A low-carb diet most effective for weight loss

September 23 2013 by in The Swedish revolution, Weight loss studies

Which diet is the most effective for weight loss?

This could be a historic day in Sweden. Today it became official. After over two years of work, a Swedish expert committee published their expert inquiry Dietary Treatment for Obesity (Google translated from Swedish).

This report from SBU (Swedish Council on Health Technology Assessment) is likely to be the basis for future dietary guidelines for obesity treatment within the Swedish health care system.

The health care system has for a long time given general advice to avoid fat and calories. A low-carbohydrate diet (such as low-carb) has often been dismissed as a fad diet lacking scientific foundation. The time has now come to update knowledge in this area.

According to SBU, the only clear difference among different dietary recommendations is seen during the first six months. Here a low-carbohydrate diet, such as LCHF, is clearly more effective than today’s conventional advice.

From fad diet to best in test.

Here are some more highlights from the report:

Health markers

In addition, health markers will improve on a low-carbohydrate diet, according to SBU. You’ll get:

…a greater increase in HDL cholesterol (“the good cholesterol”) without having any adverse affects on LDL cholesterol (“the bad cholesterol”). This applies to both the moderate low-carbohydrate intake of less than 40 percent of the total energy intake, as well as to the stricter low-carbohydrate diet, where carbohydrate intake is less than 20 percent of the total energy intake. In addition, the stricter low-carbohydrate diet will lead to improved glucose levels for individuals with obesity and diabetes, and to marginally decreased levels of triglycerides.

So, all important health markers improved or unchanged on a stricter low-carbohydrate diet. Just like an international review of all research in the area showed last year:

Systematic review and meta-analysis of clinical trials of the effects of low carbohydrate diets on cardiovascular risk factors

Long-term uncertainty

Long term, studies show no statistically significant differences among different diets, and the differences decrease with time. The SBU suggests that this is because of decreasing compliance with time. People simply tend to fall back to old habits.

The more studies we add, the better we can see the clear advantage of low-carbohydrate diets. Unfortunately SBU has excluded all studies examining both obese and overweight people. If you include studies on weight loss where overweight people are included – to get a greater scientific basis – a clear advantage for the low-carbohydrate diet was seen even after a year:

New Analysis: LCHF Best For Long-Term Weight and Health Markers

A well-designed study, which for the same reason as above, was dropped from the SBU report’s analysis, still showed a persistent advantage for the LCHF-like diet (Atkins) after two years, despite the difficulty with such long-term diet studies.

For the long-term effect, if you keep to a strict low-carbohydrate diet, there are only anecdotal reports on weight and cholesterol levels.

Physical activity

SBU also kills the idea that exercise plays an important roll in weight loss. Exercise may be very good for health, but:

Systematic reviews of the literature show that the addition of physical activity to a dietary intervention for individuals with obesity have, if any, a marginal effect on weight loss at the group level.

The effect of exercise on weight in studies is in other words marginal or non-existent. Just like you read about here.

Warnings against LCHF dismissed

There’s a great lack of knowledge today on what dietary guidelines are best for long-term health. We simply don’t know.

Recent cautions on low-carbohydrate diets are at best based on statistical associations derived from food questionnaires from people who didn’t (!) eat a low-carbohydrate diet. The SBU also dismisses these warnings:

Most of these studies suffer from major shortcomings, which make them difficult to interpret. The foremost shortcoming in these studies is that it’s often impossible to determine whether those with the lowest intake are knowingly eating a moderate low-carbohydrate diet for health reasons, or if they are high consumers of fast-food.

The breakdown of carbohydrates, fat and protein, which in such studies are imaginatively labeled “a low-carbohydrate diet” is usually very similar to the macronutrient distribution in a hamburger with fries and soda…

Towards the future

What will be the consequences of today’s report?

Advice on a low-carbohydrate diet is however very rare, if we look at the practice survey. It’s not clear how common it is to actively discourage patients from the strict low-carbohydrate diet. A low-carbohydrate diet, even the stricter form, will lead to a greater weight loss in the short term than the low-fat diet, and studies have indicated no adverse effects on blood lipids, provided that the weight stays low. One possible consequence of this report will therefore be an increased use of a strict low-carbohydrate diet for short-term weight reduction.

SBU will always express itself very carefully. But it can’t be said much clearer: It’s high time for the health care system to take seriously advice on LCHF for weight loss!

This is also interesting:

…it’s not possible to draw any conclusions about the relationship between a low-carbohydrate diet – regardless of fat content – and cardiovascular disease. Here we could apply the precautionary principle, and advise some restraint on saturated fat intake, as long as the documentation of the long-term effects are inadequate.

Many health care workers will no doubt (without any better reasons than preconceptions) be wary of dietary advice on more saturated fat. I was once scared of saturated fat myself.

I think that SBU is keeping a reasonable attitude here, as it isn’t even necessary to give advice on a lot of saturated fat for a low-carbohydrate diet. You can eat even a strict low-carbohydrate diet (such as low-carb) emphasizing unsaturated fats. This has been shown to be effective in studies:

It would be wonderful if the health care system started to apply the benefits of a low-carbohydrate diet, even before the outdated fear of butter has melted away everywhere.

The SBU-report Dietary Treatment for Obesity is a gigantic step towards more effective dietary guidelines within the health care system. This is a historic day in Sweden.

Media coverage

Today’s big news created quite a media frenzy in Sweden, here Google translated from Swedish:

More on the SBU report Dietary Treatment for Obesity:

LCHF for Beginners

Just a few examples of that today’s news could mean for more and more people:

Name

Provider / Domain

Expiration

Description

ckdc-premium

.dietdoctor.com

1 month

app-banner

.dietdoctor.dev.dietdoctor.com

1 day

This cookie shows whether user closed the App Banner prompt

_gaexp

Google LLC

dietdoctor.com

1 year

Used to determine a user's inclusion in an experiment and the expiry of experiments a user has been included in.

_gaexp

Google LLC

.dietdoctor.com

1 year

Used to determine a user's inclusion in an experiment and the expiry of experiments a user has been included in.

_opt_awcid

.dietdoctor.com

3 days

_opt_awmid

.dietdoctor.com

3 days

_opt_awgid

.dietdoctor.com

3 days

_opt_awkid

.dietdoctor.com

3 days

_opt_utmc

.dietdoctor.com

3 days

_opt_expid

.dietdoctor.com

25 seconds

gtm_auth

.dietdoctor.com

3 days

gtm_debug

.dietdoctor.com

3 days

gtm_experiment

.dietdoctor.com

3 days

gtm_preview

.dietdoctor.com

3 days

_hjAbsoluteSessionInProgress

Hotjar Ltd

.dietdoctor.com

30 minutes

The cookie is set so Hotjar can track the beginning of the user's journey for a total session count. It does not contain any identifiable information.

_ga

Google LLC

.dietdoctor.com

2 years

This cookie name is associated with Google Universal Analytics - which is a significant update to Google's more commonly used analytics service. This cookie is used to distinguish unique users by assigning a randomly generated number as a client identifier. It is included in each page request in a site and used to calculate visitor, session and campaign data for the sites analytics reports.

_dc_gtm_UA-3268327-1

.dietdoctor.com

1 minute

This cookie is associated with sites using Google Tag Manager to load other scripts and code into a page. Where it is used it may be regarded as Strictly Necessary as without it, other scripts may not function correctly. The end of the name is a unique number which is also an identifier for an associated Google Analytics account.

_hjFirstSeen

Hotjar Ltd

.dietdoctor.com

30 minutes

The cookie is set so Hotjar can track the beginning of the user's journey for a total session count. It does not contain any identifiable information.

_dc_gtm_UA-22012422-2

.dietdoctor.com

1 minute

AWSELBCORS

Amazon.com Inc.

www.podbean.com

5 minutes

The cookies AWSELB and AWSELBCORS are functionally the same cookies. The latter has an explicit SameSite attribute set because of changes made from Chrome 80 and upwards.

_ga_YMCP8KW9S4

.dietdoctor.com

2 years

_hjIncludedInSessionSample

Hotjar Ltd

www.dietdoctor.com

2 minutes

This cookie is set to let Hotjar know whether that visitor is included in the data sampling defined by your site's daily session limit

__cf_bm

Cloudflare Inc.

.vimeo.com

30 minutes

This cookie is used to distinguish between humans and bots. This is beneficial for the website, in order to make valid reports on the use of their website.

_gid

Google LLC

.dietdoctor.com

1 day

This cookie is set by Google Analytics. It stores and update a unique value for each page visited and is used to count and track pageviews.

CookieScriptConsent

CookieScript

www.dietdoctor.com

1 year

This cookie is used by Cookie-Script.com service to remember visitor cookie consent preferences. It is necessary for Cookie-Script.com cookie banner to work properly.

__cf_bm

Cloudflare Inc.

.podbean.com

30 minutes

This cookie is used to distinguish between humans and bots. This is beneficial for the website, in order to make valid reports on the use of their website.

_hjIncludedInPageviewSample

Hotjar Ltd

www.dietdoctor.com

2 minutes

This cookie is set to let Hotjar know whether that visitor is included in the data sampling defined by your site's pageview limit.

_dc_gtm_UA-22012422-1

.dietdoctor.com

1 minute

_gaexp_rc

.dietdoctor.com

25 seconds

Name

Provider / Domain

Expiration

Description

IDE

Google LLC

.doubleclick.net

1 year

This cookie is set by Doubleclick and carries out information about how the end user uses the website and any advertising that the end user may have seen before visiting the said website.

_uetvid

Microsoft Corporation

.dietdoctor.com

1 year

This is a cookie utilised by Microsoft Bing Ads and is a tracking cookie. It allows us to engage with a user that has previously visited our website.

loc

Oracle Corporation

.addthis.com

1 year 1 month

Stores the visitors geolocation to record location of sharer

test_cookie

Google LLC

.doubleclick.net

15 minutes

This cookie is set by DoubleClick (which is owned by Google) to determine if the website visitor's browser supports cookies.

_gcl_au

Google LLC

.dietdoctor.com

3 months

Used by Google AdSense for experimenting with advertisement efficiency across websites using their services

_uetsid

Microsoft Corporation

.dietdoctor.com

1 day

This cookie is used by Bing to determine what ads should be shown that may be relevant to the end user perusing the site.

uvc

Oracle Corporation

.addthis.com

1 year 1 month

Tracks how often a user interacts with AddThis

YSC

Google LLC

.youtube.com

Session

This cookie is set by YouTube to track views of embedded videos.

MUID

Microsoft Corporation

.bing.com

1 year

This cookie is widely used my Microsoft as a unique user identifier. It can be set by embedded microsoft scripts. Widely believed to sync across many different Microsoft domains, allowing user tracking.

_fbp

Meta Platform Inc.

.dietdoctor.com

3 months

Used by Facebook to deliver a series of advertisement products such as real time bidding from third party advertisers

VISITOR_INFO1_LIVE

Google LLC

.youtube.com

6 months

This cookie is set by Youtube to keep track of user preferences for Youtube videos embedded in sites;it can also determine whether the website visitor is using the new or old version of the Youtube interface.

Name

Provider / Domain

Expiration

Description

_ga_7S1SXKKDKN

.dietdoctor.com

2 years

Name

Provider / Domain

Expiration

Description

_hjSession_1945121

.dietdoctor.com

30 minutes

_hjSessionUser_1945121

.dietdoctor.com

1 year

_ga_Y4DLH4EPXM

.dietdoctor.com

2 years