148 obese men and women were randomized to a low fat (<30% of calories) or a low carbohydrate diet (<40 grams per day) for 12 months. By the end of follow up, participants on the low carb diet lost significantly more weight (8 pounds), lost significantly more fat mass, had significantly lower total:HDL cholesterol ratios, had significantly lower triglycerides, and significantly higher HDL cholesterol. Annals of Internal Medicine 2014; 161:309-18.
Take Home Message
This study
showed that a lower carb/moderate fat diet not only enhanced weight loss, but
also improved risk factors for coronary heart disease. The design of this study
was exceptional, with low drop-out rates and high compliance. The only problem
I have is with the title: “Effects of low carbohydrate and low fat diets”. By
the end of the study, the participants were not really following a traditional
low carb diet.
When I think of
a low carb diet, I think Atkins, with very little carbohydrate, tons of steak,
bacon, cheese and very little fiber. However, the low carb diet in this study
was quite different. By the end of the 12 months, the low carb dieters were not
consuming the recommended 11% of calories as carbohydrate, but fully 34% of their
calories were carbohydrate. They also had very similar amounts of fiber as the
low fat group. Although they did include a bit more saturated fat than the low
fat group, the majority of their fat consumption (about 70%) was healthy
monounsaturated or polyunsaturated fat. Indeed, what they were consuming by the
end of follow-up was much more of a Mediterranean diet than a low carb
diet. Either way, this is still a well-designed study showing that a low fat diet is not the way to go for weight loss
or improved health.
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