LowCarbohydrate, HighProtein diets and weight loss

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Low-Carbohydrate, High-Protein diets and weight
loss!

• By Katie Swafford

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Agenda

• Purpose
• Prevalence of obesity
• Defining low-carbohydrate, high protein (LCHP)
  diets
  
• History of LCHP diets
• Overview of the different LCHP
• Studies
• Weight maintenance
• Conclusions
• Implications

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Purpose

• Define a LCHP
• Evaluation of low-carbohydrate high-protein
  diets, and the effectiveness of weight loss.

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Obesity

• Rapidly increasing
• More than 1 billion overweight adults
• 300 million obese adults
• 325,000 deaths/year
• Overweight BMI 25-29.9
• Obesity BMI 30

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Common Names

• Very-low-carbohydrate diet
• Low-carbohydrate diet
• High-protein diet
• Ketogenic diet
• High fat diet

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Define a LCHP?

• What does it mean to you?
• USDA
• CHO 55 Protein 15 Fat 20

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History

• 1860s
• Discovered by William Harvey
• Banting diet
• Named after Harveys pt William Banting
• Later followers
• Blake Donaldson in 1944
• Stillman and Baker in 1967

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Carbohydrate Addicts

• Dr. Rachael Heller and Dr. Richard Heller
• 1991
• Hunger, cravings, or desire for carbohydrate rich
  foods.
  
• Releases more insulin than necessary, thus not
  feeling satisfied after eating or within 2 hours
  of eating.
  
• Exercise

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Entry Plan

• 2 weeks
• Eat 2 meals that are low in CHO
• The third meal - Reward meal
• Rich in CHO foods
• 60 minutes
• Nourished and well balanced meal
• Consumed at the same time everyday

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Next Step

• Based on weight loss, choose a plan that fits
  your needs
  
• Plan A used for slow wt loss
• Plan B used for slow wt loss
• Plan C used for rapid wt loss
• Plane D used for rapid wt loss

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Sugar Busters Diet

• Leighton Steward - 1995
• Sugar is Toxic
• Overproduction of insulin
• Successfully control insulin levels by
  controlling intake of sugar
  
• Exercise

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Diet

• 3 balanced meals with 1-2 snacks, 1 snack may be
  a dessert after dinner
  
• Eat low glycemic indexed CHO
• Food should not overflow plate
• No midnight snacks, do not eat after 800 pm

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The Zone Diet

• Barry Sears - 1984
• Too much CHO ? fat and sluggish
• The key is to regulate insulin Too much or not
  enough insulin is indicated if you get hungry
  within 2-3 hours after eating a meal
  
• Exercise

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• Keep insulin in a tight range by hormonal
  carburetor
  
• Based on CHO blocks - 9g, Pro blocks - 7g, Fat
  blocks - 1.5g
  
• 11 ratio of Pro and CHO, plus 1 fat

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• 3 meals and 2 snacks
• CHO 40, Pro 30, Fat 30
• 1000-1600 calories/day
• Eat low glycemic index CHO

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Protein Power

• Dr. Michael Eades and Dr. Mary Eades
• 1996
• Insulin is the culprit
• High insulin levels produce obesity

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• Phase 1
• 4-6 weeks eat 30g of CHO or less/day
• Phase 2
• Eat 55g of CHO or less/day
• Increase daily CHO intake until the amount in
  grams is equal or slightly more than protein
  intake
  
• Gradually increase CHO intake to 10g weekly

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Atkins Diet

• Dr. Robert Atkins
• High insulin levels cause one to be overweight or
  obese by preventing fat from breaking down.
  
• Eat low glycemic foods

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Phase 1

• The Induction phase
• 14 days
• Less than 20g of CHO/day
• salad greens and other vegetables
• Addiction of CHO gone in 3-days

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Phase 2

• Ongoing weight loss or OWL
• Pick your goal wt
• Increase 5g of CHO/day
• If wt loss continues add another 5g of CHO
• Add 5g of CHO/day until you stop losing wt

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Phase 3

• Pre-maintenance
• The last 5-10
• Increase 10g of CHO/week as long as you continue
  to lose wt
  
• If at goal wt maintain CHO for a month
• If you gain drop 10g of CHO

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Phase 4

• Lifetime maintenance
• Made it to goal wt
• If gain more than 5 go back to induction phase
  and then OWL
  
• Exercise

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The South Beach Diet

• Dr. Arthur Agatston - 2003
• Insulin resistance syndrome can cause obesity
• Eat low glycemic CHO
• Eat until you are no longer hungry
• Exercise

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Phase 1

• Restricts all CHO for 14 days
• No bread, rice potatoes, pasta or baked goods,
  fruit, candy, cake, cookies, ice cream, or sugar,
  no beer or alcohol,
  
• Will lose 8-13 s

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Phase 2

• Will lose 1-2 /week
• Slowly add good CHO back into diet.
• Gradually add CHO until you stop losing wt.
• On this phase until you reach goal wt.

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Phase 3

• Once you hit target wt you are on this the rest
  of your life.
  
• More liberal diet. If you want it eat it.
• If gain wt go back to phase 1 then phase 2 or 3.

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• Any Questions?

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• Research Studies

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Foster et al 2003

• 12 month, multi-center, randomized, controlled
  trial
  
• 33 subjects on LCHP diet, 20 left
• Met with a dietitian
• 30 subjects on conventional diet, 17 left
• BMI ranges 30-38

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• LCHP (Similar to Atkins or South Beach)
• First two weeks 20g/day of CHO, gradually
  increase until desired weight is achieved
  
• Conventional
• CHO 60, Fat 25, Protein 15,

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Weight Loss of Body Wt
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Samaha et al 2003

• Randomized
• Started with 132 volunteers, ended with 79
• 6 month study
• BMI 35 or greater
• Death of one subject

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• LC (43)(Similar to Atkins, South Beach, Protein
  Power)
  
• 30g or less of CHO/day
• Pro 22 CHO 37, Fat 41 at 6m
• LF (36)
• Pro 16, CHO - 51,Fat - 33 at 6m

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Weight Loss In kg
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Brehm et al 2003

• Randomized 6 month trial
• 53 obese females and 6 males
• 42 volunteers completed the study
• Both groups met with dietitians
• BMI 33.6 /- 0.3

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• LF (calorie restricted)
• CHO 55, Fat 30 Protein 15
• 20 subjects
• VLC (Similar to Atkins, South Beach,or Protein
  Power)
  
• 20g of CHO/day after 2w increase to 40-60g/day,
  ad libitum
  
• 22 subjects

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Weight Loss In kg
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Luscombe et al 2002

• 26 obese, Caucasian, volunteers
• 12 week study
• BMI was not given

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• 1600 kcal diet first 8 weeks, energy balance 4
  weeks
  
• LCHP (Similar to Zone diet)
• CHO 40, Fat 32, Protein 28
• HCLP
• CHO 55, Fat 29, Protein 16

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Layman et al 2003

• 24 women
• 10 weeks
• BMI greater than 26
• First 4 weeks food prepared in food research
  labs
  
• Last 6 weeks food prepared at home

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• 1700 kcal/day
• High CHO diet
• CHO 58, Pro 16, Fat 26
• Moderate protein diet
• CHO 41, Pro 30, Fat 29
• Similar to Zone diet

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Weight Loss in kg
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Skov et al 1999

• Randomized dietary intervention of 65 volunteers,
  60 complete the study
  
• 6 month trial
• BMI not available
• Chose food freely from a shop
• Instructed how to prepare meals

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• HC
• CHO 58, Pro 12, Fat 30
• HP
• CHO 45, Pro 25, Fat 30
• Similar to Zone diet

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Weight Loss in kg
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Summary
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Other Studies

• Westman et al, 2002
• Compared only 1 diet (10.3)
• Johnston et al, 2003
• Equally effective
• Racette et al 1995
• Significant wt loss for both groups
• Clifton et al, 2002
• Significant difference

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More Studies

• Sondike et al, 2003
• Significant difference
• Volek et al, 2002
• Significant difference
• Skov et al, 2002
• No significant difference
• Golay et al, 1996
• No significant difference

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More Studies

• Golay et al, 1996
• No significant difference
• Lean et al, 1997
• No significant difference
• Yancy et al, 2002
• No significant difference
• Brown et al, 2000
• No significant difference

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More Studies

• Skov et al, 1999
• No significant difference
• Landers et al, 2002
• No significant difference

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Summary of all Studies

• 18 studies total

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Weight Maintenance

• Little is known about the best way for long-term
  maintenance
  
• Little progress has been made in long-term
  maintenance interventions with the exception of
  surgery.
  
• Limited data is available

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Weight Maintenance

• National Weight Control Registry - 1995
• 3,000 individuals who lost 30s and kept the
  weight off for more than a year
  
• Compared 2,700 members diets to the Atkins
  diet.
  
• 8 liberal 90g of CHO
• 1 ingesting less than 24g of CHO

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NWCR

• Higher CHO intake verses 1 group consuming less
  than 24g of CHO/day
  
• The low CHO group maintained their weight loss
  for less time and were less physically active.

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Conclusions

• People lose weight on most diets
• American Dietetic Association American Heart
  association

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Conclusions
Insufficient evidence for or against the use of
low carbohydrate, high protein diets.
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Professional Implications

• Need for more research
• Longer and larger studies required
• Long-term and efficacy and safety remain poorly
  understood
  
• Long-term success rates are not convincing

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Questions?

• ?