And the Best Weight Loss Diet IS…..

Before I answer this question, let’s look to popular diet books for insight.  Gary Taubes, journalist and author of Why We Get Fat—And What to Do About It, contends that obesity researchers have it all wrong, there is no evidence that diets work, no evidence that counting calories is an effective weight loss strategy, and no evidence that exercise can help you lose weight.  Ironically, his litany against diets is a build-up to introducing his own diet plan (insert cash register noise), which is the wow-I’ve-never-heard-of-it, low carbohydrate diet.  Oh but it’s different than previous versions, he contends that Atkins didn’t get the science right, and he then proceeds to correct the science, utilizing his background in journalism, physics, and aerospace engineering. What do those have to do with the science of weight loss?  Don’t ask me, I’m an obesity researcher.  Ok, so Taubes puts one vote for in for low carb diets, at least his version, which, by the way, has never been tested in a randomized trial.

In the other corner, we have Tim Ferriss, 33 year old entrepreneur and motivational speaker, who cracks open the science of obesity wielding an East Asian studies degree from Princeton and his own personal experience as a young skinny guy.  His New York Times Bestseller  is entitled, The 4-Hour Body: An Uncommon Guide to Rapid Fat-Loss, Incredible Sex, and Becoming Superhuman.  Sounds like an exhausting 4 hours.  Plus I’m a working mom, Tim, I am already superhuman.  The diet put forth is the also-not-so-novel low carbohydrates diet.  Add on a few other bells and whistles (like weekly binges, ice baths, and fat burning cottage cheese) and you have his unique version, also never specifically tested in a controlled trial.  Alas, that is two votes for low-carb diets.

Suzanne Somers, Sexy Forever: How to Fight Fat After Forty, is our other current bestseller.  I do not know Suzanne’s training background but boy was I a fan of Three’s Company back in the day.  Suzanne shares her diet secrets among which include organic food and low glycemic load foods, which involves eliminating simple carbs. That makes 3 out of 3 votes for low-carb diets.

According to mass media, low-carb diets are the most effective weight loss approach.  However, when compared to other types of diets in controlled trials, do they do better?  The answer is a resounding no.  Several trials and reviews of trials have concluded that low-carb diets are no more or less effective than low-fat diets at weight loss.  In fact, the majority of head-to-head diet studies result in a draw no matter which diets are tested.  Most notably is a study by Dansinger and colleagues published in the Journal of the American Medical Association in 2005.  This study compared Atkins (low carb), Zone (low carb), Weight Watchers (low fat), and Ornish (low fat) diets and found no differences between diets in weight loss. The strongest predictor of weight loss was adherence to the diet, regardless of which diet it was.  In 2006, the Archives of Internal Medicine published a review of 5 trials that compared low-fat to low-carb diets and the conclusion was that weight loss was no different in these trials.  More recently, in 2010, Foster and colleagues published randomized trial findings in Annals of Internal Medicine that showed no weight loss differences in low-carb versus low-fat diets at 2 years. Wycherly and colleagues also published a randomized trial in 2010 in the Journal of Internal Medicine that showed no difference in weight loss between low-carb and low-fat diets.  In my search of this literature, I could not find a single trial that showed a weight loss advantage of one or the other of these diets.

Let’s revisit our original question: what is the BEST weight loss diet?  None?   No, the answer is the diet you can stick to for the long haul.  The diet you want to marry, until death do you part.  Remember the Dansinger study found that the strongest predictor of success is sticking to it?  What this means is that you have to pick something that you can stick to and not just for a few weeks or months, forever.  Short-term adherence means short-term weight loss.  If you love steak, cheese, and eggs, and you can live without the bread basket, then a low-carb diet will be a good fit.  If you love carbs and could live with less meat and cheese, then a low-fat diet makes the most sense for you.  Unfortunately, people who love carbs feel like they need to give up carbs to lose weight.  Not so!  Your weight loss diet should be one that reflects your tastes and preferences.  The diet you will stick to best is the one that is the most similar to your current diet.

Try this.  Write down what you eat for one week, figure out the calories, carbs, fat, and protein, and then calculate the percentage of your calories that come from carbohydrates, fat, and protein.  This will give you an idea of your tastes and preferences. A balanced diet is 30% fat, 30% protein, 40% carbs. If your numbers are higher on any of these, that indicates your preference. For example, if you are 35% fat, 35% protein, and 30% carbs, you are a good candidate for low-carb diet.  When I look at mine I see that I eat a slightly higher percentage of calories from carbohydrates.  A low-carb diet would be hard for me to follow, I would have to give too much up, not to mention consuming foods that I do not enjoy (did I mention I lasted 1 day on Atkins, but have been eating low fat for 20 years?).  A diet mismatch will not work in the long run.  This does not mean that a high carb eater does not need to cut back on carbs, in fact she/he probably does to some extent, but a low-carb diet is going to be too extreme a reduction in carbs to feel comfortable.  You will be going too much against the grain (pun intended). The more extreme a step you take from your norm, the harder it will be in the long run.  In fact, make the fewest changes to your current diet that are necessary to achieve weight loss.

The diet books will come and go. The bottom line is to take what the aerospace engineers, Asian lit majors, and anyone else yielding a pen says with a grain of salt.  What works for you, really is what is going to work for YOU.  Only you can know what this is.

References

Dansinger, M.L.,et al. (2005). Comparison of the Atkins, Ornish, Weight Watchers, and Zone Diets for Weight Loss and Heart Disease Risk Reduction: A Randomized Trial. Journal of the American Medical Association, 293(1), 43-53.

Wycherly et al (2010). Long-term effects of weight loss with a very low carbohydrate and low fat diet on vascular function in overweight in obese patients, Journal of Internal Medicine, 267 (5), 452-461.

Foster et al (2010). Weight and metabolic outcomes after 2 years on a low-carbohydrate versus low-fat diet:  A randomized trial.  Annals of Internal Medicine, 153(3), 147-157.

Nordmann et al (2006). Effects of low-carbohydrate versus low-fat diets on weight loss and cardiovascular risk factors.  Archives of Internal Medicine, 166, 285-293.

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10 Comments

  1. Tremalien says:

    I’m not an aerospace engineers, Asian lit major, motivational speaker, or Chrissy. I’m just an average Joe living an average life. (desk job, two kids, minivan…) Until last year my average life and average diet led me to become an average unhealthy man approaching 40.

    January of 2010, I decided to do something about it. I researched the many diet options and even tried a few (Atkins, Slimfast) with no success. Then I started to actually count the calories I ate as well as the calories I burned through exercise.

    Once I did this I was made painfully aware of the uneven balance between the two, so I changed my eating habits and increased my exercise until I was burning more calories than I was eating. It was that little equation (calories in < calories burned) that helped me drop 40 lbs. And since I wasn't make any drastic diet changes, just practicing moderation. I have been able to keep 30 of those pounds off a year later.

    • Sherry says:

      After all you accomplished Tremalien, I think you could be Chrissy if you really wanted to. 🙂

  2. Susan Bakke says:

    I really believe that the word “diet” puts people in a tailspin..there is so much confusion on the consumers plate because of the constant bombardment of information..Sherry you said it right..do what works…write things down..you will get a clear sense of what you are doing and where your calories are coming from..look at the changes you are making as lifestyle changes and stick to it..you will become healthier and feel better about yourself in the long run…

  3. Barbara says:

    Thanks for these very important messages, Sherry! When you go against your own food patterns and preferences, you are setting yourself up to feel deprived. And we humans do not do well with feeling deprived. I really like the approach of recording what you eat and using that as your starting point.

  4. Barb,RN says:

    I agree that you need to find an eating plan that works for you. The word diet affects me that way too. I start craving all the foods I’m not supposed to be eating. It’s much simpler to find out which you are overdoing : fats, carbs or proteins, like you said. Then you can gradually cut back on the offenders without feeling that you are depriving yourself. I know I’m a carboholic and it’s much harder for me to follow a low carb diet. So instead of eating white breads and pasta, I try whole grain ones.They have more fiber anyway. Instead of eating 2 or 3 carbs in a meal, I just choose one. Instead of french fries I select salad or veggies. It may take longer for gradual diet changes but they will be long lasting ones and easier to live with.
    The authors of diet books are making a lot of money. Hopefully these books are helping some people. But I have a feeling that after awhile they end up on a bookshelf getting dusty like my copy of “The South Beach Diet”.

    • Sherry says:

      I love the idea of carb switching — simple carbs to whole grains. It’s like having your cake and eating it too. Well, having a whole grain cake and eating it!

  5. ss says:

    Love, love the statement “strongest predictor of weight loss is ADHERANCE to the diet.”….I’ve been yo-yoing most of my adult life after 35. Plain and simple, the weight program I’ve selected, is result oriented IF I adhere to the the plan along with drinking water and exercise. No adherance, no weight loss. This philosophy is so true for any plan you select that meets your lifestyle. I keep hearing the words of a Stress Reduction counselor speaking to his class when he would ask how many engaged in the practice exercises assigned the previous week, with a minimal show of hands: “If you don’t start today, when ARE you going to start?” Maybe applies to weight loss program as well?

  6. John says:

    Diet is just another 4 letter word. So much of what we eat has so little to do with being hungry. We use food as a coping mechanism to compensate for ________. A food diary is a useful tool. It would be interesting to couple it side by side with a regular diary to see what triggers are sending us down the wrong path. As a Life Insurance Salesman (and part time group fitness instructor) what do I know?

    • I have been tracking my calories off and on for about a year. About a month ago, i started tracking them religiously, and have noticed trends. I don’t have a ‘regular’ journal, but i do tend to TWEET my moods, feelings, etc, (as my followers are painfully aware). Comparing tweets to my myfitnesspal data i can easily see when my moods influence my food choices…..

  7. Mary says:

    Love your message here!! Sticking to something (anything) is inevitably better than trying the new hot thing that may not work for your unique preferences. Turns out the aerospace engineer and Asian lit major may not have all the answers, huh?

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