Jan 27, 2015
A study examined this very question as it relates to long-term heart health. In a large study from Tulane University, Kaiser Permanente, and Johns Hopkins School of Public Health, 148 people without heart disease were recruited to participate in either a low fat or low carb diet to see if choice of diet reduced heart disease risk. These patients met individually with a dietitian weekly for the first four weeks and then in small group meetings every other week for the next five months. Then they participated in monthly sessions for six more months. The intensity of diet training highlights the challenges of staying on a diet long-term, and how working with others and as a team often helps you make it and stay compliant. In this study, a low-carb diet was defined as one with fewer than 40 carbohydrate grams per day. When calculating your carbohydrate consumption, you need to take your total carbohydrates and subtract those carbs you’re getting from fiber. The low-fat diet was defined as having fewer than 30 percent of daily calories from total fat (with less than 7 percent from saturated fat) and 55 percent from carbohydrates. A diet is no easy matter and takes preparation. You have to be organized and create food lists, learn to read nutritional panels, make detailed shopping lists, take time to cook, and create a diverse menu. Getting some of this type of information is one of the greatest benefits of meeting with a dietitian who can help you plan your diet and with subsequent meetings help you stay on track. In this study, a handbook that contained this kind of information was given to all participants. The results of maintaining a diet were profound. At one year, participants had lost an average of 8 pounds.
In the low-fat group, the average weight loss was 4 pounds. In the low-carb group, the average weight loss was much greater, at nearly 12 pounds. Regarding waist circumference, the low-fat group’s average loss was 5.0 centimeters (about 2 inches) whereas the loss in the low-carb group was greater, at 6.7 centimeters (over 2.5 inches). In addition, for people in the low-carb diet group, the amount of body weight from lean mass compared to fat mass improved. In the low-fat diet group, these changes were not observed. Markers of heart health, like cholesterol and blood pressure, also changed. In both groups there was a decrease in cholesterol and blood pressure. Blood sugar levels were lower in the low-fat group, whereas body inflammation markers were lower in the low-carb group. In both groups, nearly all patients stayed on their diet for the year. In both groups, the level of physical activity was similar, so this really became a study of diets, not exercise. What the authors found was that the low-fat diet, although helpful in weight loss, did not reduce risk of heart disease. In contrast, with the low-carb diet, the 10-year risk of heart disease was reduced by 1.4 percent on average. This number may not seem that high, but in a 30-year-old person who could live another 40 to 50 years, the cumulative effects of diet choice can be seen, with risk reductions ranging from 4 percent to 10 percent.
A low-carb diet is better than a low-fat diet, if you want to lose more weight and reduce your waist circumference.
If you have heart disease in your family, a low-carb diet is likely a better choice as it can reduce risk over time. The low-fat diets alone do not appear to reduce risk.
If you have elevated markers of inflammation in your blood tests, diet choice may help reduce these.
Finally, maintaining a diet is hard and takes a lot of work and frequent follow-up