Primum non nocere [First, do no harm] — A principal precept of medical ethics
When it comes to medical issues, the wrong treatment can often be worse than no treatment. For example, subjects in a University of Minnesota experiment were prescribed a regimen of eating less and exercising more for weight loss. Taking a more conservative approach than many of today’s traditional “eat less, exercise more” advocates, the researchers conducting the experiment prescribed subjects 1,600 calories and about an hour of low-intensity exercise per day.
As expected, subjects temporarily lost weight by shedding water, muscle, and fat. They then gained back significantly more fat than they lost. By the end of the analysis, subjects’ body fat percentage rose by about 52%. The completely unexpected results of the study were the shocking and severe psychological side-effects of this treatment, which included but were not limited to:
- Social Withdrawal
- Loss of Sexual Drive and Function
- Mild Hallucinations
- Mood Swings
- Loss of Ambition
- Hormonal Dysregulation
So profound were the detrimental psychological effects of traditional eat-less-exercise-more therapy that researchers coined the term “semistarvation neurosis” to describe the mental breakdown accompanying the subject’s physical breakdown.
As the side-effects from this and many other studies show, when it comes to long-term fat loss and psychological and physical health:
Doing nothing is better than doing the wrong thing.
The good news is that the top scientific minds in the research community are now writing a new, safe, and proven prescription for long-term fat loss and robust health. Now it’s up to us to learn and live that smarter science of slim.
- Arora SK, McFarlane SI. The case for low carbohydrate diets in diabetes management. Nutr Metab (Lond). 2005 Jul 14;2:16. PubMed PMID: 16018812; PubMed Central PMCID: PMC1188071.
- Augustin LS, Franceschi S, Jenkins DJ, Kendall CW, La Vecchia C. Glycemic index in chronic disease: a review. Eur J Clin Nutr. 2002 Nov;56(11):1049-71.Review. PubMed PMID: 12428171.
- Baba NH, Sawaya S, Torbay N, Habbal Z, Azar S, Hashim SA: High protein vs high carbohydrate hypoenergetic diet for the treatment of obese hyperinsulinemic subjects. Int J Obes23 :1202 –1206,1999.
- Børsheim E, Bui Q-UT, Tissier S, Kobayashi H, Ferrando AA, Wolfe RR. Effect of amino acid supplementation in insulin sensitivity in elderly. Fed Proc (in press).
- Brand-Miller J. Diets with a low glycemic index: From theory to practice. Nutrition Today. 1999;34:64–72.
- Brehm BJ, Seeley RJ, Daniels SR, D’Alessio DA: A randomized trial comparing a very low carbohydrate diet and a calorie restricted low fat diet on body weight and cardiovascular risk factors in healthy women. J Clin Endocrinol Metab88 :1617 –1623,2003
- Crawford D, Jeffery RW, French SA. Can anyone successfully control their weight? Findings of a three year community-based study of men and women. Int J Obes Relat Metab Disord. 2000 Sep;24(9):1107-10. PubMed PMID: 11033978.
- Despres JP, Moorjani S, Lupien PJ, Tremblay A, Nadeau A, Bouchard C. Regional distribution of body fat, plasmalipoproteins, and cardiovascular disease. rteriosclerosis 1990;10: 497–511.
- Despres JP. Dyslipidaemia and obesity. Baillieres Clin Endocrinol Metab 1994; 8: 629–660.
- Due A, Toubro S, Skov AR, Astrup A. Effect of normal-fat diets, either medium or high in protein, on body weight in overweight subjects: a randomised 1-year trial. Int J Obes Relat Metab Disord. 2004 Oct;28(10):1283-90. PubMed PMID:15303109.
- Farnsworth E, Luscombe ND, Noakes M, Wittert G, Argyiou E, Clifton PM. Effect of a high-protein, energy-restricted diet on body composition, glycemic control, and lipid concentrations in overweight and obese hyperinsulinemic men and women.Am J Clin Nutr. 2003 Jul;78(1):31-9.
- Foster GD, Wyatt HR, Hill JO, McGuckin BG, Brill C, Mohammed S: A randomized trial of a low-carbohydrate diet. N Eng J Med348 :2082 –2090,2003
- Frisch S, Zittermann A, Berthold HK, Götting C, Kuhn J, Kleesiek K, Stehle P, Körtke H. A randomized controlled trial on the efficacy of carbohydrate-reduced or fat-reduced diets in patients attending a telemedically guided weight loss program. Cardiovasc Diabetol. 2009 Jul 18;8:36. PubMed PMID: 19615091; PubMed Central PMCID: PMC2722581.
- Frost G, Keogh B, Smith D, Akinsanya K, Leeds A. (1996). The effect of low-glycemic carbohydrate on insulin and glucose response in vivo and in vitro in patients with coronary heart disease. Metabolism, 45: 669-672.
- Gannon MC, Nuttall FQ, Saeed A, Jordan K, Hoover H. An increase in dietary protein improves the blood glucose response in persons with type 2 diabetes. Am J Clin Nutr. 2003 Oct;78(4):734-41. PubMed PMID: 14522731.
- Garrow JS. The safety of dieting. Proc Nutr Soc. 1991 Aug;50(2):493-9. Review. PubMed PMID: 1749815.
- Harrison BC, Leinwand LA. Fighting fat with muscle: bulking up to slim down.Cell Metab. 2008 Feb;7(2):97-8. Review. PubMed PMID: 18249167.
- Izumiya Y, Hopkins T, Morris C, Sato K, Zeng L, Viereck J, Hamilton JA, Ouchi N, LeBrasseur NK, Walsh K. Fast/Glycolytic muscle fiber growth reduces fat mass and improves metabolic parameters in obese mice. Cell Metab. 2008 Feb;7(2):159-72. PubMed PMID: 18249175.
- Johnson D., Drenick E. J. (1977) therapeutic fasting in morbid obesity: long-term fellow-up. Arch. Intern. Med. 137:1381–1382.
- Keys, Ancel. The biology of human starvation. New York: Oxford U.P, 1950. Print.
- Kissebah AH, Krakower GR. Regional adiposity and morbidity. Physiol Rev 1994; 74: 761–811.
- Lasker DA, Evans EM, Layman DK. Moderate carbohydrate, moderate protein weight loss diet reduces cardiovascular disease risk compared to high carbohydrate, low protein diet in obese adults: A randomized clinical trial. Nutr Metab (Lond). 2008 Nov 7;5:30. PubMed PMID: 18990242; PubMed Central PMCID: PMC2585565.
- Layman DK, Boileau RA, Erickson DJ, Painter JE, Shiue H, Sather C, Christou DD. A reduced ratio of dietary carbohydrate to protein improves body composition and blood lipid profiles during weight loss in adult women. J Nutr. 2003 Feb;133(2):411-7. PubMed PMID: 12566476.
- Lejeune MP, Kovacs EM, Westerterp-Plantenga MS. Additional protein intake limits weight regain after weight loss in humans. Br J Nutr. 2005 Feb;93(2):281-9. PubMed PMID: 15788122.
- Low-carbohydrate diet in type 2 diabetes. Stable improvement of bodyweight and glycemic control during 22 months follow-up Jørgen Vesti Nielsen and Eva Joensson Nutr Metab (Lond). 2006; 3: 22. Published online 2006 June 14. doi: 10.1186/1743-7075-3-22. PMCID: PMC1526736
- McAuley KA, Hopkins CM, Smith KJ, McLay RT, Williams SM, Taylor RW, Mann JI. Comparison of high-fat and high-protein diets with a high-carbohydrate diet in insulin-resistant obese women. Diabetologia. 2005 Jan;48(1):8-16.
- McAuley KA, Smith KJ, Taylor RW, McLay RT, Williams SM, Mann JI. Long-term effects of popular dietary approaches on weight loss and features of insulin resistance. Int J Obes (Lond). 2006 Feb;30(2):342-9.
- Meckling KA, Sherfey R. A randomized trial of a hypocaloric high-protein diet, with and without exercise, on weight loss, fitness, and markers of the Metabolic Syndrome in overweight and obese women. Appl Physiol Nutr Metab. 2007 Aug;32(4):743-52. PubMed PMID: 17622289.
- Noakes M, Keogh JB, Foster PR, Clifton PM. Effect of an energy-restricted, high-protein, low-fat diet relative to a conventional high-carbohydrate, low-fat diet on weight loss, body composition, nutritional status, and markers of cardiovascular health in obese women. Am J Clin Nutr. 2005 Jun;81(6):1298-306.
- Nuttall FQ, Gannon MC. Metabolic response of people with type 2 diabetes to a high protein diet. Nutr Metab (Lond). 2004 Sep 13;1(1):652.
- Nuttall FQ, Gannon MC. The metabolic response to a high-protein, low-carbohydrate diet in men with type 2 diabetes mellitus. Metabolism. 2006 Feb;55(2):243-51.
- Parker, B., Noakes, M., Luscombe, N. & Clifton, P. (2002) Effect of a high-protein, monounsaturated fat weight loss diet on glycemic control and lipid levels in type 2 diabetes. Diabetes Care 25:425-430.
- Piatti PM, Monti F, Fermo I, Baruffaldi L, Nasser R, Santambrogio G, Librenti MC, Galli-Kienle M, Pontiroli AE, Pozza G. Hypocaloric high-protein diet improves glucose oxidation and spares lean body mass: comparison to hypocaloric high-carbohydrate diet. Metabolism. 1994 Dec;43(12):1481-7. PubMed PMID: 7990700.
- Pirozzo S, Summerbell C, Cameron C, Glasziou P. Should we recommend low-fat diets for obesity? Obes Rev. 2003 May;4(2):83-90. Review. Erratum in: Obes Rev. 2003 Aug;4(3):185. PubMed PMID: 12760443.
- Samaha FF, Iqbal N, Seshadri P, Chicano KL, Daily D, Mcgrory J: A low carbohydrate as compared with a low fat diet in severe obesity. N Eng J Med348 :2074 –2081,2003 .
- Skov AR, Toubro S, Rønn B, Holm L, Astrup A. Randomized trial on protein vs carbohydrate in ad libitum fat reduced diet for the treatment of obesity. Int J Obes Relat Metab Disord. 1999 May;23(5):528-36. PubMed PMID: 10375057.
- Skov, A. R., Toubro, S., Ronn, B., Holm, L. & Astrup, A. (1999) Randomized trial on protein vs carbohydrate in ad libitum fat reduced diet for the treatment of obesity. Int. J. Obes. 23:528-536.
- Summerbell CD, Cameron C, Glasziou PP. WITHDRAWN: Advice on low-fat diets for obesity. Cochrane Database Syst Rev. 2008 Jul 16;(3):CD003640. Review. PubMed PMID: 18646093.
- Weigle DS, Breen PA, Matthys CC, Callahan HS, Meeuws KE, Burden VR, Purnell JQ. A high-protein diet induces sustained reductions in appetite, ad libitum caloric intake, and body weight despite compensatory changes in diurnal plasma leptin and ghrelin concentrations. Am J Clin Nutr. 2005 Jul;82(1):41-8
- Westerterp-Plantenga MS, Lejeune MP, Nijs I, van Ooijen M, Kovacs EM. High protein intake sustains weight maintenance after body weight loss in humans. Int J Obes Relat Metab Disord. 2004 Jan;28(1):57-64.
- Wolfe RR. The underappreciated role of muscle in health and disease. Am J Clin Nutr. 2006 Sep;84(3):475-82. Review. PubMed PMID: 16960159.
- Worthington BS, Taylor LE: Balanced low calorie vs high protein, low carbohydrate reducing diets. J Am Diet Assoc64 :47 –51,1974 .
- Yancy Jr WS, Olsen MK, Guyton JR, Bakst RP, Westman EC: A low-carbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia. Ann Intern Med140 :769 –777,2004