Journal of the American Medical Association 2012; 307(24):2627-34.
Objective
After weight loss, the
human body fights hard to regain weight.
One of the ways it does this is to decrease the amount of calories it
burns on a day to day basis. This is
known as a decrease in resting energy expenditure. The objective of this study
was to examine the effects of 3 different diets varying in macronutrient
content and glycemic load on resting energy expenditure following weight loss.
Methods
21 overweight young men
and women completed a 12 week weight loss program that resulted in an average
weight loss of 13.6% of body weight.
Once the weight was lost, they each went on one of 3 diets for a period
of 4 weeks. Each of these diets contained the same exact number of calories.
Diet #1: Low Fat: 60%
carbohydrate, 20% protein, 20% fat
Diet #2: Low Glycemic
Index: 40% carbohydrate, 20% protein, 40% fat
Diet #3: Low Carbohydrate:
10% carbohydrate, 30% protein, 60% fat
After each 4 week diet
intervention, a variety of measures were taken, including resting energy
expenditure, hormone levels, and components of the metabolic syndrome.
Results
The decrease in resting
energy expenditure was greatest with the low fat diet (-205 calories per day). Next was the low glycemic index diet (-166
calories per day). The least was the low
carbohydrate diet (-138 calories per day).
Comment
This is a ground breaking
study that challenges the assertion that a calorie is a calorie. The 3 diets that were tested were isocaloric,
in other words they had the same amount of calories. The fact that each had a different impact on
resting energy expenditure means that something is going on hormonally that
will impact your body’s reaction to weight loss. It would be easy to look at the results of
this study and say that the low carb diet is the way to go.
Not so fast! The researchers measured a bunch of other
things besides resting energy expenditure.
During the low carb phase, subjects had a significantly higher cortisol
level. This is a hormonal measure of
stress and has been associated with a variety of negative health outcomes, such
as insulin resistance and cardiovascular disease. Subjects in the low carb phase also had a
higher level of C-reactive protein. This
is a measure of body wide inflammation and has also been associated with a
variety of chronic diseases.
The low fat diet showed the
greatest decrease in resting energy expenditure and also showed some negative
metabolic effects, including an increase in insulin resistance, a decrease in
HDL cholesterol, and an increase in triglycerides.
The low glycemic index
diet seemed to be the best of both worlds.
You get a reduced decrease in resting energy expenditure without the
metabolic changes that increase risk of chronic disease.
Take Home Message
The study provides more
evidence that a low fat diet is not the way to go if you want to lose weight
and keep it off. While the low carb diet
had the most favorable impact on resting energy expenditure, it also resulted
in some very unfavorable metabolic changes.
The low glycemic approach seems to offer the best combination of
blunting the reduction in resting energy expenditure that comes with weight
loss while protecting you from chronic disease.
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