July 18th, 2008

What The New”Low Carb”Study REALLY Says

A news media feeding frenzy erupted earlier this week when a new diet study broke in the New England Journal of Medicine (NEJM) on Thursday, July 17th. Almost all the reporters got it wrong, wrong WRONG! So did most of the gloating low carb forumites and bloggers. Come to think of, almost everyone interpreted this study wrong. Some valuable insights came out of this study, but almost everyone missed them because they were too busy believing what the news said or defending their own cherished belief systems …

NEJM2.gif

The new study, titled, “Weight Loss With a Low-Carbohydrate, Mediterranean, or Low-Fat Diet” was published in The New England Journal of Medicine (NEJM) in issue 359, number 3.

I quickly read the full text of the research paper the day it was published. Then, I shook my head in dismay as I scanned the news headlines.

I found it amusing that the media turned this into a three ring circus, putting a misleading “low carb versus high carb,” “Atkins vindicated” or “Diet wars” spin on the story. But that’s mainstream journalism for you, right? Gotta sell those papers!

Just look at some of these headlines:

“Study Tips Scales in Atkins Diets Favor: Low Carb Regimen Better Than Low Fat Diet For Weight And Cholesterol, Major Study Shows. “

“Low-Carb and Low-Fat Diets Face Off “

“The Never-Ending Diet Wars”

“Low Carb Beats Low Fat in Diet Duel.”

“Atkins Diet is Safe and Far More Effective Than a Low-Fat One, Study Says”

“Unrestricted Low-Carb Diet Wins Hands Down”

Some of these headlines are hilarious! I wonder if any of these reporters actually read the whole study. Geez. Is it too much trouble to read 13 pages before you write a story that will be read by millions of already confused people suffering the pain and frustration of obesity?

Here’s a quick look at the study design.

The low fat restricted calorie diet was based on American Heart Association guidelines. Calorie intake was set at 1500 for women, 1800 a day for men with 30% of calories from fat, and only 10% from saturated fat. Participants were instructed to eat low fat grains, vegetables, fruits and legumes and to limit their consumption of additional fats, sweets and high fat snacks.

The Mediterranean diet group was placed on a moderate fat, restricted calorie program rich in vegetables and low in red meat, with poultry and fish replacing beef and lamb. Energy intake was restricted to 1500 calories per day for women and 1800 calories per day for men with a goal of no more than 35% of calorie from fat. Added fat came mostly from nuts and olive oil.

The low carb diet was a non-restricted calorie plan aimed at providing 20 grams of carbs per day for the 2 month induction phase with a gradual increase to 120 grams per day to maintain the weight loss. Intakes of total calories, protein and fat were not limited. However, the participants were counseled to choose vegetarian sources of protein (more on that bizarre-twist shortly).

The study subjects were mostly male (86%), overweight (BMI 31) and middle age (mean age 52)

Here were the study results:

There were some health improvements in cholesterol, blood pressure and other parameters in the Mediterranean and low carb group that bested the high carb group. That was the focus of many articles and discussions that appeared on the net this week. However, I’d like to focus on the weight loss aspect as I’m not a medical doctor and fat loss is the primary subject matter of this website.

All three groups lost weight. The low carb group lost 5.5 kilos, the Mediterranean group lost 4.6 kilos and the low fat group lost 3.3 kilograms…. IN TWO YEARS! Whoopee! 🙂

My conclusion would be that the results were similar and that none of the diets worked very well over the long term!

Amanda Gardner of the US News and World Report Health Day was one of the few reporters who got it right:

“Diet plans produce similar results: Study finds Mediterranean and low-carb diets work just as well as low fat ones.”

Tara Parker-Pope of the New York Times also came close with her headline:

“Long term diet study suggests success is hard to come by: In a tightly controlled experiment, obese people lost an average of just 6 to 10 pounds over two years.”

Even this headline wasn’t 100% accurate. The study was HARDLY tightly controlled. Tightly controlled means metabolic ward studies where the researchers actually count and control the calorie intake.

The problem is, you can’t lock people in a hospital or research center ward for two years. So in this study, they used a food frequency questionnaire. Sure, like we believe what people report about their eating habits at restaurants and at home behind closed doors! BWAHAHAHAHAHAHAHAHA!

“No! I swear Dr. Schwarzfuchs! I swear I didn’t eat those donuts over the weekend! I stayed on my Mediterranean diet. Honest!”

One of the most firmly established facts in dietetics research is that almost everyone underreports their food intake BADLY, sometimes by as much as 50%. I’m not saying everyone “lies,” they just forget or don’t know. In fact, this underreporting of calorie intake is such a huge problem that it makes obesity research very difficult to do and conclusions difficult to draw from free-living studies.

Another blunder in the news reports is that this study didn’t really follow Atkins diet parameters OR even the traditional low fat diet for that matter, so it’s not an “Atkin’s versus Ornish” showdown at all.

If you actually take the time to read the full text of the research paper it doesn’t say ANYTHING like, “Atkins is the best after all.” That’s the spin that some of the news media cooked up (and what the Atkins foundation was hoping for).

It says, “The diet was based on the Atkins diet.” However, the sentence right before that says, “The participants were counseled to choose vegetarian sources of fat and protein.” Vegetarian Atkins?

The chart on page 236 says the low carb diet provided 40% of calories from carbs at 6, 12 and 24 months. If I’m reading that data properly, then the only low carb period was a brief induction phase in the very beginning.

Does that sound like Atkins? 40% carb sounds more like the Zone diet or my own Burn The Fat program to me.

The Atkins Foundation, which partially supported this study, told reporters, “We feel vindicated.” HA! They should have paid off the reporters and told the researchers they felt ripped off and they wanted a refund for misuse of their research grant!

After carefully reading the full text of this study, there are many interesting findings we could talk about, from the differences in results between men and women to the improvements in health markers. Here’s what the study really says that stood out to me. It’s what I would have talked about if the newspapers or TV stations had called me:

1. “Mediterranean and low carb diets may be effective alternatives to low-fat diets.”

I can agree completely with that statement. All three diets created a calorie deficit. All three groups lost weight. Low carb lost a little more, which is the usual finding because low carb diets often control appetite and calorie intake automatically (you eat less even if you don’t count calories). Also, if body composition is not indicated, there’s an initial water weight loss that makes low carb diets look more effective in the very early stages.

2. “Personal preferences and metabolic considerations might inform individualized tailoring of dietary interventions.”

Absolutely! Nutrition should be individualized based on goals, health status, body type, activity level and numerous other factors. Different people have different phenotypes. Some people are more predisposed to thrive on a low carb approach. Others feel like crap on low carbs and do better with more carbs or a middle of the road approach. Those who dogmatically follow and defend one type of diet or the other are only handcuffing themselves by limiting their options. Iris Shai, a researcher in the study said, “We can’t rely on one diet fits all.” Hmm, far cry from “Atkins wins hands down,” wouldn’t you say?

3. “The rate of adherence to a study diet was 95.4% at 1 year and 84.6% at 2 years.”

THIS was the part of most interest to me. When I read this, immediately I could have cared less about the silly low carb versus high carb wars that the news reporters were jumping on.

I wanted to know WHY the subjects were able to stick with it so well. Of course, that’s boring stuff to journalists… adherence? What does that word mean anyway? Yawn – not interesting enough for prime time, I guess.

But it was interesting to me, and I hope YOU pay attention to what I found. The authors of the study wrote:

“This trial suggests a model that might be applied more broadly in the workplace. Using the employer as a health coach could be an effective way to improve health. The model of group intervention with the use of dietary group sessions, spousal support, food labels, and monthly weighing in the workplace within the framework of a health promotion campaign might yield weight reduction and long term health benefits.”

Hmmmmm, lets see:

* Dietician coaching
* Group meetings
* Motivational phone calls
* Spousal support
* Workplace monitoring (corporate health program)
* Food labels – calorie monitoring
* Weigh ins (required and monitored)

Wow, everything helpful to long term weight loss that sticks. Can you say, ACCOUNTABILITY? These factors help explain the better adherence.

By the way, the adherence rate for the low carb group was the lowest.

90.4% in low fat group
85.3% in the Mediterranean group
78% in the low carb group

Here’s the bottom line, the way I see it:

First, please, please, please learn how to find and read primary research and take the news media stories with a grain of salt. If you want to know who died, what burned down or what hurricane is coming, tune in to the news – they do a GREAT job at that. If you want to know how to lose weight or improve your health, look up the original research papers instead of taking second hand information at face value.

Second, those who prefer a low carb approach; more power to them. Most studies, this one included, show at the very least that low carb is an option and it’s not necessarily an unhealthy one if done intelligently. I also have no qualms with someone claiming that low carb diets are slightly more effective for weight loss, especially in the short term, free living situations. Is low carb superior for fat loss in the long haul? That’s STILL highly debatable. It’s probably superior for some people, but not for others.

Third, low carb people, Listen up! Even if low carb is superior, that doesn’t mean calories don’t count. Deny this at your own peril. In fact, this study shows the reverse. The low carb group was in a larger negative energy balance than the high carb and Mediterranean group (according to the data published in this paper), which easily explains the greater weight loss. Posting the calories contained in foods in the cafeteria may have improved the results and helped with compliance in all groups.

When energy intake is matched calorie for calorie, the advantage of a low carb diet shrinks or disappears. For most people, low carb is a hunger management or calorie control weight loss advantage, not metabolic magic (sorry, no magic folks!)

tom venuto Burn The Fat

Fourth, choose the nutrition program that’s most appropriate for your personal preferences, your current health condition, your genetics (or phenotype) and most important of all… the one you can stick with. Then tend your own garden instead of wasting time criticizing how the other guy is eating. Your results will speak for themselves in the end. Take your shirt off and show us.

If I were forced to choose only one approach (and thank god I’m not), I would recommend avoiding the extremes of very low carb or very low fat or very high fat or very high carbs. Balance makes the most sense to me, and the research suggests that this helps produce the highest compliance rate. That’s not rocket science either, it’s common sense. If you have a serious fat loss goal, as when I compete in bodybuilding, then a further reduction in carbs and increase in protein makes perfect sense to me as a peaking diet.

If an extremely low or extremely high carb diet worked for you, great. But generalizing your experience to the entire rest of the world makes no sense. Arguing from extremes is the weakest form of argument.

The reason I have THREE nutrition plans (three phases) in my own fat loss program is because programs with flexibility and room for individualization beat the others hands down in the long term. In fact, I wrote an entire chapter in my e-book about unique body types, how to determine yours and how to individualize your nutrition – it’s THAT important.

If you have more choices, you have more power. The people who are shackled by dogma and narrow thinking are stuck. They also risk missing what’s really important. Things like:

Personalization
Adherence
Long term maintenance
Accountability
Social Support

and

CALORIES!

Train hard and expect success,

Tom Venuto
www.BurnTheFat.com
www.BurnTheFatInnerCircle.com

PS.If you want to learn more about a balanced, flexible and proven approach, which teaches nutritional individuality and which can produce similar weight loss in one month, month after month that the subjects of this study produced in TWO YEARS, (if you ADHERE to it!), then visit my fat loss website.

If you’re interested in leveraging the power of accountability and social support to help you stick with your program better and get leaner, faster, then visit the Inner Circle support community

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29 Responses to “What The New”Low Carb”Study REALLY Says”

  • As I read the headline for the study at CNN, my BS detector went off as I started thinking, “what would Tom think?” Now I know…. Great Analysis!!

  • John D

    Dateline BFFM: “Tom Venuto gets it right again!” – Thanks for the heads up, as always.

  • Bob

    As I watched the newsies I struggled with the thought of how these participants will be doing in six months if tehy are not monitored. I have done the low carb successfully, until I wasn’t successful..it is hard to maintain that life style. I have accomplished more in two months with BFFM than the low carb over six months because of the emphasis on cardio, weights and my personal goals as well as my nutritional choices.Thanks for your insights Tom. We need an honest appraisal of the gobbleity goop the media gives us.

  • Mel

    Best analysis I’ve read of this study to date.

  • On other blogs I have seen comments like:”This study was conducted over 2 years so all the “There’s no long-term study” people really need to start listening up!”If you’ve lost only 2-5 lbs in 2 years and you’ve had to follow a diet in any form, in my personal opinion, you’re doing something wrong.As you say, Whoopee!To be honest, I don’t think 1% of the bloggers or news organizations read past the study’s title. Reading 15 pages and pulling out what you did, requires more than skimming. Our society is so used to short 30 second ads, 2-3 seconds between scene changes and the Internet … that reading has become difficult.When you skim, you frequently miss the main points. When you skim, it’s easy to jump to conclusions.From the limited reading I did on this and other blogs, you are one of the few that has broken down the study and made comments.Most others, pointed to the 2 years as being a long-term study and that people lost weight.I guess if you skim, then losing weight is great. But if you read, 5.5 lbs in 2 years is very low. In fact, if I had a client and I put them on any type of eating plan and they only lost 5.5 lbs of fat, I’d be disappointed in myself.Thanks once again for raising the bar and pointing out that it’s important to read all the facts before jumping to a set conclusion.

  • Thanks! Enjoyed your thoughts about this BS.All the best!

  • Phil Lucas

    Hi Tom,One thing that I would like to point out. I’ve been a diabetic for at least 4 years and maybe more. I have struggled with my diet and through a lot of personal research have found that low carb works best to control my blood sugar. I read a fascinating book by Dr. Richard Bernstein who advocates 6 Total carbs for breakfast, 12 total carbs for lunch, and 12 total carbs for dinner. Of course eliminte all white sugar and fructose. The closer i can stay to the formula, the better I can manage my Blood sugar. It’s not for everyone, but for us diabetics it appears to work. I do cheat an enjoy low glycemic fruit, mostly berries, fro time to time.

  • Phil. Thanks for mentioning this.This NEJM study did in fact track health parameters and blood lipids including HDL, LDL cholesterol, insulin, glucose and a whole lot more. There were favorable changes with low carb and mediterranean diets compared to low fat, high carb.As I mentioned in my post, I wanted to stay ON the subject of weight loss and OFF the subject of health parameters because for one, I am not a medical doctor, and second becauuse I have seen some HUGE confusion created by the media, bloggers, practitioners, and experts alike regarding the potential benefits of low carb on HEALTH as opposed to benefits of low carb diets on weight loss. sure, they overlap, but that is two separate discussions. My post was about low carb and weight lossIndeed, against conventional high carb, low fat wisdom, many people are seeing improvements in both blood lipids, especially triglycerides and also blood sugar management with adoption of various types of low carb diets.I simply want to make it TOTALLY clear that a calorie deficit is a requirement for weight loss, not low carbs per se.My post should not be misconstrued as an argument against low carb, or an argument against potential health benefits of low carb.On the other hand, I’m not a fan of the extremes of low carb diets(ie 20 gram inductions or 30 grams a day restrictions as in Bernstein), where carbs are so low that you even have to reel in the fruits and veggies.thanks again for your post.

  • James

    I have issues with the study too, just from a different perspective. I found the variability in headlines to be funny. If you take a look at some of the headlines from the UK, they seem more able to relate what happened without much of an agenda (e.g., Ornish in Newsweek).Did you find it at all curious the researchers recommended vegetable protein for the Atkins lite group? Also, the Atkins diet group ate too many carbs to be considered truly “Atkins,” so I’m wondering why all the “vindication” talk is coming out.As the study progressed, the Atkins group consumed more carbohydrates. But there didn’t appear to be a corresponding increase in fiber consumption. Am I looking at this correctly? If so, what do you think this means regarding the results?To me, the fiber part would indicate they consumed more processed carbs (no fiber). If that were the case, I’d have to say the low-carb results are impressive given this fact.What are your thoughts?James in H-town, where its real easy to get my Vitamin D from the sun right now :-).

  • John

    Tom,Nice job. This obfuscation of so-called facts is so pervasive these days that my paranoia has now peaked out. Humanity now has over a century’s worth of at least anecdotal “evidence,” a pool of millions of potential “study” participants and so many fitness “experts” and “gurus” that they seem to outnumber the obese. Still, we can’t unequivocally answer such basic questions as “What causes hypertrophy?” or “What causes diabetes?”To my mind, this means one of two things. Either we as a species have reached our intellectual limit and are now on the decline or the fitness and medical professions have more liars than the used car business and snake oil sales combined.It’s a conspiracy. I’m just not sure who is behind it or what their goal is. Is it the government and the food industry (from farmers to packagers), bent on enslaving us like so many fat, lazy cattle? Is it the medical profession (from vitamin producers to doctors), dreading health as an end to their ride on the gravy train?I’m thirty-nine years old, I’ve been training and actually studying fitness since I was fifteen years old, yet, I am still just as confused as anyone else out there. Everything is a lie, it would seem. If it isn’t a lie, it’s just an illogical assumption made and then reported by someone with an alternate agenda.Here’s what we definitely know:”How do I gain muscle?”Use steroids.The use of pharmaceuticals has prevented us all from knowing anything more than this about hypertrophy.”How do I lose weight?”Starve. Then gain it all back, then starve again.The whole idea of dieting is unnatural, yet this is the best that we have come up with so far.I’m also sick of the excuses offered by these “professionals.”Examples:”Everyone’s different, so there are no hard and fast rules.”Bull. There were no obese Auschwitz survivors–no “individual differences.” I’m not saying that there isn’t a sliding scale, just that these differences from person to person are minimal, at best.”Your genetics won’t allow you to get any bigger or stronger.”Bull. If you can overcome genetics through the use of steroids, then this supposed “ceiling” does not exist in practical terms.What does exist is confusion, outright lies and pure stupidity–not to mention laziness, gluttony and lack of discipline.Just “food” for thought.Kudos to you for telling the brutal truth in your program. As I read it, I said to myself, “I know all of this already.” What I did not know, or acknowledge to myself, was that reaching my goals require some old school work. Yes–WORK. So fitness isn’t your life? You can’t devote “X” time and energy to fitness?Fitness IS your life–not just Tom’s. Money, success, power, marriage, love–all of these things are just the rewards for being fit in some manner, whether mentally, emotionally or physically. They come and they go. When the chips are down, all you really have in life is yourself and what you can do about your situation.If you get nothing else out of Tom’s program, let it be this:”BURN THE FAT.”Thanks, Tom. You have displayed a lot of courage and honesty in your program. That is rare and inspirational.John

  • Jacob

    Thanks for this info. Despite my extreme anti-Atkins bias, my own feeling is that different strokes work for different folks and diets that people are most comfortable with are the ones they’re most likely to stick to. It’s like martial arts, some are naturally better at or more suited to boxing or Karate, some at wrestling or Judo. (Personally, I would never follow a diet devised by someone who died of a heart attack and obese at the relatively young age of 72, but that’s just me. Any of you young people ever heard of Jack Lalanne? He’s the real deal! Still strong in his 90’s!)

  • Ari Cohn

    According to some follow-up investigation, partcipants in the low-carb cohort were not counseled to eat vegetarian protein, and they were not restricted to this. Here’s a citation from Regina Wilshire, who maintains the low-carb blog, The Weight of the Evidence:”I received an email today from a friend who asked one of the researchers about the reference to plant-based (vegetable) fats and proteins. Dr. Shai assured him that the low-carbohydrate group was not advised to consume a vegetarian low-carb diet, nor were they specifically restricted from eggs, cheese, red meat, poultry or fish. Due to dietary restriction (religious) the group would not, for instance, have a cheeseburger or butter on top of their steak. Olive oil featured prominently. The participants did read the Atkins diet book. And the examples provided of the types of meals was “For example, a plate could include : fish or fried/(not bread coated) chicken/or red meat, broccoli, and mushrooms coated with eggs, roasted eggplants, vegetable salad (peppers, cucumber, green leaves, ((not lettuce)) with olive oil dressing.”

  • arde johnson

    I am a personal trainer and health coach and have just opened up a fitness training studio here in Portland, Oregon. I am so glad I discovered this site. I appreciate the information and dialogue and am able to keep learning which to me is what it is all about. And yes, just like in my grad nutrition class….go to original source and study it before you make your conclusion.

  • Jules

    Hi Tom, I actually went on an Atkins diet for 3 months. This was pure 3 months of no carbs – no induction phase BS – and I lost 35 lbs. At one point I was loosing 1 lbs a day. After having to replace my wardrobe twice, the weight loss stopped. No matter what i did, the body could not shed additional fat I could see in my abdomen. I have maintained my weight since and feel great about my new body. But I’m so curious why I can’t loose that last bit of body fat around my waist. Are these permanent fat cells that can only be removed by liposuction?Cheers.Jules.

  • Jeff Howard

    Tom,I think your post, while maybe technically accurate regarding “weight loss” (or “fat loss”; you use the terms interchangeably even though they are two completely different beasts), might be a little misleading with regard to an overall health profile. It appears you admit as much in your reply to Phil, and take the easy way out in my opinion by claiming weight loss benefits and health benefits should be kept separately.I find that kind of thinking short-sided and potentially dangerous to your readers. We don’t lose weight/fat in a vacuum, so it’s not possible to separate the health benefits from the weight loss benefits. Fat loss of any kind will certainly have an impact on overall health regardless of how much you want to claim otherwise. It’s possible to lose fat and improve overall health, but it’s also possible to lose fat and diminish overall health. Health and weight loss benefits more than overlap; they are intertwined, so why do you feel it necessary to make the distinction?Could it have something to do with your own nutrition program? It seems that ignoring the health and/or blood profile improvements made it easier for your to lump all three of the “diets” together and claim they were all about the same. Well they clearly weren’t, but by doing so you were then able to offer up your program as a better alternative. I suppose that’s OK; it’s all about marketing, but personally I would never follow a program that didn’t consider the entire picture of overall health in conjunction with fat/weight loss. Perhaps I’ve misconstrued your post, but why not promote a eating plan that promotes fat loss AND better health?

  • Jeffwe are mostly in agreement. You only misconstrued my post in assuming I bypassed the health issues (which I DID acknowledge more than once, if you read carefully), for marketing reasons. I GAVE my reasons: (1) I am not a medical doctor and (2) this is a fat loss website.For medical advice, talk to your doctor, clinical nutritionist or registered dietician ; I don’t give medical or clinical advice. I will show you how to lose fat and get in shape (of course, in losing excess weight, and especially in doing it using weight training and cardio, as I recommend, all major health parameters almost always improve right along with the lost weight).Indeed, fat loss and weight loss are two separate animals and to the contrary of your assertion, I DID NOT use the words interchangeably, I use them deliberately. IF A STUDY DOES NOT EVEN MEASURE BODY COMPOSITION (%FAT), THEN HOW CAN I SAY “FAT LOSS?” I have to say “weight loss.” the only thing they measured was weight loss.also, low carb diets often product greater weight loss that is not entirely reflective of BODY COMPOSITION (Fat versus muscle). weight loss includes water weight as well as other lean tissue. In fact, my book has an entire chapter on body composition and I write about the importance of improving body composition and fat loss as opposed to weight loss frequently.We are in complete agreement that our goal is to get LEAN AND HEALTHY, not one or the other. And, that getting lean and getting healthy overlap. That said, they are NOT one in the same – You just said so yourself — You said someone can lose weight and not get healthier!!!!!! .Someone can have some excess body fat and be healthy. OR, someone can be lean and be unhealthy. II feel it is VERY important to highlight the difference between the twoAnother reason its important to highlight the difference is because huge numbers of people in the low carb community are saying low carb is superior, but they are not saying WHAT it is superior for: They are claiming lower blood lipids and triglycerides, etc, while in the same breath saying low carb is also superior for weight loss irrespective of calories. The truth is, Its the calories that dictate the WEIGHT loss / FAT loss. NOT the macronutrient ratio or the grams of carbs. But it may in fact be the lower carbs and higher fat that has health effects such as lowering triglycerides!Quite frankly, this is really my ONLY major pet peeve with the low carb community. I think low carb can be effective for both weight loss and health, but you wont get the weight loss without the calorie deficit. The more progressive and intelligent authorities in the low carb movement are stating their firm belief in low carb, but also ackowledge that calories do count.Could it be that you too believe that calories dont matter for weight loss – that it’s some kind of metabolic magic just by reducing carbs? Were you looking for “Atkins Vindicated? like so many others?Frankly, this whole article was more about adherence than the superiority of one approach over the other. You missed my primary message! Adherence is one of the major findings that keeps coming out in the recent “diet duels” — the best diet is the one you can stick with long term. and There is more than one way to skin a cat.

  • Tom,I’m glad you are taking the time to respond to critic or attacks. To me, that shows a lot about your character and your belief system.What surprises me most is that your ‘attackers’ don’t respond back to your answer. Which leads me to think: did their first response to your post mean to provoke you?Anyway, I just wanted to say that many of your readers (including myself) are enjoying your posts and point-of-view and ‘get it’. We believe in your program/system and … keep it up!Thanks for such a great product and service.Al

  • Hi TomI had some of the same questions you did after I started reading some of these headlines and these stories. Thanks for sifting through the research and getting the story straight.Jayson

  • Scott

    Hi TomJust a few quick points on the Atkin’s diet (I’m actually reading through it now)…1) The Induction phase is 2 weeks, not 2 months.2) Atkin’s does support that ‘calories count’. He just makes the point that the simple subtraction of calories supposedly burned and the total calories consumed is not the whole picture. For example, he points out that the calories consumed from protein do not have the same weight gain/ loss effect as do calories from carbohydrates because of their differing effects on metabolism and differing functionalities in the body. Basically, he makes the point that calories from protein have a different potential for weight gain or loss than do calories from fats which have a different potential for weight gain or loss than do calories from carbohydrates. There’s more to it than simple, surfacemath is his point.3) If you haven’t read his book, you might consider it; not because I think you should agree with everything he says, but because he does make some good points. And also, you will see that his method has been bombarded with misunderstanding and misconception after isunderstandingand misconception.Scott

  • scottthanks for your comments. Yours were particularly intelligent compared to a lot of what I get!Ive read atkins diet cover to cover twice. I also believe it has has gone through more than one printing with some revisionsim also aware that even followers of atkins may misinterpret what he intended. Mainly because on very close examination of what he wrote, much of it is quite ambiguous and open to misinterpretation.you wroteAtkin’s does support that ‘calories count’.Yes, he does say calories count in his book… but… he adds a BUT afterwards.I also suppose whether he REALLY says calories count depends on how you intrerpret what he wrotehow would you interpret atkins as follows:“the so called calorie theory has been a millstone around the necks of dieters and a miserable malign influence on their efforts to lose”and“most overweight people do not overeat”LOTS of room to interpret or misinterpret those statementseither by advocate or opponent of his diet, wouldnt you agree?The second statement in particular I find quite a bit off the mark. Overweight people DO overeat although granted, they may have the genes that make them more susceptible to gaining fat quickly while in a caloric surplus; but the surplus must be there.atkins also wrote“its not that calories don;t count, its just that you can, in fact sneak them out of your body, unused, dissipated as heat.”I can only agree with this statement in the context ofa thermogenic effect of protein foods, which has been proven in controlled studies. A “metabolic advantage” oftwo different diets – one low carbs, one high carbswith equal levels of calories, has not been proven!What we HAVE seen is people going on low carbs eat less spontaneously. (and I will be the first person to tell you, that is an advantage of low carb or atkins, just not one of the “metabolic” kind… instead its an advantage of the appetite suppression and satiety kind)you wroteHe just makes the point that the simple subtraction of calories supposedly burned and the total calories consumed is not the whole picture.which is absolutely correct. — calories in vs calories out only dictates whether you will lose or gain -nutrient partioning dictates WHAT you will lose or gain and that is heavily influenced by hormones including insulin.the problem and confusion is that many low carbersbelieve that you will not gain weight in a surplus if carbs are eliminated and perhaps its an atikins follower’s misinterpertation of what dr atkins said, yet it is a very common misconception.again here is atkins” on a low carbohydrate diet, there are metabolicadvantages that will allow you to eat as many ore more calories as you were eating before starting the diet and still begin losing pounds and inches.”and again, it is an amiguous statement which is eithercompletely incorrect or which can lead to a misinpretetationof the facts, depending on how you take it. The statementdoesnt indicate surplus or deficitThe fallacy is that there is a metabolic advantage which means that if you are in a caloric surplus, ie taking in more calories than your total daily energy expenditure (TDEE) that you will NOT gain weight if you simply avoid carbohydrates, or that there is a metabolic advantage over diet A with low carbs and diet B with high carbs when A and B are equal in calories, as measured in a controlled experimentYou wrote:Basically, he makes the point that calories from protein have a different potential for weight gain or loss thando calories from fats which have a different potential for weight gain or loss than do calories from carbohydrates. There’s more to it than simple, surface math is his point.absolutely correct. What is below the surface math is:* nutrient partioning.* thermic effect of food.* effect of macros on appetite including current meal and subsequent mealsFor example, as you said, calories from protein are more thermic than calories from carbs or fat and protein calories suppress the appetite better. Ironically, thats an argument for a higher protein diet not a lower carb diet! Also below the surface math is the effect of the diet on health markers.Youre so right on many points – Atkins is misunderstoodbut equally so by its followers as its opponents. Mainly the misunderstanding is not about WHETHER it works but HOW it works and misunderstandings about HOW a diet works are causing a lot of people a lot of problems!my very best to you

  • scott

    Thanks Tom very your very thorough response.There are certainly many Atkin’s statements that may be misinterpreted in both directions, by both supporter and critic, as you pointed out. As I’ve been reading the book I have noticed that he really could have used better writing organization/advice/editing to possibly assist with someof the ambiguity and confusion.I think the core benefit of studying Atkin’s is in developing anunderstanding of the insulin and weight-gain nightmare that we can find ourselves in due to the effects of refined sugars and refined flours on our body. This nightmare provides a greater understanding of calories in verses calories out. In effect, the ratio of calories in verses calories out required for weightloss ten years ago for someone, who has since moved towards hyperinsulism from refined food abuse, is quite differenttoday.Although I’ve often looked at overweight people as undisciplined, which in many cases there may be some element of that (allot in other cases), he makes a good point in that someone could have been raised on the refined foods, leaving them in a state of food-craving and metabolic / endocrine system imbalance that is beyond resolving through just plainwill-power.For someone who can be as direct and black and white (for a lack of a better term) as I can, and I think as you can be as well, there is a certain level of ‘victimization’ that we must recognize here. That was excellent for me to learn.That is not to say that these individuals shouldn’t be striving for a solution however; the solution being largely one of insulin control by avoiding the refined foods, which is certainly what Atkin’s promotes. Ultimately, it has to be about both getting the insulin activity in check and controlling calories. Atkin’s seems to simply promote that getting the insulin activity in check is a key component of being able to control the calories.I think he ultimately supports what you promote for long-term health, which is a balance of proteins, fats, and carbs (carbs to whatever level is determined necessary to maintain desired bodyweight). Also, he points out that the individual should not stuff themselves uncontrollably (volume/calorie control by feel), but that following the basic sense of fullness and satiety is important.That being said, as you pointed out, he also promotes that the’metabolic advantage’ of increasing proteins and fats while decreasing carbs will allow for greater weight loss than higher carb programs on even fewer calories, which I seem to recall he did relate to thermal differences, as well as the difficulty (energy consuming) with which protein and fat calories are converted into fat, as opposed to the ease with which carbs might be converted. Both of these may be different waysof describing ‘thermal’.In large part, I think Atkin’s got most of his criticism, whetherjustified or not, from promoting what was ‘perceived’ as such an extreme method for weightloss. He could have avoided all of that criticism, and probably helped as many or more people lose weight, if he had not come at the ‘reduce the carbs’ logic at what many perceive as a bit too extreme. But again, I’m afraid his communication style left him far too open to misinterpretation in both directions as we both agree.Keep up the good work. Thanks again.Scott

  • Essie East

    I know low carb isn’t for everybody, but it really worked for me. I lost 35 pounds 3 years ago and have kept it off ever since. For me, the key is — NO SUGAR= LESS HUNGER!!!

  • Scott wroteI think the core benefit of studying Atkin’s is in developing an understanding of the insulin and weight-gain nightmare that we can find ourselves in due to the effects of refined sugars and refined flours on our body.Absolutely – and THAT we can ALL agree on, right? reduce the whites – white sugar and white flour along with other processed foods. But DONT demonize all “carbs” in the processUltimately, it has to be about both getting the insulin activity in check and controlling calorieswell said. yes, insulin control AND calorie controlIn large part, I think Atkin’s got most of his criticism, whetherjustified or not, from promoting what was ‘perceived’ as such an extreme method for weightlossalso, well put. In fact, understated – Atkins methods went against the whole health establishment as well. Right or wrong, agree or disagree, it WAS courageous work.thanks for the correpsondence have a great eveningtom

  • Fred

    Thanks for a great review. I noticed something that got me thinking (these are three points from your review):1. All three groups lost weight. The low carb group lost 5.5 kilos, the Mediterranean group lost 4.6 kilos and the low fat group lost 3.3 kilograms…. IN TWO YEARS! Whoopee! :-)2. “3. “The rate of adherence to a study diet was 95.4% at 1 year and 84.6% at 2 years.”3. “By the way, the adherence rate for the low carb group was the lowest.90.4% in low fat group85.3% in the Mediterranean group78% in the low carb group”I can see a more than slight conflict between point 1 on one hand and points 2 and 3 on the other hand above. If the adherence really was approximately 90% for a 1800 kcal diet for an obese man, they would have lost more than 3.3 kgs over 2 whole years. So, the 90% adherence is likely bogus. What’s amazing to me is that even in a group well supported by professionals through a number of methods, they still don’t seem to do very good at all in terms of fat loss. Some even gained weight during the program.What’s missing? Probably the all out dedication to really want to succeed with the fat loss, which is the most difficult part to push onto someone else.Thanks for a great site. I lost 15 kg’s using the BFFM books and kept it off during 5 years now. If they would have given out your book for the trial instead, the weight loss results would probably have matched the 90% reported adherence 😉

  • Losing fat and maintaining an ideal body weight is hard.Weight loss research is hard to do.apparently adherence statistics are as subject to error as self reported food intake.Still, most long term studies show relapse. In this one there was a modest, but significant loss which was maintained 2 yrs later – REGARDLESS of which diet plan was used.I think what we draw from this study design about support and accountability is good evidence of how to stick with a diet better.

  • Ian

    Excellent breakdown Tom, it’s a shame reporters have such tunnel vision. Science journalists, should have a background in science, so they can actually read the papers and understand the findings.For me losing weight wasn’t a short term fix, but a lifestyle change, a move towards consistency and self-accountability.I was always taught from a young age that nothing in life worth achieving is easy, and if you want something bad enough you’ll do whatever it takes to get it. It’s the same with weight loss.Thanks for cutting through the fog!Cheers,Ian

  • Joe

    Hi Tom,Great insight on the MSM (main stream media) twist of the results. I think “vindicated” should have been AT LEAST double the loss that was maintained.I was wondering if you have done any research into the South Beach Diet? It too seems to ignore total calories in favor of eating the right type of foods, but aside from that it looks sound from what I’ve read so far. Your input on this would be very much appreciated.Thanks, and keep up the great work of “deciphering” headlines on nutrition.Joe H.

  • Ron

    Tom, I really appreciate your reasoned approach to these kinds of studies and news reports. I have a biology background and work in public affairs. If people only knew how much the news media gets things wrong, they’d cancel their subscriptions.I have been interested in fitness and nutrition for most of my adult life. Now in my mid-50’s, I adopted a low-carb lifestyle more than 8 months ago. I did it because I was gaining fat with a moderate carb approach even with exercise. I found that anytime I ate carbs, even those considered low-glycemic, I craved more and more. Honestly, there were times I was afraid I couldn’t stop and I felt out of control. Low carb stopped my cravings, I’ve lost weight and my bodyfat percentage has dropped to 14% (measured with a digital home bodyfat floor scale).Today, someone brought cookies and brownies to work and I didn’t have any interest in the temptation. I feel great and have been able to keep up with my weight training. I’m starting to look like I did when I graduated from high school after a very successful “career” in high school track. My lipids and other blood work are in good shape.Still, I wouldn’t suggest everyone go the low-carb route. You’re right, it works for some and not for others. Each to their own. Thanks for not passing judgment!

  • Good Article. I have tried all sorts of ways to lose weight. Low carb, low calorie, low fat. They all do work but I have found that if you are burning calories( I was walking briskly 30 minutes per day), you lose the weight faster. I didn’t hit a plateau either. I have lost 70 pounds and, where my blood pressure was a lot of the time 180/110, it is now 120/70 with no need for meds. Exercise, along with carb , calorie, and fat control is essential!!

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