Diet and nutritionForty Years of Low-Fat Diets — The Biggest Dietary Mistake?
Sources: 14 · Article: 20 622 characters
The Rodzeń brothers and Prof. David Ludwig report that low-fat diets often produced worse results than diets with more fat.
- The Rodzeń brothers consider the basis for limiting fat, especially saturated fat, to be weak.
- Prof. David Ludwig cautions that not every low-fat diet has to be bad for body weight.
- The Rodzeń brothers also point out that in one two-year study, the group eating a low-carbohydrate diet to fullness lost the most weight.
What the authors write
Bracia Rodzeń
Advice that allowed people to eat fat until full was associated with greater weight loss.
„This should lead us, as physicians, to question the common belief that a low-fat diet is appropriate for most people. In fact, the meta-analyses mentioned above show that people tend to lose much more weight when they receive dietary advice that allows them to eat fat until they feel full.”To powinno skłonić nas, lekarzy, do zakwestionowania powszechnego przekonania, że dieta niskotłuszczowa jest odpowiednia dla większości ludzi. W rzeczywistości wspomniane powyżej metaanalizy pokazują, że ludzie mają tendencję do znacznie większej utraty masy ciała, gdy otrzymują porady dietetyczne, które dopuszczają spożywanie tłuszczu w celu osiągnięcia sytości.
Bracia Rodzeń
In a two-year study, the low-carbohydrate group lost the most weight, even though they could eat until full.
„This was a two-year study in which 322 people were randomly assigned to follow a Mediterranean diet, a low-fat diet, or a low-carbohydrate diet. By the end of the study, the low-carbohydrate group had lost the most weight, even though they were allowed to eat as much low-carbohydrate food as they needed to feel full; the other two groups followed calorie-restricted diets.”Było to dwuletnie badanie, w którym 322 osoby losowo przydzielono do stosowania diety śródziemnomorskiej, diety niskotłuszczowej lub diety niskowęglowodanowej. Pod koniec badania, grupa niskowęglowodanowa straciła najwięcej na wadze, mimo iż pozwolono im jeść tyle pokarmu niskowęglowodanowego, ile potrzebowali, aby czuć się najedzonymi; pozostałe dwie grupy stosowały diety o ograniczonej kaloryczności.
Bracia Rodzeń
The meta-analyses described by the Rodzeń brothers indicate that low-carbohydrate diets usually led to greater weight loss than other diets, including low-fat diets.
„A series of meta-analyses of randomized controlled trials (RCTs), considered the strongest and most reliable evidence, reached the same conclusion: low-carbohydrate diets usually outperform other diets for weight loss for up to two years.”Szereg metaanaliz przeprowadzonych w randomizowanych badaniach kontrolowanych (RCT), uważanych za najsilniejsze i najbardziej wiarygodne dowody, doprowadziło do tego samego wniosku: diety niskowęglowodanowe zwykle przewyższają inne diety w zakresie utraty wagi przez okres do dwóch lat.
Bracia Rodzeń
The research summary described by the Rodzeń brothers found no evidence that a low-fat diet helps people lose more weight than other dietary advice.
„The conclusion? There is no evidence that a low-fat diet helps people lose weight compared with other dietary advice.”Konkluzja? Nie ma dowodów na to, że dieta niskotłuszczowa pomaga ludziom schudnąć w porównaniu z innymi zaleceniami dietetycznymi.
Bracia Rodzeń
In a one-year study, the low-carbohydrate group lost 3.5 kg more than the low-fat group and improved several heart disease risk factors.
„In addition to losing 3.5 kg more than the low-fat group, the low-carbohydrate group also had greater improvements in high-density lipoprotein (HDL) cholesterol, triglycerides (TG), and other cardiovascular disease risk factors.
LINK – takes you to the source
A comparison of the Atkins, Zone, Ornish, and LEARN diets for changes in weight and related risk factors among overweight premenopausal women.”Oprócz utraty 3,5 kg więcej niż grupa o niskiej zawartości tłuszczu, grupa niskowęglowodanowa miała również większą poprawę w zakresie cholesterolu o wysokiej gęstości (HDL), trójglicerydów (TG) i innych czynników ryzyka chorób układu krążenia.
LINK – przenosi do źródła
Porównanie diet Atkins, Zone, Ornish i LEARN pod kątem zmiany wagi i powiązanych czynników ryzyka u kobiet przed menopauzą z nadwagą.
Bracia Rodzeń
Reviews of studies described by the Rodzeń brothers found no evidence that reducing saturated fat benefits heart disease or mortality.
„The latest meta-analyses of randomized and observational studies found no benefit from reducing saturated fatty acid (SFA) intake for cardiovascular disease (CVD) or all-cause mortality; instead, they found a protective effect against stroke.”W najnowszych metaanalizach badań z randomizacją i badań obserwacyjnych nie stwierdzono korzystnego wpływu zmniejszenia spożycia SFA na choroby układu krążenia (CVD) i całkowitą śmiertelność, a zamiast tego stwierdzono działanie ochronne przed udarem.
Bracia Rodzeń
The Rodzeń brothers conclude that recommendations to avoid fats, especially saturated fats, have a weak scientific basis.
„LINK – takes you to the source
“Our data suggest that low-fat diets expose the population to an increased risk of cardiovascular disease.” – Dr Andrew Mente.
The evidence above suggests that dietary recommendations to avoid fats in general, and saturated fats in particular, are based on very weak scientific evidence.”LINK – przenosi do źródła
Nasze dane sugerują, że diety niskotłuszczowe narażają populację na zwiększone ryzyko chorób sercowo-naczyniowych. – Dr Andrew Mente.
Powyższe dowody wskazują, że zalecenia dietetyczne dotyczące ogólnie unikania tłuszczów,a w szczególności tłuszczów nasyconych, są oparte na bardzo słabych podstawach naukowych.
Bracia Rodzeń
The Rodzeń brothers state that low-fat diets that lower cholesterol do not reduce cardiovascular events or mortality.
„LINK – takes you to the source
The weight of evidence indicates that low-fat diets that lower serum cholesterol do not reduce cardiovascular events or mortality. In particular, replacing saturated fats with polyunsaturated fats does not convincingly reduce cardiovascular events or mortality.”LINK – przenosi do źródła
Przeważająca liczba dowodów wskazuje na to, że diety niskotłuszczowe, które obniżają poziom cholesterolu w surowicy, nie zmniejszają zdarzeń sercowo-naczyniowych ani śmiertelności. W szczególności zastępując tłuszcze nasycone tłuszczami wielonienasyconymi nie zmniejszają w przekonujący sposób zdarzeń sercowo-naczyniowych ani śmiertelności.
Bracia Rodzeń
The Rodzeń brothers cite an observation in which higher fat intake was associated with longer life, while higher carbohydrate intake was associated with earlier death.
„Scientists found that people who ate the most carbohydrates died earlier. On the other hand, higher fat intake was associated with greater longevity, whether the fat was unsaturated or saturated.
The Lancet 2017: Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries across five continents (PURE): a prospective cohort study.”Naukowcy odkryli, że osoby, które zjadły najwięcej węglowodanów, zmarły wcześniej. Z drugiej strony, większe spożycie tłuszczu wiązało się z dłuższą żywotnością, niezależnie od tego, czy był to tłuszcz nienasycony, czy nasycony.
The Lancet 2017: Związki spożycia tłuszczów i węglowodanów z chorobami układu krążenia i śmiertelnością w 18 krajach na pięciu kontynentach (PURE): prospektywne badanie kohortowe.
Bracia Rodzeń
The Rodzeń brothers describe a call to reconsider saturated fat limits because there is no strong evidence of their benefits.
„The scientists argue that “there is no strong scientific evidence that current population-wide upper limits on commonly consumed saturated fats will prevent cardiovascular disease or reduce mortality. They add that maintaining a limit on these fats is not justified.””Naukowcy argumentują, że „nie ma mocnych dowodów naukowych na to, że obecne dla całej populacji górne limity powszechnie spożywanych tłuszczów nasyconych zapobiegną chorobom sercowo-naczyniowym, lub zmniejszą śmiertelność. Dodają, że ciągły limit tych tłuszczów nie jest uzasadniony.”
Bracia Rodzeń
The Rodzeń brothers repeat that there is no strong evidence that limits on saturated fat prevent heart disease or reduce mortality.
„The scientists argue that “there is no strong scientific evidence that current population-wide upper limits on commonly consumed saturated fats will prevent cardiovascular disease or reduce mortality. They add that maintaining a limit on these fats is not justified.””Naukowcy argumentują, że „nie ma mocnych dowodów naukowych na to, że obecne dla całej populacji górne limity powszechnie spożywanych tłuszczów nasyconych zapobiegną chorobom sercowo-naczyniowym, lub zmniejszą śmiertelność. Dodają, że ciągły limit tych tłuszczów nie jest uzasadniony.”
prof. David Ludwig
Prof. David Ludwig reports that reviews of studies usually find less weight loss with low-fat diets than with diets containing more fat.
„Systematic reviews consistently report LESS weight loss on conventional low-fat diets compared with all higher-fat diets, low-carbohydrate diets, very-low-carbohydrate diets, or Mediterranean diets. High-fat, calorie-dense foods like nuts, olive oil, and dark chocolate are not associated with weight gain in the best observational research, whereas processed carbohydrates top the list.”Systematic reviews consistently report LESS weight loss on conventional low-fat diets compared to all higher-fat diets, low-carbohydrate diets, very-low-carbohydrate diets, or Mediterranean diets. High fat and calorie dense foods like nuts, olive oil and dark chocolate are not associated with weight gain in the best observational research, whereas processed carbohydrates top the list.
prof. David Ludwig
In the WHI study, the low-fat group lost little weight, and by the end of the study the difference from the control group was one pound; there was also no reduction in cancer, diabetes, or heart disease.
„Women in the low-fat group lost a maximum of only 5 pounds compared with the control group, and this small difference decreased to 1 pound by the end of the study. Furthermore, there was no reduction in rates of cancer, diabetes, or heart disease. From any perspective, this was a resounding failure for the low-fat diet.”Women in the low-fat group lost a maximum of only 5 pounds compared to the control group, and this small difference decreased to 1 pound by the end of the study. Furthermore, there was no reduction in rates of cancer, diabetes, or heart disease. From any perspective, this was a resounding failure for the low-fat diet.
prof. David Ludwig
Prof. David Ludwig notes that not all low-fat diets have to be bad for body weight.
„(Ludwig does not rule out red meat as a healthy option, but he also encourages alternatives such as chicken, fish, and soy products.)
Ludwig acknowledges that not all low-fat diets are necessarily bad for body weight. But as fat intake decreases, he argues, it becomes increasingly difficult to avoid overeating grains.”(Ludwig does not exclude red meat as a healthy option, but he also encourages alternatives such as chicken, fish, and soy products.)
Ludwig acknowledges that all low-fat diets aren’t necessarily bad for body weight. But as fat intake decreases, he argues, it becomes increasingly difficult to avoid overeating grains.
prof. David Ludwig
Prof. David Ludwig says that reducing fat can make it harder to avoid overeating grains and recommends replacing refined carbohydrates with healthy fats.
„But as fat intake decreases, he argues, it becomes increasingly difficult to avoid overeating grains. He notes that even whole grains can cause a spike in blood sugar if they are heavily processed, because certain processing techniques disrupt fiber’s natural ability to lower blood sugar. (They can also degrade healthy natural antioxidants.) He therefore recommends replacing refined carbohydrates with healthy fats (such as nuts, avocado, and olive oil) as a more practical and effective solution for most people.”But as fat intake decreases, he argues, it becomes increasingly difficult to avoid overeating grains. He notes that even whole grains can cause a spike in the level of blood sugar if heavily processed, because certain processing techniques disrupt the fiber’s natural ability to lower blood-sugar concentration. (They can degrade healthy natural antioxidants as well.) He therefore recommends replacing refined carbohydrates with healthy fats (such as nuts, avocado, and olive oil) as a more practical and effective solution for most people.
prof. David Ludwig
Prof. David Ludwig notes that in the Look Ahead study, a low-fat diet did not show promise for reducing cardiovascular disease, while higher-fat diets in another study were associated with substantial protection.
„Of particular interest, the Look Ahead study was terminated prematurely for “futility” when its low-fat diet showed no promise of ever reducing cardiovascular disease. Compare that result with Predimed, a study that also ended early, but in this case because the higher-fat diets demonstrated unexpectedly great protection against cardiovascular disease.”Of particular interest, the Look Ahead study was terminated prematurely for “futility” when its low-fat diet showed no promise of ever reducing cardiovascular disease. Compare that result to Predimed, a study that also closed early, but in this case because the higher-fat diets demonstrated unexpectedly great protection again cardiovascular disease.
prof. David Ludwig
Prof. David Ludwig describes how obesity increased as fat intake fell to the level recommended by the government, though he does not present this as proof of a causal link.
„Today, fat intake approaches the government-recommended limit of 30 percent, but rates of obesity have skyrocketed. These opposite trends are probably not coincidental.
With enthusiasm for the low-fat diet reaching a crescendo in the 1990s, the government launched the world’s largest clinical diet trial as part of the Women’s Health Initiative (WHI).”Today, fat intake approaches the government-recommended limit of 30 percent, but rates of obesity have skyrocketed. These opposite trends are probably not coincidental.
With enthusiasm for the low-fat diet reaching a crescendo in the 1990s, the government launched the world’s largest clinical diet trial as part of the Women’s Health Initiative (WHI).
Research from PubMed · Europe PMC
We selected 6 studies with the best, positive results. This is a selection, not a full review of all research.
Total number of studies on this topic in PubMed: 1 690.
A review indicates that reducing saturated fat may bring cardiovascular benefits, especially for people at high risk and when it is replaced with polyunsaturated fats.
Aim of the study: Debates about optimal advice on saturated fat continue. This study aimed to systematically summarize randomized trial data on the effects of reducing or modifying saturated fat intake on cholesterol, mortality, and major cardiovascular events.
Results: For people at low cardiovascular risk, reducing or modifying saturated fat intake has little or no benefit over a period of 5 years. Among people at high cardiovascular risk, evidence of low to moderate certainty showed important reductions in mortality and major cardiovascular events, particularly myocardial infarction (MI), when saturated fat was replaced with polyunsaturated fat.
Money for the studynot stated
Do the authors have ties to companies?not stated
Did a manufacturer help with the study?unknown
Type of studyreview of many studies
“Not stated” does not mean nobody paid — the database does not always record it.
A review of the evidence indicates that replacing saturated fat with polyunsaturated vegetable fats reduced the risk of cardiovascular disease.
Aim of the study: Cardiovascular disease (CVD) is the leading global cause of death, accounting for 17.3 million deaths per year. Preventive treatment that reduces CVD by even a small percentage can substantially reduce, nationally and globally, the number of people who develop CVD and the cost of caring for them.
Results: In contrast, replacing saturated fat with mostly refined carbohydrates and sugars is not associated with lower rates of CVD and did not reduce CVD in clinical trials. Replacing saturated with unsaturated fats lowers low-density lipoprotein cholesterol, a cause of atherosclerosis, linking biological evidence with CVD rates in populations and clinical trials. Taking the totality of the scientific evidence into consideration and applying rigorous criteria for causality, we conclude with confidence that lowering saturated fat intake and replacing it with unsaturated fats, especially polyunsaturated fats, will lower the incidence of CVD.
Money for the studynot stated
Do the authors have ties to companies?not stated
Did a manufacturer help with the study?unknown
Type of studydiscussion of other studies
“Not stated” does not mean nobody paid — the database does not always record it.
A meta-analysis found that a low-fat diet was associated with weight loss compared with a standard lipid-lowering diet.
Aim of the study: Eating patterns have a significant impact on the weight loss process. This study aimed to investigate the influence of primary eating patterns on weight loss in overweight and obese adults using a network meta-analysis.
Results: Initial literature searches yielded 1574 citations. Ultimately, 1004 participants from 7 RCTs (or 9 trials) met the inclusion criteria. All diets resulted in weight loss. Comparatively, the low-carbohydrate diet showed significantly less weight loss than the Mediterranean diet (MD = -2.70 kg, 95% CI: -4.65, -0.75). Indirect evidence revealed that both the low-carbohydrate diet (MD = -6.31 kg, 95% CI: -11.23, -1.39) and the low-fat diet (MD = -5.61 kg, 95% CI: -10.61, -0.61) significantly reduced weight among overweight/obese adults compared with the standard lipid-lowering diet. Rankings indicated that the low-carbohydrate diet was the most effective dietary intervention for increasing weight loss (P-score = 0.8994) and reducing body fat (P-score = 0.7060). Overall, a low-carb diet appears to be among the most effective approaches for weight loss and body fat reduction.
Money for the studynot stated
Do the authors have ties to companies?not stated
Did a manufacturer help with the study?unknown
Type of studycombined analysis of many studies (meta-analysis)
“Not stated” does not mean nobody paid — the database does not always record it.
In the study, the low-fat diet produced a similar weight loss after two years to the high-fat diet.
Aim of the study: The possible advantage for weight loss of a diet that emphasizes protein, fat, or carbohydrates has not been established, and few studies extend beyond 1 year.
Results: At 6 months, participants assigned to each diet had lost an average of 6 kg, which represented 7% of their initial weight; they began to regain weight after 12 months. By 2 years, weight loss remained similar in those assigned to a diet with 15% protein and those assigned to a diet with 25% protein (3.0 and 3.6 kg, respectively); in those assigned to a diet with 20% fat and those assigned to a diet with 40% fat (3.3 kg for both groups); and in those assigned to a diet with 65% carbohydrates and those assigned to a diet with 35% carbohydrates (2.9 and 3.4 kg, respectively) (P>0.20 for all comparisons). Among the 80% of participants who completed the trial, the average weight loss was 4 kg; 14 to 15% of participants lost at least 10% of their initial body weight. Satiety, hunger, satisfaction with the diet, and attendance at group sessions were similar for all diets; attendance was strongly associated with weight loss (0.2 kg per session attended).
Money for the studygovernment, public institutions · NCRR NIH HHS, NIDDK NIH HHS, NHLBI NIH HHS
Do the authors have ties to companies?not stated
Did a manufacturer help with the study?unknown
Type of studystudy with random allocation to groups (RCT)
Participants811
“Not stated” does not mean nobody paid — the database does not always record it.
In an observational study, higher fat intake was associated with worse hearing, but the abstract alone does not allow us to assess whether low-fat dietary recommendations were a mistake.
Aim of the study: The relationship between hearing loss (HL) and diet is unclear. This study examined the association between midlife macronutrient intake and low-carbohydrate and low-fat dietary patterns and hearing function measured later in life.
Results: Participants with high total protein intake (quintile 5) exhibited better hearing, particularly at mid and high frequencies, compared with those with lower intake (quintile 1). High protein intake was inversely associated with the odds of experiencing any HL (odds ratio = 0.63, 95% confidence interval [CI] 0.47-0.84). The relative risk ratio (RRR) for mild HL was 0.63 (CI 0.46-0.85), and for moderate or greater HL, the RRR was 0.64 (CI 0.44-0.94). In contrast, high total fat intake was linked to worse hearing outcomes; additionally, high adherence to a low-fat dietary pattern was inversely associated with HL. No association was found between total carbohydrate intake and hearing. Our findings suggest that high dietary protein intake and adherence to a low-fat dietary pattern in midlife are associated with better hearing function later in life.
Money for the studygovernment, public institutions · European Regional Development Fund/European Social Fund, National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, under Contract nos
Do the authors have ties to companies?yes — the authors reported it
Did a manufacturer help with the study?YES
Type of studyobservation of people
Participants2 773
“Not stated” does not mean nobody paid — the database does not always record it.
In a short study in pigs, a low-carbohydrate, high-fat diet improved body composition and selected insulin-related measures.
Aim of the study: Our objective was to evaluate body composition and muscle insulin receptor concentration resulting from consumption of a low-carbohydrate, high-fat diet, using pigs as a surrogate for humans. Two treatments, a standard control pig feed (CON; n = 7) and a test diet in which beef tallow replaced corn carbohydrate (LCHF; n = 8), were fed for 32 days to post-pubertal gilts (Landrace × Yorkshire).
Results: LCHF gilts had reduced ADG, ADFI, FD, and visceral fat (p = 0.09, 0.04, 0.06, and 0.03, respectively) with similar BW (p = 0.18). Blood chemistry parameters were not affected, except for fasting glucose, which tended to be higher for LCHF (p = 0.054). The percentage (p = 0.09) and number (p = 0.07) of active pancreatic β-cells tended to be higher for LCHF gilts, as was the concentration of semimembranosus insulin receptors (p = 0.04). Short-term consumption of a low-carb, high-fat diet improved body composition, insulin production mechanics, and muscle insulin receptor density in a swine biomedical model.
Money for the studyuniversity or foundation · North Dakota Agricultural Experiment Station (NDAES), NDSU Explore program
Do the authors have ties to companies?no — the authors say so
Did a manufacturer help with the study?NO
Type of studyanimal study
“Not stated” does not mean nobody paid — the database does not always record it.
Perspectives and opinion materials
The content below presents the authors’ opinions, interpretations and hypotheses. It is not treated as equal to scientific studies and systematic reviews.
Orthomolecular Medicine News Service Opinion material
„Global dietary guidelines should be reconsidered in light of these findings." Conclusion So it’s not just me, or “lunatic charlatans” like me, saying it: it’s official now. Sugar is the Devil, and Fat is our Friend.”Global dietary guidelines should be reconsidered in light of these findings." Conclusion So it's not just me, or "lunatic charlatans" like me, saying it: it's official now. Sugar is the Devil, and Fat is our Friend.
Orthomolecular Medicine News Service Opinion material
„Dietary Misdirection: The AHA’s long-standing endorsement of low-fat (and consequently high-carbohydrate) diets may have inadvertently contributed to the obesity and diabetes epidemics, which are significant drivers of ASCVD(10–15). Emerging evidence indicates that low-carb, anti-inflammatory diets can effectively reverse metabolic syndrome and improve cardiovascular health(16–19). Contrary to the AHA’s long-term advocacy of low-fat diets, studies increasingly show that high-fat ketogenic diets support weight loss, enhance glycemic control, improve lipid profiles and insulin resistance, and reduce inflammation(20–23).”Dietary Misdirection: The AHA’s long-standing endorsement of low-fat (and consequently high-carbohydrate) diets may have inadvertently contributed to the obesity and diabetes epidemics, which are significant drivers of ASCVD(10–15). Emerging evidence indicates that low-carb, anti-inflammatory diets can effectively reverse metabolic syndrome and improve cardiovascular health(16–19). Contrary to the AHA's long-term advocacy of low-fat diets, studies increasingly show that high-fat ketogenic diets support weight loss, enhance glycemic control, improve lipid profiles and insulin resistance, and reduce inflammation(20–23).
Orthomolecular Medicine News Service Opinion material
„For decades, dietary guidelines promoted low-fat, high-carb diets based on flawed interpretations of limited data. The outcome?”For decades, dietary guidelines promoted low-fat, high-carb diets based on flawed interpretations of limited data. The outcome?
Pisaczek does not judge who is right. It shows what was written and where to read it. Every sentence above has its source.