Wednesday, June 21, 2006

Low fat? Low carb? Who cares?

Cover your ears medical organizations, low-fat is not the magic bullet for weight management. The low fat movement, born out of the simple fact that there are more calories per gram of fat than there are per gram of carbohydrate or protein, is dying a slow, painful death. Medical professionals and governments around the globe have latched onto the low fat approach as not only the healthiest way to live, but also as the only way to lose weight. It seems that finally, that tide is turning.

Two days ago the American Heart Association released their 2006 dietary recommendations and for the first time in over two decades, they focused on the currency of weight - calories, rather than just a blanket statement about the reduction of dietary fat (for full text visit the journal Circulation and read the 16 page scientific report of the AHA).

Another blow to the low-fat proponents came from this months issue of the journal Obesity where Rena Wing and Jim Hill have continued their exemplary reporting on what it takes to not only successfully lose weight, but more importantly keep it off. In 1994 Drs. Wing and Hill established the National Weight Control Registry in order to study people who had lost at least 30lbs and kept it off for at least 1 year (actually the average results are even better with the average registrant having lost 67lbs and kept it off for 5 or more years). What they found originally was that those folks who were successful did so with low-fat approaches. Of course the late 80s and early 90s were the low-fat diet years so it is not altogether surprising that the folks who enrolled in the registry had tried low-fat approaches. What had always frustrated me was that people often used the data from the registry to suggest that therefore low-fat was the only way to go. Well guess what, they're wrong - the registry is changing. In the article in Obesity, it turns out that those folks entering the registry in the late 90s and early 2000s in fact were much less likely to be on a low-fat diet.

Bottom line of course is it doesn't matter if it's low fat, high fat, low carb or high carb, if you're happy and it's less calories, it's good.