A study confirms what we pretty much already know: regardless of "diet" - it's the actual cutting of calories that aids in weight loss. In this study - the weight lost was the same for the participants on different diets. The effects of the 'diets' were also only helpful short term.
"Reduced-calorie diets result in clinically meaningful weight loss regardless of which macronutrients they emphasize."
http://content.nejm.org/cgi/content/full/360/9/859
To confuse further - everything we hear - "LOW CARB! LOW FAT! HIGH PROTEIN!" My diet's better than your diet!
What are you supposed to do? As a weight loss surgery patient, you might follow a low carbohydrate diet because your anatomy pretty much forces it on you. Particularly those with a gastric bypass - carbs can make you sick - so you learn to avoid. Also, most of us remain on a high-protein diet to aid in healing, and save muscle mass. But, the real reason WE lose truckloads of weight?
HOW MANY CALORIES DO WE EAT? Think about it. In the first year after weight loss surgery (I speak to RNY because it's what I know) 300 calories in the first few weeks, maybe? 500-1000 in the first year? That is a drastic, (insane) cut in caloric intake compared to what we were taking in to maintain 300++ lbs, right? We lose weight mostly because we are on a high-maintenance forced crash diet. It works, until we add the calories back in. Long term post ops will tell you exactly when the forced diet (lifestyle, I know) stops working. There comes a point where we might have to start cutting calories again. We might try cutting out all carbs, and that works for a time, too. (Until that piece of bread comes back to haunt us.)
"There is intense debate about what types of diet are most effectivefor treating overweight — those that emphasize protein,those that emphasize carbohydrates, or those that emphasizefat. Several trials showed that low-carbohydrate, high-proteindiets resulted in more weight loss over the course of 3 to 6months than conventional high-carbohydrate, low-fat diets but other studies did not show this effect. Asmaller group of studies that extended the follow-up to 1 yeardid not show that low-carbohydrate, high-protein diets weresuperior to high-carbohydrate, low-fat diets.In contrast, other researchers found that a very-high-carbohydrate,very-low-fat vegetarian diet was superior to a conventionalhigh-carbohydrate, low-fat diet. Among the few studiesthat extended beyond 1 year, one showed that a very-low-fatvegetarian diet was superior to a conventional low-fat diet,one showed that a low-fat diet was superior to a moderate-fatdiet,two showed that a moderate-fat, Mediterranean-stylediet was superior to a low-fat diet, one showed that alow-carbohydrate diet was superior to a low-fat diet,12andanother showed no difference between high-protein and low-proteindiets.10Small samples, underrepresentation of men, limitedgeneralizability, a lack of blinded ascertainment of the outcome,a lack of data on adherence to assigned diets, and a large lossto follow-up limit the interpretation of many weight-loss trials.27The novelty of the diet, media attention, and the enthusiasmof the researchers could affect the adherence of participantsto any type of diet. The crucial question is whether overweightpeople have a better response in the long term to diets thatemphasize a specific macronutrient composition. Thus, we recognizedthe need for a large trial that would be designed to overcomethe limitations of previous trials and that would compare theeffects of three principal dietary macronutrients. We studiedweight change over the course of 2 years, since weight losstypically is greatest 6 to 12 months after initiation of thediet, with steady regain of weight subsequently."
The nutrient goals for the four diet groups were: 20% fat, 15% protein, and 65% carbohydrates ( low-fat, average-protein ); 20% fat, 25% protein, and 55% carbohydrates ( low-fat, high-protein ); 40% fat, 15% protein, and 45% carbohydrates ( high-fat, average-protein ); and 40% fat, 25% protein, and 35% carbohydrates ( high-fat, high-protein ).
Thus, two diets were low-fat and two were high-fat, and two were average-protein and two were high-protein, constituting a two-by-two factorial design. The four diets also allowed for a dose–response test of carbohydrate intake that ranged from 35 to 65% of energy. Other goals for all groups were that the diets should include 8% or less of saturated fat, at least 20 g of dietary fiber per day, and 150 mg or less of cholesterol per 1000 kcal. Carbohydrate-rich foods with a low glycemic index were recommended in each diet. Each participant's caloric prescription represented a deficit of 750 kcal per day from baseline, as calculated from the person's resting energy expenditure and activity level.
Downloadthe Supplementary Appendix (PDF).Sacks FM et al. Comparison of Weight-Loss Diets with Different Compositions of Fat, Protein, and Carbohydrates.N Engl J Med 2009;360:859-73.
The participants diet plans are in this appendix.
Calories are calories, regardless of the source.
A study confirms what we pretty much already know: regardless of "diet" - it's the actual cutting of calories that aids in weight loss. In this study - the weight lost was the same for the participants on different diets. The effects of the 'diets' were also only helpful short term.
http://content.nejm.org/cgi/content/full/360/9/859
To confuse further - everything we hear - "LOW CARB! LOW FAT! HIGH PROTEIN!" My diet's better than your diet!
What are you supposed to do? As a weight loss surgery patient, you might follow a low carbohydrate diet because your anatomy pretty much forces it on you. Particularly those with a gastric bypass - carbs can make you sick - so you learn to avoid. Also, most of us remain on a high-protein diet to aid in healing, and save muscle mass. But, the real reason WE lose truckloads of weight?
HOW MANY CALORIES DO WE EAT? Think about it. In the first year after weight loss surgery (I speak to RNY because it's what I know) 300 calories in the first few weeks, maybe? 500-1000 in the first year? That is a drastic, (insane) cut in caloric intake compared to what we were taking in to maintain 300++ lbs, right? We lose weight mostly because we are on a high-maintenance forced crash diet. It works, until we add the calories back in. Long term post ops will tell you exactly when the forced diet (lifestyle, I know) stops working. There comes a point where we might have to start cutting calories again. We might try cutting out all carbs, and that works for a time, too. (Until that piece of bread comes back to haunt us.)
Thus, two diets were low-fat and two were high-fat, and two were average-protein and two were high-protein, constituting a two-by-two factorial design. The four diets also allowed for a dose–response test of carbohydrate intake that ranged from 35 to 65% of energy. Other goals for all groups were that the diets should include 8% or less of saturated fat, at least 20 g of dietary fiber per day, and 150 mg or less of cholesterol per 1000 kcal. Carbohydrate-rich foods with a low glycemic index were recommended in each diet. Each participant's caloric prescription represented a deficit of 750 kcal per day from baseline, as calculated from the person's resting energy expenditure and activity level.
The participants diet plans are in this appendix.