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Saturday, February 28, 2009 Worthless Study, Worthless Reporting By Diana Hsieh @ 7:00 AM Yesterday, I was annoyed to read a Denver Post article on a new diet study. Here's the opening of the article: Two decades after the debate began on which diet is best for weight loss, a conclusion is starting to come into focus. And the winner is not low-carb, not low-fat, not high-protein, but any diet. That is, any diet that is low in calories and saturated fats and high in whole grains, fruits and vegetables -- and that an individual can stick with -- is a reasonable choice for people who need to lose weight. That's the conclusion of a study published Wednesday in the New England Journal of Medicine, representing the longest, largest and most rigorous test of several popular diet strategies. Simply based on my own experience -- let alone what I've read in Good Calories, Bad Calories and elsewhere -- I was skeptical of those conclusions. But mostly, I was irritated that the article didn't provide even the basic data required to support the opinions of its many quoted experts. It didn't discuss the methods used, the diets tested, or the results. (Seriously!) It was all assertion without any supporting facts. So I dug up some actual facts about the study at Scientific American: The study subjects were divided into four groups, each assigned to a special diet. One group ate a "low-fat, average-protein" diet (20 percent fat, 15 percent protein, 65 percent carbs); a second consumed a "low-fat, high-protein" diet (20 percent fat, 25 percent protein, 55 percent carbs); a third followed a "high-fat, average-protein" diet (40 percent fat, 15 percent protein, 45 percent carbs); and the remaining group ate a "high-fat, high-protein" diet (40 percent fat, 25 percent protein, 35 percent carbs). All four regimens were heart-healthy (low in saturated fat and cholesterol) and included 20 grams (0.7 ounce) of daily dietary fiber. For each study participant, the researchers calculated personalized daily consumption levels ranging from 1,200 to 2,400 calories per day. Duh! The requirement of low saturated fat is really dumb, and the requirement of low dietary cholesterol is even dumber. But more importantly, not one of those diets is genuinely low-carb, and the high-fat diet isn't that either. As Richard Nikoley of Free the Animal observes in his debunking: The lowest carbohydrate intake of all the diets was a whopping (yea, I can do the media hype, too) 35%. Presuming an average 2,500 kcal intake per day, that's about 220 grams of carbs -- not "low carb" by any means. So, this is merely a comparison between various moderate to high carb approaches -- approaches that leave insulin high and fat mobilization low. The highest fat intake is only 40%. A true high fat diet is 60%+ of energy from fat. You can't go above about 35% from protein, and that's pushing it (25% is more realistic). Simple: protein remains about the same, and the tradeoff is between carbs and fat. This study was heavily weighted in favor of carbs, particularly when one considers that carbs hammer insulin and fat has little to no effect. High insulin = no fat mobilization. So, given those defects, what did the study actually find? Here's what the Scientific American article reports: "No matter which way you look at it, there were no [statistically significant] differences between any of the groups," Loria says. At six months, the average total weight loss for all of the groups was approximately 14 pounds (6.5 kilograms); by the end of two years that number had dipped to about nine pounds (four kilograms). "A lot of times in these weight loss studies, people tend to regain," notes Loria, adding that she will now study strategies that help people keep lost pounds off. In other words, the recommendation of weight loss via "any diet that is low in calories and saturated fats and high in whole grains, fruits and vegetables" cited in the Denver Post article is wholly unjustified. The study didn't test diets varying along any of those dimensions -- e.g. more or less refined grains versus no grains, low in saturated fats versus high in saturated fats, more or less fruits and veggies, etc. So any conclusions about the value of those foods in weight loss are completely unwarranted. More particularly, as Richard observed, the study "proved that all diets with excess carbohydrate are crap and deliver virtually no results for most people." Bingo! Labels: Food, Health Share |    E-mail Diana Hsieh     PermaLink ()    Comments (New Page)   Subscribe to NoodleFood Blog Posts via Feed Reader   via E-mail Subscribe to NoodleCast Podcasts M4A via iTunes (MP3)   via Feed Reader   via E-mail

Comments
	Saturday, February 28, 2009 at 8:15:20 mst Comment ID: #1 Name: Daniel URL: http://thenearbypen.blogspot.com Thinking out loud again: has anybody questioned whether "weight loss" should be the ultimate goal of an eating plan? I think about everything I eat in terms of either "enjoyment" or "energy"--with the latter being mostly achieved (or rather my usual state of energy "defended") by portion sizes. In any case, something seems initially wrong about pursuing a goal stated negatively. As I've said before, this is an area that I plan to give future thought to as I tweak what I eat. Am wondering though if those who've given more thought to the subject have come up with a generalized positive goal--which I'd assume would lead to the effects of enjoyment and energy in a person but focus more on the cause of both.
	Saturday, February 28, 2009 at 9:39:25 mst Comment ID: #2 Name: Monica Hughes E-mail: monicabeth10(at)gmail.com URL: http://fa-rm.org Great analysis, Diana. Yet another example showing how unbelievable crappy the reporting is on health and medical issues -- and why ANY popular article reporting on "science" needs to be seriously questioned for bias, even beyond health and medicine.
	Saturday, February 28, 2009 at 9:45:52 mst Comment ID: #3 Name: JT E-mail: JT30014(at)hotmail.com I'm a professional journalist, and I'm sad to say that I'm dismayed but not surprised at all by this. I graduated from one of the most top journalism schools in America. Though the most fundamental news skills were taught well, far more emphasis was put on "socially responsibility" than on how to analyze "scientific" studies like this one in order to write accurate stories before their deadlines. As a result, most journalists today (even those working at dailies in major cities) just parrot whatever is touted in press releases about new studies without much critical thought. Of course, that means readers are mislead about what those studies have actually proven or failed to prove. It's a sorry state of affairs, but that's the culture we live in--for now.
	Saturday, February 28, 2009 at 9:53:56 mst Comment ID: #4 Name: Richard Nikoley E-mail: rnikoley(at)gmail.com URL: http://www.freetheanimal.com "has anybody questioned whether "weight loss" should be the ultimate goal of an eating plan?" Oh, many times. This is part of the problem. It's really about body recomposition. For a normal person, body fat ought to be 10-13% for a man, and 15-18% for a woman (yes, certainly there are going to be normal outliers either side of the distribution). There are two ways to achieve this, and both ought to be employed for maximum effect. Lose fat and/or gain lean tissue. An approach that focuses on just losing fat (losing "weight" for most) will usually lose lean mass as well, so the person just becomes someone who weighs less but has a similar composition in terms of fat %. An approach that focuses on just building lean mass (in hopes of upping metabolism and burning more fat at baseline) is only marginally effective and very limited. See here. That first set of comparison photos was me after about six months of high intensity training without much focus on a good diet (left, and not a lot different from what it would have looked like six months earlier), while the photo to the right is me only three months later, one month of which had been only improving the diet dramatically (more Paleo-like), and then adding in intermittent fasting for the other two months. http://www.freetheanimal.com/root/2008/09/periodic-photo-progress-u ... Hope that explains a bit.
	Saturday, February 28, 2009 at 10:56:49 mst Comment ID: #5 Name: Aaron Davies E-mail: agd12(at)columbia.edu Typical. Reminds me of comments going all the way back to _Protein Power_ about academic blind spots on nutrition. (As I type this, I'm eating three fried eggs for a midnight snack, having lost about 12 pounds in the last six weeks since going back onto strict Atkins.)
	Saturday, February 28, 2009 at 11:10:46 mst Comment ID: #6 Name: Diana Hsieh E-mail: diana(at)dianahsieh.com URL: http://www.dianahsieh.com/blog Wow, congrats Aaron!
	Saturday, February 28, 2009 at 14:09:44 mst Comment ID: #7 Name: Tom Rowland E-mail: trowland08(at)gmail.com bingo, indeed! I've seen it in my own life, I've seen it in the lives of friends and family. A Low-carb higher protein diet beats a calorie counting diet every time. Does anybody remember the book that tauted calorie counting alone as a diet? My then wife and I started trying it out eating dairy queen soft-serve cones, among other things forbidden on the usual eating plan. Do I need to tell you that very soon we could see the results. They weren't good.
	Saturday, February 28, 2009 at 14:23:35 mst Comment ID: #8 Name: Richard Nikoley E-mail: rnikoley(at)gmail.com URL: http://www.freetheanimal.com Tom: Astute. I think that most will find, over time, that low-carb alone works because it eliminates most bad food, not that low-carb, in itself is the answer. (It is for T2s and people with bad BG control). The real foundation is real food: natural fats (animal, coconut, olive), meat, fowl, fish, veggies, fruits, nuts. Limit the starchy veggies and quantity of fuit if BG is a particular problem, otherwise unrestricted. Boosting the fat to 60% ish of cals helps a lot and hunger will reset and you're set for life. Fasting helps, too. Too many strict low-carbers, by focussing on that, eat too much low carb junk, processed food (just like the vegetarians, now). They will often fail, 'cause they don't have it down by the proper principles.
	Saturday, February 28, 2009 at 14:37:55 mst Comment ID: #9 Name: KPO'M E-mail: ka84796(at)comcast.net Slightly OT, but regarding "worthless reporting," based on my experience, the health reporters are head and shoulders above the typical financial reporter. The business pages of the paper aren't as glamorous as the sports, news, or entertainment sections. Most local papers have only a fraction of the articles they used to. As such, the quality of reporters assigned to the area is quite low. Even at the financial-oriented papers it doesn't seem that even a cursory understanding of business is a requirement. Some of the factual inaccuracies in financial reporting are startling. The Lex reporters for the FT are pretty good, though still lean center-left. IBD has some good editorials but sometimes shill for the right a bit. They cater to speculators and personal investors, and thus their articles are geared more to stock picking and analysis than general journalistic reporting. There's a massive disconnect between the news and editorial writers at the WSJ. Despite its reputation as a pro-business paper, the news department is about as left-leaning as the NY Times, though the quality tends to be decent. Why is this important? Just as people are fed (literally) a lot of misinformation about their physical health, so too are they with respect to their fiscal health. When financial papers write that banks should be nationalized, and local papers call out a healthy bank in Chicago for sponsoring a golf tournament, it's no wonder that the average person is grossly misinformed about the causes of the current crisis.
	Saturday, February 28, 2009 at 19:08:49 mst Comment ID: #10 Name: Daniel URL: http://thenearbypen.blogspot.com Richard: Thanks for the excellent comments. I bookmarked your site and will be reading more there...
	Saturday, February 28, 2009 at 19:12:22 mst Comment ID: #11 Name: Mike Hardy E-mail: (my last name) (at) math.umn.edu I have long thought that journalists are required to have flunked statistics, especially if they can do so by never having heard of statistics.
	Monday, March 2, 2009 at 0:07:16 mst Comment ID: #12 Name: Emma B E-mail: fertilityproject(at)gmail.com URL: http://twinproject.blogspot.com Richard, 18% in women is about the point where amenorrhea starts to become a factor, especially in women who are not naturally slender. That was my experience when a low-carb diet and an aggressive lifting regimen tipped me into hypothalamic amenorrhea once I passed below the 20% mark. It sent me into nearly a year of hormone hell and infertility treatment, and has left me with some permanent health consequences. 20-25% is a safer range for women to maintain. I'm still a believer in the virtues of carbohydrate restriction and weight training, but it's possible to take those too far and damage your health. Certainly, my thyroid and my bones would have been better off if I hadn't tried to reach fitness-competition shape.
	Monday, March 2, 2009 at 12:16:00 mst Comment ID: #13 Name: Richard Nikoley E-mail: rnikoley(at)gmail.com URL: http://www.freetheanimal.com Emma: I'll put that down on my list to check into. Do you have any sources I could begin with?
	Monday, March 2, 2009 at 21:56:38 mst Comment ID: #14 Name: Emma B E-mail: fertilityproject(at)gmail.com URL: http://twinproject.blogspot.com Richard, the American Council on Exercise cites "athletic" bodyfat as 14-20%, "fitness" as 21-24%, "acceptable" as 25-31%, and "obese" as 32% or more. However, amenorrhea is widespread in women in the "athletic" category, and there is a fair bit of research supporting a correlation between sub-20% body fat and amenorrhea. R.E. Frisch is a researcher who does a lot of work in this area -- see http://www.ncbi.nlm.nih.gov/pubmed/3117838 , and studies of recovering anorexics like http://www.ncbi.nlm.nih.gov/pubmed/16801735 support his numbers . Elzi Volk discusses the high incidence of amenorrhea among female athletes, especially among competitive bodybuilders, at http://www.thinkmuscle.com/articles/volk/menstrual-cycle.htm ,although she questions whether it is the body fat level itself or the caloric restrictions necessary to maintain that level . Here's the full text of an article discussing ballet dancers and amenorrhea: http://www.redorbit.com/news/health/161094/body_mass_index_body_fat ... , which notes the increased frequency of amenorrhea in ballet dancers with an average body fat of 18.8% (bioimpedance) . http://www.ncbi.nlm.nih.gov/pubmed/15356043 shows that the body fat of the eumenorrheic controls was about 21%, compared to 16.7% in the amenorrheic group. As Volk says, there's some chicken-egging going on about whether it's the diet or the weight causing the amenorrhea, and not every woman with a body fat below 20% will lose her cycle -- it may well be related to genetic setpoints, or to the rate of weight loss, and the bodyfat association is correlative. However, it's clear that *something* about striving for a low body fat percentage significantly increases a woman's risk of amenorrhea and bone loss, and that can leave you with lifelong damage.
	Tuesday, March 3, 2009 at 1:55:51 mst Comment ID: #15 Name: Richard Nikoley E-mail: rnikoley(at)gmail.com URL: http://www.freetheanimal.com Emma: Thanks. I had always thought that 15% wasw normal for men and 25% for women. As men don't have this issue, my personal goal is 10% BF. Some in the EvFit circle, Art De Vany in particular, call optimal fat at 13% (or less for me), and 17-18% for women. That's what I was going off of. Looks like I'll have to make up my own mind, and I think you for passing along these links (have yet to look into them. Any opinion on whether that changes post-menopause; that is, could a post-menopausal woman be perfectly healthy at a BF that would have otherwise cause amenorrhea pre-menopause?
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