Weight loss diets and macronutrient composition

From Medscape:

The quick summary: “Dieters ate different amounts of protein, fat, and carbohydrate — but, after 2 years, most were still obese.”

Here’s some more detail: “While weight-loss diets claim unique nutrient compositions that guarantee unusually rapid and effortless success, comparative studies — usually with small populations and short follow-ups — have yielded widely disparate results. Now, a large long-term multisite study suggests that all these diets result in similar outcomes.

Researchers randomized 811 overweight adults (81% white; 62% female; 69% college graduates; mean body-mass index, 33 kg/m2) to four restricted-calorie eating plans:

* High fat, high protein
* High fat, average protein
* Low fat, high protein
* Low fat, average protein

Carbohydrate intake ranged from 35% (in the first plan) to 65% (in the fourth) of total calories. All meals were prepared at home, and participants ate from a single menu with each dish’s components adjusted to reflect each diet’s emphasis; all participants were offered weight-loss counseling.

Changes in weight and waist circumference at 6, 12, 18, and 24 months were indistinguishable among groups: At 2 years, only about 15% of each group had lost at least 10% of body weight. Attendance at group counseling sessions strongly predicted successful weight loss. At 2 years, hunger and diet-satisfaction scores were all similar. Food diaries and urinary nitrogen analyses indicated that the actual nutrients consumed might have been more similar among groups than had been planned.”

I think that this situation is to be expected. Deprivation, as a general rule, is extremely hard to maintain over the long haul. It’s better to gradually change by learning how to eat plant-based, whole foods. Bottom line: its not the macro-nutrient balance that counts. It’s the micro-nutrients (and of course physical activity) that ultimately determine health and fitness.