Kathy Kolasa column: Expert help contributes to weight-loss success
Q I read the recent headlines saying the Mediterranean diet was better for losing weight than a low-fat diet. What's your opinion? - J.H., Greenville
A Any approach that leads to you eat fewer calories than you use will lead to weight loss. But not all reduced-calorie diets give you all the nutrients you need.
You must have read the news about a study published in the New England Journal of Medicine in July. It's a pretty interesting study for several reasons. The first was that most of the participants were men. That's pretty unusual in itself, since most studies of dieters are predominantly about women. It was also unusual because 95 percent of the participants reported continuing to follow their diet at one year and an amazing 85 percent at the end of year two. Those are incredible adherence percentages for people who are not getting their food given to them.
There were three diets being studied: low-fat, Mediterranean and a low-carb, Atkins-like diet. The point of the study was actually to prove that both the Mediterranean and the low-carb were safe to follow.
This study was really like a demonstration of a worksite sponsored weight-loss program. The participants all worked for the same company in Israel where they ate the main meal of the day in the worksite cafeteria. The cafeteria prepared and clearly labeled the right foods for the participants although they were free to select the foods they wanted to eat.
If you wanted to follow any of these diets, you actually could do so in the cafeteria of the Pitt Memorial Hospital right now. The appropriate foods are there, but they aren't labeled in a way that makes it easy to do so.
The weight loss did vary for the individuals. As seen in most studies, most of the weight was lost in the first six months. What is encouraging about this study is many of these individuals were able to maintain their weight loss. At two years, on average, those on the low fat diet lost 7.3 pounds, those on the Mediterranean lost 10.2 pounds, and those on the low-carb lost 12.1 pounds.
While this doesn't sound like a lot of weight, for most people losing 5 percent-10 percent of their excess weight and keeping it off helps their blood pressure, blood sugar and blood cholesterol. The average BMI in this study was 31, so the participants did not have huge amounts of weight to lose to be healthier. Importantly, they all experienced a reduction in waist circumference, which may actually be more important than pounds lost when it comes to health outcomes.
The low-fat diet was pretty much like the American Heart Association diet. Those following the Mediterranean diet ate lots of fruits, vegetables, whole grains and limited red meat and processed foods while including olive oil and a few nuts. Those on the low-carb diet initially followed an Atkins-like approach of fewer than 20 grams of carbs per day, but quickly found they were able to follow a diet with 120 grams. Please note that experts, including myself, do not recommend dropping below 130 grams of carbs a day if you want to feel good and be productive at work or play or at home.
One other point is important. The participants all had great access to a registered dietitian either individually or in a group at weeks 1, 3, 5 and 7 and then every 6 weeks for the whole two years. Spouses, too, could get help. It just goes to show that having expert help available can contribute to weight-loss success by teaching people about food and also keeping them motivated.
I bet it helped to have the meetings with the dietitians when the dieters hit their weight-loss plateaus. In my experience that's when folks get discouraged and gain back the weight they lost.
The researchers concluded that all three diets were safe to follow. There were some statistical differences in the results but all three approaches had positive effects. So, as I have said about a gazillion times, there is no single best diet for every person. Find a way of healthy eating that suits your tastes, your preparation skills, your pocket book, and keep to it.
Professor Kathy Kolasa, a registered dietitian and Ph.D., works with the Family Medicine Center, Brody School of Medicine at ECU. Contact her at kolasaka@ecu.edu, or C/O The Daily Reflector, P.O. Box 1967, Greenville, NC 27835.
By Kathy Koalasa
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