A study recently published in JAMA has found that people who “cut back on added sugar, refined grain, and highly processed foods”1 and focused instead on eating plenty of vegetables and whole foods, but DID NOT count calories or limit portion size, lost significant amounts of weight over the course of a year. (This strategy worked among people who ate diets that were mostly low in fat or carbohydrates, regardless of their genetics or their insulin-response to carbohydrates.)

Dr. Dariush Mozaffarian, a cardiologist and dean of the Friedman School of Nutrition Science and Policy at Tufts University said the findings showed that “It’s time for U.S. and other national policies to stop focusing on calories and calorie counting.” We agree. For far too long the focus has been on calories rather than the actual food people are putting into their bodies.

The research, led by Christopher D. Gardner, director of nutrition studies at the Stanford Prevention Research Center, was carried out on more than 600 people.

“Dr. Gardner and his colleagues designed the study to compare how overweight and obese people would fare on low-carbohydrate and low-fat diets. But they also wanted to test the hypothesis — suggested by previous studies — that some people are predisposed to do better on one diet over the other depending on their genetics and their ability to metabolize carbs and fat. A growing number of services have capitalized on this idea by offering people personalized nutrition advice tailored to their genotypes.”2

The subjects were split into two diet groups: “healthy” low carb and “healthy” low fat. Participants attended classes with dietitians where they were trained to eat “nutrient-dense, minimally processed whole foods,”3that had been cooked at home whenever possible and they were encouraged, but not required, to meet federal guidelines for physical activity.

“Soft drinks, fruit juice, muffins, white rice and white bread are technically low in fat, for example, but the low-fat group was told to avoid those things and eat foods like brown rice, barley, steel-cut oats, lentils, lean meats, low-fat dairy products, quinoa, fresh fruit and legumes. The low-carb group was trained to choose nutritious foods like olive oil, salmon, avocados, hard cheeses, vegetables, nut butters, nuts and seeds, and grass-fed and pasture-raised animal foods.”4

The importance of calorie counting has been ingrained in many of us. However, the study shows that after one year of focusing on food quality, not calories, the two groups lost substantial amounts of weight: on average, the low-carb group lost just over 13 pounds and the low-fat group lost about 11.7 pounds. Both groups also saw improvements in other health markers, like reductions in their waist sizes, body fat, and blood sugar and blood pressure levels.5

Some of the most important takeaways from the study were:6

  • the subjects’ genotypes did not appear to influence their responses to the diets
  • people who secreted higher levels of insulin in response to carbohydrate intake, a barometer for insulin resistance, did not necessarily do better on the low-carb diet
  • a “high-quality diet” produced substantial weight loss and the percentage of calories from fat or carbs did not matter

While it’s true that very often “dieters” regain what they lose, according to Dr. Gardner the people who lost the most weight reported that the study had “changed their relationship with food.”7 He stressed that it’s not that calories don’t matter but, rather, once you train your mind and body to want foods that are nutritious, whole, and satisfy hunger, it’s easy to lose weight and keep it off.

Sources and References

  1. NY Times, February 20, 2018.
  2. NY Times, February 20, 2018.
  3. NY Times, February 20, 2018.
  4. NY Times, February 20, 2018.
  5. NY Times, February 20, 2018.
  6. NY Times, February 20, 2018.
  7. NY Times, February 20, 2018.