What The New "Low-Carb" Study REALLY Says

A news media feeding frenzy erupted recently when a new diet study broke in the New England Journal of Medicine (NEJM). Almost all the reporters got it wrong, wrong WRONG! So did most of the gloating low carb forumites and bloggers. Come to think of it, almost everyone interpreted this study wrong. Some valuable insights came out of this study, but almost everyone missed them because they were too busy believing what the news said or defending their own cherished belief systems …

The new study, titled, “Weight Loss With a Low-Carbohydrate, Mediterranean, or Low-Fat Diet” was published in The New England Journal of Medicine (NEJM) in issue 359, number 3.

I quickly read the full text of the research paper the day it was published. Then, I shook my head in dismay as I scanned the news headlines.

I found it amusing that the media turned this into a three ring circus, putting a misleading “low carb versus high carb,” “Atkins vindicated” or “Diet wars” spin on the story. But that’s mainstream journalism for you, right? Gotta sell those papers!

“Study Tips Scales in Atkins Diets Favor: Low Carb Regimen Better Than Low Fat Diet For Weight And Cholesterol, Major Study Shows. “

“Low-Carb and Low-Fat Diets Face Off “

“The Never-Ending Diet Wars”

“Low Carb Beats Low Fat in Diet Duel.”

“Atkins Diet is Safe and Far More Effective Than a Low-Fat One, Study Says”

“Unrestricted Low-Carb Diet Wins Hands Down”

Some of these headlines are hilarious! I wonder if any of these reporters actually read the whole study. Geez. Is it too much trouble to read 13 pages before you write a story that will be read by millions of already confused people suffering the pain and frustration of obesity?

The low fat restricted calorie diet was based on American Heart Association guidelines. Calorie intake was set at 1500 for women, 1800 a day for men with 30% of calories from fat, and only 10% from saturated fat. Participants were instructed to eat low fat grains, vegetables, fruits and legumes and to limit their consumption of additional fats, sweets and high fat snacks.

The Mediterranean diet group was placed on a moderate fat, restricted calorie program rich in vegetables and low in red meat, with poultry and fish replacing beef and lamb. Energy intake was restricted to 1500 calories per day for women and 1800 calories per day for men with a goal of no more than 35% of calorie from fat. Added fat came mostly from nuts and olive oil.

The low carb diet was a non-restricted calorie plan aimed at providing 20 grams of carbs per day for the 2 month induction phase with a gradual increase to 120 grams per day to maintain the weight loss. Intakes of total calories, protein and fat were not limited. However, the participants were counseled to choose vegetarian sources of protein (more on that bizarre-twist shortly).

The study subjects were mostly male (86%), overweight (BMI 31) and middle age (mean age 52)

There were some health improvements in cholesterol, blood pressure and other parameters in the Mediterranean and low carb group that bested the high carb group. That was the focus of many articles and discussions that appeared on the net this week. However, I’d like to focus on the weight loss aspect as I’m not a medical doctor and fat loss is the primary subject matter of this website.

All three groups lost weight. The low carb group lost 5.5 kilos, the Mediterranean group lost 4.6 kilos and the low fat group lost 3.3 kilograms…. IN TWO YEARS! Whoopee! 

Amanda Gardner of the US News and World Report Health Day was one of the few reporters who got it right:

“Diet plans produce similar results: Study finds Mediterranean and low-carb diets work just as well as low fat ones.”

Tara Parker-Pope of the New York Times also came close with her headline:

“Long term diet study suggests success is hard to come by: In a tightly controlled experiment, obese people lost an average of just 6 to 10 pounds over two years.”

Even this headline wasn’t 100% accurate. The study was HARDLY tightly controlled. Tightly controlled means metabolic ward studies where the researchers actually count and control the calorie intake.

The problem is, you can’t lock people in a hospital or research center ward for two years. So in this study, they used a food frequency questionnaire. Sure, like we believe what people report about their eating habits at restaurants and at home behind closed doors! BWAHAHAHAHAHAHAHAHA!

One of the most firmly established facts in dietetics research is that almost everyone underreports their food intake BADLY, sometimes by as much as 50%. I’m not saying everyone “lies,” they just forget or don’t know. In fact, this underreporting of calorie intake is such a huge problem that it makes obesity research very difficult to do and conclusions difficult to draw from free-living studies.

Another blunder in the news reports is that this study didn’t really follow Atkins diet parameters OR even the traditional low fat diet for that matter, so it’s not an “Atkin’s versus Ornish” showdown at all.

If you actually take the time to read the full text of the research paper it doesn’t say ANYTHING like, “Atkins is the best after all.” That’s the spin that some of the news media cooked up (and what the Atkins foundation was hoping for).

It says, “The diet was based on the Atkins diet.” However, the sentence right before that says, “The participants were counseled to choose vegetarian sources of fat and protein.” Vegetarian Atkins?

The chart on page 236 says the low carb diet provided 40% of calories from carbs at 6, 12 and 24 months. If I’m reading that data properly, then the only low carb period was a brief induction phase in the very beginning.

Does that sound like Atkins? 40% carb sounds more like the Zone diet or my own Burn The Fat program to me.

The Atkins Foundation, which partially supported this study, told reporters, “We feel vindicated.” HA! They should have paid the reporters and told the researchers they felt ripped off and they wanted a refund for misuse of their research grant!

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