Catching Up: The DIRECT study.

Hey all, a little backlogged with projects and posts right now. Your pardons as I sort everything out in one big vomitus:

Last Thursday, the New England Journal of Medicine released a study comparing low-fat, Mediterranean, and low-carb diets. The big winner? The low-carb diet (much to everyone’s chagrin – false sarcasm). There are two extensive write-ups on this study over at Dr. Eades‘ and Scott’s blogs, but allow me to present the highlights:

First (and certainly to the delight of Rich and Andrius), the low-carb diet was a vegetarian low-carb diet. From the study text: “…the participants were counseled to choose vegetarian sources of fat and protein…” So it appears that the benefits of following the low-carb regimen are not exclusive to gun-totin’, America-lovin’ carnivores – just those who choose to reduce intake of grains, sugars, and starches.

While the Mediterranean diet resulted in more favorable LDL levels than the low-carb diet (”a collective ‘So what?’ washed over the crowd…”), the low-carb diet killed in just about everything else: higher HDL, lower TG, and better TC:HDL ratio. Additionally, both the Mediterranean and low-carb approaches resulted in a drop in C-reactive protein, indicating lower levels of inflammation.

Sadly (for the AHA, at least), the low-fat group fared worst overall: Least fat loss, highest LDL (isn’t a low-fat diet supposed to decrease this? Hmmm…), highest TG, least change in C-reactive protein, and an increase in blood glucose for diabetics. Yet this is the type of diet recommended by the AHA for diabetics. Yikes.

Of course, the punchline: While the Mediterranean diet was pretty close to specs, at two years (the end of the study) the low-carb diet had degenerated to 40% of calories from carbs (definitely not low-carb) and the low-fat diet had degenerated to 30% of calories from fat (definitely not low-fat). So that explains the lackluster amounts of fat loss. And yet, while proponents of low-fat will argue that their diet didn’t perform as planned because it wasn’t correctly represented, the low-carb diet seemed to defy this limitation (what’s scary is it would’ve done even better were it actually followed to the letter).

The bottom line: Even a little reduction in carbohydrate consumption (or a short period eating in a strict low-carb fashion) can provide some real health and fat loss benefits.  And that low-carb doesn’t have to mean eggs and bacon for breakfast, steak and salad for lunch, and salmon and tomato for dinner (although that sounds mighty tasty to me).