Valvoja: San Martino
Stabiili kirjoitti:Tutkimus on julkaistu kokonaisuudessaan t?ss?. Kannattaa perehty? kuvaan 2, josta saa heti hyv?n yleisk?sityksen tuloksista.
Low-carb-dieetti kuvataan n?in:
"The low-carbohydrate, non?restricted-calorie diet
aimed to provide 20 g of carbohydrates per day
for the 2-month induction phase and immediately
after religious holidays, with a gradual increase
to a maximum of 120 g per day to maintain the
weight loss. The intakes of total calories, protein,
and fat were not limited. However, the participants
were counseled to choose vegetarian sources of
fat and protein and to avoid trans fat. The diet
was based on the Atkins diet (see Supplementary
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 ?
-- 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 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 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 fat 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!)
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 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.
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.
19. hein?kuuta 2008
Mit? Atkins-ryhm? s?i?
Internetiss? porukka ihmettelee mit? em. dieettitutkimuksen Atkins-ryhm?l?iset s?iv?t, sill? er?iss? tiedotusv?lineiss? on h?pisty kasvipainoitteisesta Atkins-dieetist?. T?ss? vastaus suoraan p??kallopaikalta:
This is kind of funny that some could think of a "vegetarian low-carb"
diet. Is it a new suggested strategy? Could be interesting idea but this
wasn't the case here. Our low-carb diet was based on Atkins, the
participants read the book and the recipes were more or less comparable
to what you know in the states. Beef is the main red meat. What could be
different? People here would not mix in the same meal meat and butter, a
salad is considered a very rich one and not a lettuce based, and the
main dressing is olive oil. As for beverages, same industry that makes
For example, a plate could include: fish or fried/not bread coated
chicken/or red meet, broccoli and mushrooms coated with eggs, roasted
eggplants, vegetable salad (peppers, cucumber, green leaves, not
lettuce) with olive oil dressing. I understand that some of the
low-fat people find it hard to believe that such a low-carb diet was
tremendously favorable within 2 years in a well designed study, but
these are the facts and the science of tomorrow, with the next long term
studies in the pipeline, may confirm or not these findings.
Best regards, Iris
we found that the Mediterranean and low-carbohydrate diets are effective alternatives to the low-fat diet for weight loss and appear to be just as safe as the low-fat diet. In addition to producing weight loss in this moderately obese group of participants, the low-carbohydrate and Mediterranean diets had some beneficial metabolic effects, a result suggesting that these dietary strategies might be considered
in clinical practice and that diets might be individualized according to personal preferences and metabolic needs.
The similar caloric deficit achieved in all diet groups suggests that a low-carbohydrate, non?restricted-calorie diet may be optimal for those who will not follow a restricted-calorie dietary regimen. The increasing improvement in levels of some biomarkers over time up to the
24-month point, despite the achievement of maximum weight loss by 6 months, suggests that a diet with a healthful composition has benefits beyond weight reduction.
The present study has several limitations. We enrolled few women; however, we observed a significant interaction between the effects of diet
group and sex on weight loss (women tended to lose more weight on the Mediterranean diet), and this difference between men and women was also reflected in the changes in leptin levels. This possible sex-specific difference should be explored in further studies.
The data from the few participants with diabetes are of interest, but we recognize that measurement of HOMA-IR is not an optimal method to assess insulin resistance among persons with diabetes.
We relied on self-reported dietary intake, but we validated the dietary assessment in two different dietary-assessment tools and used electronic questionnaires to minimize the amount of missing data.
Finally, one might argue that the unique nature of the workplace in this
study, which permitted a closely monitored dietary intervention for a period of 2 years, makes it difficult to generalize the results to other freeliving populations. However, we believe that similar strategies to maintain adherence could be applied elsewhere.
The strengths of the study include the onephase design, in which all participants started simultaneously; the relatively long duration of the
study; the large study-group size; and the high rate of adherence. The monthly measurements of weight permitted a better understanding of the
weight-loss trajectory than was the case in previous studies.
We observed two phases of weight change: initial weight loss and weight maintenance. The maximum weight reduction was achieved during
the first 6 months; this period was followed by the maintenance phase of partial rebound and a plateau.
Among all diet groups, weight loss was greater for those who completed the 24-month study than for those who did not.
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