Can Genetics Predict Which Diet is Best For You?

Written by Dr. Steve Chaney on . Posted in Genetics and Diet

Author: Dr. Stephen Chaney

 

genetix and dietIt is so confusing. The weight loss claims for popular diets sound so convincing, but they can’t all be true.

The low carb proponents give impressive metabolic arguments for why their diet works best. (Of course, you aren’t a biochemist. You have no idea whether they are speaking the truth or just trying to pull the wool over your eyes.) They quote clinical studies and offer testimonials that “prove” their diet works.

Other “experts” tell you that is nonsense. Your diet needs to be individualized to fit your genetic and metabolic profile. Who do you believe? Do low-carb or low-fat diets work better? Are individualized diet plans the solution?

Fortunately for you a recent study (CD Gardner et al, JAMA, 319: 667-679, 2018 ) has answered your questions. Let me start with some background to put this study in perspective. Then I will describe how the study was done, the study results, and what this study means for you.

 

What Did We Already Know About Diets?

The studies that low-carb proponents quote to “prove” the success of their diet approach are misleading because:

  • Most of the studies are short-term. This is misleading because low-carb diets lead to an initial loss of water weight that is not seen with low-fat diets.
  • Most of the comparisons are done with the typical American diet (which is high in sugar, refined carbohydrates, and junk food) rather than a healthy low-fat diet.
  • Note: This is the short version. I cover this in more detail in my new “Slaying The Food Myths” book.

In contrast, there have been numerous studies comparing the effectiveness of low-carb versus low-fat diets long term (12 months or more). These studies have not found a dimes worth of difference between the two diets. Weight loss was virtually identical.

genetix and diet bestThat has led some weight loss experts to point out that any “one size fits all” diet fails to account for individual variability. They point out that while average weight loss on a particular diet might be 12-15 pounds, some people will have lost 45 pounds and others gained 5 pounds. That has led to research efforts to discover biomarkers that could predict which diet will work best for you. Let me share the two most promising approaches.

A DNA testing approach measures genetic variation in the PPARG, ADRB2, AND FABP2 genes [Don’t worry. There won’t be a quiz.] These are genes involved in fat and energy metabolism. Animal studies have suggested that genetic variation in these genes might be useful in predicting whether individuals respond better to a low-fat or low-carb diet. One preliminary clinical study has suggested it may work for humans as well.

An insulin sensitivity approach measures insulin levels 30 minutes after a glucose challenge (a measurement called INS-30). Some small clinical studies have suggested this approach might also have value in predicting the success of low-carb versus low-fat diets for weight loss.

Unfortunately, some companies are already promoting individualized diet plans based on DNA testing and insulin sensitivity measurement – even though the clinical support for the predictive power of those tests is very preliminary at present.

The current study was designed to compare the effectiveness of healthy low-carb and low-fat diets on weight loss. In addition, it evaluated whether either DNA testing or insulin sensitivity measurements could effectively predict whether individuals lost weight better on low-fat or low-carb diets.

How Was This Study Done? 

genetix and diet studyThis was an excellent study. In fact, it is one of the best studies comparing weight loss diets I have seen in recent years. It enrolled 609 middle-aged (average age = 40), overweight (average BMI = 33) adults from the San Francisco Bay area in a 12-month weight loss study. Here was the breakdown of participants:

  • 57% were women, 43% were men.
  • 40% had a DNA pattern considered favorable for a low-fat diet, 30% had a DNA pattern considered favorable for a low-carb diet (30% had an intermediate DNA pattern that did not predict either low-carb or low-fat).
  • 67% had insulin sensitivity values considered favorable for low-carb diets, 33% had insulin sensitivity considered favorable for a low-fat diet.

The study participants were randomly assigned to either the low-carb diet group or low-fat diet group by a computerized protocol that assured DNA patterns and insulin sensitivity were equally distributed across the two groups.

In contrast to many earlier studies, both groups followed a relatively healthy diet. They were instructed to:

  • Maximize vegetable intake.
  • Minimize intake of added sugars, refined flours, and trans-fats.
  • Focus on whole foods that were minimally processed, nutrient dense, and prepared at home whenever possible.

The participants were not advised to restrict their calories. However, they were given an extraordinary degree of support. They were further divided into groups of 17 that met a total of 22 times over the 12 months with a registered dietitian who provided instruction, support and encouragement. That level of support assured that the participants stuck with their diet for the full 12-month period.

 

Can Genetics Predict Which Diet Works Best?

genetix and diet works best Participants in the study lost an average of 12 pounds. That is not a huge amount of weight, but it is enough weight loss to make a difference, and it is consistent with the results of most long-term studies. When the results were broken down further:

  • There was no significant difference in weight loss between the low-carb group and low-fat group at 12 months. This is consistent with multiple previous studies.
  • Both diets were equally effective at improving lipid profiles and lowering blood pressure, insulin, and blood sugar levels. This is the dirty little secret that many low-carb enthusiasts don’t tell you. The improvements seen in health parameters such as lipids, blood pressure, insulin, and blood glucose are due to the weight loss, not whether the diet is low-carb or low-fat.
  • Neither the DNA pattern or insulin sensitivity offered any predictive value as to whether a low-carb or low-fat diet was more effective for weight loss.

That does not mean that DNA testing is of no value. It simply means that the human genome is far more complex than the companies offering DNA tests have assumed. There will be a day when we know enough to individualize diets based on DNA testing. That day is not now.

What Does This Mean For You?

Forget the weight loss claims of the low-carb enthusiasts. Ignore companies that promise they can select the best diet approach for you based on some simple DNA tests and/or measurements of insulin sensitivity.

This study does not provide definitive answers, but it hints at the weight loss tips that really matter:

  • Ditch the sodas, sweets, fast and processed foods. Instead focus on whole foods, primarily fruits and vegetables, whole grains, and legumes.
  • If you wish to follow a low-carb diet, choose one that is primarily plant-based  rather than meat-based.
  • Focus on what you are eating rather than on calories.
  • Find a group to provide support and encouragement. It doesn’t need to be some expensive diet program. It could just be a group of friends who agree to provide each other with support, encouragement, and accountability.

I cover this topic in much more detail in my new book “Slaying The Food Myths”.

 

The Bottom Line:

 

A recent study compared the effectiveness of healthy low-carb and low-fat diets on weight loss over a 12-month period. In addition, it evaluated whether DNA testing or insulin sensitivity measurements could effectively predict whether individuals lost weight better on low-fat or low-carb diets.

  • There was no significant difference in weight loss between the low-carb and low-fat groups at 12 months. This is consistent with multiple previous studies.
  • Both diets were equally effective at improving lipid profiles and lowering blood pressure, insulin, and blood sugar levels. This is the dirty little secret that many low-carb enthusiasts don’t tell you. The improvements seen in health parameters such as lipids, blood pressure, insulin, and blood glucose are due to the weight loss, not whether the diet is low-carb or low-fat.
  • Neither the DNA pattern or insulin sensitivity offered any predictive value as to whether a low-carb or low-fat diet was more effective for weight loss.

That means you can forget the weight loss claims of the low-carb enthusiasts. You should also ignore companies that promise they can select the best diet approach for you based on some simple DNA tests and/or measurements of insulin sensitivity.

As for what works and why, I cover that in detail in my new book “Slaying The Food Myths

 

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.

Trackback from your site.

Leave a comment

Recent Videos From Dr. Steve Chaney

READ THE ARTICLE
READ THE ARTICLE

Latest Article

Can Plant-based Diets Be Unhealthy?

Posted September 10, 2019 by Dr. Steve Chaney

Do Plant-Based Diets Reduce Heart Disease Deaths?

Author: Dr. Stephen Chaney

 

plant-based diets vegetablesPlant-based diets have become the “Golden Boys” of the diet world. They are the diets most often recommended by knowledgeable health and nutrition professionals. I’m not talking about all the “Dr. Strangeloves” who pitch weird diets in books and the internet. I am talking legitimate experts who have spent their life studying the impact of nutrition on our health.

Certainly, there is an overwhelming body of evidence supporting the claim that plant-based diets are healthy. Going on a plant-based diet can help you lower blood pressure, inflammation, cholesterol and triglycerides. People who consume a plant-based diet for a lifetime weigh less and have decreased risk of heart disease, diabetes, and cancer.

But, can a plant-based diet be unhealthy? Some people consider a plant-based diet to simply be the absence of meat and other animal foods. Is just replacing animal foods with plant-based foods enough to make a diet healthy?

Maybe not. After all, sugar and white flour are plant-based food ingredients. Fake meats of all kinds abound in our grocery stores. Some are very wholesome, but others are little more than vegetarian junk food. If you replace animal foods with plant-based sweets, desserts, and junk food, is your diet really healthier?

While the answer to that question seems obvious, very few studies have asked that question. Most studies on the benefits of plant-based diets have compared population groups that eat a strictly plant-based diet (Seventh-Day Adventists, vegans, or vegetarians) with the general public. They have not looked at variations in plant food consumption within the general public. Nor have they compared people who consume healthy and unhealthy plant foods.

This study (H Kim et al, Journal of the American Heart Association, 8:e012865, 2019) was designed to fill that void.

 

How Was The Study Done?

plant-based diets studyThis study used data collected from 12,168 middle aged adults in the ARIC (Atherosclerosis Risk in Communities) study between 1987 and 2016.

The participant’s usual intake of foods and beverages was assessed by trained interviewers using a food frequency questionnaire at the time of entry into the study and again 6 years later.

Participants were asked to indicate the frequency with which they consumed 66 foods and beverages of a defined serving size in the previous year. Visual guides were provided to help participants estimate portion sizes.

The participant’s adherence to a plant-based diet was assessed using four different well-established plant-based diet scores. For the sake of simplicity, I will include 3 of them in this review.

  • The PDI (Plant-Based Diet Index) categorizes foods as either plant foods or animal foods. A high PDI score means that the participant’s diet contains more plant foods than animal foods. A low PDI score means the participant’s diet contains more animal foods than plant foods.
  • The hPDI (healthy plant-based diet index) is based on the PDI but emphasizes “healthy” plant foods. A high hPDI score means that the participant’s diet is high in healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, coffee and tea) and low in animal foods.
  • The uPDI (unhealthy plant-based diet index) is based on the PDI but emphasizes “unhealthy” plant foods. A high uPDI score means that the participant’s diet is high in unhealthy plant foods (refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts) and low in animal foods.

For statistical analysis the scores from the various plant-based diet indices were divided into 5 equal groups. In each case, the group with the highest score consumed the most plant foods and least animal foods. The group with the lowest score consumed the least plant foods and the most animal foods.

The health outcomes measured in this study were heart disease events, heart disease deaths, and all-cause deaths. Again, for the sake of simplicity, I will only include 2 of these outcomes (heart disease deaths and all-cause deaths) in this review. The data on deaths were obtained from state death records and the National Death Index. (Yes, your personal information is available on the web even after you die.)

 

Do Plant-Based Diets Reduce Heart Disease Deaths?

plant-based diets reduce heart deathsThe participants in this study were followed for an average of 25 years.

The investigators looked at heart disease deaths over the 25 years and compared people with the highest intake of plant foods to people with the highest intake of red meat and other animal foods. The results were:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, coffee and tea) had a 19-32% lower risk of dying from heart disease than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods (refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts) had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

When the investigators looked at all-cause deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had an 11-25% lower risk of dying from any cause than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

What Else Did The Study Show?

The investigators made a couple of other interesting observations:

  • The association of the overall diet with heart disease and all-cause deaths was stronger than the association of individual food components. This underscores the importance of looking at the effect of the whole diet on health outcomes rather than the “magic” foods you hear about on Dr. Strangelove’s Health Blog.
  • Diets with the highest amount of healthy plant foods were associated with higher intake of carbohydrates, plant protein, fiber, and micronutrients, including potassium, magnesium, iron, vitamin A, vitamin C, folate, and lower intake of saturated fat and cholesterol.
  • Diets with the highest amount of unhealthy plant foods were associated with higher intake of calories and carbohydrates and lower intake of fiber and micronutrients.

The last two observations may help explain some of the health benefits of plant-based diets.

 

Can Plant-Based Diets Be Unhealthy?

plant-based diets unhealthy cookiesNow, let’s return to the question I asked at the beginning of this article: “Can plant-based diets be unhealthy?” Although some previous studies have suggested that unhealthy plant-based diets might increase the risk of heart disease, this study did not show that.

What this study did show was that an unhealthy plant-based diet was no better for you than a diet containing lots of red meat and other animal foods.

If this were the only conclusion from this study, it might be considered a neutral result. However, this result clearly contrasts with the data from this study and many others showing that both plant-based diets in general and healthy plant-based diets reduce the risk of heart disease deaths and all-cause deaths compared to animal-based diets.

The main message from this study is clear.

  • Replacing red meat and other animal foods with plant foods can be a healthier choice, but only if they are whole, minimally processed plant foods like whole grains, fruits, vegetables, nuts, legumes, coffee and tea.
  • If the plant foods are refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts, all bets are off. You may be just as unhealthy as if you kept eating a diet high in red meat and other animal foods.

There is one other subtle message from this study. This study did not compare vegans with the general public. Everyone in the study was the general public. Nobody in the study was consuming a 100% plant-based diet.

For example:

  • The group with the highest intake of plant foods consumed 9 servings per day of plant foods and 3.6 servings per day of animal foods.
  • The group with the lowest intake of plant foods consumed 5.4 servings per day of plant foods and 5.6 servings per day of animal foods.

In other words, you don’t need to be a vegan purist to experience health benefits from adding more whole, minimally processed plant foods to your diet.

 

The Bottom Line

A recent study analyzed the effect of consuming plant foods on heart disease deaths and all-cause deaths over a 25-year period.

When the investigators looked at heart disease deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had a 19-32% lower risk of dying from heart disease than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

When the investigators looked at all-cause deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had an 11-25% lower risk of dying from any cause than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

The main message from this study is clear.

  • Replacing red meat and other animal foods with plant foods can be a healthier choice, but only if they are whole, minimally processed plant foods like whole grains, fruits, vegetables, nuts, legumes, coffee and tea.
  • If the plant foods are refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts, all bets are off. You may be just as unhealthy as if you kept eating a diet high in red meat and other animal foods.

A more subtle message from the study is that you don’t need to be a vegan purist to experience health benefits from adding more whole, minimally processed plant foods to your diet. The people in this study were not following some special diet. The only difference was that some of the people in this study ate more plant foods and others more animal foods.

For more details on the study, read the article above.

 

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.

UA-43257393-1