Sorry, but Low-Carb and Low Fat Diets Get Pretty Much the Same Results

Have you bought into a low-carb or low-fat diet? Which one is the better answer for people who want to lose weight? It turns out, they both work about the same. A giant new study on nutrition is the subject of this week's HCT.

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Aaron has a book out now! It’s called The Bad Food Bible: How and Why to Eat Sinfully. You can order a copy now!!!

Any local bookstore you might frequent. You can ask for the book by name or ISBN 978-0544952560

John Green -- Executive Producer
Stan Muller -- Director, Producer
Aaron Carroll -- Writer
Mark Olsen – Graphics
Meredith Danko – Social Media

And the housekeeping:

[jamesmckean]

I like this message, because after years of thinking a zero-carb keto diet is the only way, I am finally trying a conventional low-fat diet and losing weight painlessly and happily.

[tulsaTMR]

So you are telling me... if I exercise, cut out processed food, stop drinking sugary drinks, and regulate the amount of calories I put into my body.... I'll be more healthy?

[cassieoz]

Basically, an eating pattern that minimises hunger and allows you to stick to it (for life) without misery and feeling deprived, should be the goal. I followed low fat most if my life, was continuously hungry and reached 130kg. I finally sacked the dieticians and tried a ketogenic diet: I weigh 75kg for the last 4 years, no longer prediabetic or hypertensive (BP normalised within 7 days), HDL higher, Trigs much lower, LDL same. It suits ME. There's no one-size-fits-all so don't be afraid to experiment with what works for you.

[jhuger]

These studies never seem to track what's really important: Did either group show a statistically significant difference in how insufferably self-righteous they were?

[moestietabarnak]

I'd like to see study that evaluate satiety, hunger, 'energy level', craving etc.
I started Keto, and I found out that after a while I would skip meal without thinking about food and I lose 10kg in around 2 months, without EVER feeling starved or counting calorie. Now I'm starting IF and OMAD... Keto diet did prepare me better for that.

[OniAzul]

The key to weight loss is to find a diet that gets you into a negative energy balance and that you can stick with for the rest of your life.

[BullShitThat]

People!!! A Keto diet, is an EXTREMELY low-carb diet; *however* for the average person, 30% IS still consider a low-carb diet (but not Keto).

"low-carb" does NOT necessarily mean Keto

[jandeeb]

If you ask me, the keto diet is not for most people. It is just really difficult to follow and you feel exhausted. But the Agoge diet on the other hand feels great, and it works too.

[duchessconlon]

What about other measures of health besides weight loss? Like insulin sensitivity, cholesterol, thyroid function, inflammation, etc. There's little evidence to suggest that weight loss makes any difference in health outcomes in the absence of these other factors. On the other hand, there have been several studies that have shown these factors can influence health outcomes with or without weight loss. I don't think we're getting the full picture just by looking at pounds lost or gained. I would be interested to see how both diets performed on these kinds of metrics.

[fournya]

Getting 29% of your calories from fat is not a low fat diet. Typically HCLF diets keep fat as under 20% of calories, aiming ideally for 10%.

[Roll]

I think both fats and carbs are important. But that may be because avocado on a triscuit with cheddar cheese is THE BEST.

[DomSchu]

Less refined food and less calorically dense food helps you lose weight. That's all there is to it. The way you choose to do that depends on what you like and what works for you.

[matthewdockter]

I needed this information today. I didn't know I needed it, so I didn't go looking for it. However, after getting this information I realize how valuable and timely it is for me. I'm glad I subscribe. I'm writing this simply because I think that, by now, the HT staff isn't doing these videos for profit. The only other thing of value you are looking to reap may very well be the confirmation I just wrote up.

Thank You.

[GirlAcrossTheWorld]

Obviously the main difference between both of these diets and the standard American diet is the encouragement to eat more vegetables/fruits and less processed food/refined sugar/etc, and that probably gets you most of the way to a healthy diet no matter what else you consider.

But people who believe in a specific low carb or low fat diet don't just believe that you should make fat or carbs around 30% of calories. Many low fat people believe that cutting out animal products/going vegan is the most important thing and it's the types of fat that are dangerous; most low carb people believe in a diet of 5-10% carbohydrates and staying in ketosis.

In my opinion, the jury is still out until those specific claims, and not this very broad percentage based approaches, are tested.

And this study doesn't appear to have monitored any other health outcome other than weight? Which I know is what a lot of people are interested in, but it's certainly not the only marker of health.

[paulnixon]

I replaced craft beer with dry gin martinis (Bombay Sapphire to be precise) and lost over 20 pounds in a couple of months.

Of course I also eliminated everything with added sugars, white bread, most fried foods, etc. I also run at least a mile and half a day, usually more, and am on a high protein diet.

Thanks to my doctor, Nike Run + Club and MyFitnessPal by UnderArmor! But most importantly to my empty calorie, zero carbs, zero fat martinis! Stirred, never shaken 🍸

[Marco-jxrr]

I often have to argue with people of both sides. I had to learn on myself how both camps are effective but also detrimental to health on the long run for different reasons, fatty acids depletion vs thyroid and adrenals impair, etc. So as an equal macros diet such as the zone works as long as hypocaloric. Fasting works too. Combining days of low carb with days of low fat with days of equal ratio (in calories) and less energy intake, and regular fasting, this is what works at best to me. This ideological war of diets has to end!

[ExPwner]

Calorie reduction, not a crazy amount of sugar intake....surprise surprise! Weight loss!

I do agree with others saying that this isn't a great low carb comparison. I'd call that moderate carb intake.

[alias]

I mean... 30% calories from carbs in the low carb group? I usually agree with the finding - healthy living and calories are king, but that's just not fair to the low carb paradigm.
I don't care about keto btw, I would consider 20% and lower as low carb.
Maybe I'm just wrong on the definition though...

[Sandreline]

No, 30% is not keto. But he never claimed to be discussing keto. The study isn't going to work if people don't adhere to it, and they're less likely to adhere to an extreme diet like keto.

30% is still low carb. Keto isn't the only form of low carb out there.

[SomeoneBeginingWithI]

I wish there had been a control group where the participants had been given the general advice about vegetables and avoiding processed food, but no specific instructions to reduce carbohydrates or fats.