Low-carb? Low-fat? Study... Whats your take?

Jim Mills

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Low-carb? Low-fat? Study finds calories count more


Feb 26, 7:15 AM (ET)

By ALICIA CHANG

LOS ANGELES (AP) - Low-fat, low-carb or high-protein? The kind of diet doesn't matter, scientists say. All that really counts is cutting calories and sticking with it, according to a federal study that followed people for two years. However, participants had trouble staying with a single approach that long and the weight loss was modest for most.

As the world grapples with rising obesity, millions have turned to popular diets like Atkins, Zone and Ornish that tout the benefits of one nutrient over another.

Some previous studies have found that low carbohydrate diets like Atkins work better than a traditional low-fat diet. But the new research found that the key to losing weight boiled down to a basic rule - calories in, calories out.

"The hidden secret is it doesn't matter if you focus on low-fat or low-carb," said Dr. Elizabeth Nabel, director of the National Heart, Lung and Blood Institute, which funded the research.

Limiting the calories you consume and burning off more calories with exercise is key, she said.

The study, which appears in Thursday's New England Journal of Medicine, was led by Harvard School of Public Health and Pennington Biomedical Research Center in Louisiana.

Researchers randomly assigned 811 overweight adults to one of four diets, each of which contained different levels of fat, protein and carbohydrates.

Though the diets were twists on commercial plans, the study did not directly compare popular diets. The four diets contained healthy fats, were high in whole grains, fruits and vegetables and were low in cholesterol.

Nearly two-thirds of the participants were women. Each dieter was encouraged to slash 750 calories a day from their diet, exercise 90 minutes a week, keep an online food diary and meet regularly with diet counselors to chart their progress.

There was no winner among the different diets; reduction in weight and waist size were similar in all groups.

People lost 13 pounds on average at six months, but all groups saw their weight creep back up after a year. At two years, the average weight loss was about 9 pounds while waistlines shrank an average of 2 inches. Only 15 percent of dieters achieved a weight-loss reduction of 10 percent or more of their starting weight.

Dieters who got regular counseling saw better results. Those who attended most meetings shed more pounds than those who did not - 22 pounds compared with the average 9 pound loss.

Lead researcher Dr. Frank Sacks of Harvard said a restricted calorie diet gives people greater food choices, making the diet less monotonous.

"They just need to focus on how much they're eating," he said.

Sacks said the trick is finding a healthy diet that is tasty and that people will stick with over time.

Before Debbie Mayer, 52, enrolled in the study, she was a "stress eater" who would snack all day and had no sense of portion control. Mayer used to run marathons in her 30s, but health problems prevented her from doing much exercise in recent years.

Mayer tinkered with different diets - Weight Watchers, Atkins, South Beach - with little success.

"I've been battling my weight all my life. I just needed more structure," said Mayer, of Brockton, Mass., who works with the elderly.

Mayer was assigned to a low-fat, high-protein diet with 1,400 calories a day. She started measuring her food and went back to the gym. The 5-foot Mayer started at 179 pounds and dropped 50 pounds to 129 pounds by the end of the study. She now weighs 132 and wants to shed a few more pounds.

Another study volunteer, Rudy Termini, a 69-year-old retiree from Cambridge, Mass., credits keeping a food diary for his 22-pound success. Termini said before participating in the study he would wolf down 2,500 calories a day. But sticking to an 1,800-calorie high-fat, average protein diet meant no longer eating an entire T-bone steak for dinner. Instead, he now eats only a 4-ounce steak.

"I was just oblivious to how many calories I was having," said the 5-foot-11-inch Termini, who dropped from 195 to 173 pounds. "I really used to just eat everything and anything in sight."

Dr. David Katz of the Yale Prevention Research Center and author of several weight control books, said the results should not be viewed as an endorsement of fad diets that promote one nutrient over another.

The study compared high quality, heart healthy diets and "not the gimmicky popular versions," said Katz, who had no role in the study. Some popular low-carb diets tend to be low in fiber and have a relatively high intake of saturated fat, he said.

Other experts were bothered that the dieters couldn't keep the weight off even with close monitoring and a support system.

"Even these highly motivated, intelligent participants who were coached by expert professionals could not achieve the weight losses needed to reverse the obesity epidemic," Martijn Katan of Amsterdam's Free University wrote in an accompanying editorial.
 
Enigma76

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You beat me to it!

I'm not surprised with the results. I believe the actual study used people with a BMI of 25-40; it is pretty well documented that for overweight to obese people, simply cutting calories is sufficient to lose weight.

Which of their "diets" is the healthiest is up for debate. I'm not even sure it matters. In the long run, these people need to lose weight, not worry as much about the macronutrient breakdown of their diet.

The overall caloric consumption becomes even more pronounced when you work with the morbidly obese. Simply having them switch from regular to diet soda can produce drastic amounts of weight loss (I'm talking people with BMIs above 50).

Its when you get to the lower range of normal bodyfat (15%ish) that you have to start tweaking carbs/protein/fat. At least, thats how I see it.

Still, good study nonetheless.
 
Jim Mills

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Its when you get to the lower range of normal bodyfat (15%ish) that you have to start tweaking carbs/protein/fat. At least, thats how I see it.
How true that is... When I'm bulking and reach 14-15% bf, I'll start cutting to get myself back down to 9-10% BF by way of no carb/low carb diet (anabolic diet)..... The only problem I have is, I'm 5'7" at 185 lbs and I'm in a 32 waist... If my pants start to get tight, I'm afraid to jump into a 34 because I feel I'll keep going and lose control of my weight.... I'm just wondering if it's possible to go over 200lbs and still be in a 32 waist.
 
Enigma76

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How true that is... When I'm bulking and reach 14-15% bf, I'll start cutting to get myself back down to 9-10% BF by way of no carb/low carb diet (anabolic diet)..... The only problem I have is, I'm 5'7" at 185 lbs and I'm in a 32 waist... If my pants start to get tight, I'm afraid to jump into a 34 because I feel I'll keep going and lose control of my weight.... I'm just wondering if it's possible to go over 200lbs and still be in a 32 waist.

You know its funny, I do the same thing with my clothes. When I was at my lightest last summer (~200lbs), I had a bunch of dress shirts custom made and I purposely did not alter the measurements. It forces me to maintain my weight, even though I went up to ~215-220 over the winter.

At your height I bet it would be a prob to go over 200lbs and be a 32. I'm 6'0 215 and in a 34...when I'm down to 200, I'm more like a tight 32. Then again, I've hurt myself powerlifting so many times that I rarely train my legs anymore via squats or deads (once in awhile when I'm feeling particularly crazy I'll go for a max deadlift day just to see where I'm still at). Not doing those exercises allows me to fit into a narrower waist because by core isn't so well trained and bulky.
 
machinehead

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How true that is... When I'm bulking and reach 14-15% bf, I'll start cutting to get myself back down to 9-10% BF by way of no carb/low carb diet (anabolic diet)..... The only problem I have is, I'm 5'7" at 185 lbs and I'm in a 32 waist... If my pants start to get tight, I'm afraid to jump into a 34 because I feel I'll keep going and lose control of my weight.... I'm just wondering if it's possible to go over 200lbs and still be in a 32 waist.
Do you do cardio during bulking? How long does it take you to go from 10% to 15%?

Re: the article, I love me having a Porterhouse for dinner almost every day :food:
 
machinehead

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At your height I bet it would be a prob to go over 200lbs and be a 32. I'm 6'0 215 and in a 34...when I'm down to 200, I'm more like a tight 32. Then again, I've hurt myself powerlifting so many times that I rarely train my legs anymore via squats or deads (once in awhile when I'm feeling particularly crazy I'll go for a max deadlift day just to see where I'm still at). Not doing those exercises allows me to fit into a narrower waist because by core isn't so well trained and bulky.
Some people have tiny waist. Mine was 28" at 5'9". Now I can fit in 33 dress pants but wear 36 baggy jeans so I can sit at work all day without compressing my testicles.

The real question is how much of waist growth is fat and how much is distension from forcefeeding all day. Core muscles don't seem to make much difference in my case, although I love deadlifting.
 
Nitrox

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Its when you get to the lower range of normal bodyfat (15%ish) that you have to start tweaking carbs/protein/fat. At least, thats how I see it.
I still don't see it. I have seen no convincing arguments or studies that justify any heavily skewed macro ratio'ed diets. Calories come first followed by a diet that each individual can live with. If you like carbs then put some in, if you don't then cut them back, etc...
 
Enigma76

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Some people have tiny waist. Mine was 28" at 5'9". Now I can fit in 33 dress pants but wear 36 baggy jeans so I can sit at work all day without compressing my testicles.

The real question is how much of waist growth is fat and how much is distension from forcefeeding all day. Core muscles don't seem to make much difference in my case, although I love deadlifting.
Distention from eating definitely plays a huge role. For me, it was a combination of core bulk size (some fat but its noticeably an increase in circumference without much of a fat increase) and hip flexor/glut size. When I was training legs normally (prior to injuries), I would require higher waist-size pants and have to cinch them down with a belt, because my hips and ass would prevent me from fitting into smaller clothing for my true waist size. It looked pretty dumb actually in retrospect haha.
 
Enigma76

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I still don't see it. I have seen no convincing arguments or studies that justify any heavily skewed macro ratio'ed diets. Calories come first followed by a diet that each individual can live with. If you like carbs then put some in, if you don't then cut them back, etc...
I doubt you'll find a convincing study...it just isn't worth studying IMHO because it isn't medically relevant health-wise to go from 15% to 10% or 6%.

"The diet that each individual can live with" is what I'm referring to when I speak of tweaking macronutrient ratios. Personally I am carb sensitive, so I limit my carb intake. If I don't, my weight loss slows or even reverses.

There is plenty of anecdotal evidence on this board and many others about nutrient ratios to attain lower bodyfat levels.
 
Nitrox

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I doubt you'll find a convincing study...it just isn't worth studying IMHO because it isn't medically relevant health-wise to go from 15% to 10% or 6%.

"The diet that each individual can live with" is what I'm referring to when I speak of tweaking macronutrient ratios. Personally I am carb sensitive, so I limit my carb intake. If I don't, my weight loss slows or even reverses.

There is plenty of anecdotal evidence on this board and many others about nutrient ratios to attain lower bodyfat levels.
'Anecdotal evidence' is an oxymoron. My personal anecdotal evidence is that moderate carb and trace carb diets work. However the latter left me weaker, flatter, and more fatigued. Since I am in the minority, does that mean my 'evidence' is wrong?

Just because people have managed to achieve certain results with a certain macro ratio does not mean that it was critical in achieving it. The only thing that can be inferred is that it did not hinder that achievement. There are too many variables in the equation to conclude otherwise.

How did you come to the conclusion that substituting X amount of carb calories for the same amount of fat calories slowed or reversed your weight loss? Is this how you determined that you are carb sensitive?

As always, I am not trying to pick on you or anyone in particular. Just trying to get people to question some common conceptions.
 
Hank Vangut

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true, total calorie intake is far more important.
the reason i prefer the lower carbohydrate diet on a cut is for satiety reasons.
i seem to be better able to consistently maintain a lower calorie intake when macros favor more filling fat & protein intake.
 
B5150

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true, total calorie intake is far more important.
the reason i prefer the lower carbohydrate diet on a cut is for satiety reasons.
i seem to be better able to consistently maintain a lower calorie intake when macros favor more filling fat & protein intake.
And in here lies the secondary issue behind the calories - consistency.

A diet that is too restrictive in general is often abandoned. A challenge for most/many (myself included) is that trace carbs can wreak havoc on cravings - resulting in binges.

The successfulness of any diet starts out with adherence IMHO
 
EasyEJL

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And in here lies the secondary issue behind the calories - consistency.

A diet that is too restrictive in general is often abandoned. A challenge for most/many (myself included) is that trace carbs can wreak havoc on cravings - resulting in binges.

The successfulness of any diet starts out with adherence IMHO
although I must admit that the evidence towards lack of carb intake lowering T4/T3 levels seems to at least partially make too low of a carb dieting for too long of a time counterproductive.

BTW, i've been buying Newman-Os now (the organic paul newman oreos) so at least if I take in a few extra cals its healthier cals.
 
Jim Mills

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And in here lies the secondary issue behind the calories - consistency.

A diet that is too restrictive in general is often abandoned. A challenge for most/many (myself included) is that trace carbs can wreak havoc on cravings - resulting in binges.

The successfulness of any diet starts out with adherence IMHO
50,000 rep point hey... Guess you know what your talking about.... Most of the times. :biglaugh:
 
Enigma76

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'Anecdotal evidence' is an oxymoron. My personal anecdotal evidence is that moderate carb and trace carb diets work. However the latter left me weaker, flatter, and more fatigued. Since I am in the minority, does that mean my 'evidence' is wrong?

Just because people have managed to achieve certain results with a certain macro ratio does not mean that it was critical in achieving it. The only thing that can be inferred is that it did not hinder that achievement. There are too many variables in the equation to conclude otherwise.

How did you come to the conclusion that substituting X amount of carb calories for the same amount of fat calories slowed or reversed your weight loss? Is this how you determined that you are carb sensitive?

As always, I am not trying to pick on you or anyone in particular. Just trying to get people to question some common conceptions.

A person I admire very much once told me that "the plural of anecdote doesn't make fact".

Don't worry I understand your intentions, no offense taken.

You describe finding that trace carb diets leave you feeling worse than moderate carb diets. This is indeed anecdote, but I am sure that you utilize this information when you consider things to eat during the day or when you tailor a diet plan. That "evidence" is not objective in the least and only applies to you, yet it doesn't make it any less true for you personally. You, in essence, are utilizing personal anecdote to tweak your macronutrient ratios for whatever goal you are attempting to pursue.

I'm not making the argument that macronutrient ratios become more important than the amount of calories consumed, at ANY level of bodyfat. Rather, I'm making the argument that the ratios gain importance as your bodyfat drops near "set-point" and as you change or alter goals. From my mindset (and I think the majority on this message board), the goal is to lose as much fat as possible while preserving as much muscle as you can.

I found myself being "carb sensitive" based upon my results with a high protein/fat/low carb diet compared to my results with a moderate carb diet. Granted they were at different parts of my life, and the variables are too numerous to even guess at. In the end, low carb works for me, like how moderate carbs work for you, like how high carbs might work for Mr XYZ.

But, if the ratios didn't matter, then it wouldn't matter for either of us what we did. You shouldn't feel flatter and weaker on a trace carb diet if the ratios didn't matter.

Thats all I'm saying. Ultimately, the calories in need to be lower than the calories out, regardless of ratio.
 

russy_russ

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In the end it boils down to calories in Vs calories burned. However, different macro percents dictate which substrate will primarily be utilized for ATP resynthesis. If you do (high protein, high fat, low carb) the body will increase cortisol release to aid in protein catabolism (even from muscles) to be converted to glucose via gluconeogensis in the liver, to pyruvate and/or kreb's intermediates--depending on which amino acids are in abundance. Also noted with this diet high in fat the body will use it's glycogen stores and glucose (which will be quickly depleted in a week or two on low carb). When this happens the conversion of carbohydrates to kreb's intermediates are slowed, which in turn slows the kreb's cycle (this is the where fatty acids which have been converted to acetyl-coa in beta-oxidation are oxidized further *note the only way to further fatty acid oxidation*). In other words for this type of diet, your body will use its glycogen stores (which are needed for quick resynthesis of ATP during exercise) will be quickly depleted and the fats that are taken in will be burned by these glycogen stores; however, most of the stored fats (as triglycerides) will not be broken down (lipolysis). Which accounts for the water weight that is lost with low-carb diets (carbohydrates bind 3 water molecules).
 
Nitrox

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But, if the ratios didn't matter, then it wouldn't matter for either of us what we did. You shouldn't feel flatter and weaker on a trace carb diet if the ratios didn't matter.
Actually you make a very good point there and have identified that I overextended one of my arguments. So to clarify I should not say that ratios do not matter but rather that there is little to no value in heavily favoring or reducing one macro nutrient at the expense of the others. Meaning, it is improbable that a reasonably balanced diet can be improved upon by skewing macros.
 
EasyEJL

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Meaning, it is improbable that a reasonably balanced diet can be improved upon by skewing macros.
Definitely true in the long run, possibly less true for a short span of time - 4-8 weeks. And really thats what this study is about, long term. I still would think that a precontest diet could be most advantageous if ratios were purposefully skewed short term
 
Enigma76

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Actually you make a very good point there and have identified that I overextended one of my arguments. So to clarify I should not say that ratios do not matter but rather that there is little to no value in heavily favoring or reducing one macro nutrient at the expense of the others. Meaning, it is improbable that a reasonably balanced diet can be improved upon by skewing macros.
I agree with you completely. I don't think heavily skewing the ratios one way or the other is the right thing to do, at the least it isn't the healthy thing to do. We were built as omnivores, not as strict carnivores. When I say I like to limit my carbs, I still eat enough to maintain my mental clarity. Personally I can't afford to go through the fogginess and general lethargy that comes with a trace carb diet...been there, done that, no thanks.
 
B5150

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Definitely true in the long run, possibly less true for a short span of time - 4-8 weeks. And really thats what this study is about, long term. I still would think that a precontest diet could be most advantageous if ratios were purposefully skewed short term
I absolutely agree with short term aesthetic benefits of low carb diets. I can loose lbs of water weight and a considerable amount of girth when I am carb depleted. But my muscle volume suffers just as quickly.
 

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yea the thing with that study and many other studies is.. all they ever talk about is weight loss and reduction in waiste size.

Where's the mention of FAT loss using relative skinfold measurements?.......

my point being, if muscle building and fat loss were just about calories in vs calories out, All we have to do is eat at donut king and McDonalds to gain muscle and eat less of donut king and mcdonalds to lose fat.
 
EasyEJL

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yea the thing with that study and many other studies is.. all they ever talk about is weight loss and reduction in waiste size.

Where's the mention of FAT loss using relative skinfold measurements?.......

my point being, if muscle building and fat loss were just about calories in vs calories out, All we have to do is eat at donut king and McDonalds to gain muscle and eat less of donut king and mcdonalds to lose fat.
do you have a study that shows it won't?
 
B5150

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Some phenotypes are just predisposed to storing surplus calories as fat regardless of the macronutrients and the energy expenditure.
 
Nitrox

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yea, myself 6 months ago..... getting up to 26% bodyfat thru heavy lifting and a fast food diet.
What was your total calorie intake and what was your approximate energy expenditure?
 

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