Israeli Study: Low Fat Diet Is The Least Healthy & Effective

The statue above is the Venus of Willendorf. It is 30,000 years old, predating the written record by some 20 millenium. But it is an anatomically correct statue of an obese woman, thus letting us know that the problem of obesity has been with us for a long time - and apparently was possible even on a hunter gatherer diet.

"Low Fat" diets have been a fad for years and companies have been cashing in on "low fat" foods of all stripes. But fat plays a critical role in depressing appetite and the proper mix of fats (omegas 3, 6 and 9) plays a crucial role in long term health. At any rate, it is no surprise to learn today that a two year study of 322 people by researchers at Ben-Gurion University of the Negev has found that the "Mediterranian" Diet and the low carb diet, both of which are moderately high in fats, are safer and more effective at creating sustained weight loss than the low fat diet typically recommended by physicians.
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This from an article on the study:

. . . In the two-year study, 322 moderately obese people were intensively monitored and were randomly assigned one of three diets: a low-fat, calorie-restricted diet; a Mediterranean calorie-restricted diet with the highest level of dietary fiber and monounsaturated/saturated fat; or a low-carbohydrate diet with the least amount of carbohydrates, highest fat, protein, and dietary cholesterol. The low-carb dieters had no caloric intake restrictions.

Although participants actually decreased their total daily calories consumed by a similar amount, net weight loss from the low-fat diet after two years was only 6.5 lbs. (2.9 kg) compared to 10 lbs. (4.4 kg) on the Mediterranean diet, and 10.3 lbs. (4.7 kg) on the low-carbohydrate diet. "These weight reduction rates are comparable to results from physician-prescribed weight loss medications," explains Dr. Iris Shai, the lead researcher.

The low-fat diet reduced the total cholesterol to HDL ratio by only 12 percent, while the low-carbohydrate diet improved the same ratio by 20 percent. Lipids improved the most in the low-carbohydrate, with a 20% increase in the HDL ("good") cholesterol and, 14% decrease in triglycerides. In all three diets, inflammatory and liver function biomarkers was equally improved. However, among diabetic participants, the standard low-fat diet actually increased the fasting glucose levels by 12mg/dL, while the Mediterranean diet induced a decrease in fasting glucose levels by 33mg/dL.

In addition to the findings, this two-year study is also significant because of the relatively large number of participants coupled with a low drop-out rate – 95 percent were in the study after one year and 85 percent were still participating after the second.

Dr. Iris Shai is a researcher at the S. Daniel Abraham International Center for Health and Nutrition in the Department of Epidemiology at Ben-Gurion University of the Negev. She conceived the study with Dr. Stampfer, the senior author, while she was a Fulbright fellow at Harvard School of Public Health and Channing Laboratory in Boston, Massachusetts.

. . . "Clearly, there is not one diet that is ideal for everyone," Shai concludes. "We believe that this study will open clinical medicine to considering low-carb and Mediterranean diets as safe effective alternatives for patients, based on personal preference and the medical goals set for such intervention. Furthermore, the improvement in levels of some biomarkers continued until the 24-month point, although maximum weight loss was achieved by 6 months. This suggests that healthy diet has beneficial effects beyond weight loss."

Read the entire article.

Cross posted from Wolf Howling

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Healty Diets & The Israeli Study

Healthy diets will improve health, even if resulting in only a modest sustained weight loss, according to the NYT analysis of the recent Israeli study of three different diets - low fat, Mediterranean, and low carb - over a two year period. Further, the study is of note because the vast majority of people who started the study completed it - something which the plans authors attribute to diet restrictions that were modest at inception and did not vary throughout the study.
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This from the NYT:

In a tightly controlled dieting experiment, obese people lost an average of just 6 to 10 pounds over two years.

The study, published Thursday in The New England Journal of Medicine, was supposed to determine which of three types of diets works best. Instead, the results highlight the difficulty of weight loss and the fact that most diets do not work well.

The researchers followed 322 dieters, 277 men and 45 women. The dieters were assigned to follow one of three types of diets — a diet with about 30 percent fat, based on American Heart Association guidelines; a Mediterranean diet; and a low-carbohydrate diet based on the Atkins diet plan. The study was partly financed by the Atkins Research Foundation.

The trial was conducted at the Nuclear Research Center in Dimona, Israel, an isolated workplace that has its own medical department.

In addition to regular meetings and telephone calls with dietitians for the participants, the plan included nutrition counseling for spouses and a revamping of the food served in the center’s cafeteria.

Because the center is in an isolated area, the dieters consistently ate lunch, the largest meal of the day, in the company cafeteria, where food was color-coded to help dieters comply with their eating plan.

The biggest weight loss happened in the first five months of the diet — low-fat and Mediterranean dieters lost about 10 pounds, and low-carbohydrate dieters lost 14 pounds.

By the end of two years, all the dieters had regained some, but not all, of the lost weight. The low-fat dieters showed a net loss of six pounds, and the Mediterranean and low-carbohydrate dieters both lost about 10 pounds.

Researchers said the results sound modest, but they said the small weight loss had resulted in improvements in cholesterol and other health markers.

“In order to keep participants on the diet for long term as a way of life, we did not impose extreme diet protocols,” said Iris Shai, the study’s lead author and a registered dietitian at Ben-Gurion University of the Negev at the S. Daniel Abraham International Center for Health and Nutrition. “More dramatic diet protocols could probably reduce more weight for the short term, but participants would have dropped out.”

There were subtle differences in the three diets studied. Men did better on the low-carbohydrate diets, losing 11 pounds compared with about 9 pounds for the Mediterranean diet.

Women fared best on the Mediterranean diet, losing about 14 pounds compared with about 5 pounds on the low-carbohydrate plan.

For all dieters, there were improvements in the ratios of good to bad cholesterol.
“This suggests that healthy diet has beneficial effects beyond weight loss,” Ms. Shai said.

Read the entire article.

As an aside, it seems apparent that significant weight loss cannot be sustained, irrespective of diet, unless accompanied by at least an hour a day of excercise of sufficient rigor to get the endorphins pumping. That seems to be borne out by an analysis done at the National Weight Control Registry of people who have lost significant amounts of their bodyweight and then have kept it off. Over 90% of these people maintain a robust exercise regime of over an hour per day.

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