Low-carb diet pitted against low-fat PLUS medication (low-carb still wins)

Posted By _Dr John Briffa_ On January 26, 2010 @ 2:23 pm In _Healthy
Eating_, _Unhealthy Eating!_, _Weight Loss_ | _1 Comment
<http://www.drbriffa.com/blog/2010/01/26/low-carb-diet-pitted-against-low-fat-plus-medication-low-carb-still-wins/print/#comments_controls>_

I suspect there's always going to be a raging debate about the best way
to go about losing weight. From a dietary perspective, a myriad of
suggested approaches exist, though within these the two most popular and
well-known 'diets' are those low in carbohydrate and fat respectively.
Both of these approaches have their advocates. I'm generally in the
low-carbohydrate camp. Why? Well, one major reason has to do with the
fact that when these diets are pitted against each other, the low-carb
diets generally outperform low-fat ones in terms of weight loss. Also,
low-carb diets generally improve biochemical and physiological markers
for cardiovascular disease compared to low fat ones.

I was interested to read a study published yesterday in the Archives of
Internal Medicine which, once again, pitted low-carb and low-fat diets
against each other [1]. The low-carb diet initially restricted
carbohydrate intake to less than 20 grams a day. Calorie intake was not
restricted (meaning individuals could eat as much as they liked of
permitted foods including meat and fish).The low-fat diet, as is usual
in these studies, restricted calories (to produce a deficit of 500-1000
calories a day). In addition, though, individuals eating the low-fat
diet took the weight loss drug orlistat (Xenical, Alli) at a dose of 120
mg, three times a day.

Orlistat works by reducing absorption of fat from the gut. A [1] review
of the evidence
<http://www.drbriffa.com/blog/2007/11/19/weight-loss-drugs-revealed-to-have-only-slim-benefits/>
shows that the average weight loss achieved by people taking this drug
in studies is about 3 kg (approximately 6.5 lbs).

At the end of the study (48 weeks) the low-carbers had been found to
have lost an average of about 11.5 kg in weight, compared to about 9.5
kg loss in the low-fat, medication taking group. This difference was not
statistically significant. Unfortunately, this study made no attempt to
assess body composition changes. This is a shame, as it's not really
weight loss that is important, but /fat loss/. However, the subjects did
have their waist circumferences assessed, which reflects the extent of
'abdominal obesity' (the form of obesity most strongly linked with
chronic disease). Here, the low-carbers lost almost an inch more than
the low-fat, medication-taking group, though the difference was not
statistically significant.

One significant difference between the groups was seen in blood
pressure: low-carbers saw an average drop of about 6 and 4.5 points in
their systolic (higher) and diastolic (lower) blood pressure. In
comparison, the low-fat eaters saw small though non-statistically
significant increases in their blood pressure.

Overall, the results of this study show similar weight loss but improved
effect on blood pressure for those eating the low-carb diet. On top of
this we have the fact that the low-carbers did not need to restrict
calories, and did not take medication either. This drug has expense
associated with it, as well as potential side effects (including
flatulence and 'oily leakage from rectum'). I'll stick with the low-carb
eating, thanks.
*
References:*

1. Yancy WS, et al. A randomized trial of a low-carbohydrate diet vs
orlistat plus a low-fat diet for weight loss. Archives of Internal
Medicine. 2010;170(2):136-145

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Article printed from Dr Briffa's Blog: *http://www.drbriffa.com*