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by octamer 2712 days ago
Interesting review (that first graph in particular is definitely non-obvious to me), but under the diet section I think it understates the current body of research regarding low-carb/keto diets - some studies have begun to show energy expenditure[1] and insulin[2] benefits that uniquely exist with low-carb. I think we'll find out soon enough that a lower-carb approach, given the current American diet, does definitively perform better than other dieting approaches on average.

[1] https://www.bmj.com/content/363/bmj.k4583

[2] http://annals.org/aim/article-abstract/718265/effect-low-car...

3 comments

First study:

>"During the test phase, high, moderate, and low carbohydrate diets varied in carbohydrate (60%, 40%, and 20% of total energy, respectively[...]We randomly assigned participants who achieved the target weight loss to high, moderate, or low carbohydrate test diets for a 20 week test phase.)"

Second study:

>"14 days of a low-carbohydrate diet (21 g of carbohydrates per day)"

So the first study went for 5 months but didn't include an actual low-carb diet:

  100 g -> ~400 cal -> ~20% of 2k cal/day
The second study only went for 2 weeks but did include a low carb diet:

  21g -> ~84 cal -> ~4% of 2k cal/day
Now someone just needs to combine these methods into one valid study.
Those are both very short term studies. The only critical factor in weight loss is how much people weigh in the long term as in 5+ years.

“20% of overweight individuals are successful at long-term weight loss when defined as losing at least 10% of initial body weight and maintaining the loss for at least 1 y.” Things get much worse in terms of 5+ year weight loss.

I'll just say that American culture in general makes it extremely difficult to stick to a healthy and disciplined lifestyle, no matter the specific diet. In keto communities I see people who have met lots of success but find it rough being bombarded by family, friends, and dining out options in general all going against their way of eating.

It's getting better, with restaurants especially. But it's still a large hurdle to any diet and/or healthy lifestyle. I'm sure it's better in some areas of the country than others.

I find that I do okay (with keto) at most restaurants, usually have to modify a meal, but can usually find something.

The vegetarian centered places tend to be much harder for me. I'm allergic to legumes, cranberries and blueberries, and just don't do well with grains anymore.

Last week, I had a cheat day with out of town friends and I'm still recovering from it. It's actually worse than the keto flu when starting out on keto in the first place, followed by increased hunger after eating carb heavy one day.

It is a problem in India too. Moreover people here consider being overweight to be healthy and equate being lean to being malnourished!
Agreed... I will personally say that it's far easier for me to eat very low carb or keto most days than other diets... I'm usually 1-2 meals a day, under 50g total carbs and under 20g net carbs. Getting used to not eating/snacking helps a lot, but I do notice when I have sweetened drinks between meals or dairy I don't lose as well.
I imagine very few people stick to a diet for 5 years, partly because they're not fun, and partly because many are unhealthy when done long term. Also, many health professionals recommended a max of 500 calorie deficit, which would mean ~50 pounds of weight loss in a year.

When would you need to follow a diet for 5 years if most people can reach their goal weight in 1-2 years? Once people reach their goal weight, they'll transition off to something else, which usually isn't a specific diet, but "eat more veggies" or whatever.

Given that long term diets are quite niche, I think limiting the study to 1 year makes a lot of sense.

Fat burns calories.

Generally, to maintain X pounds of weight loss you must consume ~10X fewer calories every day. In order to more quickly reach a new weight most people exceed that difference, but they can’t go back to old eating habits without regaining their original weight.

PS: Metabolism and exercise have real impact, but you can easily out eat any reasonable exercise plan.

  Fat burns calories.
Only brown fat (BAT) does, and humans have very little.
All cells require energy to survive.

On top of that strapping an extra 10+ pounds to your body and walking around would require extra energy for the same movements.

I lost 20% of my wheight with this diet (under 20g carbs daily), in 1 year. my fat ratio was too high, now it's good. I would never eat carbs again... Benefits are really great: mood, energy (no peak or bottom), clear mind (no dizzy when hungry or full), actually never hungry (my stomach never scream), full very fast (fat will make you full fast).

Yes sometimes i would like to eat a cake. I did it once. there was too much sugar, and it made me sick off it, i'm vaccinated!

“made me sick”

Convincing myself a particular food is disgusting has been an effective way to cut it from my diet.

Started with donuts. Horrible greasy dough blobs, dripping with artificially colored sticky, bug-collecting sugar slime. Blehhhh. (Unless it’s hot out of the fat at Bob’s or Leonard’s, then it’s something completely different.)

Next up was fries/chips. Horrid frozen potatoes coated in preservatives, sugar and salt, then boiled in rancid grease. (Unless it’s the Anstruther or Fochabers chipper, local potatoes, barely fried, mashed potato insides.)

Sweetened drinks are on the block now. May as well inject that lab-made carb goo straight into my pancreas, let those guys fight it out.

Fruit juices have been tough. I’ve been doing a trick I saw in Zurich, which is serve the only the best, fresh squeezed juice, but in a shot glass.

Damn though, I like a bowl of cereal (unsweetened, whole grain) at midnight. Will back it off to a small glass.

I watched an ancient Tony Robbins video where a member of the audience came up and said his biggest food issue was pizza. Robbins spent 7 minutes getting him to reimagine pizza as a digusting, mold-covered triangle.

I don't think that strategy would work for me. I understand trying to reframe things in a different way, but come on, unless they find a way to make pizza smell bad, I'm never going to believe it's a "disgusting" food I should avoid. It's just an unhealthy, carb-loaded food that's easy to binge on.