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Which Diet Works?

Anyone who has battled their waistline has asked the same question: Which diet works best? Low-carb? Low-fat? High-protein? A new government-sponsored study out today finally tries to offer a definitive answer.

The study, published in today's issue of The New England Journal of Medicine and sponsored by the National Institutes of Health, is the biggest to date to compare different strategies head-to-head and to follow dieters long-term to see not only which approach helps shed pounds but which helps keep them off.

It turns out -- surprise, surprise -- that they're all about the same. It's not what you eat, but how many calories you take in, that makes the difference. So, the bad news is: There's no magic in any approach. But the good news is: If you stick with any calorie-reduction diet, it can help you lose a moderate amount of weight and keep it off.

The study was funded by the National Heart Lung and Blood Institute and conducted by researchers at the Harvard School of Public Health in Boston and Pennington Biomedical Research Center in Baton Rouge, La. Researchers assigned an ethnically diverse group of 881 overweight and obese men and women ages 30 to 70 to one of four diets:

  • Low-fat, average protein, which consisted of 20 percent fat, 15 percent protein and 65 percent carbohydrates.
  • Low-fat, high protein, which consisted of 20 percent fat, 25 percent protein and 55 percent carbohydrates.
  • High-fat, average protein, which consisted of 40 percent fat, 15 percent protein and 45 percent carbohydrate.
  • High-fat, high-protein, which consisted of 40 percent fat, 25 percent protein and 35 percent carbohydrate.

After six months, the subjects on all four diets lost about the same amount of weight --13 pounds on average. After two years, the subjects kept off an average of nine pounds, reducing their waistlines by one to three inches.

The volunteers report about the same sense of craving, fullness, hunger and satisfaction for all four diets.

All the study subjects were asked to keep a diary of what they ate, and they attended diet group counseling sessions twice a month as well as individual counseling every two months. They were also asked to engage in moderate physical activity, such as brisk walking for at least 90 minutes each week.

All four diets reduced the risk for heart attacks by lowering triglycerides, bad cholesterol and blood pressure and boosted levels of good cholesterol.

If you're interested in watching some videos about the new study from the National Heart, Lung and Blood Institute click here.

By Rob Stein  |  February 26, 2009; 7:00 AM ET
Categories:  General Health , Obesity  
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Interesting, but a couple of caveats. (1) The "low carb" plan wasn't exactly low carb. Reduced, maybe, compared to some of the crap we currently eat. But 35% is not "low carb" according to any of that diet's proponents. And in the follow-up, the study participants reported eating more like 43% carb. (2) I don't think that any of the groups distinguished between better carbs (beans, whole grains) and the refined, processed grains and sugar that we eat way too much of.

I suspect that all of the four programs led to a significant cutback on a lot of the highly-processed, high-sugar crap that is so prevalent now; if you're cutting out 750 calories a day, that doesn't leave room for too many Krispy Kremes. But it doesn't really show anything about low carb diets, or whether the type of carb makes a difference.

Posted by: laura33 | February 26, 2009 10:48 AM | Report abuse

The study recommended low-glycemic index carbs to all four diet cohorts. So Krispy Kremes were out.

This study proves once again just how hard it it to lose weigh and keep it off. Despite best of intentions and effort, study participants all tended to gravitate back to their usual way of eating.

Researchers tried to teach people how to reduce caloric intake by 750 per day, but at six months they had reduced only by 225 cals/day.

For anyone interested, I blogged about the 15-page study at my healthy lifestyle blog today:


Posted by: SteveParkerMD | February 26, 2009 12:36 PM | Report abuse

Thanks for the informative article. It just seems like the world has turned obese at such a fast pace it really is scary. I have struggled with weight for my whole life and finally have a grip on it after 30 years of suffering from diet-itis!! It really helps to know what you are doing and you don't have to work nearly as hard when you do. Go to this site It was recommended to me by a friend and it really changed my thinking and helped me turn the tide and finally lose weight and keep it off without the constant struggle and fluctuations. I have lost over 50 lbs and kept it off. I finally have enough energy to keep up with my children. Best of luck to every one of you who knows what it is like to struggle to lose weight...hope this makes your life easier!!

Posted by: LindaMCC | February 28, 2009 4:29 PM | Report abuse

Just eat healthy, no diet needed.

Fred Smilek is the acting president of the Society to Save Endangered Species. It was founded two years ago by Fred Smilek along with his two best friends Charles and Jonathan.

Posted by: fredsmilek | March 4, 2009 6:58 PM | Report abuse

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