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Sunday
Nov082009

Comparing Low-Fat and Low-Carb

Written by Tom Nikkola - Director of Nutrition & Weight Management

Dr. Atkins may have brought a heightened awareness of the use of low-carbohydrate diets, but their use in weight-loss is hardly new. They have been used in clinical practice since the 1800s. However, if you ask the average person about whether they are safe or healthy, you'll receive quite a mix of responses. More than likely, most people will say they are unsafe, bad for your heart, increase cholesterol, lead to malnutrition and a so on.

A Research Review of Diets from A to Z

Vegetarian, Dr. Christopher Gardner and his team, developed a unique research study which compared the results of four different diets: Atkins, LEARN, Ornish and Zone Diets. The four diets covered the spectrum from low-fat to low-carb. It was a unique research study in that it actually used specific diets rather than only putting research subject on various nutrient intake plans. A total of 311 overweight and obese women took part in the study and were divided amount the four different diet groups. Each group received classroom education and support in their specified diet plan. They were instructed to follow the diet as explained in the book. During the study, carbohydrate, fat and protein intake was as follows:

At 2 Months

Atkins

Zone

LEARN

Ornish

Carb (%)

18%

42%

49%

48%

Fat (%)

55%

35%

30%

21%

Protein

28%

24%

20%

17%

At 12 Months

Atkins

Zone

LEARN

Ornish

Carb (%)

35%

45%

47%

52%

Fat (%)

44%

35%

33%

30%

Protein

20%

20%

19%

18%

Looking at the comparison of the diets from month two to month twelve, there are a few interesting points that stand out.

  • Based on the books, there is a clear difference in fat and carbohydrate intake between the Atkins and the Ornish plans, with the Zone and LEARN diets being in the middle of the other two.
  • For both the Atkins and Ornish diets, you can see the eventual movement away from the very low carb or very low fat diet. With today's variety of foods, it's more difficult to stay at the extreme of either diet plan.
  • Even though the Atkins group did eventually increase their carbohydrate intake and lower their fat intake, it still did not come close to the standard way of eating, which was more like the LEARN group.

Study Findings

Even though it rarely makes news headlines, many research studies have shown that low-carb diets are as good as and sometimes better, for weight loss than low-fat diets. The results of this study reiterate those findings. They were as follows:

  • Women on the lowest carb diet had more weight loss and body fat percentage loss
  • LDL cholesterol fell the most for the Ornish group and rose slightly with the Atkins group. Although the slight rise in LDL cholesterol was seen as a negative in the past, there is mounting evidence to show that rise in LDL cholesterol from higher fat intake comes from large-particle LDL cholesterol, which does not have a negative effect on health.
  • HDL cholesterol (healthy cholesterol) rose the most with the Atkins group an did not rise at all with the Ornish group
  • Triglycerides fell the most with the Atkins group
  • Blood pressure decreased the most with the Atkins group and the least with the low-fat group
  • Fasting insulin decreased the most with the Atkins and LEARN groups and fasting glucose decreased the most with the Atkins group

Summary

There have not been many long-term studies done to compare low-carb and low-fat diets. This study resulted in several important teaching points. First, it showed that sticking to the extreme of a very low carbohydrate or a very low fat diet is very difficult unless someone cooks each meal for an individual. That said, the Atkins group, although their carbohydrate intake increased and their fat intake decreased over the twelve months, did consume significantly less carbohydrate and more fat than the other groups. The low-carb group had better weight and body fat loss, and improved heart health risk factors more than the other groups. An October research review of low-carb diets in Current Diabetes Reports concluded:

"Although science continues to advance in this field, current research suggests that low-carbohydrate diets can be a viable option for achieving weight loss and may have beneficial effects on glycemic control, triglyceride levels, and high-density lipoprotein cholesterol levels in some patients."

Although reduced-carbohydrate diets may not be necessary for everyone to lose weight, evidence suggests that they can be beneficial for many people. The Atkins group was not able to maintain the low-carbohydrate levels they started with, but they still took in far less than the other groups and had better results in the end.

For a full review of the study in an entertaining lecture by Dr. Gardner, click on the video below:

References:

Gardner C, Kiazan A, Alhassan S, Kim S, Stafford R, Balise R, Kraemer H, King A. Comparison of the Atkins, Zone, Ornish, and LEARN Diets for Change in Weight and Related Risk Factors Among Overweight Premenopausal Women. JAMA 2007;297(9):969-977

Wylie-Rosett J, Davis NJ. Low-carbohydrate diets: an update on current research. Curr Diab Rep. 2009 Oct(5)396-404

This article is not intended for the treatment or prevention of disease, nor as a substitute for medical treatment, nor as an alternative to medical advice. Use of recommendations in this and other articles is at the choice and risk of the reader.

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