Low Carb vs Low Fat?

[Knowledge]

I know this topic is discussed frequently on this board. And there's a lot of science behind both. I thought this lecture was enlightening, and it will help explain why those of us who are on a low-carb diet do so well. If you're open minded you will appreciate the topic. (Oh and the first 7 minutes are kind of non-related so I would skip those)

https://www.youtube.com/watch?v=fL5-9ZxamXc

[SunsetRunner]

@KnowledgeI am completely up to date on physiology, biology and nutrition, and have education and

experience to prove it. You have every right to your point of view, and there are several non-pier reviewed,

non-double blind, and non-longitudinal studies that can be quoted to support your point of view. You have

obviously done some reading, and are passionate about your point of view. I hope it works out for you.

Many converts to a cause tend to want to proselytize.

[Knowledge]

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@yarddog wrote:

@KnowledgeI am completely up to date on physiology, biology and nutrition, and have education and

experience to prove it. You have every right to your point of view, and there are several non-pier reviewed,

non-double blind, and non-longitudinal studies that can be quoted to support your point of view. You have

obviously done some reading, and are passionate about your point of view. I hope it works out for you.

Many converts to a cause tend to want to proselytize.

---

My proselytizing is only because in my experience nothing has ever worked for me, including counting calories. Low-carb was the only thing that melted off the fat and on top of it all allowed me to actually feel full for once in my life. Of course I did research before starting any diet, but for me this isn't a diet but a lifestyle change.

I too am educated, currently completing a Ph.D. in Neuroscience. I don't think credentials matter, but I'm certainly qualified enough to be able to judge journal publications.

Before I discuss journals here is what Harvard's School of Public Health says:

http://www.hsph.harvard.edu/nutritionsource/carbohydrates/low-carbohydrate-diets/

"The low-carb diet was most beneficial for lowering triglycerides, the main fat-carrying particle in the bloodstream, and also delivered the biggest boost in protective HDL cholesterol.

Research shows that a moderately low-carbohydrate diet can help the heart, as long as protein and fat selections come from healthy sources.

• A 20-year prospective study of 82,802 women looked at the relationship between lower carbohydrate diets and heart disease; a subsequent study looked at lower carbohydrate diets and risk of diabetes. Women who ate low-carbohydrate diets that were high in vegetable sources of fat or protein had a 30 percent lower risk of heart disease (4) and about a 20 percent lower risk of type 2 diabetes, (34) compared to women who ate high-carbohydrate, low-fat diets. But women who ate low-carbohydrate diets that were high in animal fats or proteins did not see any such benefits. (4,34)

• More evidence of the heart benefits from a lower-carbohydrate approach comes from a randomized trial known as the Optimal Macronutrient Intake Trial for Heart Health (OmniHeart). (35) A healthy diet that replaced some carbohydrate with protein or fat did a better job of lowering blood pressure and “bad” LDL cholesterol than a healthy, higher-carbohydrate diet.
• Similarly, the small “EcoAtkins” weight loss trial compared a low-fat, high-carbohydrate vegetarian diet to a low-carbohydrate vegan diet that was high in vegetable protein and fat. While weight loss was similar on the two diets, study subjects who followed the low-carbohydrate “EcoAtkins” diet saw improvements in blood lipids and blood pressure. (36)

Please see the peer-reviewed journals I've seen:

Foster GD, et al.

A randomized trial of a low-carbohydrate diet for obesity.

New England Journal of Medicine, 2003.
http://www.nejm.org/doi/full/10.1056/NEJMoa022207

"The low-carbohydrate diet produced a greater weight loss (absolute difference, approximately 4 percent) than did the conventional diet for the first six months, but the differences were not significant at one year. The low-carbohydrate diet was associated with a greater improvement in some risk factors for coronary heart disease. Adherence was poor and attrition was high in both groups. Longer and larger studies are required to determine the long-term safety and efficacy of low-carbohydrate, high-protein, high-fat diets."

Brehm BJ, et al.

A randomized trial comparing a very low carbohydrate diet and a calorie-restricted low fat diet on body weight and cardiovascular risk factors in healthy women.

The Journal of Clinical Endocrinology & Metabolism, 2003.

"The low-carb group lost more weight (2.2 times as much) and had significant reductions in blood triglycerides. HDL improved slightly in both groups."

Aude YW, et al.

The national cholesterol education program diet vs a diet lower in carbohydrates and higher in protein and monounsaturated fat.

Archives of Internal Medicine, 2004.

"The low-carb group lost 1.8 times as much weight. There were also several changes in biomarkers that are worth noting:

• Waist-to-hip ratio is a marker for abdominal fat. This marker improved slightly in the LC group, not in the LF group.

• Total cholesterol improved in both groups.

• Triglycerides went down by 42 mg/dL in the LC group, compared to 15.3 mg/dL in the LF group.

• LDL particle size increased by 4.8 nm and percentage of small, dense LDL decreased by 6.1% in the LC group, while there was no significant difference in the LF group."

Sondike SB, et al.

Effects of a low-carbohydrate diet on weight loss and cardiovascular risk factor in overweight adolescents.

The Journal of Pediatrics, 2003.

"The low-carb group lost significantly more (2.3 times as much) weight and had significant decreases in Triglycerides and Non-HDL cholesterol. Total and LDL cholesterol decreased in the low-fat group only."

Samaha FF, et al.

A low-carbohydrate as compared with a low-fat diet in severe obesity.

New England Journal of Medicine, 2003.

"Severely obese subjects with a high prevalence of diabetes or the metabolic syndrome lost more weight during six months on a carbohydrate-restricted diet than on a calorie- and fat-restricted diet, with a relative improvement in insulin sensitivity and triglyceride levels, even after adjustment for the amount of weight lost. This finding should be interpreted with caution, given the small magnitude of overall and between-group differences in weight loss in these markedly obese subjects and the short duration of the study. Future studies evaluating long-term cardiovascular outcomes are needed before a carbohydrate-restricted diet can be endorsed."

Yancy WS Jr, et al.

A low-carbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia.

Annals of Internal Medicine, 2004.

"The low-carb group lost significantly more weight and had greater improvements in blood triglycerides and HDL cholesterol."

JS Volek, et al.

Comparison of energy-restricted very low-carbohydrate and low-fat diets on weight loss and body composition in overweight men and women.

Nutrition & Metabolism (London), 2004.
"The low-carb group lost more weight. The men on the low-carb diet lost three times as much abdominal fat as the men on the low-fat diet."

Shai I, et al.

Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet.

New England Journal of Medicine, 2008.
"The low-carb group lost more weight than the low-fat group and had greater improvements in HDL cholesterol and triglycerides."

Volek JS, et al.

Carbohydrate restriction has a more favorable impact on the metabolic syndrome than a low fat diet. Lipids, 2009
"

The low-carb group lost almost twice the amount of weight as the low-fat group, despite eating the same amount of calories.

This study is particularly interesting because it matched calories between groups and measured so-called “advanced” lipid markers. Several things are worth noting:

• Triglycerides went down by 107 mg/dL on LC, but 36 mg/dL on the LF diet.

• HDL cholesterol increased by 4 mg/dL on LC, but went down by 1 mg/dL on LF.

• Apolipoprotein B went down by 11 points on LC, but only 2 points on LF.

• LDL size increased on LC, but stayed the same on LF.

• On the LC diet, the LDL particles partly shifted from small to large (good), while they partly shifted from large to small on LF (bad)."
  
  Hu T et al.
• The low-carbohydrate diet and cardiovascular risk factors: evidence from epidemiologic studies.
• Nutr Metab Cardiovasc Dis. 2014 T
  "Recent randomized controlled trials document that low-carbohydrate diets not only decrease body weight but also improve cardiovascular risk factors. In light of this evidence from randomized controlled trials, dietary guidelines should be re-visited advocating a healthy low carbohydrate dietary pattern as an alternative dietary strategy for the prevention of obesity and cardiovascular disease risk factors."
  
  The list goes on and on...

[_daniel_]

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@yarddog wrote:

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@_daniel_ wrote:

Great lecture! Thank you Knowledge. Until recently I was pretty biased against low carb diets, but the more I learn, the more I understand the merits of it.  

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You should remain biased against it, as it has few merits. It is characterized by initial rapid weight loss

and then weight stabilization at a level well above where it should be. @Knowledge has provided himself

as an example of this. There are also serious physical problems that may also result. Ask your doctor.

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Bias: A partiality that prevents objective consideration of an issue or situation

I'm going to continue to work on being more open minded and objective, and looking to see where the evidence takes me.  BTW, I'm using the word diet to refer to dietary patterns, not any specific short term weight loss program. Low carb is a big tent.

[Knowledge]

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@_daniel_ wrote:

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@yarddog wrote:

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@_daniel_ wrote:

Great lecture! Thank you Knowledge. Until recently I was pretty biased against low carb diets, but the more I learn, the more I understand the merits of it.  

---

You should remain biased against it, as it has few merits. It is characterized by initial rapid weight loss

and then weight stabilization at a level well above where it should be. @Knowledge has provided himself

as an example of this. There are also serious physical problems that may also result. Ask your doctor.

---

Bias: A partiality that prevents objective consideration of an issue or situation

I'm going to continue to work on being more open minded and objective, and looking to see where the evidence takes me.  BTW, I'm using the word diet to refer to dietary patterns, not any specific short term weight loss program. Low carb is a big tent.

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I would highly recommend you read this book with an open mind:

http://amazon.com/Great-Cholesterol-Myth-Disease--Statin-Free/dp/1592335217/ref=sr_1_1?ie=UTF8&qid=1...

Titled: "The Great Cholesterol Myth: Why Lowering Your Cholesterol Won't Prevent Heart Disease-and the Statin-Free Plan That Will"

by Dr. Jonny Bowden and Dr. Stephen Sinatra

If you'd like a quick overview Dr. Jonny Bowden explains many of the things in his book in this free 1 hour lecture:

https://www.youtube.com/watch?v=YGOpjPNtjes

Goes through the evidence (or lack thereof) linking Saturated Fat to Heart Disease and why Low-Carb diets have a lower risk of Heart Disease than a High-Carb diet. He also explains the particle basis of Cholesterol which has yet to become mainstream because of insurance companies (yet in the medical establishment its been shown that a particle test of LDL is very important while the overall LDL number means nothing unless you know the proportion of LDL-C (the small LDL which is very bad for you versus the larger LDL which is not harmful))

[Knowledge]

Also thought I would put this out there. I did not write this but took it from another source after verifying the facts from the study (why re-create the wheel?)

Here is a randomized controlled trial (RCT) comparing a low-carb diet (Atkins) to a low-fat near-vegan diet (Ornish).

RCTs are the best types of studies to prove cause and effect in humans.

This is scientific evidence, as good as it gets.

The study is called The A to Z Weight Loss Study and was conducted by researchers at Stanford.

In it, they tested 4 different diets: Atkins, Ornish, Zone and LEARN. I’m going to focus on Atkins and Ornish.

The study subjects, who were overweight or obese women, were given a diet book, either The Atkins New Diet Revolution or Eat More, Weigh Less and received some counseling on how to follow the two diets.

The Atkins diet, as I’m sure you know, is a low-carb, high-fat diet that includes lots of animal foods and vegetables.

The Ornish diet is an ultra-low-fat vegetarian diet (fat as 10% of calories) that includes almost no animal foods. Small amounts of non-fat dairy and egg whites are allowed in moderation. More details on the diet here.

A total of 77 people were assigned to the Atkins Diet group, while 76 were assigned to Ornish. The study went on for 12 months.

This study is representative of real world results. People buying a diet book, making a commitment towards a diet and doing their best to stick to it.

The Study Results

All diets are hard to stick to. At the end, the Atkins group had gravitated towards a 30% carb intake, while the Ornish group had started eating about 30% fat (and probably some amount of animals).

Weight Loss: Individuals in the Atkins group lost more weight, 4.7 kg (10.4 lbs), while the Ornish group lost only 2.6 kg (5.7 lbs). However, the difference was not statistically significant at 12 months.

When you look at health biomarkers, you see where the low-carb diet really starts to shine:

• Systolic Blood Pressure: Down 7.6 mmHg on Atkins, down 1.9 mmHg on Ornish.

• Diastolic Blood Pressure: Down 4.4 mmHg on Atkins, down 0.7 mmHg on Ornish.

• HDL (the good) Cholesterol: Up by 4.9 mg/dL on Atkins, didn’t change at all on Ornish.

• Blood Triglycerides: Decreased by 29.3 mg/dL on Atkins, down by 14.9 mg/dL on Ornish.

Other markers like glucose and insulin also improved further on Atkins, but didn’t reach statistical significance.

LDL cholesterol improved slightly on the Ornish diet at the 2 month mark, but then the difference diminished and was not statistically significant.

There was a staggering difference in the dropout rate. 88% of the Atkins group made it to the end, compared to 78% on Ornish.

To put the data another way, the relative risk of dropout was 1.9 for Ornish compared to Atkins, meaning that the low-fat vegetarian dieters were almost twice as likelynot to make it to the end of the study.

Out of all 4 diets, the Atkins dieters were most likely to make it to the end. However, the difference was not statistically significant.

Basically, there were several very important advantages for the Atkins diet, while there were zero advantages for the Ornish diet.

Atkins did the best out of all 4 diets, while Ornish did by far the worst.

This is scientific evidence, as good as it gets, that low-carb diets (that include meat) are superior to vegan diets, at least for overweight / obese premenopausal women.

If you want to see the lead researcher of the study, Dr. Christopher Gardner, explain the results, then watch this video.

Interestingly, Dr. Dean Ornish, despite being very aware of this study, still has the audacity to claim that low-carb diets are dangerous and peddle his diet as the optimal human diet.

[SunsetRunner]

Please let us know how you are doing, from time to time ...

[_daniel_]

Good write up of the A to Z Weight Loss Study. I will check out the book and/or video you recommended. It's an apt recommendation for me because the subject of saturated fat and cholesterol, and whether it is or is not healthy, is a primary interest of mine.   I just started reading "The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet" a few days ago. 

I've heard it said that "For every complex problem there is an answer that is clear, simple, and wrong."  I'm coming to the realization that the establishment dogma about saturated fat falls into that category. 

[SunsetRunner]

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@_daniel_ wrote:

Good write up of the A to Z Weight Loss Study. I will check out the book and/or video you recommended. It's an apt recommendation for me because the subject of saturated fat and cholesterol, and whether it is or is not healthy, is a primary interest of mine.   I just started reading "The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet" a few days ago. 

I've heard it said that "For every complex problem there is an answer that is clear, simple, and wrong."  I'm coming to the realization that the establishment dogma about saturated fat falls into that category. 

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He is against statin drugs, but is for complex carbohydrates (not simple carbohydrates).

He is against processed oils and fats, and simple (processed/refined) carbohydrates.

The study was only 12 months. That's where an Atkins like diet will work (as mentioned

previously), rapid initial loss (various metabolic reasons) and then the weight stabilizes.

[Knowledge]

Do you have any evidence the weight stabilizes? That's usually due to people not sticking to the diet not because the diet failed. I know many low carbers that have gotten down to 10 or less percent body fat and remained there for years. You keep saying things on this forum and yet have not posted one shred of proof.

[SunsetRunner]

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@Knowledge wrote:
Do you have any evidence the weight stabilizes? That's usually due to people not sticking to the diet not because the diet failed. I know many lowcarbers that have gotten down to 10 or less percent body fat and remained there for years. You keep saying things on this forum and yet have not posted one shred of proof.

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You, yourself, will eventually have the proof that weight stabilizes.

This is the result of Atkins type diets causing rapid weight loss for a year or so, and

subsequently not being sustainable due to various adverse metabolic and disease states.

You keep saying "low carb", but if you mean "low complex carb" you'll develop problems.

It is necessary, to have an abundance of complex carbohydrates, to maintain health.

Since you are adamant in your views, there needs to be no further discussion.

[Knowledge]

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@yarddog wrote:

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@Knowledge wrote:
Do you have any evidence the weight stabilizes? That's usually due to people not sticking to the diet not because the diet failed. I know many lowcarbers that have gotten down to 10 or less percent body fat and remained there for years. You keep saying things on this forum and yet have not posted one shred of proof.

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This is the result of Atkins type diets causing rapid weight loss for a year or so, and

subsequently not being sustainable due to various adverse metabolic and disease states.

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Where is your evidence for this statement?

Here is more evidence that for an Athlete a low-carb diet is more advantageous than a high-carb diet:

https://www.youtube.com/watch?v=6WVLrQmnnAY

My views are strong not because I'm stubborn but because I've actually read the literature and know what is going on in the scientific community. I am not trying to start a flame war here, but the only source you've cited all week is from "Quackwatch". I doubt you have taken even 1 second to watch or read anything I've posted probably because of your "bias" preventing you from accepting changes in the scientific community.

[josephz2va]

I've always known it by this:

[cskate]

really well ! DR said Im in better shape then she is and im 20 years older.

[Knowledge]

Just posting an update for @SunsetRunner who insists a low carb diet causes your weight to stabilize. Since I last posted 3 weeks ago I have lost 13 more lbs and am now at 235lbs and still going strong. Body fat is down to 27% from 30% in early april

[SunsetRunner]

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@Knowledge wrote:

Just posting an update for @SunsetRunner who insists a low carb diet causes your weight to stabilize. Since I last posted 3 weeks ago I have lost 13 more lbs and am now at 235lbs and still going strong. Body fat is down to 27% from 30% in early april

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So, you are still getting it wrong - so here it is again:

I recommend a high complex carbohydrate diet, along with limited amount of protein

and fats. All natural and unprocessed sources as possible, and cooked as preferred.

My concern is your apparent recommendation of a high protein/fat diet (Atkins diet),

which results in rapid initial weight loss, but may cause long term health problems.

You are more than welcome to eat whatever you want to eat.

[Knowledge]

If you can suggest me one study that shows a low carb diet can have long term health consequences I may be willing to consider your position but unfortunately the studies indicate otherwise. By the way I am not recommending the Atkins diet specifically, and regardless most low carb diets advise against too much protein as protein can elevate insulin levels and are considered a moderate protein diet.

[SunsetRunner]

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@Knowledge wrote:
If you can suggest me one study that shows a low carb diet can have long term health consequences I may be willing to consider your position but unfortunately the studies indicate otherwise. By the way I am not recommending the Atkins diet specifically, and regardless most low carb diets advise against too much protein as protein can elevate insulin levels and are considered a moderate protein diet.

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http://www.webmd.com/diet/high-protein-low-carbohydrate-diets

http://www.mayoclinic.org/healthy-living/nutrition-and-healthy-eating/expert-answers/high-protein-di...

http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/High-Protein-Diets_UCM_305989_Article.j...

[Proudpatriot]

Those are not studies.

[Mermaid3011]

There will always be an MD to support one theory and another MD to support the other. 

Medicine is not MATH. Bodies are all different. People, Lifestyles, Psyche... there are so many factors. 

How about letting everybody decide what they feel best with?

For me personally I make sure I get enough lean, unprocessed protein, 20-30% of my daily calorie intake, 25% from healthy fatsand the 40-50% from complex, unprocessed carbs that give me the daily energy to keep going. Lots of veggies, some fruit (juice is NOT a fruit serving!), lots of water, less coffee, rarely alcohol etc. enough dietary fibre (at least 50 grams)

My carbs usually come either with healthy fat, protein or some other good reason why I eat it. 

[DominicJ]

"It is necessary, to have an abundance of complex carbohydrates, to maintain health.!"

Simply not true

Protein is essential

Fat is essential

Carbs are not.