The Diet Wars: Low-Fat vs Low-Carb

A new study comparing the Atkins diet, a Mediterranean diet and a low-fat diet published on July 17 inThe New England Journal of Medicine (NEJM), is likely to inspire headlines saying that the Atkins diet is better for your waistline and your health than a low-fat diet.

However, as a lead investigator on numerous peer-reviewed studies of low-fat diets, and the author of several books about the benefits of healthy low-fat lifestyles, I believe this study is extremely flawed. Here's why:

The NEJM study, which was funded in part by the Atkins Foundation, reported that participants who ate a low-carb (Atkins) or Mediterranean diet (restricted calorie, moderate fat intake) for two years lost more weight, and saw more of an improvement in their glucose and cholesterol levels, than those who were on a low-fat, restricted calorie diet. However, participants in the study who were on the "low-fat" diet decreased their total fat intake from 31.4 percent to 30.0 percent, hardly at all.

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Comments

[OldSchoolLiberal]

Its all about balance, isn`t it.

I am very happy with a diet where most of my eating is raw, steamed, and slightly boiled veggies. Baked fish once per day, very little rice or pasta and only in the morning or lunch. Some potatoes here and there and no refined sugar if I can help it.

Unfortunately there is one carb I regularly intake; beer.

But I have not had even a cold since I started this diet and started running regularly. My jogging partner reports that she has not had a cold in years. Its anecdotal but I beleive her because of how I feel since giving up pasta and fast food and becoming a veggie grazing pescetarian.

[CintiBlue]

Yes, it is balance. My balance came via a different route, same positives.

Like you, I cleaned up my diet by getting rid of pasta, fast food, grains, and sugar. I do best with animal protein in my diet so that's eggs, meat and chicken from a local sustainable farm. Also I never miss the daily dose of high vitamin fish oil and a probiotic.

Same as you, I went 4 or 5 years without a cold, until last year when one got me. Most of my adult life I got one, usually two colds a year and just accepted that as my fate. Well, obviously a few healthy changes disproved that.

I'm no saint and having struggle with food obsession most of my life, it's almost impossible to describe the mental calm I now have since choosing whole food and allowing butter back into my diet. I don't spend the day thinking about what I'm going to "let" myself eat, have that not satisfy and turn around and eat a bag of baby Snickers. I'm free of that now.

I know the picture accompanies the article for a purpose but my thinking is, have the salad with one or two pieces of the bacon crumbled on it.

This comment rambled on, but I find our anecdotal reports far more helpful than the dictates that fill various pages. We found what worked for us based on individual needs and preferences.

[TeenaGreena]

I totally agree with Cintiblue. I could've written that post!

Diet is not one size fits all. Just b/c something works for you (e.g. vegetarianism) doesn't mean it works well for everyone.

Getting rid of processed foods is the foundation for a healthy diet -- where you go from there depends on YOUR body needs.

For me, sugar is the enemy.....

[TroubleNYC]

Here's the best diet. Think of yourself as a cave(wo)man. Only eat what was available to them. Fruits, vegetables, meat. That's about it.

[leftcoastindy]

Not even close. Meat is NOT REMOTELY good for you. Cave men at it to keep from starving.

I'm only going to have to start eating meat if gas goes to $10 a gallon.

[NoSillyName]

Why would that cause you to start eating meat?

[jinjinpinti]

Modern processed meats, yes, but the wild game and fish, etc eaten by our prehistoric ancestors was far superior in protein content and much lower in fat. It wasn't until agriculture began, that human remains and mummies of that period began to evidence rotted teeth, clogged arteries and diabetes. All grains are sugar to your body and sugar is poison.

[jsarets]

Low-fat, low-carb... whatever. It's really about low-calorie. At least nobody is marketing a low-protein diet. Ultimately, the operative metrics in determining the diet-worthiness of foods are calories per gram and nutrients per calorie, sometimes called fullness factor and nutrient density. The objective is to fill up and get your nutrients with as few wasted calories as possible.

In general, a high-fiber, high-protein diet biased toward whole grains, legumes, and dark green vegetables delivers more satisfaction and nutrition per calorie. Replacing white pasta and white rice with whole wheat pasta and brown rice is a good start. A breakfast of hulled oats (groats) and dried fruit is ideal. Wheat berries, grano, bulgur, hulled barley, quinoa, and amaranth are excellent whole grain products. Flax or wheat germ can be added to pancake batter or other flour-based recipes. Lentils are about as nutritious as any other dry legume but take much less time and energy to prepare.

No diet is complete without fish, or at least fish oil. Egg whites and skim milk are the most complete and digestible protein sources in the natural world, even better than whole grains and beans. Shrimp, skinless chicken breast, and pork tenderloin are also good sources of lean protein. And, of course, tofu, tempeh, TVP, and other soy protein products are excellent choices. Remember to drain and press firm tofu before marinating or cooking. That's why you didn't like it the last time.

[leftcoastindy]

You sound like I should get all the protein I can to be healthy. Why? What will my body do with more than 1 gram per kilo of body weight? If I would be completely healthy with 10% protein diet, how could I be optimum health with more than 20%?

[Topfeeder]

If it's white, I don't eat it. Simple and it works.

[SharonB]

This is how I live also. It is easy to do and it offers a wonderful variety of foods. Also, I am really scarce with the dairy... milk and cream they are part of that "white" food group, too.

[mphalen]

That's the Muslim diet, and a friend of mine went from 270 lbs. to 140 following it. Eat no white foods like white flour, white sugar, white rice, milk, etc. Sounds like a low-carb diet to me.

[moAb]

Fear fat. Complex carbs. Exercise. Enjoy.

[jinjinpinti]

Your brain is made up largely of a fatty acid, DHA. Without fat in your diet, you will die, which is why you cannot survive on wild rabbits in the forest. No fat to 'em. Eskimos live on massive amounts of fat and have no heart disease or other ailments of the civilized world. It's not so much the fat that gets you, it's the high glycemic index carbs you eat alongside it, ie, mac AND cheese, toast AND butter, salad AND dressing, potato AND sourcream, burger AND bun, etc, etc. Eat a palm sized portion of LEAN protein and twice as much complex carbs, mostely veggies, add some olive oil, or other healthy fat three times a day and you will have a passport to "The Zone."

[LollieDotCom]

A low fat diet is very bad for your physical, mental and emotional health.

Healthy fats in moderation... walnuts, olive oil, that sort of thing.

[ramper]

Couldn't we just mix the two in the picture and split the difference?

[SharonB]

Well, actually the salad is the best choice even in a low carb diet. Along with the low carb you need to be really picky about the fat. Bacon is something I would never watse my time eating.

[ramper]

Can I have your portion?

[Whycee54]

Well we all go on diets and then open a magazine or turn on a TV or radio and get bombarded with the bad stuff so what gives? How can you expect America to totally change its eating habits when the Media and the sponsors spend millions of dollars coaxing us to eat the bad stuff?

If the gas goes any higher, we all will be on a diet...

[euthman]

As a physician myself, I agree with Dr. Ornish that it is possible to lose weight on his extreme low-fat diet. However, the problem is that hardly anyone can stick with such a diet. It's simply too severe, and the patient is constantly wracked with hunger and cravings. A low-fat diet, on the other hand, is much easier for most people to comply with. Bottom line, the Ornish approach works fine on people at the 99th percentile of self-discipline. For everyone else, it simply won't work.

[leftcoastindy]

On a raw vegetable diet, you can eat all you want. No hunger pangs. Steamed is OK too.

[davedave]

"A low-fat diet, on the other hand, is much easier for most people to comply with."......did you mean to say low carb?

dr ornish has peddled his stuff for decades. afa ornish is concerned, in the court of diet opinion, question asked and answered.

dean baby--don't go away angry, just go away!

d

[mphalen]

Exactly. I have found that a low carb diet is much easier to follow. By the way, eating low carb curbs your appetite much better because it controls your blood sugar that helps control your appetite. You feel much more satisfied and have less cravings.

[naschkatze]

I always though some fat was good for you as a source of energy. Carbs are the quick shot of energy and a little bit of fat sees you through to the next meal.

[NoSillyName]

Fats help produce hormones and have many other functions..

[gwpriester]

Try reading Michael Pollan's excellent book, In Defence of Food. Micheal's advice: Eat Real Food, Not Too Much, Mostly Plants.

And his best tip: Shop around the walls of the supermarket and avoid all the processed foods in the center aisles.

[TroubleNYC]

Shop around the walls of the supermarket and avoid all the processed foods in the center aisles.

Exactly! The junk is in the aisles!

[wm1066]

I liked his book but he kept talking about how vitamin pills weren't good for you then he turned around and said you should take them. That confused me. But I don't think vitamin pills work, and I was a true believer of vitamins for years, now, not so much.

[Moshe]

Here's a healthy thought: Moderation.

Extreme plans sell books, and may even show results in the short-term, but they don't make people healthy in the longer run.

If it makes anyone feel better though, please send me $19.95 and I can sell you the same advice in a 200 page paperback.

[Eek909]

It's just everything in moderation. If you eat too many carbs, you'll get fat. If you eat too much fat, you'll get fat.

A low-calorie, balanced diet heavy in whole grains, fruits, vegetables, healthy oils, dairy, farm-fresh meat---and low on processed foods, hydrogenated oils, and high fructose corn syrup---has been the key to my losing over 50 lbs. And, of course, lots of good, healthy exercise.

But that sounds too complicated to people, it seems like. People want someone to tell them "Eat this, not that" We're an all or nothing culture, in most ways. Moderation is not one of our virtues.

[euthman]

What you are describing is the South Beach Diet, and yes, I totally agree with you.

[Twopennygal]

Of course, they show a picture of bacon vs salad. That is so not what low-carbing is about. The better picture for low-carbing would be my typical dinner: A reasonably-sized steak *(6 - 8 ounces) and vegetables such as broccoli or asparagus or even that salad, which I typically have for lunch.

And the low-fat diet picture should be what I used to try to "diet" on: A plate of pasta with a low/non-fat dressing (check out most of the Lean Cuisine offerings).

When I was on a low-fat diet, I was sick all the time, weak, and never could keep any weight off. I also had polycystic ovary syndrome and on the verge of diabetes and all the doctors ever told me was lose weight and I would be fine. Well, I lost weight, was never "fine," and then wound up putting not just the weight I lost back on but more on top of it.

I have been living low-carb for over 5 years now and I've kept my 50 pound weight loss off, I have more energy than I ever had low-fatting, and my insulin/cholesterol levels are picture perfect. In fact my HDL (the good cholesterol) is over 100! And for the first time in my life, I have regular periods! Not even when I first started my cycles have I had regular periods.

[deepintheheartoftejas]

I'd like to agree heartily. I've been on a lowish-carb diet since 2004, and I'm back to the weight I was in my mid 20s, down 60 pounds from where I was when I started. I tried low-fat diets in the 90s, and they left me hungry and craving food all the time. I'd get sleepy and tired in the afternoon, and I'd usually hit the snack machine for some pick-me-up just to get through.

I've never eaten a plate of bacon (though, I admit knowing a few people during the low-carb fad phase that did). I eat bacon 3 or 4 times a year, usually breakfast when I'm visiting my parents. I eat far more vegetables than I did at any time in my life previously, but not many fruits (except in late fall thru early spring when assorted tangerines are in season). I do like 3 or 4 good beers during the week, and I don't think I consume much more meat than I did before.

Really, what I love is that I eat only about 1000 calories a day, but I feel satisfied and not hungry and I have a lot of energy. Adult-onset diabetes is common in my family, but my insulin levels have been fine for years now.

[Twopennygal]

Part 2:

I'm really tired of the misconception that is being foisted on the public that when you eat low-carb you are getting an unhealthy diet. What could be healthier than getting the fats and proteins your body needs to build good muscles, bones, and maintain proper hormone health. And I am eating carbs, just not those insulin-peaking starches (grains & potatoes) and sugars (candy!) that the foisters think we can't live without. I'm living proof that they are superfluous to living a healthy life.

[Anastasia]

One of the issues that has been raised about the Atkins or a low carb diet is that it's hard on the kidneys. I did Atkins myself and loved it but I'm having kidney issues that may or may not have been the result of the diet. While one does tend to lose weight and have plenty of energy on high protein diets, the price may be a bit steep.

http://www.atkinsexposed.org/atkins/41/Kidney_Scarring.htm

In a press release entitled "American Kidney Fund Warns About Impact of High-Protein Diets on Kidney Health," Chair of Medical Affairs, Paul W. Crawford, M.D., wrote, "We have long suspected that high-protein weight loss diets could have a negative impact on the kidneys, and now we have research to support our suspicions." Dr. Crawford is worried that the strain put on the kidneys could result in irreversible "scarring in the kidneys."

[ThoughtAboutIt]

>>"American Kidney Fund Warns About Impact of High-Protein Diets on Kidney Health,"

[mphalen]

Water. That is the solution for the kidneys. You have to drink water for health and especially on a low carb diet.

[levelshot]

Ok, a study funded in part by the Atkins Foundation = A completely flawed Study

[Twopennygal]

So all the other studies that purported to support low-fat dieting that were funded by the agricultural industry are not flawed? All those studies that, when you look at the real numbers, actually show that low-fat dieting is not effective and may actually be harmful to your health?

Just because a study was partially funded by the Atkins Institute, which you and the author clearly are biased against, is no reason to discard it out of hand.

If you want to criticize a study, look at the raw numbers. The "results" as published are often colored by the studier and often have nothing to do with the actual data collected.

For me, my own experience and health are all the proof I need to say that low-carbing is right for me.

[USLabor]

That salad in the picture could be part of a lo-carb diet., as well as that mouth watering bacon. MMMMM, bacon.