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Higher-protein, lower-carbohydrate diets win in the war on weight

Posted Nov 26 2010 7:53am

The big diet news of the week surely has to be the publication of a study in the New England Journal of Medicine comparing the effect of different types of diet on weight regain [1]. In this study, 938 ‘obese’ (average body mass index – 34) adults (average age – 41) were put on an 800 calorie-a-day diet. Participants lost an average of about 11 kg (24 lbs) on this quite unsustainable regime.

However, the truly interesting part of this study concerned what happened next. Each of the study participants was randomised to eat one of five diets. These were:

1.     a relatively high-protein, low-glycaemic index (GI) diet

2.     a relatively high-protein, high-GI diet

3.     a relatively low-protein, low-GI diet

4.     a relatively low-protein, high-GI diet

5.     a ‘control’ diet

For each of the diet, individuals could eat as much as they like.  This phase of the study lasted 6months.

Here’s a summary of what they found:

In terms of weight regain: individuals who ate the high-protein, low-GI diet did the best, and those who ate the low-protein, high-GI diet did the worst.

The message? If you want to manage your weight without starving yourself, a relatively protein-rich diet is a good starting point, and so is one that avoids blood sugar disruptive (high-GI) foods.

I am gratified to say that this study has had a lot of press. And that’s a good thing, because it has led to people thinking less about calorific intakes, and much more about the macronutrient content of the diet as a means to healthy weight management.

I don’t want to be a killjoy, but I’d also like to add that the results of this study were quite predictable on the basis that previous research has found higher protein intakes are more satisfying, while diets of high-GI tend to be less satisfying, even for a given number of calories.

This helps to explain why individuals who adopt lower-carbohydrate approaches (generally low-GI and usually quite-rich in protein) find they’re less hungry, and eat less as a result. Never mind that – having worked with literally thousands of real people over 20 years I have become convinced that this way of eating really does, overall, trump others (e.g. low-calorie, low-fat) in terms of sustainable weight loss. And this is why it forms the basis of the advice I offered in my latest book Waist Disposal .

I have seen countless individuals get on and off ‘diets’ and therefore suffer cycles of weight loss and weight gain. What is it that causes individuals to default back to their original diet? Lots of things, but one factor that almost always plays a part is hunger. It’s a plain and simple fact that unless forced, individuals tend not to tolerate hunger at all well in the long term. And that’s particularly the case where food is often tempting, visible and readily available.

One of the keys to successful weight loss and then maintenance of that loss is not to allow oneself to get too hungry. You see, once someone gets very hungry, it becomes difficult to eat healthily. Hunger tends to cause individuals to want to eat, say, starchy carbohydrates (like bread) that can be fat-forming through their effect on hormones (principally insulin), and are not particularly satisfying anyway.

Not being very hungry makes it generally easy for individuals to eat nutritious, satisfying foods that assist weight loss through moderation of the hormone insulin. Read the reviews of Waist Disposal here and you’ll see a common theme is hugely significant weight loss without hunger or portion control. It is this fundamental feature of any regime that makes it truly sustainable. Here’s an example in the form of a review from 12th November:

This isn’t a diet it’s a lifestyle!!,

Nine years ago I bought a dress which was the perfect dress. There was just one thing wrong with it — it didn’t fit! But I always said that I would get into it one day and that day came last week thanks to the Waist Disposal regime and I’m thrilled. This is the easiest diet I have ever been on — I don’t feel hungry, I know exactly what I can eat and it works. And there’s no guilt so if I find myself at a dinner party or an event where it would impolite to be picky it’s not the end of the world if I have the odd potato or piece of bread cause I know it’s not going to be a permanent situation. So thank you John — I just wish you had written this book sooner!!

A couple of weeks ago I had an email from someone who has lost more than 50 kg (yes, kilograms, not pounds) over several months eating more-or-less as advised in Waist Disposal. I replied offering my congratulations but adding that that I hoped he was not starving himself and doing things sustainably. His reply was that he thought he was probably eating more than before.

I have a bit of refrain when advising individuals about weight loss which is designed to be an antidote to the calorie principle-driven advice that is commonly invoked (and rarely works). It is this: “In the long term, the less hungry you are, the more weight you’ll lose.”

Regular meals and the odd healthy snack is a good starting point here. But, in terms of what to eat, I’d go with what science and experience tells us works: a diet relatively rich in protein and low in carb.

After a few weeks on such a diet I might have occasion to ask an individual this question: “Can you imagine eating like this for the rest of your life?” Almost always, the answer is an unhesitant ‘yes’. This response is, in my opinion, a pretty sure sign that sustained healthy eating is not going to be problem for this individual in the long term.

References:

1. Meinert Larsen T, et al. Diets with High or Low Protein Content and Glycemic Index for Weight-Loss Maintenance. N Engl J Med 2010; 363:2102-2113

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