Best Diet For Weight Loss

Written by Dr. Steve Chaney on . Posted in current health articles, Healthy Lifestyle, Healthy Living, Nutritiion

The Diet Wars Heat Up Again

Author: Dr. Stephen Chaney

best diet for weight loss

What is the best diet for weight loss? One week the headlines say that low-carbohydrate diets are better. The next week it’s low-fat diets that are better. There is even the occasional headline proclaiming that it doesn’t matter which diet you follow as long as you control your calories. It is no wonder that you are confused.

It is unusual, however, to have conflicting headlines within the same week, but that is exactly what happened last week. Let me take you behind the headlines to the actual clinical studies and help you sort through the conflicting headlines.

Are Low-Carbohydrate Diets Best For Weight Loss?

The manuscript behind this headline was published September 2nd in the Annals of Internal Medicine (Bazzano et al, Annals of Internal Medicine, 161: 309-318, 2014). This study was designed to determine which was the best diet for weight loss, low carb diet or low fat diet. The study recruited 148 overweight participants (mean age, 46.8, 88% female, 51% black) and randomly assigned them to either a low-fat diet or low-carbohydrate diet.

The participants on the low-fat diet were instructed to consume <30% of their calories from fat, while the participants on the low-carbohydrate diet were told to limit carbohydrates to <40 g/day. Neither group was told to limit calories. They met with a dietitian 10 times during the 12-month study and received information on dietary fiber (target = 25 g/day) and healthy fats (target = <7% saturated fat and little or no trans fats).

At the end of 12 months the low-carbohydrate diet resulted in significantly greater…

  • Weight loss (7.7 pounds)…
  • Decrease in triglyceride levels…
  • Increase in HDL cholesterol…
  • Decrease in the ratio of total to HDL Cholesterol…

…than the low-fat diet. In short, the results suggested that the low-carbohydrate diet was not only better than the low-fat diet for weight loss, but that it was also more effective in reducing risk factors for cardiovascular disease.

Case closed, you might be tempted to say. The low carb diet is the best the diet for weight loss. But there have been lots of other studies that have come to the opposite conclusion. So we have to ask the question: “Is this study significantly better than all of the studies that have failed to find any difference between the low-fat and low-carbohydrate diets with respect to weight loss and cardiovascular risk?”

What Are The Strengths & Weaknesses Of the Study?

Strengths of the Study: This was a very well designed study. In particular:

  • Dietitians met with the participants at multiple times during the program to assure adherence to the diet, which was very good.
  • The study utilized multiple dietary recalls, both during the week and on weekends.
  • The study had a diverse population.

Weaknesses of the Study:

  1. The study did not control calories. In fact, the caloric intake was ~160 calories/day greater for the low-fat group than the low-carbohydrate group for at least the first 6 months of the study. low carb dietThat alone would be enough to account for the 7.7 pounds difference in weight loss.The reason for the higher caloric intake of low-fat group is not known. It could be due to the lower palatability of the low-carbohydrate diet. Alternatively, it could be due to the lower satiety of the low-fat diet. It was low in both fat and protein, both of which contribute to satiety (the feeling of fullness after we eat).
  2. The study did not specify the type of carbohydrates consumed. The dietitians instructed the participants on the type of fat they should be eating, but not the type of carbohydrate. That was a significant omission. Diets high in sugars and refined carbohydrates provide less satiety and adversely affect cardiovascular risk factors compared to diets where the carbohydrate comes primarily from fresh fruits, vegetables and legumes.
  3. The study did not control protein intake. In fact, the low-fat group consumed significantly less protein than the low-carbohydrate group. As I pointed out in a previous “Health Tips From the ProfessorHigh Protein Diets and Weight Loss , higher protein intakes are essential for maintaining muscle mass during weight loss. That is important because loss of muscle mass can decrease metabolic rate (the rate at which we burn calories 24 hours a day – even at rest).

The amount of protein consumed by the low-carbohydrate group was close to the amount shown to maintain muscle mass during weight loss, while the amount of protein consumed by the low-fat group was close to the amount associated with loss of muscle mass during weight loss. That was reflected in the results. The low-fat group lost muscle mass while the low carbohydrate group actually gained muscle mass. The resulting difference in muscle probably meant that the low-carbohydrate group was burning more calories on a daily basis than the low-fat group.

In short, this is a good study, but it has important flaws. It is not a game changer.

Do Low-Carbohydrate & Low-Fat Diets Result In Identical Weight Loss?

The study behind this headline was published in the September 3rd edition of the Journal of the American Medical Association (Johnson et al, JAMA, 312: 923-933, 2014). This study was a meta-analysis that combined the results of 48 studies with 7286 participants. When the authors combined the data from all of the published studies there was no difference in weight loss for the low-fat and low-carbohydrate diets over a one or two year period.

The strength of the study is that it combines the results of multiple studies. That increases the statistical power of the observations and smoothes over the effect of outlier studies, such as the one described above. This is the study I would trust.

What Do The Experts Say?

Dr. Walter Willett, Chair of the Department of Nutrition at the Harvard School of Public Health was best diet for weight lossquoted as saying: “…some people [would] do well on either diet. The key issue for each person is finding a way of eating that is healthy and can be maintained for the long term.”

Dr. Bradley Johnson (the author of the meta-analysis) was quoted as saying: “The take home message is that people should choose a diet they can adhere to…”

The Bottom Line

1)  Ignore the recent headlines suggesting that low-carbohydrate diets may be more effective than low-fat diets for weight loss. When you control for calories and protein intake there is no difference between the two diets with respect to long term weight loss.

2)  You can also ignore the headlines telling you that low-carbohydrate diets are better for cardiovascular health. You don’t need to avoid carbohydrates to have a healthy heart. You just need to make healthy carbohydrate choices – fruits, vegetables, legumes and whole grains instead of refined flour products and sugary junk food.

3)  Experts will tell you that the best diet is a healthy diet that you can stick with long term.

4)  My personal recommendations are to avoid extremes (either low-fat or low-carbohydrate). Instead:

  • Aim for moderate amounts of healthy fats and healthy carbohydrates.
  • Don’t ignore protein. Make sure you get enough protein to maintain your muscle mass.
  • Control calories by reducing portion sizes and choosing healthy snacks.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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Latest Article

How to Choose the Right Pillow

Posted April 17, 2018 by Dr. Steve Chaney

Wake Up Each Morning Pain Free

Author: Julie Donnelly, LMT – The Pain Relief Expert

Editor: Dr. Steve Chaney

 

how to choose the right pillow without headachesThe way you sleep is often a key to discovering the cause of headaches and more. If you wake up with neck pain, a headache, or you suffer from ringing in your ears, dizziness, or ear pain, there is a good possibility that it may be caused by the way you are sleeping. Your pillow may be the culprit.  But if you need to know how to choose the right pillow for you, it’s easy.   It just takes a little “investigation.”

 

How to Choose the Right Pillow if You Sleep On Your Side

Your head, neck, and spine need to always stay in a nice straight line, just as it is when you are standing up, but that takes a little thought and understanding of the way you sleep.  So, get comfy in your bed and then notice how your head is resting.

how to choose the right pillow to sleep painfreeIf you sleep on your side, your pillow needs to be just the right size, so your head doesn’t point down toward the mattress (your pillow is too soft) or up to the ceiling (your pillow is too thick). Either of these positions will make the muscles on the side of your neck stay in the contracted position for hours and pull your vertebrae in that direction, especially when you try to turn over to your other side.

Your SCM Muscle May Cause Serious Problems

You also need to notice if you turn your head a bit, especially if you are turning into your pillow or turning your head up toward away from your pillow. In either of these two cases you will be causing your sternocleidomastoid (SCM for short) to be held shortened for hours.

Your SCM originates on your collarbone and inserts into the bone behind your ear.  When it contracts you turn your head to the opposite side. However, if the muscle is tight (for example, when you’ve held your head turned toward one side for an extended period of time) and then you bring your head back so you are facing forward, the tight muscle will pull on the bone behind your ear and cause havoc.

The symptoms for a tight SCM are tinnitus (ringing in the ear), dizziness, loss of equilibrium, ear pain, headaches, pain in the eye and around the skull, pain at the top of the head, and even pain in the throat. Amazing! What’s even more amazing is that it’s rare that this muscle is considered when a medical professional is searching for the cause of your symptoms.

These are the things to know when considering how to choose the right pillow if you sleep on your side.

How To Choose The Right Pillow If You Sleep On Your Back

how to choose the right pillow for sleeping on your backIf you sleep on your back, your head should be on the mattress (not propped up with a pillow) and you should have a tiny support (like a folded washcloth) under your neck.  Or, you can have a wedge pillow that starts at your mid-back and gently raises your entire trunk and head up while still allowing your head and back to be in a straight line.

It’s always a challenge for people who toss and turn during the night, sometimes on their side and sometimes on their back.  The best thing I’ve found for this situation is to have the pillow below shoulder level so when you turn on your side your shoulder will automatically slide to the edge of the pillow while still supporting your head properly, and when you turn onto your back, the pillow will start at shoulder level so your head and neck are supported, but your head is being pushed in a way that causes your chin to move down to your chest.

hip pain causes and treatment pain freeIt’s tricky, but I can personally attest to the fact that it will work.  I can always tell when I’ve had my head tilted (I toss and turn during the night) because I will wake with a headache. When that happens I’m grateful that I know how to self-treat the muscles of my neck and shoulders so the headache is eliminated quickly.  If you already have Treat Yourself to Pain Free Living,  you can self-treat all your neck and shoulder muscles to release the tension.

How To Choose The Right Pillow If You Sleep On Your Stomach

If you sleep on your stomach, this is the one position that is so bad that it behooves you to force yourself to change your position. Your head is turned to the side and held still for hours, putting a severe strain on all your cervical and upper thoracic vertebrae. Not only will this cause headaches, tinnitus, and a list of other pains, but it can cause problems down your entire spine. It can also impinge on the nerves that pass through the vertebrae on their way to your organs.

If you do sleep that way, let me know and I’ll give you some suggestions that work to change your habit of sleeping. It takes time and energy, but the results are worth the effort.

In every case, the way you sleep may cause neck pain that won’t go away until the pillow situation is resolved.

Now you should know how to choose the right pillow for the way you sleep.

Wishing you well,

Julie Donnelly

About The Author

julie donnelly

Julie Donnelly is a Deep Muscle Massage Therapist with 20 years of experience specializing in the treatment of chronic joint pain and sports injuries. She has worked extensively with elite athletes and patients who have been unsuccessful at finding relief through the more conventional therapies.

She has been widely published, both on – and off – line, in magazines, newsletters, and newspapers around the country. She is also often chosen to speak at national conventions, medical schools, and health facilities nationwide.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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