Looking for the magic weight loss bullet?  Tricks for “burning off” the fat?

Let’s face it. When it comes right down to weight loss and fat loss, it’s the calories that count.

Yet how many of us have spent years – decades even – in the quest for JUST the right trick or tweak?

Report from Two Weight Loss Studies

Two studies have been completed and reviewed within the past 2 years with similar findings.

I’ll review the details of the most recent study, which you may have seen referred to in the news over the past week.  Then, I’ll jump back to the report of another study completed prior to.

The studies are a match in their findings: when it comes to dietary analysis of what works best for weight loss, it comes right down to one thing:  dietary compliance that results in a negative energy balance (overall calorie reduction) is the deciding factor on fat loss.

It doesn’t matter which diet, it’s the reduction in calories that does it bottom line.

Study One:  New England Journal of Medicine Report  (2009)

[Ref: NEJM Vol 360:859-873  February 26, 2009  Number 9; Comparison of Weight-Loss Diets with Different Compositions of Fat, Protein, and Carbohydrates;  Frank M. Sacks, M.D., et al]

Weight-Loss Intervention

Four groups were created for purposes of this study.  Each group followed a different dietary prescription in terms of the ratio of fat, protein, and carbohydrate calories.

The nutrient goals for the four diet groups were varied in the following macronutrient breakdowns:

Group 1:  20% fat, 15% protein, and 65% carbohydrates (low-fat, average-protein);

Group 2:   20% fat, 25% protein, and 55% carbohydrates (low-fat, high-protein);

Group 3:   40% fat, 15% protein, and 45% carbohydrates (high-fat, average-protein); and

Group 4:   40% fat, 25% protein, and 35% carbohydrates (high-fat, high-protein).

Thus, two of the diets were low-fat and two were high-fat; two were average-protein and two were high-protein.

Other goals for all groups included: that

1)  the diets should include 8% or less of saturated fat,

2)  the diets should include at least 20 g of dietary fiber per day, and

3)  the diets should include 150 mg or less of cholesterol per 1000 kcal.

In addition, 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 the level of calorie intake that would sustain their current body weight. This was calculated from the person’s resting energy expenditure and activity level.

The goal for physical activity was 90 minutes of moderate exerciseper week. Participation in exercise was monitored by questionnaireand by the online self-monitoring tool.

Results

Average weight lost?  For each group, an average of 13 lbs at six months.  Not surprisingly after the six month point, diet compliance tended to waiver.

Conformity to cultural norms, scientific novelty, and media attention are nonbiologic reasons for the success of specific diets. We used a generic approach to developing each diet and the instructions for following it, in order to minimize such influences. No diet was considered to be a control diet, and the dietary counseling and the attention that we provided were the same for all diet groups throughout the study period. … results suggest that any type of diet, when taught for the purpose of weight loss with enthusiasm and persistence, can be effective. When non nutritional influences are minimized, as they were in our study, the specific macronutrient content is of minor importance, as was suggested many years ago.

Study Two: The “A-Z Diet Study”, Intl. Journal of Obesity (2008)

Quite possibly, the reference to previous studies includes that which was reported just last year by the International Journal of Obesity.

[Ref Intl J. Obesity (2008) 32, 985–991; doi:10.1038/ijo.2008.8; published online 12 February 2008]

In that study, 181 overweight/obese women averaging in the mid-forties age group participated in a one year long randomized clinical trial  referred to as the A TO Z study.

This study was designed to compare results from popular weight loss diets:  the Atkins Diet, Zone Diet, and Ornish Diet.  Subjects were tracked for diet compliance, or adherence.  Results of the A-Z Diet Study?

Regardless of assigned diet groups, 12-month weight change was greater in the most adherent compared to the least adherent tertiles. These results suggest that strategies to increase adherence may deserve more emphasis than the specific macronutrient composition of the weight loss diet itself in supporting successful weight loss.

In other words, there was NO difference in overall weight loss between these four groups that was not also specifically correlated with diet adherence.  Researchers concluded that it doesn’t matter what diet you’re on to lose weight, it’s simply sticking to a reduced calorie load that does the trick.  Whether it’s a specific diet,  Mini-Fasts, or any other strategy to influence energy balance.


Is A Calorie A Calorie?

Let’s not throw the baby out with the bathwater.

There are some food choices and dietary guidelines that can make it easier to be compliant with a calorie reduction.  It is common knowledge that highly processed carbohydrates, for example, can drive up our hunger due to insulin surges, which makes a calorie deficit more difficult to maintain.

We also know that food plans high in dietary fats can mean bodyfat gain as well as reluctance of the body to let go of fat stores.

In addition, cutting calories TOO severely week after week only rebounds in makeup eating and excess hunger.  But you may well know that from experience, just like me!

Thus, it still makes sense to pay attention to the quality, variety, and availability of food when it comes to fat loss, weight loss, or optimizing body composition.  Specialized, deeply restrictive diets with a gimmick or two are simply a way to trick us into a calorie deficit.  I remember the grapefruit and egg diet.  Sure, it worked.  Because that was all you could eat, and who doesn’t get sick of THAT after about a day and a half?!  This kind of diet brings the compliance issue quickly to a head, am I right?

Just the same, overall, it’s the calories – and not the magic of a specific dietary tactic, taboo, or secret – that  count when it comes to weight loss, fat loss, and management.  An let’s not forget that health is another matter.

If you’d like to read the abstracts/more details of these studies, here are the links:

International Journal of Obesity

New England Journal of Medicine

Looking forward to your thoughts in “comments” below.

© Lani Muelrath

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