Since blowing my top the other day, I've waited until a few of the excellent reviewers out there had a shot at the recent diet study. I'll point you to three excellent, substantive, thorough reviews. Otherwise, you'd have only fat-faced liars like Tara Parker-Pope of the NYT.
First up: Stephan at Whole Health Source, who notes that the diet, indeed as I suspected and speculated, wasn't particularly low in carbs. Also:
And finally, it caused the biggest improvement in the triglyceride:HDL ratio. This ratio is the best blood lipid predictor of heart disease risk I’m aware of in modern Western populations. The lower, the better. They didn't calculate it in the study so I had to do it myself.
Click over to see the chart he created; and:
Other interesting findings: despite the calorie restriction, diabetic participants on the AHA group actually saw a significant increase in fasting blood glucose.
I've speculated before that wheat and sugar may cause hyperphagy, or excessive eating. We can see from these results that reducing carbohydrate (and probably wheat) reduces overall caloric intake quite significantly. This squares with the findings of the recent Chinese study that showed an increase in calorie intake and weight, correlating with the replacement of rice with wheat as the primary carbohydrate. It also squares with diet trends in the US, where wheat consumption has risen alongside calorie intake and weight.
If he's right about the hyperphagy, and I suspect he is, that's the resolution to the calories in/out vs. "good calories bad calories" debate: i.e., it's both.
Next up, Regina Wilshire at Weight of the Evidence. She also notes the absolutely devastating result that the diet diabetics are being put on actually raised fasting glucose levels. Here's how she puts it:
This is critically important to note – the low-fat group experienced a rise in fasting blood glucose over the course of the two years; this despite a greater calorie deficit than the other two diets, and a greater increase in physical activity! Yet, this type of diet is exactly how the ADA recommends people at risk for or diagnosed with diabetes eat, while expecting ever increasing doses of medication to cover their progressive decline in glycemic control.
She extracted a very nice graph comparing the lipid panels of the three diets. Click over to take a look.
Then the good Doctor, Michael Eades of Protein Power takes a stab. Of course, he notes that it's not even a low-carb diet, but one of moderate intake. Low carb is <60 grams per day. He speculates as to why they still came out on top.
Despite the instruction to increase carbs to 120 grams per day, I believe these subjects had a long-term benefit from the two months of rigid low-carb dieting (20 grams per day) with which they started the study. Why do I believe that? There is a terrific study in Nutrition & Metabolism showing that subjects with diabetes who underwent a strictly supervised low-carb diet for six months, and who lost weight, improved blood sugar control and lipid parameters, were still showing the positive effects of this intervention 44 months later. These impressive findings seem to indicate that there is some sort of rejuvenation that takes place in people after they have spent a period of time on an honest-to-God low-carb diet that carries over for several years. Maybe this is the phenomenon we’re seeing in the subjects in this NEJM study. The two months of rigid low-carb carries over for the rest of the study despite the subjects cranking their carbs up to non-low-carb levels.
He ridicules that lying fuckwad Dean Ornish in the comments and links to a past blog post of his that exposes just what a liar Dean Ornish is.