Look past the headlines that the study, led by Tulane University's Dr. Lydia Bazzano and published this week in the Annals of Internal Medicine, has generated, and you will find that the message is not, in fact, about the importance of really cutting back on carbohydrates — it's yet another heads up to be more careful about what we're eating.
The study found that a group following a low-carb diet lost more weight — an average of 7.7 pounds worth — and their levels of HDL ("good") cholesterol had increased "significantly more" than a group following a low-fat diet over a year's time. Their triglycerides also fell sharply, and their Framingham scores, which predict how likely a patient is to have a heart attack within 10 years, also dropped.
Many see the results as an endorsement of an Atkins-like high-protein, high-fat diet, but Sharon R. Akabas, Ph.D., director of the M.S. in nutrition program at the Institute of Human Nutrition for Columbia University, said that we may be missing the point.
"The message that may be lost in translation is that eating unprocessed foods is very important," she said.
America has made a "big mistake" in making fat out to be villainous, she said, and the foods we developed in the wake of the "low-fat" craze may be low in fat but high in sugar and really low in nutrients. So while there's nothing inherently wrong with using a low-fat diet to keep your weight down, it's difficult to do without eventually eating processed foods. The reason? We've got to get our calories somehow. Low-carb diets, on the other hand, may not be as difficult to maintain; dieters may eat more fat, but if it's healthy fat – from nuts and olive oil, for example – that's OK.
"The higher-fat diet seems to allow us to select less processed foods, and that allows people to manage their weight better," Akabas said. "That ultimately affects their health in a positive way." In other words, she noted, this study reinforces what scores of previous studies have found: "People should reduce their simple sugars and processed foods while moving to a more plant-based diet."
The study took a group of 148 obese people and divided them into two groups: one that followed a traditional low-fat diet that restricted them to getting no more than 30 percent of their daily energy intake from fat, and another that followed a low-carbohydrate approach and limited participants to no more than 40 grams a day (an average diet allows for around 300 grams). The subjects ranged from 22 to 75 years old, had a body mass index of between 30 and 45 (doctors prefer it to be between 18 and 25), and had no reported history of cardiovascular problems. The diets included no specific calorie goal, and both groups were asked not to change their physical activity levels.
Cardiologist Benita Burke, M.D., medical director of Valley Medical Group's Heart Care for Women, said that the study had flaws, such as a limited scope, short timeline and a reliance on participants reporting what they ate. And while triglycerides and other inflammation markers fell among the low-carb eaters, blood pressure readings didn't, and levels of LDL cholesterol — (the "bad" cholesterol) — didn't change with either group. Larger studies with final tallies of how many patients later suffered heart attacks or strokes are necessary before a final judgment is made, she said.
The one benefit, Burke said, was the insinuation that sugar is a no-no. "It's a good thing to say, 'Keep people away from the bagels and the muffins,' because we have to stay away from them. We know it turns into sugar, and we're already on sugar overload," she said.
"It all comes back to these processed foods and these sugars … everything we eat that's 'white' should be out."
Email: janoski@northjersey.com
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