September 3, 2014
When it comes to weight loss, there is no "magic" diet, says a review of published studies. The review looked at 48 studies involving more than 7,000 people. Some were on low-carb diets, such as Atkins or South Beach. Others followed low-fat diets. People lost an average of 18 pounds over 6 months, regardless of the diet they followed. People tended to lose a few more pounds if the program told them to exercise, or if they had behavioral counseling at least twice a month for the first 3 months. By the one-year mark, however, most people had gained back 2 to 4 pounds. The study focused only on weight loss; it did not look at heart-disease risk or other health effects. The researchers say that the standard weight-loss advice of cutting calories and exercising still stands. They also say that the best diet is the one that a person can stick with over time. The review appears in the September 3 issue of the Journal of the American Medical Association. HealthDay News wrote about it.
By Howard Lewine, M.D.
Harvard Medical School
What is the Doctor’s Reaction?
High carb, low fat vs. low carb, high fat. We have a winner of the long debate about which style of weight loss diet is most effective. They both win.
After 6 months, average weight loss was nearly equal, about 8 kilograms (about 17.5 pounds). However, neither diet was successful at keeping the weight off. People gained back 1 to 2 kilograms (2.2 to 4.4 pounds) on average by 12 months. And after several years, most people regained all of the weight and more.
Rather than thinking about diet as your first goal in weight loss, focus on getting more exercise first. You want to get at least 30 minutes of dedicated exercise daily. Once exercise becomes part of your daily routine, you are much more likely to eat healthier.
Don't worry about how many carbs or how much fat is in your diet. Pick foods that contain the healthy carbohydrates, fats and proteins. But you must keep track of your total calories. If you are not losing weight, you need to both increase your physical activity and reduce your daily caloric intake. Calories out spent to create energy must be greater than calories in by mouth.
This study of the most popular diets did not include Mediterranean style diets. Many experts now recommend this style of eating as the healthiest.
The health benefits were first recognized after a study done 50 years ago. Researchers looked at the eating patterns in the United States and six European countries. They compared how long people lived and rates of heart disease in the different countries.
People living in the southern parts of Greece and Italy lived longer and had less heart disease than people from other parts of the world. Their diets were loaded with plant-based foods and unsaturated fats (mainly from olive oil), lots of fish, and relatively little red meat and few sweets.
What Changes Can I Make Now?
Although it might be nice to live close to the Mediterranean Sea, this diet works anywhere in the world.
These are the basics of a Mediterranean-style diet:
- Four or more servings of vegetables a day. A serving is ½ cup of raw or cooked vegetables, 1 cup of raw leafy greens or ½ cup of vegetable juice.
- Four or more servings of fruit a day. A serving is ½ cup of fresh, frozen or canned fruit; ¼ cup of dried fruit; one medium-sized piece of fruit; or ½ cup of fruit juice.
- At least 4 tablespoons of olive oil a day.
- One handful (about 1½ ounces) of nuts, 3 or more times per week.
- Three or more servings of legumes (beans, peas and lentils) per week. A serving is ½ cup.
- Six or more servings of whole grains a day. A serving is 1 cup of dry breakfast cereal; ½ cup of cooked cereal, brown rice or whole-grain pasta; or one slice of whole-grain or multi-grain bread.
- Three or more servings of fish (especially fatty fish) a week. A serving is 4 ounces.
- One serving of yogurt or cheese a day.
- If you enjoy alcohol, limit yourself to 1 (for women) or 2 (for men) drinks a day. One drink is 5 ounces of wine, 12 ounces of beer or 1½ ounces of liquor.
- Soda and sugary drinks
- Sweets, pastries and commercial bakery goods
- Red and processed meats (eat white meats instead)
- Margarines and most tub spreads
You also have a good chance to lose some weight with a Mediterranean-style diet. But you still need to pay attention to your total calories.
What Can I Expect in the Future?
We don’t need more studies comparing weight loss diets. Starting a diet is easy. Sticking with it and maintaining weight loss is the bigger challenge. The menu we need is a list of ways to make that a reality.