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'Accounting approach' to weight loss fails: Low-carb diets trump low-fat

Calorie-counting method of weight loss flops.
Calorie-counting method of weight loss flops.
Photo by Joe Raedle/Getty Images

Do you suffer from fear of fats? Symptoms include running past the cheese aisle to avoid temptation, covering your eyes when someone offers you a bowl of cashews, and buying products with ingredients you can't pronounce and names such as "I Can't Believe It's Not Butter." Now, showing the shift in mainstream medicine when it comes to diet advice, Time magazine unveiled the newest research on high fat low carb diets for health and weight loss on July 16.

"Calories in, calories out" is the foundation of traditional weight loss wisdom. There's just one problem: As evidenced by the escalating epidemic of obesity and diabetes, it's not true.

"By and large, we've been taking an accounting approach to weight loss," summed up Dr. David Ludwig, a professor of nutrition at the Harvard School of Public Health, in his description of the problem with calorie-counting approaches. When you do the math, a low-fat diet should be the ideal approach to weight loss because cutting fat reduces the total number of calories.

"Mediterranean or low-carbohydrate diets outperform a low-fat diet every time, and that wouldn't be true if calories were the only measure that mattered," explained Ludwig. The latest research shows that our bodies react differently to fat and protein than to carbohydrates.

"Your weight is regulated by a complex system of genetic factors, hormonal factors, and neurological input, and not all calories affect this system the same way," he said. And rather than avoid fat, he praises its health benefits and weight loss results.

"Some naturally high-fat foods are among the most healthful we can eat in terms of promoting weight loss and reducing risk for diabetes and heart disease," he said. Although foods such as nuts and avocado are off the list if you're counting calories, the fact that they are filling makes them beneficial.

Still hesitant about the benefits of cheese melted over eggs fried in butter? A new study shows that consuming full-fat dairy rather than low-fat or fat-fee dairy actually boosts weight loss, reported Everyday Health on July 16.

The researchers found that people who ate cheese and drank full-fat milk had lower body weights. They theorized that the benefits result from the satiety factor of high-fat dairy.

So if fat doesn't make us fat, what does? Blame it on the sugar and starches, according to a study reported on July 18 by Fox News. And even the researchers were surprised at their results.

"The first studies were indeed surprising to us," admitted Dr. Ronald M. Krauss, a director at the Children’s Hospital Oakland Research Institute. He found that patients who ate the saturated fats in dairy and meat were less apt to suffer heart attacks. Moreover, those who followed high carb low-fat diets did not benefit with reduced risks of heart disease.

However, Dr. Krauss believes in the concept of moderation rather than going on a diet of butter, bacon and cheese. "There’s been this ricocheting back and forth between extremes," he noted. "“It’s sort of like this binary thing: If something is true, then something else is false."

Not so, he said. His hope is that people will recognize the healthiest foods - and that doesn't mean carbohydrates.

"The important issue is that when reducing saturated fat, there’s an increase in intake of carbohydrates; when you make a change in one, you automatically make a change in the other," he explained. "There are actually adverse results in substituting carbohydrates for fat."

Dr. Krauss advises emphasizing vegetables, and avoiding starches and sugar. And while steak isn't the bad-for-you-food of the century, he recommends making veggies the focus rather than super-sizing that beef.

While most of the above fits into the Paleo diet model, dairy is not allowed on a caveman plan. If you do decide to include dairy on your low-carb diet, quality counts, said Franziska Spritzler, RD, CDE, in an exclusive interview.

"I think response to dairy varies from individual to individual. For those who want to follow a "traditional Paleo" diet, milk isn't allowed because of potential sensitivity to casein, which may cause problems with "leaky gut" in susceptible individuals," she clarified.

"For people who don't experience gastrointestinal issues when consuming dairy, I think it's fine, provided that it's high quality, hormone- and antibiotic-free, and preferably organic or pastured," she noted.

And while vegetables are virtuous, trying to achieve nutritional ketosis on a vegan diet can be challenging "because of its reliance on soy and seitan (vital wheat gluten), each of which may cause problems in sensitive individuals." Instead, she suggests"a plant-based very-low-carbohydrate diet that includes eggs and dairy would be the best way to go."

As for as the concept of adding butter to everything that some low carb dieters advocate? "Butter is carb-free and a good source of saturated fat and vitamin K2," she noted. But while it's "extremely satiating, for people who have familial hypercholesterolemia or those who have very high LDL cholesterol levels," she recommends moderation.

Dr. Stephen Phinney, who has an M.D. from Stanford University, PhD in Nutritional Biochemistry from MIT and post-doctoral training at the University of Vermont and Harvard, also notes that the key to health and weight loss lies in carbohydrates. "At this juncture, we are not recommending that everyone should go on a ketogenic diet," qualified Dr. Phinney in an exclusive interview. "But everyone should markedly reduce their intakes of sugars (sucrose, glucose, fructose) and refined carbs."

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