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The low-fat, high carbohydrate diet - or,
the Anti-Atkins diet
There has been a great deal of controversy about low-carbohydrate diets and weight loss. The main argument is that it is easier for people to lose weight eating a low-carb "Atkins" type diet than the recommended low-fat diets, which have been shown to help reduce risk of heart disease and other illness.
Low-Carb Diets Linked with Higher Risk of Type 2 Diabetes
If you've been following Dr. Gourmet for a while, you already know what I think about the Atkins Diet and other low-carbohydrate diets: why follow a diet - any diet - that takes entire food groups away from you? Certainly we know that such diets work to help people lose weight, which is largely due to the fact that when most people stop eating carbohydrates, they stop eating junk.
More poorly designed diet research: low-fat vs. low-carb diets
The media has been all over today's study from the Annals of Internal Medicine(doi:10.7326/M14-0180), for the most part acting as if this were the last word on healthy eating. Proponents of the Atkins Diet are understandably celebrating, as the results of the study as published are that a low-carbohydrate diet increases weight loss and improves cholesterol scores more than a low-fat diet.
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It does appear from several studies that it is the protein in your meal that helps you feel fuller and more satisfied, for longer than you would if you ate a meal with less protein. This is one of the reasons that my recommendations for a healthy breakfast consist of a starch, a fruit and some protein - that protein helps you avoid the lure of the doughnuts in the break room.
One of the claims of the high-protein fad diets is that eating more protein helps you remain satisfied even though you are consuming fewer calories. Then there are those weight loss gurus who argue that eating more frequently - every two hours - will keep you more satisfied than if you eat three larger meals.
A team of researchers from the University of Missouri and Purdue University, with funding from the National Pork Board and the American Egg Board - Egg Nutrition Center, designed a study to investigate both claims (Obesity 2011;19(4):818-824). Would eating a higher protein diet help keep you satisfied? And would eating more frequent meals make a difference?
They began by recruiting 27 healthy, non-diabetic adult men whose Body Mass Indices were between 25 and 34.9 (overweight to clinically obese) to participate in a 12-week feeding study. The men were randomly assigned to a Normal Protein diet (14% protein, 60% carbohydrate and 26% fat) or a High Protein diet (25% protein, 49% carbohydrate and 26% fat). Regardless of which diet pattern they were assigned to, the participant's diets were all designed to reduce their caloric intake by about 750 calories per day.
The researchers provided the participants with daily menus that detailed specific quantities of brand-specific foods that they were to eat each day. In addition to their special menu, those on the High Protein diet were provided with cooked pork and egg products in quantities that represented 40% of their daily protein assignment. Those on the Normal Protein diet, however, had no animal protein in their diet except milk and cheese.
After about 6 weeks of following their assigned diet, the sub-study began, which lasted two weeks. For the first three days of each week, instead of eating their assigned foods at three regular meals, the participants were instructed to break up their eating into 6 smaller meals eaten at 2-hour intervals. On days two and three of the sub-study, the participants used a Palm Pilot to answer hourly questionnaires regarding their feelings of hunger, fullness, the desire to eat, and whether they were preoccupied with thoughts of food.
At the close of the study, the researchers compared compared the appetite questionnaires of the men on the Normal Protein diet with those on the High Protein diet. They also compared the questionnaires of those who ate every two hours with the questionnaires from those who ate every five hours (three meals a day).
Their results are rather interesting. The levels of hunger in the morning were the same, regardless of whether the men were following the Normal Protein or the High Protein diet. In the evening, however, which is when a lot of diet "cheating" seems to happen, those on the High Protein diet reported less of a desire to eat and fewer thoughts of food than those on the Normal Protein diet.
And the more frequent meals? The participants reported no difference in their levels of hunger or desire to eat when they ate more frequently as compared to when they ate just three meals a day. That's likely a good thing: the researchers note that they initially recruited 58 men to participate in the study, but only 27 were able to complete it. 90% of those who dropped out of the study did so because they found it difficult to adhere to the eating every two hours portion of the study.
You might be tempted to conclude that following a high protein diet will help you feel more satisfied when you're restricting your calories. But that's the flaw with this study: the researchers themselves admit that they can't tell whether the results are because of the levels of protein in their participants' diets or if it's because those on the High Protein diet ate animal protein. A better-designed study would use the same protein sources for both groups - and wouldn't be funded by the National Pork Board and the American Egg Board.
First posted: April 6, 2011