Low Carb vs. Low Calorie in the Fight against Weight – what is to be preferre

You may already have guessed it: a good barbecue with salad is preferable over a small-sized Italian pasta even with low-fat sauce Napoli! A study in 2003 put obese (body mass index average of 33.6), but otherwise healthy women for six months on either a very low carbohydrate diet (VLCD) or a calorie-restricted diet with 30% dietary fat (= low-fat diet). Importantly, the VLCD subjects were allowed to eat freely in regards of quantity, i.e. no calorie restriction, eat as much as you can! Nevertheless, the VLCD women achieved more than double losses of their weight (8.5 kg vs. 3.9 kg) and of their body fat (4.8 kg vs. 2.0 kg) than their counterparts on the low-fat diet. These results were highly significant with a probability of 99.9% (p<0.001) for body weight, and 99% (p<0.01) for body fat. No differences on cardiovascular disease risk factors could be detected. (Brehm et al, 2003. J Clin Endocrin Metab)

A recent meta-analysis confirmed these results (Nordmann et al, 2006. Arch Intern med): low-carb, not energy-restricted diets appear to as effective as low-fat, energy-restricted diets in inducing weight loss for up to one year. Meanwhile, a second meta-analysis also concluded that low-carb/high-protein diets favourably affect body mass and composition independent of energy intake. (Krieger et al, 2006. Am J Clin Nutr)

Aside from better weight control there is emerging evidence on health advantages regarding blood lipid profile of low-carb diets compared to low-fat diets. Especially striking is that the so-called DASH diet (Dietary Approach to Stop Hypertension) proved less effective in lowering blood pressure than a high-protein or a fat-rich diet, i.e. both of them constituting low-carb diets. These results have just been confirmed: an impressive advantage regarding reduction of blood pressure has been shown by a low-carb diet compared with the well-known weight-loss medical Orlistat plus a low-fat diet. In spite of a respectable 10% weight loss in both groups during a one year period in 146 overweight participants, only 21% of the patients with Orlistat and the low-fat diet could reduce their blood pressure medication, whereas 47% of the low-carb dieters (without Orlistat) could decrease or even discontinue their blood pressure medication. (Yancy et al, 2010. Arch Intern Med)

Certainly, overweight is a risk factor for cardiovascular diseases per se. But the right way to reduce body weight and body fat has typically been considered to be a calorie-restricted diet, which is most easily reached by cutting down dietary fat because of its high caloric value! Furthermore, fat is still considered to be unnecessary or even avoidable ballast in our nutrition by some, whereas carbs are looked upon as the good guys. But times are changing at last…please find your SPONSER weight management product recommendations here.[RJ2] 

To finish off let’s imagine a hunter-gatherer diet, which has been commonly accepted to be meat-based, yet non-atherogenic (thickening/hardening of artery walls). Compared to a Western diet a hunter-gatherer’s regimen was high in protein (19-35%), relatively low in carbs (22-40%), and high in fat (28-58%) but with crucial differences in fat quality, including a high content of mono- and poly-unsaturated fatty acids along with a lower omega-6 to omega-3 fatty acid ratio, which may have protected from the development of cardiovascular disease. Other dietary characteristics, for example high intakes of antioxidants, fibres, vitamins, phytochemicals, as well as lifestyle factors with more exercise, less stress, and no smoking, most probably will have operated synergistically. (Cordain et al, 2002. Eur J Clin Nutr)