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Low-fat diet best for weight maintenance
Tuesday, May 25, 2004 2:14 pm Email this article
ALTHOUGH A LOW-CALORIE DIET IS BEST for losing weight, a low-fat, high-carbohydrate diet is better for maintaining that weight loss according to a one study (Toubro et al, 1997). (Note that this study did not include comparison to a low-carbohydrate diet.)
Forty-three obese adults with a BMI of 27 to 40 were randomly assigned to lose weight either quickly (on a diet of 500 calorie per day for two months) or slowly (on a diet of 1200 calories per day diet for four months).
During this weight loss period patients also took 20 mg of ephedrine combined with 200 mg of caffeine before each meal. The speed at which patients lost weight did not affect how much they lost nor did it affect their weight maintenance. Both groups lost an averaged of 27.7 pounds.
Patients were then re-randomized and assigned to eat either a low fat/high carbohydrate diet (20-25% fat/55% carbohydrate/20-25% protein) or a low calorie diet of 1800 calories or less.
After one year the group eating the ad lib low fat high carbohydrate diet had gained back only 0.7 pounds of the 29.7 pounds they had lost.
However the group attempting to count calories had gained back 9 pounds of the 30.4 pounds they had lost.
One year after the weight maintenance period (2 years after the weight loss) the low fat group had maintained three times more weight loss than the calorie counting group (17.8 pounds vs 5.5 pounds, respectively).
During weight maintenance the patients were seen in groups 2-3 times per month for the first six months and then once a month for the next six months.
The sessions involved giving dietary instructions, reinforcement, support, nutritional education and practical instruction in food preparation in a kitchen.
Although this study found that an ad lib low-fat high-carbohydrate diet is better than counting calories for maintaining weight, a previous study (Schlundt, 1993) found that calorie counting was better for losing weight initially (males 26 pounds vs 17.6 pounds, respectively; females 18 pounds vs 8.6 pounds, respectively.)
The bottom line seems to be that it is best to count calories to lose the weight and then reduce fat to maintain weight.
Other interesting points made in this article are that:
- Obesity is estimated to contribute to 8 percent of health costs in the U.S. (Colditz, 1992).
- There is strong evidence that weight loss reverses almost all the health hazards of obesity (Garrow, 1991) and normalizes mortality (Williamson, 1995).
Toubro S, Astrup A. Randomised comparison of diets for maintaining obese subjects’ weight after major weight loss: ad lib, low fat, high carbohydrate diet v fixed energy intake. Bmj, 1997 Jan 4, 314(7073):29-34. Correspondence: Soren Tubro, Associate Professor, Research Dept of Human Nutrition, Royal Veterinary and Agricultureal University, Rolighedsvej 30, 1958 Frederiksberg, Copenhagen, Denmark.
Schlundt DG, Hill JO, Pope-Cordle J, Arnold D, Virts KL, Katahn M. Randomized evaluation of a low fat ad libitum carbohydrate diet for weight reduction. International Journal of Obesity, 1993 Nov, 17(11):623-9.
Colditz GA. Economic costs of obesity. American Journal of Clinical Nutrition, 1992 Feb, 55(2 Suppl):503S-507S.
Garrow J. Importance of obesity. Bmj, 1991 Sep 21, 303(6804):704-6.
Williamson DF, Pamuk E, Thun M, Flanders D, Byers T, Heath C. Prospective study of intentional weight loss and mortality in never-smoking overweight US white women aged 40-64 years. American Journal of Epidemiology, 1995 Jun 15, 141(12):1128-41.
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