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*

Editorial reminds us of the value of 'primal' eating

*Editorial reminds us of the importance of looking to our nutritional
past to improve our future health*

Posted By _Dr John Briffa_ On January 1, 2010 @ 8:14 pm In
_Diabetes/Metabolic Syndrome_, _Food and Medical Politics_, _Healthy
Eating_, _Unhealthy Eating!_, _Weight Loss__
<http://www.drbriffa.com/blog/2010/01/01/editorial-reminds-us-of-the-importance-of-looking-to-our-nutritional-past-to-improve-our-future-health/print/#comments_controls>_

My last post here detailed just a few relatively easy-to-apply lifestyle
changes that might make good New Year resolutions. One of them, was to
eat a 'primal' diet – essentially a diet based on the foods we've been
eating the longest in terms of our time on this planet. The record
suggests that for the vast majority of our time here we've subsisted on
a diet made up of animal foods (e.g. meat, fish and eggs), fruit,
vegetables, nuts and water. The exact make-up of the diet would have
varied according to precise location and environment (e.g. relatively
more animal and less plant food further from the equator), but what our
ancestral diet most certainly did not contain was piles of grain and
dairy products, along with things like refined vegetable oils, refined
sugar, artificial sweeteners and processed, chemicalised fats found in
many foods including margarine.

Just a couple of days ago in the American Journal of Clinical Nutrition
was published an editorial which reminds us of the potential importance
of getting back to our nutritional roots [1]. In this editorial, the
authors make the point that our genetic make-up was selected for
behaviours and an environment (including diet) for humans appearing in
Africa between 50,000 and 100,000 years ago. Now, since that time,
certain adaptations have taken place (e.g. skin colour and the retaining
after infancy of the milk sugar digesting enzyme lactase by some of the
human population). However, as the authors point out, "core biochemical
and physiological processes have been preserved" [2].

As humans migrated around the globe and cultures changed, the authors
argue, our diet and activity changed in a way that made it impossible
for genetic evolution to keep pace. The result? Complex degenerative
diseases including atherosclerosis (the usual underlying process in
heart disease and stroke), several forms of cancer, obesity and type 2
diabetes.

According to the authors of the editorial, few would deny that
conventional nutritional advice is not working. And they suggest that
what would help would be a more rapid shift in thinking towards a diet
that gets us closer to "humanity's biological baseline". They quote a
recent scientific paper [3] which asserts that "It is difficult to
refute the assertion that if modern populations returned to a
hunter-gatherer state then obesity and diabetes would not be the major
public health threats they now are".

As we enter a new decade, perhaps more than any other time in history do
we need a radical rethink of what truly constitutes a healthy diet. For
too long now we have been 'fed' the idea that the low-fat, high-carb
diet is king. The results of this persistent public health message, and
our acting on it, appear to have been an unmitigated disaster judging by
the soaring rates of obesity and diabetes we've seen in westernised
cultures.

Enough is enough. There is more than enough evidence, I think, to
demonstrate that looking to our nutritional past will be how we can
improve our health and the health of future generations.

*References:*

1. Eaton SB, et al. Diet-dependent acid load, paleolithic nutrition, and
evolutionary health promotion. Am J Clin Nutr 30 Dec 2009 [epub ahead of
print]

2. Smith E, et al. Universality in intermediary metabolism. Proc Natl
Acad Sci USA 2004;101:13168-73

3. O'Rahilly S. Human genetics illuminates the paths to metabolic
disease. Nature. 2009;462:307-14.

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

--

Norma Bridge, Dip ION FdSc

Essentia Nutrition
+44 (0)7791 890 541
www.essentianutrition.co.uk

Member of the British Association for Applied Nutrition & Nutritional Therapy (BANT)
Nutrition Therapy Council Registered Practitioner (NTC)
Dip NT Clinical Studies Tutor - Premier International

10 'bite-sized' New Year resolutions worth considering

*10 realistic and achievable New Year resolutions worth considering*

Posted By _Dr John Briffa_ On December 31, 2009 @ 6:30 pm In _Exercise
and Activity_, _Healthy Eating_, _Sleep_, _Sunlight_

I read a report in the last week regarding New Year resolutions, the
thrust of which was that setting the bar too high is more likely to lead
to us not keeping to whatever resolutions we have made. In other words,
opting for smaller, more manageable changes might be a better long-term
strategy. I agree with this sentiment wholeheartedly. And I also believe
that even seemingly relatively minor adjustments to lifestyle can reap
enormous dividends in terms of it's impact on things like energy and
vitality (too things that many of us can find our in short supply from
time to time).

So here, in no particular order, are 10 suggestions for 'bite-sized' New
Year resolutions that some of you may feel inclined to act on. My
suggestions is to pick just one or two (maybe three) of these in the
first instance, and allow a month or two for you to feel the benefit of
your new behaviour and settle in to your new habit(s). You can always
add further healthy behaviour later on.

1. Drink water

Maintaining hydration, in my experience, has a profound influence on
vitality and energy levels, including mental energy. I suggest drinking
enough water to keep your urine pale yellow throughout the course of the
day. The usually-critical step that needs to be taken to make this
possible is to keep water by you e.g. put a bottle and glass on your
desk or carry a water bottle with you as you go out and about during the
day.

2. Take exercise

This is certainly one where setting the bar too high can be
counter-productive. I'd advise against, therefore, promising yourself
you're going to spend an hour in the gym, four times a week. If you
really are quite sedentary right now, how about committing to a 10
minute walk each day. Earlier this year I developed with the help of
some colleagues a 12-minute exercise routine as part of a forthcoming
book. I've managed with relatively little effort to perform this every
day for the last six months (except for when I 'put my back out'
recently). Previous attempts at more ambitious exercise have generally
been less successful.

3. Eat mindfully

In our fast-paced world, there can be a tendency to eat while distracted
and 'shovel in' more food than we need. See [1] here
<http://www.drbriffa.com%20http://www.drbriffa.com/blog/2009/08/05/mindful-eating-associated-with-lower-risk-of-weight-gain/>
for some information about why eating mindfully can be beneficial to
health, and how to do it.

4. Chew thoroughly

Part of mindful eating can be thorough chewing of food, which at the
very least will enhance the body's ability to digest food efficiently,
and will usually help with any symptoms of indigestion/reflux. I most
recently wrote about the value of chewing [2] here
<http://www.drbriffa.com/blog/2009/11/24/gastroenterologist-disses-the-value-of-chewing/>,
where you will also find links to blogs which explore the relationship
between slower eating and reduced food consumption.

5. Make time

Some new habits (e.g. exercise) can take time, which some of us believe
we already don't have enough of. See [3] here
<http://www.drbriffa.com/blog/2006/12/31/creating-time-for-the-whatever-new-behaviours-you-may-have-planned/>
for a blog post which is about creating time for whatever new habits
demand this.

6. Sleep

Sleep has the ability to optimise mental and physical energy, and
optimal levels of sleep (about 8 hours a night on average) is linked
with reduced risk of chronic disease and improved longevity. One simple
strategy that can help ensure you get optimal amounts of sleep is to go
to bed earlier. Getting into bed a 10.00 or 10.30 pm (rather than 11.30,
say) is not a waste of time, but a potentially useful investment in
terms of your short and long-term health.

7. Eat a primal diet

Common sense and a stack of science dictate that the best diet for us is
one based on foods we've been eating the longest. If you know nothing
else about diet, this nutritional 'nugget' will help you cut through the
marketing hype and dietary misinformation, and allow you to make healthy
food choices (if you so wish) quickly and confidently.

8. Snack healthily

Snacking tends to have a 'bad' reputation, and at least some of this is
based on the fact that many snack foods (e.g. biscuits, confectionery,
crisps/chips) are far from healthy. However, going for too long between
meals (especially between lunch and dinner) can cause the appetite to
run out of control, which can lead to the overconsumption of unhealthy
food and drink later on. Quelling appetite with something healthy (e.g.
a handful or two of nuts) can do wonders to help us maintain our healthy
eating habits will minimal effort.

9. Get more sunlight

Sunlight and the vitamin D this can make in the skin has a myriad of
benefits for body and brain (see category 'sunlight' in left hand
sidebar for more information regarding this). While burning is to be
avoided, I advise getting as much sunlight exposure as possible if
optimal health is your goal.

10. Appreciate more

In a [4] recent post
<http://www.drbriffa.com/blog/2009/12/25/a-random-act-of-kindness/> I
wrote about how my New Year's resolution this year was inspired by
witnessing a random act of kindness recently. In the comments section of
this post, the subject of appreciation came up. It occurs to me that
many of us live in societies that are hugely aspirational, and as a
result we can easily find ourselves chasing an ever-growing list of
goals, many of which can be material in nature. To be frank, many of us
could do with spending more time focusing not on what we don't have, but
on what we do – in its broadest sense. So, in addition to whatever
material things we may want to give thanks for, we might also feel
appreciation for our things including people, pets, our health, a
beautiful landscape or sunset or whatever.

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

--

Norma Bridge, Dip ION FdSc

Essentia Nutrition
+44 (0)7791 890 541
www.essentianutrition.co.uk

Member of the British Association for Applied Nutrition & Nutritional Therapy (BANT)
Nutrition Therapy Council Registered Practitioner (NTC)
Dip NT Clinical Studies Tutor - Premier International