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Low-carb and Mediterranean diets better than low-fat diet for weightloss
The New England Journal of Medicine (NEJM) published a couple of days
ago the results of two-year randomized controlled clinical trial (N=322) Shai I et al. Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet. The New England Journal of Medicine (NEJM), Volume 359:229-241, July 17, 2008, Number 3 http://content.nejm.org/cgi/content/full/359/3/229 which compared the efficacy and health effects of low-carb, Mediterranean and low-fat diets in weight loss. Below the abstract of the study; "Background Trials comparing the effectiveness and safety of weight-loss diets are frequently limited by short follow-up times and high dropout rates. Methods In this 2-year trial, we randomly assigned 322 moderately obese subjects (mean age, 52 years; mean body-mass index [the weight in kilograms divided by the square of the height in ' meters], 31; male sex, 86%) to one of three diets: low-fat, restricted-calorie; Mediterranean, restricted-calorie; or low-carbohydrate, non–restricted-calorie. Results The rate of adherence to a study diet was 95.4% at 1 year and 84.6% at 2 years. The Mediterranean-diet group consumed the largest amounts of dietary fiber and had the highest ratio of monounsaturated to saturated fat (P0.05 for all comparisons among treatment groups). The low-carbohydrate group consumed the smallest amount of carbohydrates and the largest amounts of fat, protein, and cholesterol and had the highest percentage of participants with detectable urinary ketones (P0.05 for all comparisons among treatment groups). The mean weight loss was 2.9 kg for the low-fat group, 4.4 kg for the Mediterranean-diet group, and 4.7 kg for the low-carbohydrate group (P0.001 for the interaction between diet group and time); among the 272 participants who completed the intervention, the mean weight losses were 3.3 kg, 4.6 kg, and 5.5 kg, respectively. The relative reduction in the ratio of total cholesterol to high-density lipoprotein cholesterol was 20% in the low-carbohydrate group and 12% in the low-fat group (P=0.01). Among the 36 subjects with diabetes, changes in fasting plasma glucose and insulin levels were more favorable among those assigned to the Mediterranean diet than among those assigned to the low-fat diet (P0.001 for the interaction among diabetes and Mediterranean diet and time with respect to fasting glucose levels). Conclusions Mediterranean and low-carbohydrate diets may be effective alternatives to low-fat diets. The more favorable effects on lipids (with the low-carbohydrate diet) and on glycemic control (with the Mediterranean diet) suggest that personal preferences and metabolic considerations might inform individualized tailoring of dietary interventions." The full text of the article seems also to be free, although to read it a free registrations is probably required. Below a citation from the Discussion chapter: "In this 2-year dietary-intervention study, 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." News reports about this study: Low-Carb and Mediterranean Diets Beat Low-Fat for Weight Loss, Lipid Changes at 2 Years http://www.medscape.com/viewarticle/577593?src=rss (requires free registration) Low-carb and Mediterranean diets beat low-fat for weight-loss, lipid changes at two years http://www.theheart.org/viewArticle.do?primaryKey=882281&nl_id=tho16jul08 Diet Debate: 3 Top Plans Go Toe to Toe Researchers Say Mediterranean and Low-Carb Diets Are Good Alternatives to Low-Fat Plan http://www.webmd.com/diet/news/20080716/diet-debate-3-top-plans-go-toe-to-toe?src=RSS_PUBLIC http://tinyurl.com/5vsvb8 Low-carb diet beats other diets in study http://edition.cnn.com/2008/HEALTH/diet.fitness/07/16/dueling.diets.ap/index.html?eref=rss_health http://tinyurl.com/6rhfnq Low-carb beats low-fat in diet duel Those eating fewer carbs also had lower cholesterol, surprising study finds http://www.msnbc.msn.com/id/25708495/ Low-fat Diets May Not Be Best For Weight Loss, Study Suggests http://www.sciencedaily.com/releases/2008/07/080716171134.htm The two first news reports, by Medscape and www.theheart.org are the best and almost identical. They are very clear and most detailed and accurate of the all the news reports. They present some results in easily readable table format. Here is their presentation of the weight loss data: "Weight loss Group Low-fat (kg) Mediterranean (kg) Low-carb (kg) All patients –2.9 –4.4 –4.7 All completers –3.3 –4.6 –5.5 Men –3.4 –4.0 –4.9 Women –0.1 –6.2 –2.4" As can be seen the low-carb diet was best for men for weight loss, followed by the Mediterranean diet, but Mediterranean diet was the best for women, followed by the low-carb diet. Their presentation of lipid changes is as follows: "Lipid changes Parameter Low-fat (mg/dL) Low-carb (mg/dL) Mediterranean (mg/dL) HDL +6.4 +8.4 +6.3 LDL –0.05 –3.0 –5.6 Triglycerides –2.8 –23.7 –21.8 Total –0.6 –1.1 –0.9 cholesterol/ HDL ratio" As can be seen, the important Total cholesterol/HDL ratio improved most in the low-carb diet and the Mediterranean diet was very close second. LDL was lowered most by Mediterranean diet followed by low-carb diet. Low-carb diet raised HDL most. Triglycerides were lowered most by low-carb and Mediterranean diets. Finally, below some selected comments from the end of the Medscape report: "- The mean BMI changes were –1.0, –1.5, and –1.5 kg/m2, respectively. - All groups had significant decreases in blood pressure and waist circumference, with no difference among the 3 groups. - Waist circumference was decreased by 2.8, 3.5, and 3.8 cm in the low-fat, Mediterranean, and low-carbohydrate groups, respectively. - Systolic blood pressure was reduced by 4.3, 5.5, and 3.9 mm Hg, respectively. - HDL cholesterol levels increased in all groups, with the greatest increase in the low-carbohydrate group (8.4 mg/dL). - Triglyceride levels decreased significantly, with the greatest decrease seen in the low-carbohydrate group (2.7 mg/dL). - The ratio of total to HDL cholesterol decreased in all 3 groups, greatest in the low-carbohydrate group (20%). - C-reactive protein decreased significantly in the Mediterranean and low-carbohydrate groups. - In the 36 participants with diabetes, only those in the Mediterranean group had a significant reduction in fasting plasma glucose levels (32.8 mg/dL). - Hemoglobin A1c rates decreased by 0.4%, 0.5%, and 0.9% in the low-fat, Mediterranean, and low-carbohydrate groups, respectively. - The Mediterranean and low-carbohydrate diets were feasible alternatives to the low-fat diet with some benefits, and personal preference could drive tailoring of diets for weight loss." Notice especially that the very important cardiovascular risk factor C-reactive protein (CRP) was reduced significantly only in the Mediterranean and low-carbohydrate groups. -- Matti Narkia http://ma.gnolia.com/groups/Nutrition |
Thanks for this wonderful information.
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The best and almost nice articles.good diets its really effected on body. diet must be needed to make our body freely.
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