fat legs on a bathroom scale, more weight loss, diet

Which weight-loss diet works best, low fat or low carb? That was the question a team of Stanford scientists were striving to answer (Gardner et al, JAMA, Feb. 20, 2018). It has been a bone of contention among dieters and dietitians for decades.

Trying to Match the Best Diet to the Individual:

They recruited more than 600 overweight volunteers to the study, Diet Intervention Examining The Factors Interacting with Treatment Success (DIETFITS). These individuals were randomly assigned to follow either a healthy low-fat or a healthy low-carbohydrate diet for a year. (The “healthy” description is important, as it is pretty easy to follow an unhealthy eating plan, either low in fat or low in carbs.) The researchers looked at the volunteers’ genetic makeup and insulin secretion to see how those might interact with the food pattern.

The Results of the Study:

At the end of one year, people in the low-fat arm had lost more than 11 pounds. Those in the low-carb arm of the study had lost about 13 pounds. This is not a significant difference. There was quite a large range in the amounts of weight lost within each group, though. Some people lost as much as 30 pounds, while others actually gained weight during the year.

The investigators did not find any connection between genetics or insulin secretion and dietary effects on weight loss. Both diets were beneficial for lipid profiles, blood pressure, insulin and blood sugar. The low-carb diet was associated with higher LDL cholesterol. But it was also associated with higher good HDL cholesterol and lower triglyceride levels.

The researchers note that:

“The substantial variability of weight loss response suggests some strategies may work better for some individuals than others, and that no one diet should be recommended universally.”

Dr. Christopher Gardner, the lead researcher, suggests that the individuals who were most successful at losing weight were those who became more mindful about what they ate. You can listen to his interviews with The People’s Pharmacy in Show 991: New Dietary Guidelines for Americans and Show 988: Spices for a Healthy Life.

Learn More:

We discuss how to follow a low-carbohydrate diet in our book, The People’s Pharmacy Quick & Handy Home Remedies.  It also has instructions on a DASH diet, which is a healthful eating plan that is moderately low in fat.

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  1. alan
    Dallas, TX

    Keto: 25% protein, 75% fat, the rest protein (grin). Eat lotsa fatty red meat, bacon, sausage, eggs, dairy, nuts, & all the veggies & fruits I can.
    Lost 22# in 4 months: 3# down, 1# up, good lipid panel, blood pressure controlled.
    Regular exercise, hobbies. I’m 74 & life is good!

  2. Nancy
    Raleigh, NC

    Having been on just about every weight loss diet that there is since my teen years (I am now 68), it is clear that for weight loss the answer is quite simple. Calories. To lose weight you must use more calories than you take in. Count calories. All of them. There are some great little programs for your phone such as lose it and fitness pal, but of course eating out is difficult as you don’t know what is in the food, and usually a lot of butter and cream and other fats are added and fats are high in calories. Packaged foods have the calories on them, and with a simple kitchen scale you can figure the calories in anything you cook. Tedious but it works.

    Count your calories now, and then reduce them. You cannot go by charts re how much to take in because people have different metabolisms. Once you know the amount of calories that will bring weight loss, you will be in charge from that point forward.

    Calorie counting means you can eat anything, all kinds of junk food. So it is not a solution for health. Which foods you choose to eat in order to be healthy and have vigor is a separate issue. And that trips up lots of people. They think, “if I eat healthy I will lose the weight.” No. It is less caloric intake that makes you lose weight. So, for example, going on a low fat diet makes you lose weight. Yes, if you are cutting out all the fats you used to eat that were making your calorie count higher than the level required to lose. But, no, if instead you load up on other high calorie foods without fats- no matter how good those foods are for you.

  3. Janet
    Elk Grove, CA

    Diets don’t work! They never work! The diet industry is a scam! Doctors do not receive any instruction in nutrition in medical school! Eating whole foods plant-based is the only way to live. Cut out the processed food. Eat potatoes, rice, lentils instead of meat. Eat your vegetables. Eat plenty of fruit. DO NOT eat dairy. This is not a diet – it is a lifestyle.

  4. Patty

    I have just lost 50 lbs. in four months, under my primary care doc’s supervision. I already was eating a good variety of healthy options, primarily organic meats, whole grains (wheat and oats mostly), cooked fresh veggies, rice, fruit, salads and so on. I have done it by counting calories meticulously. I don’t eat out much and my husband does most the cooking since I cannot. I must get my BMI down for an upcoming surgery and have been having health problems in the meantime that will be handled with the operation. My primary care is an MD, and takes a holistic approach and has been quite helpful.

    I must limit my carbs to a certain degree, and I am eating over 100 grams protein daily, whether meat, nuts, seeds, etc. I am on 2200 calories per day.

    My downfall was terrible craving for sweets and carbs. I now eat Atklins bars in between some meals, or before bed, to keep my blood sugar from going too low. Those bars have no added sugar but are incredibly satisfying. Once I started eating two to four of those per day, the cravings all left. I am more than a third of the way to my final goal.

    Losing weight as a partially disabled senior was very hard before adding the bars. I have done a high carb diet in 1000 calories a day one time, and lost nothing. For me, it really matters what I eat while I am dieting.

  5. Pete M.

    Very Simply! If it’s true that DNA determines the best diet , WHY hasn’t someone come up with a way to link them by a DNA test for each individual????

  6. William F. W

    Many now think that ldl is a good thing!

  7. Anne

    I hate diets. They are difficult to follow and maintain. I realize that everyone has a different metabolism, but most people who are overweight simply eat too much and don’t get any exercise. I live in the Midwest, and in my relatively small town, I’m betting well over 75% of our residents are obese. Even when they could choose healthier options, they add fries and soda (or beer). Restaurants often serve outrageously large portions that could be shared by two people, but I think everyone is so accustomed to being obese, they no longer see it.

  8. chuck

    30% carbs is the average for the low carb group in this study. that is an improvement but i wouldn’t consider it a low carb diet compared to today’s trendy diets that restrict carbs to 5% or less of calorie intake. i try to stay under 20g net carbs/day. it has helped me lose weight without additional effort. i’m glad for this research and i hope there are more studies that provide more data about the long term effects of fat and sugars.

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