low-carb and low-fat diets

I just finished reading a study which came out in the American College of Physicians journal, the "Annals of Internal Medicine." I must say I'm a bit underwhelmed. A little over 300 obese subjects without diabetes or high blood pressure were followed for two years at three academic institutions. bout half were put on a diet similar to the Adkins diet, starting out with eating a small amount of low-glycemic index vegetables (I'd include spinach, broccoli, radishes and asparagus in this group, and not corn, squash, potatoes or yams), in other words foods your body can't rapidly convert to sugars. Later they got more veggies and some fruit and finally added whole grains and dairy products.

The other group got a calorie restricted diet and limited their fat intake. Both groups received behavioral therapy in groups. A multitude of measurements were made at intervals (lipids, weight, blood pressure).

At the six month mark, the low-carb group had more adverse, but relatively minor symptoms (bad breath, constipation, dry mouth, hair loss). At the one year mark the average weight loss in both groups was the same (11%); ditto at two years (7%). The low-carb group had increased HDLs averaging a 23% increase after two years.

So why am I somewhat underwhelmed? I guess I'm happy that the low-carb group raised their HDL (good lipid) numbers, but other than that there wasn't much difference between the two groups. Both regained weight in the second year, ending up roughly 15-16 pounds down from their starting weights of about 220 pounds. Yet this was in a closely followed bunch of folk with academic centers doing the study, and, for that matter, excluding obese subjects with the obesity-related diseases we worry about.

So I don't think we're there yet, in terms of helping the third of our population that is obese and not being taken studied in this detailed fashion. I was frankly hoping for more.

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