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One of my faithful readers recently e-mailed me with an excellent, thought-provoking question about all these low-carb studies that have come out in recent years. You've seen 'em, I'm sure, and I've highlighted quite a few of them at my blog, including the Stanford study from Dr. Christopher Gardner published in JAMA earlier this year and the famous Tufts Popular Diet Trial by Dr. Michael Dansinger a few years back.
The question that intrigued me the most and merited this blog post was about the actual weight loss of the study participants who allegedly went on a low-carb diet.
Here's what she wrote in her e-mail:
Dear Jimmy,
As one who finds low-carb dieting to be close to miraculous, I naturally love reading your blog. I'm down 64 pounds so far--not bad for a menopausal woman--though I'm sorry to say I'm still severely obese and 50 pounds from goal. But it is a great pleasure to be free of the ravenous hunger, exhaustion, and weight gain of the dreadful low-fat diets.
I do have one question and thought you may have a clue. I've read various medical studies about the Atkins diet the including the ones linked to the Atkins web site. I'm totally puzzled as to why these studies keep going on about its being 'safe' (at least briefly...), but no one involved has any significant weight loss.
The latest study I saw (Gardner's JAMA study) showed a loss of only ten pounds in a year! That's about what some people I know lost during Induction. Another study showed a loss of no more than 19 pounds in a year among any subject.
Tell me something: Why do none of these studies show the significant weight loss one would expect if they observed the Atkins diet in the span of a year?
I know she's not the only one to wonder about that and I too have questioned why the weight loss is so...um, inadequate and a far cry from my own experience on this way of eating. Heck, I lost 15 pounds in the first WEEK on my Atkins diet, 30 pounds in the first month, 70 pounds in the first two months, and 100 pounds in about three months!
So what's up with celebrating a measly 10 pounds lost in a year, hmmm? Sure, it was more than the low-fat diet groups, but what's going on with these people. Are they TRYING to sabotage their efforts or what?
Here was my response back to the reader:
Thanks for writing and I appreciate your questions. I was just talking to Dr. Jonny Bowden about this in an interview recently regarding the lack of weight loss in these studies like the JAMA study from Gardner where they only lost 10 pounds in a year.
Remember, compliance on such studies is absolutely horrendous and the study participants actually end up eating about 150 grams of carbohydrate--nowhere close to ANY of the acceptable phases of the Atkins diet or any low-carb diet I'm aware of.
But the good news is there were still improvements in weight and health although not as good as it could have been. The researchers said these studies mimic the real world when people don't stick to their diet. I think they need to look into WHY people don't comply with their diet. Livin' la vida low-carb has been the easiest way for me to eat healthy EVER!
Don't lose heart...this way of eating works and we know it, don't we?! Nobody can ever take that away from us. Keep livin' la vida low-carb and let's be the example of what REAL low-carbers are like!
So, the answer to the question "Why is there such trivial weight loss in low-carb studies?" comes down to compliance with the diet itself. Sure, we can be happy that progress was made in the weight and health of the individuals for moving their carb intake in the right direction, but let's not call what they did a low-carb diet. Lower-carb, perhaps, but NOT low-carb.
Although I enjoy the positive publicity that studies like this give to low-carb diets, especially when improvements are made, the fact is they could be THAT MUCH BETTER if somehow we could get people to follow the plan they were assigned. Is forced compliance too much to ask for so we can get an accurate depiction of what people can expect if they do choose to go on a strict low-carb diet?
If I was put in charge of a group of study participants to give them direction about being on the Atkins diet, you bet your sweet bippy those people would be eating 20g carbohydrates for two weeks and probably no more than 40g carbohydrates for the entire year! I can guarantee you they'll lose more than 10 pounds in that year?! :)
This issue with compliance in the real world is not a good enough reason in my eyes to prevent the study from being strictly controlled to produce meaningful results. Let's see a study that REQUIRES study participants to eat a truly low-fat diet vs. a genuinely low-carb diet and then let's talk.
Is there a researcher willing to make this happen? I know Dr. Eric Westman at Duke University is doing some of this kind of research and he is to be applauded for being willing to get in the trenches to do this kind of research. But it's high time we FINALLY get a major published peer-reviewed study like this that presents a clear picture once and for all.
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