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Some believe that increased fat in the diet is a leading cause of all kinds of health problems, especially heart disease.
These organizations generally recommend that people restrict dietary fat to less than 30% of total calories (a low-fat diet). However… in the past 11 years, an increasing number of studies have been challenging the low-fat dietary approach. Many health professionals now believe that a low-carb diet (higher in fat and protein) is a much better option to treat obesity and other chronic, Western diseases. In this article, I have analyzed the data from 23 of these studies comparing low-carb and low-fat diets.
The main outcomes measured are usually weight loss, as well as common risk factors like Total Cholesterol, LDL Cholesterol, HDL Cholesterol, Triglycerides and Blood Sugar levels. Details: 63 individuals were randomized to either a low-fat diet group, or a low-carb diet group.
Conclusion: There was more weight loss in the low-carb group, significant at 3 and 6 months, but not 12. Details: 132 individuals with severe obesity (mean BMI of 43) were randomized to either a low-fat or a low-carb diet.
Overall, the low-carb diet had significantly more beneficial effects on weight and key biomarkers in this group of severely obese individuals. Details: 30 overweight adolescents were randomized to two groups, a low-carb diet group and a low-fat diet group. Details: 53 healthy but obese females were randomized to either a low-fat diet, or a low-carb diet. Details: 60 overweight individuals were randomized to a low-carb diet high in monounsaturated fat, or a low-fat diet based on the National Cholesterol Education Program (NCEP). Overall, the low-carb group lost more weight and had much greater improvements in several important risk factors for cardiovascular disease. Details: 120 overweight individuals with elevated blood lipids were randomized to a low-carb or a low-fat diet. Conclusion: The low-carb group lost significantly more weight and had greater improvements in blood triglycerides and HDL cholesterol. Details: 40 overweight individuals were randomized to a low-carb and a low-fat diet for 10 weeks.
Details: 28 overweight premenopausal women consumed either a low-carb or a low-fat diet for 6 weeks. Conclusion: The low-carb diet caused significantly more weight loss and reduced hunger compared to the low-fat diet. Details: 102 patients with Type 2 diabetes were randomized to a low-carb or a low-fat diet for 3 months. Details: 119 overweight individuals were randomized to a low-carb, ketogenic diet or a calorie restricted low-fat diet for 6 months.
Details: 84 individuals with obesity and type 2 diabetes were randomized to a low-carb, ketogenic diet or a calorie restricted low-glycemic diet. Diabetes medications were either reduced or eliminated in 95.2% of the LC group, compared to 62% in the low-glycemic group. Conclusion: The low-carb group lost more weight than the low-fat group and had greater improvements in HDL cholesterol and triglycerides. Details: 107 individuals with abdominal obesity were randomized to a low-carb or a low-fat diet. Conclusion: The low-carb group lost more weight and there was no difference between groups on Flow Mediated Dilation or any other markers of the function of the endothelium (the lining of blood vessels).


Details: 88 individuals with abdominal obesity were randomized to a very low-carb or a low-fat diet for 24 weeks. Details: 40 subjects with elevated risk factors for cardiovascular disease were randomized to a low-carb or a low-fat diet for 12 weeks. Conclusion: The low-carb group lost almost twice the amount of weight as the low-fat group, despite eating the same amount of calories.
Details: 118 individuals with abdominal obesity were randomized to a low-carb or a low-fat diet for 1 year. Conclusion: The low-carb group had greater decreases in triglycerides and greater increases in both HDL and LDL cholesterol, compared to the low-fat group.
Details: 32 obese adults were randomized to a low-carb or a calorie restricted, low-fat diet for 6 weeks. Weight Loss: The low-carb group lost more weight and had greater decreases in BMI than the low-fat group. Details: 61 individuals with type 2 diabetes were randomized to a low-carb or a low-fat diet for 2 years.
The majority of studies achieved statistically significant differences in weight loss (always in favor of low-carb). In most cases, calories were restricted in the low-fat groups, while the low-carb groups could eat as much as they wanted. When both groups restricted calories, the low-carb dieters still lost more weight (7, 13, 19), although it was not always significant (8, 18, 20). When the researchers looked at abdominal fat (the unhealthy visceral fat) directly, low-carb diets had a clear advantage (5, 7, 19). Despite the concerns expressed by many people, low-carb diets generally do not raise Total and LDL cholesterol levels on average. There have been some anecdotal reports by doctors who treat patients with low-carb diets, that they can lead to increases in LDL cholesterol and some advanced lipid markers for a small percentage of individuals.
Having higher HDL levels is correlated with improved metabolic health and a lower risk of cardiovascular disease. You can see that low-carb diets generally raise HDL levels, while they don’t change as much on low-fat diets and in some cases go down.
It is clear that both low-carb and low-fat diets lead to reductions in triglycerides, but the effect is much stronger in the low-carb groups. In non-diabetics, blood sugar and insulin levels improved on both low-carb and low-fat diets and the difference between groups was usually small.
Only one of those studies had good compliance and managed to reduce carbohydrates sufficiently. In this study, over 90% of the individuals in the low-carb group managed to reduce or eliminate their diabetes medications.
However, the difference was small or nonexistent in the other two studies, because compliance was poor and the individuals ended up eating carbs at about 30% of calories (10, 23).
A common problem in weight loss studies is that many people abandon the diet and drop out of the studies before they are completed. Not a major difference, but it seems clear from these studies that low-carb diets are at the very least NOT harder to stick to than other diets.
The reason may be that low-carb diets appear to reduce hunger (9, 11) and participants are allowed to eat until fullness. This is an important point, because low-fat diets are usually calorie restricted and require people to weigh their food and count calories. These studies are scientific evidence, as good as it gets, that low-carb is much more effective than the low-fat diet that is still being recommended all over the world.


The low-carb group had greater improvements in blood triglycerides and HDL, but other biomarkers were similar between groups.
Study went on for 30 days (for women) and 50 days (for men) on each diet, that is a very low-carb diet and a low-fat diet.
The men on the low-carb diet lost three times as much abdominal fat as the men on the low-fat diet. Both groups had similar improvements in mood, but speed of processing (a measure of cognitive performance) improved further on the low-fat diet. There was significant improvement in glycemic control at 6 months for the low-carb group, but compliance was poor and the effects diminished at 24 months as individuals had increased their carb intake.
For this reason, it is not surprising to see that low-carb diets (higher in fat) raise HDL significantly more than low-fat diets. Effects of a low-carbohydrate diet on weight loss and cardiovascular risk factor in overweight adolescents. A randomized trial comparing a very low carbohydrate diet and a calorie-restricted low fat diet on body weight and cardiovascular risk factors in healthy women. The national cholesterol education program diet vs a diet lower in carbohydrates and higher in protein and monounsaturated fat. A low-carbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia.
Comparison of energy-restricted very low-carbohydrate and low-fat diets on weight loss and body composition in overweight men and women.
Comparison of a low-fat diet to a low-carbohydrate diet on weight loss, body composition, and risk factors for diabetes and cardiovascular disease in free-living, overweight men and women. The effects of a low-carbohydrate ketogenic diet and a low-fat diet on mood, hunger, and other self-reported symptoms.
Comparison of the Atkins, Zone, Ornish, and LEARN diets for change in weight and related risk factors among overweight premenopausal women: the A TO Z Weight Loss Study. Low- and high-carbohydrate weight-loss diets have similar effects on mood but not cognitive performance. A low-carbohydrate diet is more effective in reducing body weight than healthy eating in both diabetic and non-diabetic subjects. The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus. Effects of weight loss from a very-low-carbohydrate diet on endothelial function and markers of cardiovascular disease risk in subjects with abdominal obesity. Metabolic effects of weight loss on a very-low-carbohydrate diet compared with an isocaloric high-carbohydrate diet in abdominally obese subjects. Carbohydrate restriction has a more favorable impact on the metabolic syndrome than a low fat diet.
Long-term effects of a very-low-carbohydrate weight loss diet compared with an isocaloric low-fat diet after 12 months.
Lack of suppression of circulating free fatty acids and hypercholesterolemia during weight loss on a high-fat, low-carbohydrate diet. Efficacy and safety of a high protein, low carbohydrate diet for weight loss in severely obese adolescents. In type 2 diabetes, randomization to advice to follow a low-carbohydrate diet transiently improves glycaemic control compared with advice to follow a low-fat diet producing a similar weight loss.



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