Friday, 27 January 2017

LCHF v LFHC Diets - A Randomized Trial

Title: Effects of Low-Carbohydrate and Low-Fat Diets: A Randomized Trial

Author: Bazzano, Lydia A.; Hu, Tian
Publication: Annals of Internal Medicine
Publisher: The American College of Physicians
Date: Sep 2, 2014 Copyright © 2014, The American College of Physicians

Abstract

Background: Low-carbohydrate diets are popular for weight loss, but their cardiovascular effects have not been well-studied, particularly in diverse populations.

Design: A randomized, parallel-group trial. (ClinicalTrials.gov: NCT00609271)

Participants: 148 men and women without clinical cardiovascular disease and diabetes.

Intervention: A low-carbohydrate diet (<40 g/d) or low-fat diet (<30% of daily energy intake from total fat [<7% saturated fat]). Both groups received dietary counseling at regular intervals throughout the trial.

Measurements: Data on weight, cardiovascular risk factors, and dietary composition were collected at 0, 3, 6, and 12 months.

Results: Sixty participants (82%) in the low-fat group and 59 (79%) in the low-carbohydrate group completed the intervention.

At 12 months, participants on the low-carbohydrate diet had better statistics, than those on the low-fat diet, on the following measures.

Greater decrease in weight (mean difference in change, -3.5 kg [95% CI, -5.6 to -1.4 kg]; P = 0.002).

Bigger decrease in fat mass (mean difference in change, -1.5% [CI, -2.6% to -0.4%]; P = 0.011).

Improved ratio of total–high-density lipoprotein (HDL) cholesterol (mean difference in change, -0.44 [CI, -0.71 to -0.16]; P = 0.002).

Better triglyceride level (mean difference in change, -0.16 mmol/L [-14.1 mg/dL] [CI, -0.31 to -0.01 mmol/L {-27.4 to -0.8 mg/dL}]; P = 0.038).

Greater increases in HDL cholesterol level (mean difference in change, 0.18 mmol/L [7.0 mg/dL] [CI, 0.08 to 0.28 mmol/L {3.0 to 11.0 mg/dL}]; P < 0.001).

Conclusion: The low-carbohydrate diet was more effective for weight loss and cardiovascular risk factor reduction than the low-fat diet. Restricting carbohydrate may be an option for persons seeking to lose weight and reduce cardiovascular risk factors.

This result does not agree with conclusions of the Stellenbosch University, University of Cape Town and Cochrane Collaboration Review. The reason is easy to see, and completely scientific. According to the Review, there was little or no weight loss advantage in a low-carbohydrate diet, and no advantage in cardiovascular risk factors either. However, the definition of low-carbohydrate used was <191 g/d, with an average energy input of of 35% carbohydrate over 14 studies, which is >135 g/d, perhaps as high as 180 g/d.

Contrast that with the <40g/d specified in the study above, and the difference is crystal clear, low-carbohydrate diets work, but they need to restrict carbohydrate strongly, half measures don't produce good results.

This study from Eric Westman's lab shows the Atkins Diet (or Banting Diet) in the red column, compared with three other less restrictive diets. Here is clear evidence of the much better blood profile from a very-low-carbohydrate diet. There are dozens of studies showing similar things. Studies the Stellenbosch researchers managed to "exclude" from their analysis.

The first three columns are exactly what someone who is overweight or who has diabetes would want. The next four show favourable cholesterol measures, and the last column is a huge improvement in triglyceride levels.

For readers here, the question is, "How do I achieve good results like that?"

The simple answer is by building your dietary knowledge. The place the begin is with the Take Out Diet following the advice of Dr Hugh Butler. He gives you all the science in small doses, and he gives you a practical way to begin. As your knowledge grows, what you can easily achieve will also improve. In a year or so you will probably be Banting, without effort. Right now for most of us, trying to step straight into Banting is a road to frustration and failure. We all have too many wrong ideas in our heads. It takes time to undo that misinformation. There is no shortcut to better knowledge. Dr Butler has the method.

Imagine what you need to remove from your diet, Today and forever: that will improve your health. Take that thing out of your diet. A month later repeat the process. In less than six months, your diet will be much improved; your knowledge will be better, and you might be in a position to seriously think about Banting.

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John Stephen Veitch
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