The Diet Wars: Low Carb or Low Fat

Many people may remember this NY Times article by Gary Taubes where he explains why conventional nutritional advice on how to lose weight is all wrong. He says it is not a low fat diet that helps with weight loss but a low carb diet.

http://www.nytimes.com/2002/07/07/magazine/what-if-it-s-all-been-a-big-fat-lie.html

What if It's All Been a Big Fat Lie?
By GARY TAUBES JULY 7, 2002

If the members of the American medical establishment were to have a collective find-yourself-standing-naked-in-Times-Square-type nightmare, this might be it. They spend 30 years ridiculing Robert Atkins, author of the phenomenally-best-selling ''Dr. Atkins' Diet Revolution'' and ''Dr. Atkins' New Diet Revolution,'' accusing the Manhattan doctor of quackery and fraud, only to discover that the unrepentant Atkins was right all along. Or maybe it's this: they find that their very own dietary recommendations -- eat less fat and more carbohydrates -- are the cause of the rampaging epidemic of obesity in America. Or, just possibly this: they find out both of the above are true.
...
The science behind the alternative hypothesis can be called Endocrinology 101, which is how it's referred to by David Ludwig, a researcher at Harvard Medical School who runs the pediatric obesity clinic at Children's Hospital Boston, and who prescribes his own version of a carbohydrate-restricted diet to his patients. Endocrinology 101 requires an understanding of how carbohydrates affect insulin and blood sugar and in turn fat metabolism and appetite. This is basic endocrinology, Ludwig says, which is the study of hormones, and it is still considered radical because the low-fat dietary wisdom emerged in the 1960's from researchers almost exclusively concerned with the effect of fat on cholesterol and heart disease. At the time, Endocrinology 101 was still underdeveloped, and so it was ignored. Now that this science is becoming clear, it has to fight a quarter century of anti-fat prejudice.​

Taubes refers to Dr. David Ludwig author of the book "Always Hungry" which says that eating carbohydrates causes insulin to be produced which tells the body how much fat to store. According to Dr. Ludwig, if you increase the amount of carbs you eat you will become fatter, if you eat less carbohydrates you will lose weight.


Another book. "Foods That Cause You To Lose Weight II While You Watch TV" by Dr. Neal Barnard. explains the "negative calorie effect" (which is often misrepresented by nutritionists and journalists). The negative calorie effect is a process by which complex carbohydrates cause the body to increase its basal metabolism rate by causing the conversion of a hormone called T4 to another hormone T3. (It is often wrongly stated some foods take more calories to digest than they contain and therefore have "negative calories"). Additional factors that make carbohydrates useful for weight loss are: It takes 25% of the calories in complex carbohydrates to convert them into fat and that the body resists turning carbohydrates into fat, first storing carbohydrates as starch and only converting to fat when there is no more room to store starch and when increased metabolism cannot handle the excess carbs. Dr. Barnard says most people never come close to this point. Additionally, when the body senses it has enough carbs it turns off the appetite.

Complex carbohydrates only come from plants, they are found in vegetables, fruits, and grains.

I am not saying that the low carb diet is a fraud. Some people say it works for them. (From my own personal experiences trying these two diets I find Dr. Barnard's complex carbohydrate diet works for me and Dr. Ludwig's low fat diet did not.) But what I do think is interesting is that the people who tout the low carb diets are claiming science proves that it is carbohydrates that make you fat - and that is not necessarily true.


Here are a couple of research papers by Dr Barnard:

http://www.pcrm.org/sites/default/files/pdfs/health/medstudents/The effects of a low-fat plant-based dietary intervention on body weight metabolism and insulin sensitivity .pdf


The effects of a low-fat, plant-based dietary intervention on body weight, metabolism, and insulin sensitivity

Neal D. Barnard, MD,a,b Anthony R. Scialli, MD,c Gabrielle Turner-McGrievy, MD, RD,b Amy J. Lanou, PhD,b Jolie Glass, MS

ABSTRACT

PURPOSE: This study investigated the effect of a low-fat, plant-based diet on body weight, metabolism, and insulin sensitivity, while controlling for exercise in free-living individuals.

SUBJECTS AND METHODS: In an outpatient setting, 64 overweight, postmenopausal women were randomly assigned to a low-fat, vegan diet or a control diet based on National Cholesterol Education Program guidelines, without energy intake limits, and were asked to maintain exercise unchanged. Dietary intake, body weight and composition, resting metabolic rate, thermic effect of food, and insulin sensitivity were measured at baseline and 14 weeks.

RESULTS: Mean 6 standard deviation intervention-group body weight decreased 5.8 6 3.2 kg, compared with 3.8 6 2.8 kg in the control group (P 5 .012). In a regression model of predictors of weight change, including diet group and changes in energy intake, thermic effect of food, resting metabolic rate, and reported energy expenditure, significant effects were found for diet group (P , .05), thermic effect of food (P , .05), and resting metabolic rate (P , .001). An index of insulin sensitivity increased from 4.6 6 2.9 to 5.7 6 3.9 (P 5 .017) in the intervention group, but the difference between groups was not significant (P 5 .17).

CONCLUSION: Adoption of a low-fat, vegan diet was associated with significant weight loss in overweight postmenopausal women, despite the absence of prescribed limits on portion size or energy intake.

http://care.diabetesjournals.org/content/29/8/1777.full

A Low-Fat Vegan Diet Improves Glycemic Control and Cardiovascular Risk Factors in a Randomized Clinical Trial in Individuals With Type 2 Diabetes

Neal D. Barnard, MD12, Joshua Cohen, MD1, David J.A. Jenkins, MD, PHD3, Gabrielle Turner-McGrievy, MS, RD4, Lise Gloede, RD, CDE5, Brent Jaster, MD2, Kim Seidl, MS, RD2, Amber A. Green, RD2 and Stanley Talpers, MD1

...
CONCLUSIONS—Both a low-fat vegan diet and a diet based on ADA guidelines improved glycemic and lipid control in type 2 diabetic patients. These improvements were greater with a low-fat vegan diet.
 
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I've been experimenting with the principles of the ketogenic diet, and I have found it to have huge benefits for me.
  • No sugar (as much as I can help it)
  • Little alcohol
  • Rare simple carbs (grains legumes starches)
  • Consume most of daily calories between 12:00 and 6:00 PM fasting between
  • Morning coffee with 1/2 tblspoon of butter and 1/2 tblspoon of MCT oil
  • Lunch and dinner: complex high fiber veggies, meats, cheeses, eggs, olives, avocados, nuts, fruit
I do bodyweight exercises about 20 min and walk a mile maybe every other day. I can't resist carbs all week and have a cheat day or two, but I have noticed significant benefits:
  • Lower body fat percentage without muscle loss.
  • Sharper focus and improved memory
  • Feels like pressure inside my skull is reduced
  • More energy especially in the mornings
  • Reduced sinus issues and better breath
  • Dandruff goes away
  • Better gastrointestinal health
 
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Deal breaker.

I've hung on for dear life to the "a glass of red wine is good for you thing" that I heard once and is probably urban legend.

Hah.. well if you follow all the other guidelines I think you'd still get many benefits even with a glass of wine a day. :)

There for a while I was having one beer a day and 2 or 3 on the weekends, and just doing some of the other things made a difference, but now I've cut back to 1 or 2 only on 1 or 2 days a week.

Dry wine or vodka with no sweets is probably the healthiest alcohol option.
 
In my experience it's not all carbs, but type of carbs and level of activity. I've been extremely active all my life. Most of my adult life I was a size 2, weighing 110 lbs. But I gained weight when I moved to Virginia. Eating style in the South is heavy on processed carbs. I gained lots of weight despite exercising regularly. The processed carbs were killing me.

Back on the west coast I reverted back to what I call good carbs like quinoa and oats. Never counted a calorie. In a year I dropped from near 200 lbs back to 110. During that period while I was dropping weight I'm sure I was consuming between 2500 and 3000 calories a day.

But activity plays a major role. I hike, run, cycle, and weight train 5-6 days a week. Exercise is not just great for your health, but keeps your skin in great condition too. I'm not wrinkled. People never believe me when they ask my age. There's seven kids in my family. Two of us are die-hard athletic types. We look 15 yrs younger than our age. Our sedentary siblings look their age. Im convinced exercise has a lot to do with the fact that my bother and I are aging well.

https://well.blogs.nytimes.com/2014/04/16/younger-skin-through-exercise/
 
I have watched this area of science for some time, because it seems to be another example of failed science. I think the fact that official medical science seems determined to stick with wrong advice will ultimately come to haunt them. I don't think there is really much of an argument that the LCHF diet is better for you, and that many diabetes patients have done well on that diet.

It is beginning to look as though they are:

Wrong on the danger of saturated fat.
Wrong that polyunsaturated fats are particularly good for you.
Wrong that salt - even at the levels that Americans consume it - is harmful.
Wrong that high blood cholesterol is bad for you.
The benefits of statins seem to have been hugely exaggerated.
The side effects of statins have been downplayed (this was were I became interested in this subject - I experienced those non-existent (or very rare) side effects).

The fact that type-2 diabetes patients stop listening to their doctor and start eating an LCHF diet, and then come back cured or much improved, is is starting to blow this subject wide open!

I now refuse statin treatment, don't bother about salt, am happy to eat cream, butter, fatty meat, and avoid polyunsaturated fats - so I put my health on the line that the above is correct!

David
 
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The debate about the cause of obesity is interesting, but there is empirical evidence that suggests a solution to obesity even if the cause were unknown. The evidence comes from the diets of people in countries with the lowest rates of obesity.

People in countries with the lowest obesity rates eat a low fat diet.

(Advocates of a low carb diet say that insulin produced in response to elevated blood sugar tells the body how much fat to store. But complex carbohydrates from foods with a lot of fiber make you feel full so you don't overeat and are digested slowly so you won't produce a lot of insulin.)

http://suneeldhand.com/2012/06/12/which-countries-have-the-lowest-obesity-rates/
Take a look at the obesity rates in these countries (OECD latest data):

  1. South Korea- 3.8 %
  2. Japan- 3.9 %
...
compare these percentages with the United States, which stands at a disappointing 33.8 percent

http://www.canadianliving.com/healt...secrets-from-countries-with-low-obesity-rates

The Asian diet

Rice and rice products are a staple of this diet, and if you look at people living in rural areas of Asian countries, the diet consists of minimally processed grains, not instant white rice.

The diet is also high in vegetables, Beck said. If you look at some of the vegetables they eat, they are full of compounds called cruciferous chemicals that studies have shown can actually help reduce the risk of cancer by affecting the enzymes in our liver that detoxify cancer-causing substances.

"Soy is the main legume in their diet, soy is the protein, they use plant-based beverages every day; (they drink) green tea, saki, even beer," she noted. "It's really a low-fat diet that's almost vegetarian. Animal protein foods are used very minimally."
 
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The debate about the cause of obesity is interesting, but there is empirical evidence that suggests a solution to obesity even if the cause were unknown. The evidence comes from the diets of people in countries with the lowest rates of obesity.

People in countries with the lowest obesity rates eat a low fat diet.

http://suneeldhand.com/2012/06/12/which-countries-have-the-lowest-obesity-rates/
Take a look at the obesity rates in these countries (OECD latest data):

  1. South Korea- 3.8 %
  2. Japan- 3.9 %
...
compare these percentages with the United States, which stands at a disappointing 33.8 percent

http://www.canadianliving.com/healt...secrets-from-countries-with-low-obesity-rates

The Asian diet

Rice and rice products are a staple of this diet, and if you look at people living in rural areas of Asian countries, the diet consists of minimally processed grains, not instant white rice.

The diet is also high in vegetables, Beck said. If you look at some of the vegetables they eat, they are full of compounds called cruciferous chemicals that studies have shown can actually help reduce the risk of cancer by affecting the enzymes in our liver that detoxify cancer-causing substances.

"Soy is the main legume in their diet, soy is the protein, they use plant-based beverages every day; (they drink) green tea, saki, even beer," she noted. "It's really a low-fat diet that's almost vegetarian. Animal protein foods are used very minimally."

If any diet profile fails to mention sugar (or corn syrup), it's hard for me to draw any conclusions. What is the Korean and Japanese sugar intake like?

Although I think a vegan diet can potentially be healthy, I have to put up a filter when confronted with articles that promote a vegan diet over animal protein and high fat diets because it is a political issue with AGW. Many people believe that animal food sources are unsustainable and should be discouraged in order to save the planet, so I always have to wonder if a vegan diet promotion is morally or politically motivated by apocalyptic fears.
 
I see two distinct questions. 1) what causes obesity. 2) how to lose weight.

I am not trying to deny anything the low carb advocates say except if they say a low fat diet won't work.

(I am not a vegetarian.)

I know there are people who say they have lost weight on a low carb diet and I don't doubt them. But when I read about the theory behind low carb diets I got the mistaken impression that any kind of low fat diet could never work. A low carb didn't work for me and low fat did so I'm trying to tell people who may have been convinced that low fat diets don't work that low fat diets can work and there is empirical and scientific evidence to back up that belief.

I updated previous post with the following and not every one might have seen it so I am repeating it here:

Advocates of a low carb diet say that insulin produced in response to elevated blood sugar tells the body how much fat to store. But complex carbohydrates from foods with a lot of fiber make you feel full so you don't overeat and are digested slowly so you won't produce a lot of insulin.​

There is also a misconception that excess carbs are stored as fat. This only occurs in extreme overeating and most people never experience it. When you gain weight from overeating carbs, the fat you gain comes from the fat in your diet not the carbs.
http://caloriesproper.com/are-carbs-stored-as-fat/
 
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There's clearly a link woth overeating and weight gain. When looking at each macro nutrient it is easy to see which is the most calorie dense. Proteins and carbohydrates are each at 4 kcal/ gram and fats are at 9 kcal/ gram. The old saying it's all about calories in vs calories out. Anyone can lose weight if they are in a caloric deficit. I think there is a big misconception that carbs get stored as fat pretty easily, however when carbs are consumed they typically get stored as glycogen in muscle as well as the liver later converted to glucose for energy. On the other hand fat is not only more dense it's chemical structure is also more conducive to being stored as fat, as its chemical structure does not need to be altered once consumed. Carbohydrates on the other CAN be converted to fat, through a process called de novo lipogenisis, however this process too results in caloric expenditure.

For those of you who have converted to a diet higher in fats it would've been interesting to see your blood work after the dietary change, specificall triglycerides/ cholesterol. I'm the studies I have seen these measures typically increase, sometimes significantly.
 
I see two distinct questions. 1) what causes obesity. 2) how to lose weight.

I'm already pretty trim, so my main interest is in being healthier overall, having a healthy gut, and keeping my brain function and memory top notch for the rest of my life. My grandmother passed away after a long slide down with dementia and I'm determined that is not happening to me.

Based on what I've seen, a high quality gut microbiome is essential for good overall health and high fiber foods aid in that and sugar harms that.

Sugar also causes insulin resistance, hardening of the arteries, and inflammation which probably results in cognitive impairment and might cause Alzheimer and dementia. Cholesterol turning into plaque in the arteries could be thought of as a scab forming on the arteries. If the arteries are not damaged by sugar in the first place, then free cholesterol has no need to turn into arterial plaque.

Over the last 40 years the notion that fat is bad resulted in low fat foods... low fat foods typically taste like crap, so sugar and corn syrup is added in to everything. This makes them taste good and creates food addiction.

I am not trying to deny anything the low carb advocates say except if they say a low fat diet won't work. I know there are people who say they have lost weight on a low carb diet and I don't doubt them. But when I read about the theory behind low carb diets I got the mistaken impression that any kind of low fat diet could never work. A low carb didn't work for me and low fat did so I'm trying to tell people who may have been convinced that low fat diets don't work that low fat diets can work and there is empirical and scientific evidence to back up that belief.

I think that we are capable of adapting to and thriving on a wide range of diets, but I do think most foods that are marketed as "low-fat" are probably not the healthiest option. My co-worker offered me a "low-fat" breakfast bar yesterday and I looked at the ingredient list and the second ingredient was sugar and the 3rd ingredient was corn syrup. I still eat some carbs like quality breads and pastas, but I try to limit them to short time periods during certain meals and not include them in every meal or snack on them all day.

I have noticed that after the meals where I have no simple carbs I don't get sleepy or foggy headed and have energy and sharp focus; whereas the carb heavy meals leave me wanting a nap and I feel less sharp and I also get increased sinus drainage.

I updated previous post with the following and not every one might have seen it so I am repeating it here:

Advocates of a low carb diet say that insulin produced in response to elevated blood sugar tells the body how much fat to store. But complex carbohydrates from foods with a lot of fiber make you feel full so you don't overeat and are digested slowly so you won't produce a lot of insulin.​

Yes, what I've heard from keto advocates is the focus is not on carbs alone but on "net carbs" which are carbs minus fiber. Fiber is essentially long chain carbs so it takes much longer to digest, feeds the good bacteria in the gut, and it encapsulates shorter carbs so that they don't get absorbed as much or as quickly.

There is also a misconception that excess carbs are stored as fat. This only occurs in extreme overeating and most people never experience it. When you gain weight from overeating carbs, the fat you gain comes from the fat in your diet not the carbs.
http://caloriesproper.com/are-carbs-stored-as-fat/

I'm not knowledgeable about that, but my understanding is that your body will always use the most readily available energy and since fat takes longer to turn into energy your body will never dip into fat reserves as long as you have stored glycogen in the cells and sugars in the blood. In general (depending on activity level and contents of the last meal) it takes about 12 hrs of fasting to begin to enter ketosis (burning fat)

People who have a steady calorie deficient diet of carbs will be far hungrier and have more detrimental effects on their bodies than people who are in a state of total fasting because in the fasting state the body is in ketosis and being in this metabolic state seems to have a lot of beneficial effects on the body and mind.
 
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