Diet success depends on consistency, not diet type, says research

[Scott Kolasinski]

We get a ton of questions from our clients concerning our thoughts on different diets. Here's what the research said some of more popular ones.



3/15/2006 - The most successful way to lose weight is not the type of diet chosen, but actually sticking to it, according to research published by the ARS, which also reveals that people are most likely to stick to calorie and portion restriction diets than fat and carbohydrate restriction diets.

The study, partly funded by the Agricultural Research Service (ARS)- the US Department of Agriculture's (USDA) scientific research arm- compared four popular diet plans over a one-year period.

The diets chosen included the Atkins (carbohydrate restriction), Ornish (fat restriction), Weight Watchers (calorie and portion size restriction), and Zone (high-glycemic-load carbohydrate restriction and increased protein) diets.

Researchers from the Lipid Metabolism Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University and Tufts-New England Medical Center in Boston randomly assigned 160 overweight or obese volunteers to one of the four diet plans.

The participants in each diet plan were representative of the overweight population in the US, in terms of age, race, sex, body mass index and metabolic characteristics.

Published in this month's issue of the Agricultural Research magazine, the results revealed that all four diets led to “modest but significant” weight loss, and a 10 percent improvement in the balance of ‘good' HDL and ‘bad' LDL cholesterol levels.

However, these results were only observed in those participants who completed the full period of dieting. And when it came to what the researchers termed the more “extreme” diet plans- Atkins and Ornish- only half of the volunteers stuck to these for the full year. In contrast, almost two-thirds were able to complete the more “moderate” diet plans- Weight watchers and Zone.

“The study showed that whether volunteers restricted carbohydrate calories or fat calories-whether they lowered intake overall, or balanced intake overall-everybody lost weight,” said researcher Ernst Schaefer.

“Ultimately, it comes down to calorie restriction. The strongest predictor of weight loss was not the type of diet, but compliance with the diet plan that subjects were given.”

The findings, which were previously published in the Journal of the American Medical Association, support the belief that calorie-restriction diets must not come into conflict with a person's preferred foods.

“Implementing a dietary regimen that can transition an individual into a healthful eating pattern after the diet ends is also very important,” said ARS human nutrition national program leader Molly Kretsch. “Lifestyle practices that help people maintain a healthy body weight, incorporate the right balance of foods and appropriate portion sizes, and increase their physical activity are the keys to long-term weight management.”

Participants in the study who improved their cholesterol ratios by 10 percent improved their heart disease risk factors by 20 percent. And according to the researchers, for every one percent of weight loss a dieter achieves, there will be a two percent, or twice as much, reduction in heart disease risk factors.

In addition, all four diet plans promoted lower blood insulin levels as well as lower levels of C reactive protein (CRP). High levels of CRP in the blood have been linked to heart disease.

[Michael Greeves]

What if the headline was......Fitness success depends on consistency, not exercise type, says research

[Gabe Rinaldi]

I think diet and exercise adherance is largely psychological, and diet is to a larger extent. Therefore, there needs to be an appropriate psychological trigger to get someone to modify there diet long-term (1 year or more). Without the appropriate trigger, one can dabble on a diet for a month or two only to revert back to their pre-diet status.

In this study the participants adhered to their diet. I wonder how many people dropped out of the study. It is no surprise that those who made a long-term modification to eat better saw a positive improvement in body composition and health. Without knowing the other lifestyle modifications and exact results obtained I can't comment on all the diets being the same.

In terms of exercise, if someone has a psychological issue that prevents them from exercising long-term, then they won't get results. If they can get that trigger to do something long-term, then it is better than nothing. I can guarantee what they do in a year of training will impact their results though. Give me an obese sedentary person and I can make a lot more changes than Curves. However, the person has to be in it psychologically and if they won't maintain with me, but they will in Curves, then Curves wins.

[Thom Downing]

Sounds like you are advocating psychological support for everyone that seriously wants to lose weight (and more importantly keep it off)!

After hearing your arguement, this makes a lot of sense to me. It seems as though the research and anecdotal evidence would support this claim as well. Question is how to get this concept to the people?

What do you think would make up the perfect Weight Loss and Maintenance Program?

What testing would you use? Blood testing necessary? Psych support?

[Gabe Rinaldi]

Sounds like you are advocating psychological support for everyone that seriously wants to lose weight (and more importantly keep it off)!

After hearing your arguement, this makes a lot of sense to me. It seems as though the research and anecdotal evidence would support this claim as well. Question is how to get this concept to the people?

What do you think would make up the perfect Weight Loss and Maintenance Program?

What testing would you use? Blood testing necessary? Psych support?

Perfect weight loss program:

some sort of pre-testing, exercise intervention with a fitness professional, psychological counseling with a professional therapist, nutritional guidance with a nutritional expert, progress testing on the same tests

I think the minimum tests should be: height, weight, bodyfat, and RMR

I don't think blood testing is necessary however it would be interesting. I would defer to Scott, Dr. Wilson, Dr. Nichols, or someone else on the most appropriate blood tests.

Basically, I believe the psychological component is essential for a large number of people.

[Jen Pleimann]

Perfect weight loss program:

some sort of pre-testing, exercise intervention with a fitness professional, psychological counseling with a professional therapist, nutritional guidance with a nutritional expert, progress testing on the same tests

Basically, I believe the psychological component is essential for a large number of people.


I completely agree with Gabe that addressing the psychological component is essential for most weight loss clients. Tests, such as the RMR, give clients the numbers needed in order to figure out their individual caloric deficit needed to lose the weight. Losing weight is much more than this. So you have all the numbers, now what? Committment. It's making a lifestyle change that one will realistically stick to. Not for a week, not two months, but for good.

This is the area I love (my psychology background).:) I think there are a lot of different ways of addressing the psychological component. While seeing a therapist is great, I don't think that's the only option. Support groups are often a great resource for clients. Sometimes peer support is much more beneficial than one on one training with a therapist. Obviously, a professional needs to run the group and offer guidance. I think there is a lot to be said for support coming from those around you dealing with common issues/struggles and there are many studies to support this.

More on this later...time to train.

[Scott Kolasinski]

I agree with all of you so much with the psychological component of weight loss.

Since we're on the topic, I'll share with you what I know and hope that you can perhaps research more on this on your own and/or share it with us and your clients.

One of the areas the research looks at when it comes ot obese clients is the idea of "compulsive eating." This occurs in many people who are looking to find comfort in food. Those who eat when sad, lonely, depressed, or not good in their head. The primary blame that psychologists have found is that parenting is largely responsible for causing compulsive eating. It makes a lot of sense. When we were kids and we were having a bad day, when did mom or grandma say, "Come here, let me give you a hug. You've had a bad day. Lets go steam some broccoli. Eat all that you want."? Instead, they typically make cookies, brownies, or junk food. These feelings of love become attached to the food in childhood and when life has its troubles, and we need a pick-me-up, we go to the quick-fix. As we get older, we have more independence, and unless we recognize and make a conscious decision to change this behavior or other similar ones that may lead us down the same road, then the trend will continue.

[Tracey Downing]

I agree whole heartedly that some sort of counseling is essential for weight loss to be successful and by successful I mean that the weight is lost and kept off. Although I think an ideal situation is similar to the one Gabe mentioned, buy in from clients to the therapuetic component is a huge challenge - one that I personally have not been able to overcome with any of the weight loss clients I have trained. so, my question is, how can we as trainers help to provide the necessary support to these reluctant clients? or can we? is the answer making psychological services more easily accessible or being more cognisent of this aspect and incorporating it into or work with clients or possibly, like Jen suggested, creating some sort of support system (maybe a forum) for clients in this category. I'm guessing we all have a wealth of knowledge about the issues involved in weightloss based on our experiences with clients, is there a way to convey that knowledge in a way that supports those clients goals?

[John Seaburg]

When it comes to healthy weight loss I think it's important not to stress calories and pounds. When people think in terms of those two words bad things often happen... things like starvation diets and excessive exercise. The problem is how do you explain that to someone obsessed with what the bathroom scale says?

The best way of explaining it that I can think of is this.... get healthy so you can lose fat and look better not the other way around. Trying to shed pounds first and assuming it will lead to better health is fools gold. Usually, when someone improves their health they've already lost fat and look better but not always.

[Scott Kolasinski]

When it comes to healthy weight loss I think it's important not to stress calories and pounds. When people think in terms of those two words bad things often happen... things like starvation diets and excessive exercise. The problem is how do you explain that to someone obsessed with what the bathroom scale says?

The best way of explaining it that I can think of is this.... get healthy so you can lose fat and look better not the other way around. Trying to shed pounds first and assuming it will lead to better health is fools gold. Usually, when someone improves their health they've already lost fat and look better but not always.

How can you not emphasize pounds or calories without weight loss?

Even if a person eats properly, they can get fat. Obesity is correlated with so many diseases, why not want to shed the weight? What's foolish about weighing less when you're setting yourself up for a heart attack, stroke, hypertension, or cancer if you continue to be obese?

I'd rather inform a client on how to do it rather than assume their behavior will result in bad things. If bad things do happen, it usually means they are not prepared to take responsibility for changing their behavior or weight. They're too focused learning of a "quick fix" or believing they are a victim of some sort of excuse.

Could you, or anybody, give me an example of somebody who ate more calories and lost weight while eating correctly?

[John Seaburg]

>>How can you not emphasize pounds or calories without weight loss? <<

My comment had to do with the calories in vs. calories out mindset which tends to doom weight loss goals. Quantity matters but quality matters more.


>>Even if a person eats properly, they can get fat. <<


It's very difficult for someone not to lose fat when they eliminate the unhealthy foods from their diet. Yes, you can maintain or gain weight by eating a ton of the good stuff but that's hard to do. Compare chicken and broccoli to pizza. Which would you usually pig out on? Which would give you a good indication when you're full? Starchy carbs tend to say "eat more!"

[Tracey Downing]

When it comes to healthy weight loss I think it's important not to stress calories and pounds. When people think in terms of those two words bad things often happen... things like starvation diets and excessive exercise.

Yes, there is a risk of starvation diets, however, most people are not capable of sticking to such a strict regimen and the likelihood that most people would excessively exercise is also slim - not saying that there aren't exceptions to this, however, in general I think people have lost track (or never knew) of portion size and the number of calories they consume. Drawing their attention back to those basic principles seems like a good place to start.

[Scott Kolasinski]

>>How can you not emphasize pounds or calories without weight loss? <<

My comment had to do with the calories in vs. calories out mindset which tends to doom weight loss goals. Quantity matters but quality matters more.


>>Even if a person eats properly, they can get fat. <<


It's very difficult for someone not to lose fat when they eliminate the unhealthy foods from their diet. Yes, you can maintain or gain weight by eating a ton of the good stuff but that's hard to do. Compare chicken and broccoli to pizza. Which would you usually pig out on? Which would give you a good indication when you're full? Starchy carbs tend to say "eat more!"

Bodybuilders often eat enormous amounts of chicken and broccoli when they want to put on weight and muscle in the off season. In the Law of Thermodynamics, there's nothing that states the quality of energy is different than the quantity. Energy is energy no matter how it appears. If you are referring to the hormonal response to eating and the glycemic response, thus far, there has not been any research that supports this although theoretically, it would make sense.

Unprocessed starchy carbs, such as whole grains, that contain fiber also help make a person feel full when combined with protein and fat, especially when eaten slowly.

This is also why the first 2 weeks of the South Beach diet fails for many people who are "allowed" to eat as much protein and veggies as they want. It helps get insulin under control, but calorie restriction is still the hallmark to any sort successful weight loss.

[John Nguyen]

In the Law of Thermodynamics, there's nothing that states the quality of energy is different than the quantity. Energy is energy no matter how it appears. If you are referring to the hormonal response to eating and the glycemic response, thus far, there has not been any research that supports this although theoretically, it would make sense.



I agree that energy is energy, but since the body functions in more complex ways than a calorimeter, energy from different nutrients (fat, carbs and protein) has different reactions in the body. The biological processing of protein requires more energy than that of fat, which nets a greater amount of energy burned. And since weight loss is the meat of the topic, the thermic effect of eating needs to be considered.

JN

[Scott Kolasinski]

I agree that energy is energy, but since the body functions in more complex ways than a calorimeter, energy from different nutrients (fat, carbs and protein) has different reactions in the body. The biological processing of protein requires more energy than that of fat, which nets a greater amount of energy burned. And since weight loss is the meat of the topic, the thermic effect of eating needs to be considered.

JN

Absolutely. I agree 100%. There is a thermic effect of eating that does need to be addressed as well. This is one reason why higher protein diets create greater weight loss than higher carb diets when calories are the same.

This is an issue I try to avoid initially because it may complicate things, and depending on the activity level of an inidividual and their goals, it might affect his/her performance. Unfortunately, some people also get the idea that they can eat as protein as they want because more will be burned for energy. Once gain, not 100% the entire story.

Once an individual gets a handle on the basics of eating good nutrition, then I can tell them how to kick it up a couple of notches for the little things.

[John Seaburg]

I believe the human body is extremely complex and breaking food down into calories or even carbs, proteins, and fats doesn't help you get healthy. I know this thread is about fat loss but I want to stress the importance of thinking about micronutrients instead of macro. When you start to eat a micronutrient dense diet you almost can't help but lose fat.

[John Nguyen]

I believe the human body is extremely complex and breaking food down into calories or even carbs, proteins, and fats doesn't help you get healthy. I know this thread is about fat loss but I want to stress the importance of thinking about micronutrients instead of macro. When you start to eat a micronutrient dense diet you almost can't help but lose fat.


I agree 100% that it's important to focus on micronutrients, but how does a micronutrient-dense diet help you lose fat? I'd imagine that one can eat a diet rich in micronutrients, yet can still have little control over, or knowledge off, the total portion of food consumption, leading to the inability of losing fat weight.

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[John Seaburg]

I agree 100% that it's important to focus on micronutrients, but how does a micronutrient-dense diet help you lose fat? I'd imagine that one can eat a diet rich in micronutrients, yet can still have little control over, or knowledge off, the total portion of food consumption, leading to the inability of losing fat weight.

-

If you eat a micronutrient-dense diet you're not going to be eating bread, pasta, rice and sweets. When you eliminate those foods you will most likely become more insulin sensitve and you probably won't be pigging out. Getting in all those micronutriens will help create a good hormonal situation which can increase your metabolism. If you're starting from a position where you have some fat to lose, you will probably lose some. Can some people maintain or even gain weight by eating too much of the good foods? Sure, but it's unlikely. Remember, I'm talking about people who aren't very lean.

My main point is when you teach people to focus on portion size first and quality of food second they're probably only going to hear the "portion size" part. When you teach them the "calories in vs. calories out" theory you're going hear things like.... "I had a donut today so I better do some extra cardio". If that's what you want, fine, but I think it's a really bad approach for health and fat loss.

[Scott Kolasinski]

If you eat a micronutrient-dense diet you're not going to be eating bread, pasta, rice and sweets. When you eliminate those foods you will most likely become more insulin sensitve and you probably won't be pigging out. Getting in all those micronutriens will help create a good hormonal situation which can increase your metabolism. If you're starting from a position where you have some fat to lose, you will probably lose some. Can some people maintain or even gain weight by eating too much of the good foods? Sure, but it's unlikely. Remember, I'm talking about people who aren't very lean.

My main point is when you teach people to focus on portion size first and quality of food second they're probably only going to hear the "portion size" part. When you teach them the "calories in vs. calories out" theory you're going hear things like.... "I had a donut today so I better do some extra cardio". If that's what you want, fine, but I think it's a really bad approach for health and fat loss.
I came across this study last night and I think it could be of value here.


Weight loss on an energy-restricted, low-fat, sugar-containing diet in overweight sedentary men.
Int J Food Sci Nutr. 2004 Jun;55(4):279-90.
Drummond S, Dixon K, Griffin J, De Looy A.

With the increasing prevalence of obesity in the United Kingdom, the search for an effective weight reducing diet is a priority in helping to reverse this trend. A 12-week dietary intervention study was carried out to test the effectiveness of an energy-restricted, low-fat, sugar-containing diet on weight loss in sedentary overweight men. The study also aimed to assess eating behaviour, to measure change in attitude towards sugar-containing foods and to measure the impact of the study on perceived quality of life. Subjects were recruited from three UK cities; Edinburgh, Birmingham and London. Seventy-six men, aged between 25 and 60 years, completed the study. Baseline diets were assessed by a 7-day diet diary. Compliance to the subsequent dietary advice was measured on four occasions post intervention, by 4-day diaries. Measures of body weight status were also monitored. Eating behaviour, attitudes towards sugar-containing foods and quality of life were assessed by questionnaire. Significant reductions in body weight (5.2%), body fat (11.2%) and waist:hip ratio (3%) were observed following reported dietary changes that included a reduction in reported energy intake of 3.2 MJ/day (770 kcal/day), a reduction in the percent energy from fat (from 38.1% to 26.2%), an increase in the percent energy from total carbohydrate (from 44.4% to 54%) and from protein (from 17.3% to 20.6%). Subjects scored relatively highly for dietary restraint and emotional eating, and were strongly influenced by external eating cues. On completion of the 12-week study, subjects had a more positive attitude towards sugar-containing foods and perceived an improved quality of life. It is concluded, therefore, that including sugar-containing foods in a weight-reducing diet may be an effective strategy to achieve a palatable, low-fat, high-carbohydrate diet, which promotes weight loss in overweight individuals.