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Weight Loss Study Underscores Differences Between Fad Diets and Long-Term Lifestyles

By Christopher Clark
November 19, 2014
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Fad Diets vs. Long-Term Lifestyles for Weight Loss | The Paleo Diet

A new study, published in Circulation: Cardiovascular Quality and Outcomes, compares four popular diets—Atkins, the Zone, the South Beach Diet, and Weight Watchers—in terms of weight loss and cardiovascular disease risk factors. Researchers analyzed 26 randomized controlled trials involving 3,575 subjects, the majority of whom were young, white, obese women. Men and people with body mass indices (BMI) less than 30 kg/m2 were poorly represented in these trials.

Based on the available evidence, the researchers concluded, “Our results suggest that all 4 diets are modestly efficacious for short-term weight loss, but that these benefits are not sustained long-term.”1 Long-term, in this study, is defined as just 24 months. Do these results also apply to people with BMI scores less than 30? Can moderately overweight people expect sustained, long-term weight loss? Unfortunately, for lack of data, this study cannot answer these questions.

Curiously, the study’s discussion focuses mostly on weight loss rather than cardiovascular disease risk factors, even though elsewhere the authors comment, “Long-term RCTs comparing Atkins to usual care showed significant improvements in high-density lipoprotein cholesterol and, to a lesser extent, triglyceride levels at 12 and 24 months; there was no evidence of a low-density lipoprotein cholesterol increase.”2 Usual care refers to traditional weight loss approaches, including low-fat diets, behavioral weight loss intervention, and nutritional counseling.

Thus far, the popular press has also focused almost exclusively on the long-term weight loss prospects of “fad diets,” largely ignoring the cardiovascular disease aspect and failing to ask whether or not these diets improve health, irrespective of weight loss. In response to the study, Dr. Barry Sears, creator of the Zone, stressed that improved health, as opposed to weight loss, is indeed the goal, including better control of insulin and better control of inflammation.3

You can carry a few extra pounds and still be metabolically healthy, but you can’t have chronic, systemic inflammation and expect the same. Health improves when we stop looking at diets as temporary interventions and start adopting them as lifestyles. “You need to pick a way of life,” says Sears, “and stick with it, and a way of life that gives the greatest health for the longest period of time.”4

FAD DIETS

In an accompanying editorial, published in the same journal, Dr. David Katz questions the rational for comparing three carbohydrate-restricted diets (Atkins, Zone, South Beach) with one calorie-restricted diet (Weight Watchers). “The choices,” says Katz “are rather odd if the objective here was to examine the full expanse of competing dietary claims, which readily extends from vegan to Paleo.”5

The Circulation study only scrutinized four diets, but you wouldn’t know this by reading the headlines. The media’s all-encompassing “fad diet” pejorative casts doubt on all diets bearing particular names and espousing particular philosophies. This is unfortunate, especially for lifestyle diets, as opposed to diets based on strict calorie counting or rigid macronutrient requirements.

The Paleo Diet, of course, is a lifestyle diet encompassing movement, sleep, food choices, and much more. In other words, the Paleo Diet is a holistic approach to wellness, which draws upon the wisdom of our ancestors. It allows for customization, emphasizes whole foods, and encourages traditional practices, like nose to tail eating. To curb obesity, the Circulation study’s authors recommend lifestyle interventions with “dietary, behavioral, and exercise components.”6 Diets will always fail so long as they remain just diets. Only when they become lifestyles can they truly yield long-term results.

Christopher James Clark, B.B.A.

@nutrigrail
Nutritional Grail
www.ChristopherJamesClark.com

Christopher James Clark | The Paleo Diet TeamChristopher James Clark, B.B.A. is an award-winning writer, consultant, and chef with specialized knowledge in nutritional science and healing cuisine. He has a Business Administration degree from the University of Michigan and formerly worked as a revenue management analyst for a Fortune 100 company. For the past decade-plus, he has been designing menus, recipes, and food concepts for restaurants and spas, coaching private clients, teaching cooking workshops worldwide, and managing the kitchen for a renowned Greek yoga resort. Clark is the author of the critically acclaimed, award-winning book, Nutritional Grail.

REFERENCES

[1] Atallah, R, et al. Long-Term Effects of 4 Popular Diets on Weight Loss and Cardiovascular Risk Factors: A Systematic Review of Randomized Controlled Trials. Circulation: Cardiovascular Quality & Outcomes. Published online November 11, 2014, doi: 10.1161/CIRCOUTCOMES.113.000723

[2] Ibid, Atallah.

[3] Fox, M, et al. (November 12, 2014). 'Overcooked Baloney': Diets Don't Work for Long, Review Shows. NBCNews.com. Retrieved from //www.nbcnews.com/health/diet-fitness/overcooked-baloney-diets-dont-work-long-review-shows-n246331

[4] Ibid, Fox.

[5] Katz, D. Diets, Diatribes, and a Dearth of Data. Circulation: Cardiovascular Quality & Outcomes. Published online November 11, 2014. doi: 10.1161/CIRCOUTCOMES.114.001458

[6] Atallah, R, et al. Long-Term Effects of 4 Popular Diets on Weight Loss and Cardiovascular Risk Factors: A Systematic Review of Randomized Controlled Trials. Circulation: Cardiovascular Quality & Outcomes. Published online November 11, 2014, doi: 10.1161/CIRCOUTCOMES.113.000723

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