Which diet is the most effective for weight loss?
could be a historic day in Sweden. Today it became official. After over
two years of work, a Swedish expert committee published their expert
inquiry Dietary Treatment for Obesity (Google translated from Swedish).
This report from SBU (Swedish Council on Health Technology Assessment) is likely to be the basis for future dietary guidelines for obesity treatment within the Swedish health care system.
The health care system has for a long time given general advice to avoid fat and calories. A low-carbohydrate diet (such as LCHF) has often been dismissed as a fad diet lacking scientific foundation. The time has now come to update knowledge in this area.
to SBU, the only clear difference among different dietary
recommendations is seen during the first six months. Here a
low-carbohydrate diet, such as LCHF, is clearly more effective than today’s conventional advice.
From fad diet to best in test.
Here are some more highlights from the report:
Health MarkersIn addition, health markers will improve on a low-carbohydrate diet, according to SBU. You’ll get:
greater increase in HDL cholesterol (“the good cholesterol”) without
having any adverse affects on LDL cholesterol (“the bad cholesterol”).
This applies to both the moderate low-carbohydrate intake of less than
40 percent of the total energy intake, as well as to the stricter
low-carbohydrate diet, where carbohydrate intake is less than 20 percent
of the total energy intake. In addition, the stricter low-carbohydrate
diet will lead to improved glucose levels for individuals with obesity
and diabetes, and to marginally decreased levels of triglycerides.
all important health markers improved or unchanged on a stricter
low-carbohydrate diet. Just like an international review of all research
in the area showed last year:
Systematic review and meta-analysis of clinical trials of the effects of low carbohydrate diets on cardiovascular risk factors
term, studies show no statistically significant differences among
different diets, and the differences decrease with time. The SBU
suggests that this is because of decreasing compliance with time. People
simply tend to fall back to old habits.
The more studies we add,
the better we can see the clear advantage of low-carbohydrate diets.
Unfortunately SBU has excluded all studies examining both obese and
overweight people. If you include studies on weight loss where
overweight people are included – to get a greater scientific basis – a
clear advantage for the low-carbohydrate diet was seen even after a
New Analysis: LCHF Best For Long-Term Weight and Health Markers
well-designed study, which for the same reason as above, was dropped
from the SBU report’s analysis, still showed a persistent advantage for
the LCHF-like diet (Atkins) after two years, despite the difficulty with
such long-term diet studies.
For the long-term effect, if you keep to a strict low-carbohydrate diet, there are only anecdotal reports on weight and cholesterol levels.
Physical ActivitySBU also kills the idea that exercise plays an important roll in weight loss. Exercise may be very good for health, but:
SystematicThe effect of exercise on weight in studies is in other words marginal or non-existent. Just like you read about here.
reviews of the literature show that the addition of physical activity
to a dietary intervention for individuals with obesity have, if any, a
marginal effect on weight loss at the group level.
Warnings Against LCHF DismissedThere’s a great lack of knowledge today on what dietary guidelines are best for long-term health. We simply don’t know.
cautions on low-carbohydrate diets are at best based on statistical
associations derived from food questionnaires from people who didn’t (!)
eat a low-carbohydrate diet. The SBU also dismisses these warnings:
of these studies suffer from major shortcomings, which make them
difficult to interpret. The foremost shortcoming in these studies is
that it’s often impossible to determine whether those with the lowest
intake are knowingly eating a moderate low-carbohydrate diet for health
reasons, or if they are high consumers of fast-food.
breakdown of carbohydrates, fat and protein, which in such studies are
imaginatively labeled “a low-carbohydrate diet” is usually very similar
to the macronutrient distribution in a hamburger with fries and soda…
Towards the FutureWhat will be the consequences of today’s report?
on a low-carbohydrate diet is however very rare, if we look at the
practice survey. It’s not clear how common it is to actively discourage
patients from the strict low-carbohydrate diet. A low-carbohydrate diet,
even the stricter form, will lead to a greater weight loss in the short
term than the low-fat diet, and studies have indicated no adverse
effects on blood lipids, provided that the weight stays low. One
possible consequence of this report will therefore be an increased use
of a strict low-carbohydrate diet for short-term weight reduction.
will always express itself very carefully. But it can’t be said much
clearer: It’s high time for the health care system to take seriously
advice on LCHF for weight loss!
This is also interesting:
not possible to draw any conclusions about the relationship between a
low-carbohydrate diet – regardless of fat content – and cardiovascular
disease. Here we could apply the precautionary principle, and advise
some restraint on saturated fat intake, as long as the documentation of
the long-term effects are inadequate.
care workers will no doubt (without any better reasons than
preconceptions) be wary of dietary advice on more saturated fat. I was
once scared of saturated fat myself.
I think that SBU is keeping a
reasonable attitude here, as it isn’t even necessary to give advice on a
lot of saturated fat for a low-carbohydrate diet. You can eat even a
strict low-carbohydrate diet (such as LCHF) emphasizing unsaturated fats. This has been shown to be effective in studies:
- Spanish Ketogenic Mediterranean diet: a healthy cardiovascular diet for weight loss
- New York Times: Adding a Big Dash of ‘Health’ to Low-Carbohydrate Diets
- Science Daily: ‘Eco-Atkins’: Plant-based, Low-carb Diet May Promote Weight Loss And Improve Cholesterol Levels
would be wonderful if the health care system started to apply the
benefits of a low-carbohydrate diet, even before the outdated fear of
butter has melted away everywhere.
The SBU-report Dietary
Treatment for Obesity is a gigantic step towards more effective dietary
guidelines within the health care system. This is a historic day in
Media CoverageToday’s big news created quite a media frenzy in Sweden, here Google translated from Swedish:
- SvD: “The last fears swept aside”
- Expressen: Fatty Foods Best For Rapid Weight Loss
- Today’s Medicine: Fewer Carbohydrates For Quick Weight Loss
- SVT: LCHF Best For Rapid Weight Loss
- DN: A Low-Carbohydrate Diet Effective Against Obesity
- New Report Concludes the Best Dietary Advice
MoreLCHF for Beginners
Just a few examples of that today’s news could mean for more and more people: