December 11, 2011
Intermittent Low Carbohydrate For Weight Loss

Why restrict your calories when you can just cut back on carbs a couple of days a week.

SAN ANTONIO An intermittent, low-carbohydrate diet was superior to a standard, daily calorie-restricted diet for reducing weight and lowering blood levels of insulin, a cancer-promoting hormone, according to recent findings.

Researchers at Genesis Prevention Center at University Hospital in South Manchester, England, found that restricting carbohydrates two days per week may be a better dietary approach than a standard, daily calorie-restricted diet for preventing breast cancer and other diseases, but they said further study is needed.

"Weight loss and reduced insulin levels are required for breast cancer prevention, but [these levels] are difficult to achieve and maintain with conventional dietary approaches," said Michelle Harvie, Ph.D., SRD, a research dietician at the Genesis Prevention Center, who presented the findings at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium, held Dec. 6-10, 2011.

It is not reasonable to expect the vast majority of people to sustain a lower calorie diet. The mental pull to eat more is just too strong. Sustained weight loss requires ways to cut appetite. The "ad lib" here means ad libitum which means "at pleasure": eat as much as you want. So an ad libitum low carbohydrate diet involves eating as much as you want as long as its only fat or protein or very low carb high fiber foods such as many vegetables (e.g. cauliflower).

Harvie and her colleagues compared three diets during four months for effects on weight loss and blood markers of breast cancer risk among 115 women with a family history of breast cancer. They randomly assigned patients to one of the following diets: a calorie-restricted, low-carbohydrate diet for two days per week; an "ad lib" low-carbohydrate diet in which patients were permitted to eat unlimited protein and healthy fats, such as lean meats, olives and nuts, also for two days per week; and a standard, calorie-restricted daily Mediterranean diet for seven days per week.

Eating something close to a Mediterranean diet with low carbohydrate is probably close to ideal.

Cutting calories along with cutting carbs improved insulin resistance better than just cutting carbs. But carb cutting alone delivered most of the benefit.

Data revealed that both intermittent, low-carbohydrate diets were superior to the standard, daily Mediterranean diet in reducing weight, body fat and insulin resistance. Mean reduction in weight and body fat was roughly 4 kilograms (about 9 pounds) with the intermittent approaches compared with 2.4 kilograms (about 5 pounds) with the standard dietary approach. Insulin resistance reduced by 22 percent with the restricted low-carbohydrate diet and by 14 percent with the "ad lib" low-carbohydrate diet compared with 4 percent with the standard Mediterranean diet.

The low carb diet probably cut appetite more. Hence the better result. An ideal diet should be ad libitum (no constant willpower fight) but only foods that do not stimulate the appetite.

Share |      Randall Parker, 2011 December 11 09:24 PM  Brain Appetite

Michael L said at December 11, 2011 11:14 PM:

I think at this point weight loss is not a fundamental technical problem but rather a self induced one. Much like the drug war, credentialism, nuclear power freeze and the 44th President of America. There are already things like bariatric surgery and appetite suppression using amphetamine diet pills. Now, maybe these are not perfect for everybody (and never mind FDA frothing at the mouth) but they would make sense for a lot of people for whom the disease of extra weight is a much bigger health issue than the cures. And it stands to reason that in a more innovation minded / less regulation shackled environment these and similar treatments could evolve to be healthier and more effective.

bbartlog said at December 12, 2011 7:32 AM:

Very interesting. Of course, the possibility (or likelihood) that the best diet has variable or intermittent character shows that the problem is more complicated than we thought. If the search space were just 'what balance of fat/protein/carbs is best', day after day, then it wouldn't be too hard to set up your studies. Once you add the possibility that the optimal diet involves some sort of periodic change to a very different balance, it becomes far more difficult to study the issue on a population basis. Which means that we'll probably need to pursue the other (reductionist) approach, and actually understand what all that complex molecular machinery is doing.

Kai Jones said at December 12, 2011 9:06 AM:

So our attempts to impose order on a chaotic system are futile. Entropy for the win!

PacRim Jim said at December 12, 2011 12:27 PM:

I wonder if intra-nasal blasts of oxytocin would help with weight loss.
I'll let you know.

Jake said at December 14, 2011 11:13 AM:

It seems strange they didn't try a seven day a week low carb diet, it's kind of a glaring omission (complete the sequence: 2 days low cal, 7 days low cal, 2 days low carb, ?).

Dave said at December 14, 2011 11:17 AM:

I am seven months into a very low carb diet and my weight has dropped from 245 to 190. Blood lipids moved strongly in the proper directions (Total cholesterol down, LDL down by over 50%, HDL up by 20%). The more I read, the more I think the FDA food pyramid is the greatest example of unintended consequences in the last 100 years. Carbs, even complex carbs increase appetite, and throw insulin management into chaos. One commenter at advicegoddess said, to paraphrase, "If you want to be healthy, take the USDA food pyramid, cut off the sweets and turn it upside down." @Kai - If not entropy certainly not mandating the wrong foods.

The more I read, the more I lean to going Low carb for life or Paleo.
This is the first time I can remember when I can NOT drink a whole pot of coffee. I wake up with energy and purpose. My brain is mapping out the day before my feet hit the floor. It's too bad we can't sue the experts for malpractice.

Pierre said at December 14, 2011 11:20 AM:

Why do you need carbs on those other days? Not required and you will feel so much better without them.

Mac Murry said at December 14, 2011 12:01 PM:

This is intriguing, especially about the insulin resistance. People with Type 2 diabetes should research this a lot more before going on a high-protein or higher fat diet. For Type 2 diabetics, carbs are not the enemy (complex carbs, that is), fat and cholesterol are because they increase insulin resistance at the cellular level. Type 2 diabetics gain much healthier blood chemistry by foregoing animal foods because they are, with very few exceptions, the only way to ingest fats and cholesterol.

OTOH, there is almost nothing that helps T2 diabetics more than losing weight, so if a restricted-carb, high-protein diet does that, then it may even out or better.

Years ago I heard the president of America's dietitians association say in an interview not to go on a diet that you are not willing to stay on for the rest of your life. I think that's good advice.

Bill Quick said at December 14, 2011 12:08 PM:

"Years ago I heard the president of America's dietitians association say in an interview not to go on a diet that you are not willing to stay on for the rest of your life. I think that's good advice."

And that right there eliminates every single standard low-calorie diet ever proposed.

Andy Freeman said at December 14, 2011 12:16 PM:

> The more I read, the more I think the FDA food pyramid is the greatest example of unintended consequences in the last 100 years.

What makes you think that the consequences were unintended?

The FDA food pyramid is designed to achieve a specific goal, which it does. If you're using it for some other purpose, you've made a huge mistake.

Mac Murry said at December 14, 2011 12:40 PM:

Bill, I think you are right. Eventually all low-cal diets are unsustainable because eventually they become unhealthy.

Another thing the dietitian lady said was, "There are no bad foods. There are only bad meals." The interviewer had commented that one should never eat white bread or baked potatoes, and that was her reply. It was also her segue to her advice I first related. This was a huge aha moment for me because her advice of what constituted a bad meal was very simple: a monotone plate of food. "Eat a colorful plate," she said. And if you think about it, a plate full of carbs, whether simple or complex, is basically white.

Since that interview, my own dietary practice has been pretty simple, too: don't eat monotone, make the plate as colorful as possible. Indulge in the most colorful foods and restrain the least colorful ones. So I tend to go pretty hog wild about green beans and spinach, both of which I fortunately love, and eat very little potatoes - but I have not stricken potatoes off my diet altogether. (I have stricken white bread, though, because I have been eating Roman Meal for so long that now I do not like the taste or texture of white bread.)

Maureen said at December 14, 2011 2:00 PM:

Going low carb all the time gave me malnutrition, gave me pains in my joints, did bad things to my nails, made me catch every respiratory illness in the book for six months, and made my hair fall out. I didn't get better without a year with a heck of a lot of vitamins, and going back to whole grain, fortified grain, potatoes, and all the rest. So there are some fairly obvious disadvantages to low carb for some of us grass- and root-eaters.

Not every human is the same, and some of you folks need to quit pushing low carb on everyone. You will never find out how many people unsuited to low carbs that you kill, especially with winter coming on.

Maureen said at December 14, 2011 2:01 PM:

Oh, and I gained weight to boot. Thirty or forty pounds, going from slightly overweight to really obese. Thanks, low carb diet! (Not that I'm bitter or anything.)

bud said at December 14, 2011 2:55 PM:

Sounds to me like intermittent-fasting-lite.

I've managed to stop the "couple of pounds a year" progression by doing I.F. two days a week.

Scott said at December 14, 2011 7:35 PM:

The Four-Hour Body slow-carb diet is in line with this article. Low carb with a cheat day

Randall Parker said at December 14, 2011 8:13 PM:

PacRim Jim,

I will be very curious to hear about your experiences with oxytocin. You going to test out ourself on oxytocin in social settings too?

Bill Quick,

Absolutely. No diet that requires sustained willpower is maintainable. BTW, Tierney and Baumeister's Willpower is a useful read.

What I like about the report above is that this is a sustainable diet. You don't have to struggle to go low carb for a couple of days. I find that if I start out with a high protein and fat breakfast and do the same for lunch and I won't feel a strong pull to eat a lot by dinner. I get home at night and I'm just not very hungry.

Russ said at December 15, 2011 11:01 AM:

The word diet is thrown around so loosely these days, it's crazy. It needs to become a lifestyle for it to stick. People in this society have forgot what the purpose of food really is, to fuel our bodies so they function at an optimal level. If people stuff fast food, processed food and junk in their bodies, then that is why they need a "diet". If they eliminated the crap and ate on the perimeter of the grocery store, then it becomes a lifestyle and we don't have a country that is 60% obese!

The best way to lose weight and keep it off is by joining The 90 Day Challenge! It's safe, easy and FUN and is highly effective! View the program here;

Lisa said at December 27, 2011 2:46 AM:

Maureen: If you had those sort of issues low carbing then you were doing it wrong. If a low carb eating plan is done correctly you certainly aren't going to be malnorished. You should have been logging your food intake with a program like If you did that you would know where you stood on vitamins and nutrients. The hair loss can happen anytime you lose or gain weight too rapidly. It means you were either lacking vitamins or getting too much of something. Too much iron can cause hair loss. A low carb eating plan done correctly is healthy and nutrient-complete. I am an asthmatic with COPD and a low immune system. The only time I feel BETTER is when I am eating low carb. My skin clears up. I don't get allergy/sinus/respiratory illnesses that last from fall through the winter. I don't get the flu. Never felt better or had more energy in my life and I'm 44 yrs old. A low carb lifestyle done correctly won't kill anyone.

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