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Low-carb and Mediterranean diets beat low-fat for weight-loss, lipid changes at two years



 
 
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  #1  
Old July 16th, 2008, 11:56 PM posted to alt.support.diet.low-carb
Roger Zoul
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Posts: 1,790
Default Low-carb and Mediterranean diets beat low-fat for weight-loss, lipid changes at two years

Beer-Sheva, Israel - Both a low-carbohydrate diet or a Mediterranean-style
diet may be "effective alternatives" to a low-fat diet, with more favorable
effects on lipids and/or glycemic control, new research suggests [1]. The
two-year study, which managed to keep almost 85% of the 322 study
participants on one of the three diets for the entire period, offers the
hope that weight-loss diets can be tailored to personal preferences, without
sacrificing efficacy, researchers say.
"Several recent one-year dietary studies have led the American Diabetes
Association to state in January 2008 that low-carb diets should be
considered for a maximum of one year," lead author on the study, Dr Iris
Shai (Ben Gurion University of the Negev, Beer-Sheva, Israel), told
heartwire. "The current two-year study suggests that one low-fat diet
doesn't fit all, meaning that the old paradigm should be reconsidered."

http://www.theheart.org/viewArticle...._id=tho16jul08


  #2  
Old July 17th, 2008, 12:34 AM posted to alt.support.diet.low-carb
FOB
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Posts: 583
Default Low-carb and Mediterranean diets beat low-fat for weight-loss, lipid changes at two years

Been doing the happy dance ever since I heard this on the evening news.
They emphasized the improvement in cholesterol. I'm so tired of people
whining about what they can't eat because they have to watch their
cholesterol and it's always fat. They'll have to excuse us long time low
carbers for gloating a bit.

Roger Zoul wrote:
| Beer-Sheva, Israel - Both a low-carbohydrate diet or a
| Mediterranean-style diet may be "effective alternatives" to a low-fat
| diet, with more favorable effects on lipids and/or glycemic control,
| new research suggests [1]. The two-year study, which managed to keep
| almost 85% of the 322 study participants on one of the three diets
| for the entire period, offers the hope that weight-loss diets can be
| tailored to personal preferences, without sacrificing efficacy,
| researchers say. "Several recent one-year dietary studies have led
| the American Diabetes Association to state in January 2008 that
| low-carb diets should be considered for a maximum of one year," lead
| author on the study, Dr Iris Shai (Ben Gurion University of the
| Negev, Beer-Sheva, Israel), told heartwire. "The current two-year
| study suggests that one low-fat diet doesn't fit all, meaning that
| the old paradigm should be reconsidered."
|
| http://www.theheart.org/viewArticle...._id=tho16jul08


  #3  
Old July 17th, 2008, 10:18 AM posted to alt.support.diet.low-carb
Steve
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Posts: 12
Default Low-carb and Mediterranean diets beat low-fat for weight-loss, lipid changes at two years

On Wed, 16 Jul 2008 18:56:23 -0400, Roger Zoul wrote
(in article ):

Beer-Sheva, Israel - Both a low-carbohydrate diet or a Mediterranean-style
diet may be "effective alternatives" to a low-fat diet, with more favorable
effects on lipids and/or glycemic control, new research suggests [1]. The
two-year study, which managed to keep almost 85% of the 322 study
participants on one of the three diets for the entire period, offers the
hope that weight-loss diets can be tailored to personal preferences, without
sacrificing efficacy, researchers say.


A loss of 3 - 4 kilograms over a two year period is a bit underwhelming no
matter what the diet.

--
Steve

** Posted from http://www.teranews.com **
  #4  
Old July 17th, 2008, 02:57 PM posted to alt.support.diet.low-carb
Matti Narkia
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Posts: 19
Default Low-carb and Mediterranean diets beat low-fat for weight-loss,lipid changes at two years

Roger Zoul wrote:

Beer-Sheva, Israel - Both a low-carbohydrate diet or a Mediterranean-style
diet may be "effective alternatives" to a low-fat diet, with more favorable
effects on lipids and/or glycemic control, new research suggests [1]. The
two-year study, which managed to keep almost 85% of the 322 study
participants on one of the three diets for the entire period, offers the
hope that weight-loss diets can be tailored to personal preferences, without
sacrificing efficacy, researchers say.
"Several recent one-year dietary studies have led the American Diabetes
Association to state in January 2008 that low-carb diets should be
considered for a maximum of one year," lead author on the study, Dr Iris
Shai (Ben Gurion University of the Negev, Beer-Sheva, Israel), told
heartwire. "The current two-year study suggests that one low-fat diet
doesn't fit all, meaning that the old paradigm should be reconsidered."

http://www.theheart.org/viewArticle...._id=tho16jul08


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
elow 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.

The best news report about this study is probably Medscape's

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)

Medscape's report is very clear, detailed and accurate. It
presents some results in easily readable table format. Here
is Medscape's 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.

Medscape's 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
  #5  
Old July 17th, 2008, 09:28 PM posted to alt.support.diet.low-carb
FOB
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Posts: 583
Default Low-carb and Mediterranean diets beat low-fat for weight-loss, lipid changes at two years

Yes, but the lipids findings are significant. That should get the
low-fatters who always says we are heading for heart attacks off our backs
making us much lighter.

Steve wrote:
|
| A loss of 3 - 4 kilograms over a two year period is a bit
| underwhelming no matter what the diet.


  #6  
Old July 17th, 2008, 09:47 PM posted to alt.support.diet.low-carb
Cheri
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Posts: 472
Default Low-carb and Mediterranean diets beat low-fat for weight-loss, lipid changes at two years


FOB wrote in message ...
Yes, but the lipids findings are significant. That should get the
low-fatters who always says we are heading for heart attacks off our

backs
making us much lighter.



Much lighter. :-)

Cheri


  #7  
Old July 18th, 2008, 12:22 PM posted to alt.support.diet.low-carb
Hannah Gruen
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Posts: 163
Default Low-carb and Mediterranean diets beat low-fat for weight-loss, lipid changes at two years

Dr. Eades has made some intresting preliminary comments on this study.

http://www.proteinpower.com/drmike/weight-loss/low-carb-diet-trumps-low-fat-diet-yet-again/

Apparently there are a lot of questions, and the low-carb diet is certainly
not standard LC, because LC participants were asked to raise carb intake to
120 g/day after the initial "induction" period.

Meanwhile, the very-low-fat vegan starch-based diet proponent Dr. McDougall
has come out strongly against the study's conclusions:

http://www.drmcdougall.com/advertising_confuses_public.htm

His primary complaints seem to be that (1) the "low-fat" diet was not really
low-fat, with 30% of calories from fat (his plan runs around 7-10% fat), and
(2) the Atkins Foundation funded the study.

So nobody is happy with this one. I will go with my anectdotal, personal
findings. On McDougall's program I lost quite a bit of weight. But I looked
horrible, with really wrinkled skin, a very aged appearance. I had a lot of
arthritic pain. And worst, I was hungry much of the time, no matter how much
fat-free brown rice and beans I ate. I craved sugar. My hair became thin. My
waistline underwent relative expansion, so I think my pre-existing insulin
resistance worsened.

LC allowed/allows me much easier weight loss, although slower, and my skin
tone and body shape improved very noticeably. Like taking off 5-10 years!
The waist/hip ration improved quickly. I actually found (and still find)
myself eating more vegetables on LC than McDougall. And of course LC does
away with the constant craving for food/sweets/starches. I can still
remember, all these years later, how astonished I was, a couple weeks after
starting LC, upon realizing I had completely forgotten to eat lunch! Never,
never, never could have happened on vlf vegan like McDougall's plan.

Hannah

"Roger Zoul" wrote in message
...
Beer-Sheva, Israel - Both a low-carbohydrate diet or a Mediterranean-style
diet may be "effective alternatives" to a low-fat diet, with more
favorable effects on lipids and/or glycemic control, new research suggests
[1]. The two-year study, which managed to keep almost 85% of the 322 study
participants on one of the three diets for the entire period, offers the
hope that weight-loss diets can be tailored to personal preferences,
without sacrificing efficacy, researchers say.
"Several recent one-year dietary studies have led the American Diabetes
Association to state in January 2008 that low-carb diets should be
considered for a maximum of one year," lead author on the study, Dr Iris
Shai (Ben Gurion University of the Negev, Beer-Sheva, Israel), told
heartwire. "The current two-year study suggests that one low-fat diet
doesn't fit all, meaning that the old paradigm should be reconsidered."

http://www.theheart.org/viewArticle...._id=tho16jul08




  #8  
Old July 18th, 2008, 06:39 PM posted to alt.support.diet.low-carb
Hamburger
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Posts: 4
Default Low-carb and Mediterranean diets beat low-fat for weight-loss, lipid changes at two years

- 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.



Funny, these two statements seem to contradict each other...


Take care,
Hamburger


  #9  
Old July 18th, 2008, 07:23 PM posted to alt.support.diet.low-carb
Doug Freyburger
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Posts: 1,866
Default Low-carb and Mediterranean diets beat low-fat for weight-loss,lipid changes at two years

"Hannah Gruen" wrote:

Dr. Eades has made some intresting preliminary comments on this study.
http://www.proteinpower.com/drmike/weight-loss/low-carb-diet-trumps-l...


Thanks for the pointers to Eades and McDougall.

Apparently there are a lot of questions, and the low-carb diet is certainly
not standard LC, because LC participants were asked to raise carb intake to
120 g/day after the initial "induction" period.


The level of 120 grams per day is above my maintenance limit. If I
eat that much carb my appetite starts going up and my weight starts
drfting up. It makes me wonder why they'd put folks on 2 months at
20, then put them at a level that will be over their maintenance limit
for some. It doesn't make sense. Why not have them actually try,
you know, either the real Atkins plan or the real Eades plan?

Meanwhile, the very-low-fat vegan starch-based diet proponent Dr. McDougall
has come out strongly against the study's conclusions:

http://www.drmcdougall.com/advertising_confuses_public.htm

His primary complaints seem to be that (1) the "low-fat" diet was not really
low-fat, with 30% of calories from fat (his plan runs around 7-10% fat), and


If they aren't doing a real low carb plan why should anyone expect
they do a real low fat plan. Sigh.

(2) the Atkins Foundation funded the study.


This is both valid and invalid at the same time. It's valid because
the Atkins Foundation can't be expected to fund a project that
looks in advance like low carb is going to lose - Which makes it
even more bizzare that they picked a level hign enough to exceed
the mainteance limit of some. It's invalid because studies get
duplicated when they are in doubt.

So nobody is happy with this one. I will go with my anectdotal, personal
findings. On McDougall's program I lost quite a bit of weight. But I looked
horrible, with really wrinkled skin, a very aged appearance. I had a lot of
arthritic pain. And worst, I was hungry much of the time, no matter how much
fat-free brown rice and beans I ate. I craved sugar. My hair became thin. My
waistline underwent relative expansion, so I think my pre-existing insulin
resistance worsened.


I tried low fat for 20 years, gained 50 pounds, was constantly
hungry. I am well aware that low fat works for some percentage
of the population, I'm just not in that percentage.

LC allowed/allows me much easier weight loss,


I think this is the single largest advantage low carb has - For
so many people it turns off the cravings, turns down the
appetite. It no longer triggers hunger to gradually reduce
portion sizes.

although slower, and my skin
tone and body shape improved very noticeably. Like taking off 5-10 years!


The gray in my hair saw about 5 years worth of set back
in its advance.

The waist/hip ration improved quickly.


I wish I'd seen that bit.

I actually found (and still find)
myself eating more vegetables on LC than McDougall.


Yeah. Eating veggies is the low carb way. Strange how that
worked out. Strange enough that people who have never tried
low carb don't think it's a feature of the system.
  #10  
Old July 18th, 2008, 08:38 PM posted to alt.support.diet.low-carb
Matti Narkia
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Posts: 19
Default Low-carb and Mediterranean diets beat low-fat for weight-loss,lipid changes at two years

Hamburger wrote:

- 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.



Funny, these two statements seem to contradict each other...

Good observation. I noticed the same thing and quietly wondered about
it, too. From the

Figure 4. Changes in Biomarkers According to Diet Group and
Presence or Absence of Type 2 Diabetes.
http://content.nejm.org/cgi/content/full/359/3/229/F4

you can see, that fasting plasma glucose reductions of diabetic people
in the Mediterranean diet and low-carb diet groups were very close to
each other at 12 months, -23.6 and -18.1, respectively, but
after that Mediterranean diet group continued downward trend, but
the trend of the low-carb group turned upwards, so that at 24 months
the Mediterranean group was at -32.8, but the low-carb group had 1.2
_increase_. I wonder what happened after 12 months to cause this swing
upwards in the low-carb group? The reduction of HOMA-IR (homeostasis
model assessment of insulin resistance) was also largest in the
Mediterranean group followed by the low-carb group and smallest in
the low-fat group. But why the reduction of HbA1c behaved differently
from fasting plasma glucose and HOMA-IR, so that it was larger in
low-carb group than in the Mediterranean group, is a mystery to me,
too. I wish that the authors had handled this in the Discussion
chapter or elsewhere in the text, but apparently they didn't. Perhaps
people familiar with diabetes could have some kind of explanation or
speculation about this?


--
Matti Narkia

http://ma.gnolia.com/groups/Nutrition
 




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