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Study: The Calories Count, Not The Diet

By Chrissie Cole

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NEJM: 2/26/09 InjuryBoard Obesity News CDC on Healthy Weight CDC on Obesity InjuryBoard on Obesity

IMAGE SOURCE: © iStockPhoto / nutrition facts / author: kledge

Dieters everywhere may take heart in the findings of a new study, which suggests it's not the type of food you put in your mouth, or the diet plan you follow, but rather the amount of food.

In the study, which included 811 obese patients, they were randomly assigned to one of four heart-healthy diets: low fat or high fat, with either average or high levels of protein.

On average, each group lost 13 pounds, in all groups, after the first year and started to slowly gain it back during the second year, bringing the average lost after two years to nine pounds.

'Overall, all the diets performed to the same extent,' said lead author Dr. Frank Sacks, professor in the department of nutrition at Harvard school of Public Health.

'One diet is no better than the next when it comes to weight loss. It doesn't matter where your calories come from, as long as you're eating less,' he said.

Reduce Calories, Lose Weight

Each diet group was adjusted to the necessary calories for each participant to reach their ideal body-mass index (BMI), which involved overall calorie restrictions.

BMI is a measure of body fat based on height and weight that applies to both men and women. Any measurement over 25 indicates the person is overweight and at a moderately increased risk of heart disease.

Along with weight loss, participatns also reduced their risk of diabetes, heart disease and improved blood pressure.

To keep participants on track, researchers used daily food reports and one-on-one and group sessions with a dietician, all which helped to keep them informed and motivated.

'Rather than switching to a completely different type of diet, you can focus more on reducing calories,' Sacks said. 'The more challenging diets were those that departed a lot from usual intake.'

For some, the challenge proved to be too difficult. Only 15 percent of the participants were successful in reducing their body weight by 10 percent after the two-year period and some gained back more weight then they initially lost, said study author, Catherin Loria, a nutritional epidemiologist at the National Heart Lung and Blood Institute.

Not everyone was impressed with the study findings.

An editorial which also appears in the NEJM, by Martijn Katan, PhD, from the Institute of Health Sciences, VU University, Amsterdam, challenges the optimistic tone of the study. He says the data suggests that failure to lose weight is a behavioral problem bolstered by the nutritional environment in the U.S.

'We need a change of paradigm; not another diet trial,' Katan said.

While the study authors agree that creating healthier food habits is an essential goal in a country where 78 million people are obese – 12.5 of which are children, according to the CDC – they disagree with Katan's statement that individual efforts at weight loss are not significant.

'The message is, people can lose a modest amount of weight and keep it off long-term, but there is no magic diet' says George A. Bray, MD, a professor of medicine at the Pennington Biomedical Research Center of the Louisiana State University and a study co-author.

The study was published in the New England Journal of Medicine and funded by the National Institutes of Health. #

Originally posted at InjuryBoard by Chrissie Cole

Full post as published by InjuryBoard on February 26, 2009 (boomark / email).