was 95.4% at 1 year and

> 84.6% at 2 years. The Mediterranean-diet group consumed the largest

> amounts of dietary fiber and had the highest ratio of monounsaturated

> to saturated fat (P<0.05 for all comparisons among treatment groups).

> The low-carbohydrate group consumed the smallest amount of

> carbohydrates and the largest amounts of fat, protein, and cholesterol

> and had the highest percentage of participants with detectable urinary

> ketones (P<0.05 for all comparisons among treatment groups). The mean

> weight loss was 2.9 kg for the low-fat group, 4.4 kg for the

> Mediterranean-diet group, and 4.7 kg for the low-carbohydrate group

> (P<0.001 for the interaction between diet group and time); among the

> 272 participants who completed the intervention, the mean weight

> losses were 3.3 kg, 4.6 kg, and 5.5 kg, respectively. The relative

> reduction in the ratio of total cholesterol to high-density

> lipoprotein cholesterol was 20% in the low-carbohydrate group and 12%

> in the low-fat group (P=0.01). Among the 36 subjects with diabetes,

> changes in fasting plasma glucose and insulin levels were more

> favorable among those assigned to the Mediterranean diet than among

> those assigned to the low-fat diet (P<0.001 for the interaction among

> diabetes and Mediterranean diet and time with respect to fasting

> glucose levels).

>

> Conclusions Mediterranean and low-carbohydrate diets may be effective

> alternatives to low-fat diets. The more favorable effects on lipids

> (with the low-carbohydrate diet) and on glycemic control (with the

> Mediterranean diet) suggest that personal preferences and metabolic

> considerations might inform individualized tailoring of dietary

> interventions.

>

> Supported by the Nuclear Research Center Negev (NRCN), the Dr.

> C. and Atkins Research Foundation, and the S. Abraham

> International Center for Health and Nutrition, Ben-Gurion University,

> Israel.

>

> -- Al Pater, alpater@... <mailto:alpater@...>

>

>

>

[Guest guest]

Dean Ornish responds:

http://www.newsweek.com/id/146641

>

> It is good, free full-text stuff.

>  

>  

> New Engl J Med 359 — July 17, 2008 — Number 3    

> Article Summaries

> Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet

>  

> This 2-year trial, which took place in an isolated workplace that

facilitated retention in the study, randomly assigned 322 moderately

obese subjects to one of three diets: a low-fat, restricted-calorie

diet; a Mediterranean, restricted-calorie diet; or a low-carbohydrate,

non–restricted-calorie diet. The results suggest that the

Mediterranean and low-carbohydrate diets are effective alternatives to

low-fat diets and that personal preferences and metabolic

considerations might inform individualized tailoring of dietary

interventions.

>  

>

> New Engl J Med 359 — July 17, 2008 — Number 3, 229-241

> Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet

> I. Shai and Others, for the Dietary Intervention Randomized

Controlled Trial (DIRECT) Group.

> http://content.nejm.org/cgi/content/full/359/3/229

>  

> ABSTRACT

>  

> Background Trials comparing the effectiveness and safety of

weight-loss diets are frequently limited by short follow-up times and

high dropout rates.

>  

> Methods In this 2-year trial, we randomly assigned 322 moderately

obese subjects (mean age, 52 years; mean body-mass index [the weight

in kilograms divided by the square of the height in meters], 31; male

sex, 86%) to one of three diets: low-fat, restricted-calorie;

Mediterranean, restricted-calorie; or low-carbohydrate,

non–restricted-calorie.

>  

> Results The rate of adherence to a study diet was 95.4% at 1 year

and 84.6% at 2 years. The Mediterranean-diet group consumed the

largest amounts of dietary fiber and had the highest ratio of

monounsaturated to saturated fat (P<0.05 for all comparisons among

treatment groups). The low-carbohydrate group consumed the smallest

amount of carbohydrates and the largest amounts of fat, protein, and

cholesterol and had the highest percentage of participants with

detectable urinary ketones (P<0.05 for all comparisons among treatment

groups). The mean weight loss was 2.9 kg for the low-fat group, 4.4 kg

for the Mediterranean-diet group, and 4.7 kg for the low-carbohydrate

group (P<0.001 for the interaction between diet group and time); among

the 272 participants who completed the intervention, the mean weight

losses were 3.3 kg, 4.6 kg, and 5.5 kg, respectively. The relative

reduction in the ratio of total cholesterol to high-density

lipoprotein cholesterol was

> 20% in the low-carbohydrate group and 12% in the low-fat group

(P=0.01). Among the 36 subjects with diabetes, changes in fasting

plasma glucose and insulin levels were more favorable among those

assigned to the Mediterranean diet than among those assigned to the

low-fat diet (P<0.001 for the interaction among diabetes and

Mediterranean diet and time with respect to fasting glucose levels).

>  

> Conclusions Mediterranean and low-carbohydrate diets may be

effective alternatives to low-fat diets. The more favorable effects on

lipids (with the low-carbohydrate diet) and on glycemic control (with

the Mediterranean diet) suggest that personal preferences and

metabolic considerations might inform individualized tailoring of

dietary interventions.

>  

> Supported by the Nuclear Research Center Negev (NRCN), the Dr.

C. and Atkins Research Foundation, and the S.

Abraham International Center for Health and Nutrition, Ben-Gurion

University, Israel.

>

> -- Al Pater, alpater@...

>

[Guest guest]

Hi folks:

................ and one can only speculate as to why it is that the American Heart Association continues to recommend the diet it does, when it has been proved that with that diet heart disease gets worse, while studies have been done, and reported in the literature, which demonstrate how CVD can be reversed.

It is not very difficult to come up with all kinds of 'conspiracy-type' explanations for this, the discussion of which is probably not appropriate to this site. Except to say that many here have no faith at all in the American Heart Association recommendations for avoiding CVD, while the data for people on CRON leave no doubt about its benefits.

Rodney. >> Some points..> > - i am surprised this made it into the NEJM> > - the "low fat" diet was not a "low fat" diet but an American Heart > Association diet that is 30% fat, 10% Saturated fat and been proven to > be ineffective.

[Guest guest]

That is the same study that I posted several criticisms here of, about a

month ago.

There was no " low fat " group (it consumed 30% fat) , there was no " low

carb " group, as the low carb group was basically a vegetarian low carb

groups and none of the numbers for their weight and dietary intake work

out.

According to the study numbers, the low carb group started at over 200

lbs, consumed only around 1100 calories each day for 2 years and only

lost 14 lbs.

Go figure!

I am happy to repost my criticisms if you would like.

Regards

Jeff

bill4cr wrote:

>

> http://content.nejm.org/cgi/content/full/359/3/229?query=TOC

> <http://content.nejm.org/cgi/content/full/359/3/229?query=TOC>

>

>

[Guest guest]

please repost your criticisms here .. i appreciate it Jeff.

> >

> > http://content.nejm.org/cgi/content/full/359/3/229?query=TOC

> > <http://content.nejm.org/cgi/content/full/359/3/229?query=TOC>

> >

> >

>