Contributor: “Dr. J”
Dr. J offers his irreverent, slightly irrelevant, but possibly useful opinions on health and fitness. A Florida surgeon and fitness freak with a black belt in karate, he runs 50 miles a week and flies a Cherokee Arrow 200.
Wanting to provide help to our dieting readers, I decided to pursue an investigation to discover the best diet to follow for weight loss. Because of the importance of avoiding a conflict of interest, I did not include my personal favorite: The Dr. J very hard diet.
The studies:
The first study I looked at was the now classic “Comparison of the Atkins, Ornish, Weight Watchers, and Zone Diets for Weight Loss and Heart Disease Risk Reduction, A Randomized Trial” published in the Journal of the American Medical Association in January, 2005.
The results of Atkins vs. Ornish vs. Weight Watchers vs. Zone:
The average weight loss at one year was 10.56 lbs for Atkins, with 53 percent completing the study, 13.2 lbs for Zone with 65 percent completing the study. 10.78 lbs for Weight Watchers with 65 percent completing the study, and 16.06 lbs for Ornish with 50 percent completing the study.
Each diet in the study modestly reduced body weight at one year. The low rate of people who stayed with their particular diet for the entire year had the greatest weight loss in each group. In my opinion, if this was a horse race, the betters would be waiting for the results of the photo to see who was the winner at the finish.
Four Diets With Different Calorie/Fat/Protein/Carb Ratios
I then looked at a study that compared the possible advantage for weight loss with plans that varied the combinations of protein, fat, and carbohydrates in the prescribed diet.
“>This research was published in the New England Journal of Medicine in February 2009.
The researchers randomly assigned 811 overweight adults to one of four diets. The calories derived from fat, protein, and carbohydrates in the four diets were 20, 15, and six percent; 20, 25, and 55 percent; 40, 15, and 45 percent; and 40, 25, and 35 percent. All the diets consisted of similar food items. In addition, the dieters were offered group and individual instructional sessions for two years.
The results:
At six months, the dieters had lost an average of 13.2 lbs, or seven percent of their initial weight. The study groups began to regain weight after 12 months. The researchers felt that each reduced calorie diet resulted in a similar weight loss regardless of which macronutrient combination was used. Seems like another photo finish to me.
Pre-Prepared and Supplied Meal Substitute Diet
Lastly, I considered two just-published clinical trials of a commercial pre-prepared and supplied meal substitute that claimed to demonstrate effective weight loss strategies for obese and overweight adults.
Researchers from the University of Pittsburgh School of Medicine, in a one-year intensive lifestyle intervention study of diet and physical activity, had 130 severely obese adult individuals follow one of two dietary plans. One group did a prescribed diet and physical activity for the entire 12 months, while the other group had the identical dietary intervention, but with physical activity delayed for six months.
“To facilitate dietary compliance and improve weight loss, liquid and pre-packaged meal replacements were provided at no cost for all but one meal per day during months one through three and for only one meal replacement per day during months four through six of the intervention,” the authors reported. In addition, small financial incentives were provided. The participants also received a combination of group, individual and telephone contacts as part of the program.
The results:
The group that started with the diet and physical activity lost more weight in the first six months than the delayed-activity group; however, the approximately 25 pound weight loss at 12 months was about the same in both groups. 78 percent completed the study.
2-Year Women’s Lifestyle Intervention Diet
In the second study, researchers from Moores UCSD Cancer Center, La Jolla, California, conducted a randomized controlled trial of weight loss and weight maintenance in 442 overweight or obese women over a two year period.
The women were divided into three intervention groups: in-person, or telephone-based weekly one-to-one weight loss counseling, including free-of-charge prepackaged prepared foods and increased physical activity for 30 minutes a day, five days a week. The participants were eventually transitioned to a meal plan. The third group was the usual care group who received two individualized weight loss counseling sessions with a dietetics professional and monthly contacts. All participants were provided a small monetary compensation ($25) for each completed clinic visit.
The results, after two years:
At 24 months, 92.1 percent had completed the study. The average weight loss for the women participating in the center-based group was about 16 pounds or 7.9 percent of their initial weight, about 14 pounds or 6.8 percent for the telephone-based group, and about 4.5 pounds for the usual care control group.
“Findings from this study suggest that this incentivized structured weight loss program with free prepared meals can effectively promote weight loss compared with usual care group,” reported the possibly incentivized researchers.
The researchers claim that lifestyle interventions, including physical activity and structured weight loss programs, can result in weight loss for overweight, obese and severely obese adults. (And it also helps if you supply free meals and pay them.)
My results:
From what I can tell, it doesn’t matter which standard, well designed, non-fad diet you pick, each one of them in these studies gives comparable results. If you comply with the diet and do the math, you will lose weight. However, the amount of weight lost was, in my opinion, not very much.
Discussion:
I am concerned with this lowering of performance standards for weight loss. Even though all of these diets claim to work, I think the results are nowhere near impressive. Most of these diets basically enabled the dieter to lose less than 10 percent of their body weight in a year, and maintain a five percent loss in two years, unless free meals were supplied, the participants were paid, and intensive support and counseling was done.
In the morbidly obese individual, going from 300 to 280 pounds is almost meaningless from a health and wellness standpoint. Except in the first study, where the term modest was used, the researchers were proclaiming the successful amount of weight loss of the participants. In some ways, I feel this is a form of denial of the real goal they claim to be advocating.
Although some people may choose to interpret these results with the “diets do not work,” mantra, I do not see it that way. Other than the last two studies where the participants were given free food and also paid to lose weight, almost 50 percent of the dieters did not maintain the dietary constraint and commitment for anywhere near the length of the studies. It isn’t that diets do not work, it’s that people will not do the work. Many of you either read websites about individuals, or are individuals who have done a much more impressive job of becoming a healthy weight. These people applied the math. They used a plan of calorie-availability versus calorie-utilization. My thanks to all of you who have proved that it can be done and for reaching out to help others in their successes.
In the end, the best diet to follow is one that you will stick with. If it is a matter of finding what works for you, it doesn‘t really matter which diet you pick, what matters is which diet you will do.
Dr. J Advises on the Best Diet to Follow for Weight Loss is a post from: CalorieLab Diet News
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