a plate with fish and veggies, eat the Mediterranean way, low-carb diet wins

Many nutrition experts have maintained that a calorie is a calorie is a calorie. In other words, all calories are created equal. The more calories you consume the fatter you get. Put another way, these diet dictocrats insist that you will gain or lose weight based on the dictum: “calories in – calories out.” If you take in more calories than you expend, you gain weight. If you burn more calories at the end of the day than you consume, you lose weight. But a new study published in the BMJ (Nov. 14, 2018)  contradicts that old logic. In this study the low-carb diet wins.

Why We Believe the New Research:

Researchers have been studying diets for decades. This is a highly charged topic. There are strong opinions on all sides of the debate. Often the loudest shouters overwhelm solid science.

For years we were told that fat was the enemy. Calories from fat were supposed to make you fat. Researchers evaluated eating patterns in countries around the world and concluded that if you just eliminated fat, people would lose weight and avoid many of our chronic ailments—obesity, diabetes and heart disease, to name just a few.

The food industry hopped on the bandwagon. We got low-fat and no-fat foods galore—cookies, yogurt, milk, ice cream—to name just a few. People consumed more carbohydrate to make up for the lack of fat. Sugar was a prime ingredient in many of these foods. You could pat yourself on the back for eating low-fat yogurt, but there was often “fruit” added in the form of jam, loaded with sugar. The obesity epidemic accelerated.

How the Low-Carb Diet Wins:

The new study in the BMJ was elegant in its design. It did not rely on volunteers reporting what they ate. People have notoriously bad memories when it comes to detailing their caloric intake.

For this study, researchers recruited overweight volunteers from Framingham State University in Framingham, MA. These hardy souls included students, faculty and staff. They agreed to eat only the food supplied by the investigators and they weighed themselves daily with a sophisticated WiFi scale (Withings) that sent the data directly to the researchers.

There were three dietary patterns that were tested. People were randomly assigned to receive either a high-carb diet, a moderate-carb diet or a low-carb diet for 20 weeks.

The researchers describe the diets this way:

“During the test phase, high, moderate, and low carbohydrate diets varied in carbohydrate (60%, 40%, and 20% of total energy, respectively) and fat (20%, 40%, and 60%, respectively), with protein fixed at 20%.”

Why the Low-Carb Diet Wins:

One of the researchers involved in this study was David Ludwig, MD, PhD. He is an endocrinologist who has studied metabolism and weight management for years. Dr Ludwig was a Professor of Pediatrics at Harvard Medical School and Professor of Nutrition at Harvard School of Public Health. He was Founding Director of the Optimal Weight for Life (OWL) program at Boston Children’s Hospital, one of the oldest and largest family-based weight management programs.

Dr. Ludwig explained the latest research for the L.A. Times (Nov. 14, 2018). He pointed out that this was “one of the largest feeding studies ever conducted.”

“The Case Against Carbohydrates Gets Stronger”

Here is how he describes the results:

“Participants in the low (20%) carbohydrate group burned on average about 250 calories a day more than those in the high (60%) carbohydrate group, just as predicted by the carbohydrate-insulin model. Without intervention (that is, if we hadn’t adjusted the amount of food to prevent weight change), that difference would produce substantial weight loss — about 20 pounds after a few years. If a low-carbohydrate diet also curbs hunger and food intake (as other studies suggest it can), the effect could be even greater.”

We had the opportunity to interview Dr. Ludwig a couple of years ago for our syndicated public radio show. You may want to listen to the free podcast. You can also listen to the free audio file by clicking on the green arrow above Dr. Ludwig’s photograph. Here is a link.

Show 1020: How to Lose Weight Without Feeling Hungry (Archive)

The People’s Pharmacy Perspective:

We have spoken with a great many experts over the last 40+ years on our People’s Pharmacy radio show program. The overwhelming majority believe that refined carbohydrates and sugar lead to a spike in blood glucose. That leads to a corresponding spike in insulin. This hormone moves glucose into cells for storage as fat. This chain of events has helped create the obesity and type 2 diabetes epidemics.

Coming up this Saturday at 7:00 am EST we will interview Dr. Jason Fung. He is a nephrologist who got tired of trying to repair the damage diabetes does to kidneys. His intermittent fasting program coupled with a low-carb diet can help prevent or reverse type 2 diabetes. Here is a link to the show. If you cannot listen live, be sure to listen to the podcast or the streaming audio on Monday, November 19, 2018. He adds fascinating insights to this weight loss discussion.

Share Your Thoughts

We recognize that everyone is different. Some people love the low-fat approach. Others crave carbs. We are not diet dictocrats. If one approach works well for you and allows you to control your weight, we’re delighted. But we have to admit that the latest research from Framingham, MA, suggests that if all else is equal, the low-carb diet wins when it comes to weight loss. Share your thoughts below in the comment section.

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  1. Jeannine
    Brooklyn. N Y

    We need more raw fruits, fresh fruit juices and veggie juice; veggies, fruits on empty stomach, nuts seeds, never fruits for desserts! Good fats avacados, coconut, olive oils , water water water, and proper combination, and less less less, meats if any, preference vegan! no dairy, eggs, and no no no no SUGAR. Except the natural one we get from our fresh fruit & veggies! Peace love & light to all!

  2. Beth

    My number one thought and concern when I hear people say “low carb” is what are you calling a carb. I am trained in nutrition and know exactly what a carb is and where they come from. We can NOT vilify ALL carbs. Fruits and vegetables are carbs and we NEED them and cannot get from other foods the important phytonutrients we get from them. We all can definitely benefit from not eating REFINED carbs in their many forms (anything with white flour, white sugar, refined grains, etc), but when I am advising my clients on how to shift their body toward more health, I am telling them to EAT MORE PLANTS, not more animals…Whole Foods Plant Based is the healthiest advice I know to give people. Does that mean they have to become vegan? NO. It means you shift your lifestyle to have more than half your plate be vegetables at most meals, have a few fruits per day, nuts, seeds, etc and some animal products for flavor or clean, lean protein (not that they are necessary!). Hope I am not sounding too heavy-handed, but I have watched this “low carb craze” for many years now and have seen people be afraid to eat vegetables because they are “carbs”…ridiculous. If you shift your lifestyle to the above way of eating, you will definitely lose weight, lower cholesterol, lower your blood sugar as well as likely lower inflammation and other disease inducing issues.

  3. laura

    this is the only web site that constantly gives me a message that “there was a problem and site has to b reloaded”. Im getting paranoid re Big Pharma poltergeist! anyone with similar issue? (its such a nuisance & a time waster. thanx

    • Sally

      Try using a different web browser.

  4. Harold

    My wife and I have followed a low carb diet for the past five years and can attest to the effectiveness of this way of eating.

  5. Phil

    I have been eating a low carb diet for a year after being diagnosed as pre-diabetic. I eat no processed foods, eat meat, modest dairy, veggies, low glucose fruits, no grains or sugars, three separate meals per day, no snacking, no fast food. Lost 30 pounds. A1C is now 5.1. LDL is 84. HDL is 50. Total cholesterol is 134. Yep, it works and is sustainable.

  6. DeeAnn
    Orlando, FL

    At the end of the podcast, Dr. Ludwig states that the main reason people aren’t successful with dieting is that they are hungry. That isn’t my problem at all. I have found many diets in the last few years where hunger is not an issue. My problem is that I simply love to eat tasty foods, and I love to eat out socially. I am a foodie who loves to try new and interesting foods a lot. So please help me find a diet where I can do that and still be slim and healthy. Not sure it exists!

  7. joy
    N C

    I have suffered with hypoglycemia for most of my life and had to eat within 30 min. of waking up or I got weak and woozy. I now put one teaspoon of coconut oil in my cup of coffee and feel fine to walk my dogs for a mile before breakfast and am maintaining my weight loss perfectly.

  8. Pamela
    St. Louis, Missouri. 63025

    Please let me know if you agree with Dr. McDougal when he teaches that dairy products contain deadly viruses and cancer cells which the cow has. He says that our leukemia’s and lymphomas come from drinking milk and eating dairy products. I love my milk and yogurt and cheeses. Will you please email me your wisdom on this subject and the same with the meat and fish industry wherein he states people can get viruses and cancers from eating meat. Thank you so very much.

    • Jude
      Decatur, Georgia

      For evidence-based nutritional information, check out Dr. Michael Greger’s nutritionfact.org website. What he tells you comes only after extensive research, not only reading studies, but studying the studies for things like who sponsors them, what other research contradicts or supports them, etc. He himself is a vegan and advocates the vegan diet for health reasons.

  9. Susan

    Thank you for this info. I have been on a low carb diet for more than a year because of high triglycerides and high cholesterol and the inability to take the drugs that control them. After on the self-imposed diet for 1 year, both are in the normal range. I have lost about 15-20 pounds and feel great… really good for 81 years old!

  10. Vicki
    Atlanta, GA

    Thank you for posting this informative article. Earlier this year, at the age of 61, post menopausal with hypothyroidism, I lost 40 lbs in less than 4 months, eating real grocery store food. I ate fibrous carbs combined with lean proteins and healthy fats. I also included small amounts of complex carbs, but combined them appropriately for efficient fat burning. Food combinations, portion control, and void replacements for favorite unhealthy foods make this plan doable and sustainable as a lifestyle. I came off a statin drug I had been on 11 years!!! So, while not every person’s body will respond the same, please don’t discount a lower carb diet. I have maintained my weight loss for 5 months and plan to lose more. I do eat out and I do eat my “old” favorite foods occasionally, but promptly return to the plan and back into efficient fat burning. Happy Thanksgiving! Vicki Davis, Atlanta, GA


    The guest doctor compared the 1970s and today and explained that his mother used to manage and restrict his eating. I think mothers used to carefully manage the nutrition of their whole households and prepare all meals, and that was an expected duty of a housewife and mother. Today few families have anybody in the role of full time nutritionist/cook/food authority. Women are at work.

  12. Susan

    That’s what Dr. Atkins preached for years and it always works for me. I have lost 18 pounds this year on low carbs.

  13. william reichert

    The study did NOT show that low carb diets help you lose weight; It showed that low carb diets increase your metabolic rate. The weight loss implications are only speculative, not proven.

    In fact most studies have shown that low carb does little to help you lose weight, unless the diet also makes you eat less.

    Here (below) is a review of the weight loss implications of low carb. By the way , the authors state that their study suggests but does not prove that the diet could help you lose 20 pounds “in a few years”

    So lets say the few years is 6 years. That means you would lose 20/6 or 3.3 pounds a year.
    If you think this is the answer to obesity, you need to think again.
    Losing weight requires eating fewer calories or exercising more. If low carb diet enables you to eat fewer calories, then go for it.


  14. Leigh
    Jacksonville FL

    I’ve been a Type 1 diabetic for 37 years. I followed the ADA diet recommended for diabetes for many years but had many problems sustaining a healthy level of blood glucose levels no matter what I did.

    In frustration, I saw a naturopath almost 6 years ago who told me to eliminate dairy and gluten from my diet. For 2 weeks I felt flu-like then started feeling really good. Rice, beans, and pasta were always triggers for a rapid glucose rise so I rarely ate those anyway but eliminating bread, potatoes and other high starchy food smoothed out my highs which were then followed by lows caused by taking more insulin to cover the highs, took me off the roller coaster I’d been riding for years.

    My glucose levels have been more in a normal range resulting in better health. When I do eat high carb I definitely pay for it in sustained high glucose.

  15. Jennifer
    Buffalo, NY

    Besides weight loss, not eating refined carbs and sugar has helped my cholesterol drop 30 points in 3 months! I eat full fat dairy, meat, vegetables, fruit and occasional rice or potatoes. I’ve switched my tea and coffee sweetener to agave syrup (low glycemic). I am also no longer classified as pre-diabetic. This is how I eat from now on.

  16. ed
    Buffalo, New York

    Please consider having Dr. John McDougall on one of your radio shows. It seems whenever carbs are compared to fat, no mention is made of the TYPE of carbs being consumed. Of course REFINED carbs and SUGAR laden carbs are unhealthy. Yet those are the carbs used in the studies most often mentioned in media related studies the public is saturated with.
    Dr. John McDougall can discuss and illustrate what a high carb diet is and how it compares to a high fat, high meat, high dairy diet!

  17. Mary

    The diet that has worked for me for many, many years is a vegan whole foods plant based diet with small amounts of fat and sugar. It is essentially the diet recommended in the film and book, “Forks Over Knives,” by Drs. Dean Ornish, Caldwell Esselstyn, John and McDougall, and by T. Colin Campbell, Ph.D., author of the China Study. This diet helps me stay healthy and active at 70+, and it’s been documented to reverse obesity, heart disease, Type 2 diabetes, and other “lifestyle” diseases.

  18. jp

    I’m a KETO believer, and yet when asked to gain weight for a role (I’m an actor) I simply consumed more of the healthy foods I was already eating, that is, more calories. I gained 35 lbs in eight months. That excess weight is gone now…I lost it by simply returning to my previous amounts of food (fewer calories). So, calories in/out may be too simplistic, but it IS a factor…don’t kid yourself.

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