A small study recently published in The Journal of the American Medical Association reviewed the clinical responses of three popular diet regimens in people that had already achieved weight loss. The goal of the study was to not only look at energy expenditure or the amount of calories burned but also evaluating other health markers such as hormone levels, enzymes, blood fats, and insulin sensitivities. Study participants were obese or overweight adults between the ages of 18 and 40. Participants all followed the same initial diet for three months then moved to a one-month random rotation through three test diets that each mimicked popular eating plans. The initial three-month diet plan contained 45% of total calories from carbohydrates, 30% from fat, and 25% from protein. This macronutrient composition is consistent with generally accepted ranges that promote adequate intake of essential nutrients, vitamins, and minerals. A month later, each participant began a one-month rotation with one of these popular eating plans. Low fat diet - This plan consisted of 60% of total calories from carbohydrates, only 20% from fat, and 20% from protein. The meal plans focused on whole grains, fruits, and vegetables while limiting fatty meats, oils, and nuts. Very low carbohydrate diet – This eating plan modeled the popular Atkins diet and limited carbohydrates to 10% of total calories with 60% from fats and 30% from proteins. Carbohydrates such as bread, rice, pasta, potatoes, baked goods, and starchy vegetables were restricted with increases of beef, fish, chicken, eggs, cheese, and only small amounts of fruits and vegetables. Low glycemic index diet: This meal plan was similar to a Mediterranean diet and included 40% of total calories from carbohydrates, 40% from fat, and 20% from protein. Brown rice, fish, fruits, vegetables, beans, olive oil, and nuts were staples while highly processed sugary carbs and snack foods were avoided. The Results At the end of the initial three-month introductory diet phase, participants lost 10%-15% of their baseline body weight. Although body weight did not see significant differences among the three test diets, all three eating plans supported weight stability following weight loss in the short term. Participants following the very low carbohydrate plan burned more calories each day compared to those that were following the low fat eating plan but also experienced responses in several metabolic syndrome components. However, they also saw increases in the stress hormone cortisol, which have been found to promote adiposity, insulin resistance, and cardiovascular disease according to various epidemiological studies. The inflammation marker C-reactive protein (CRP) was also found to be higher in those following the very low carbohydrate eating plan. Another unrelated study published last month also found long-term consequences for women consistently following a low carbohydrate high-protein eating plan to be at increased risk of developing cardiovascular disease compared to those that do not. People following the low-glycemic eating plan burned slightly more each day compared to those following the low fat approach but also saw changes to leptin that suggest likelihood for weight regain as well as unfavorable effects on components of metabolic syndrome. Those following a low fat eating plan saw the least energy benefit while also experiencing increases in triglyceride levels and reductions in good cholesterol. On the other hand, the low-glycemic index meal plan provided similar metabolic benefits without the negative physiological stress and inflammation responses, which suggest this approach to be advantageous for weight maintenance and cardiovascular disease prevention. The Bottom Line Successful long-term weight maintenance after weight loss requires behavior modification that supports individual goals. While there are various meal plans and recommendations, it is important to remember that we are each an experiment of one. When deciding which macronutrient composition is best for YOUR meal plan, it is important to think about other physiological considerations besides just energy expenditure. Not all calories may be created equally especially if other medical conditions are involved. For weight loss success as well as heart disease prevention, it is best to avoid eating plans that severely restrict macronutrients such as fat or carbohydrate. A balanced macronutrient-eating plan with a low-glycemic index similar to a Mediterranean diet appears to represent a plan that provides high quality nutrients from a variety of foods. For people that have no medical conditions such as a high blood pressure, thyroid disease or diabetes, simply eating less by following any type of macronutrient diet may be fine. However, for the millions of us for whom this is not the case, paying attention to more than just the number of calories consumed also seems to be important for long-term weight success and health. Here are some additional resources to help you meet and maintain your weight goals. The SparkDiet: Mediterranean Style! Choose Olive Oil as a Healthy Alternative Time for Some Nuts - The Tasty and Surprisingly Healthy Snack Mediterranean Chicken with Orzo (Chef Meg's Makeover) Mediterranean Baked Fish Do you believe medical conditions influence whether all calories are created equal? Have you found the macronutrient composition of your diet influences your weight loss success? |
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