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There is a general perception that almost no one succeeds in long-term maintenance of weight loss. However, research has shown that approximately 20% of overweight individuals are successful at long-term weight loss when defined as losing at least 10% of initial body weight and maintaining the loss for at least 1 y. The National Weight Control Registry provides information about the strategies used by successful weight loss maintainers to achieve and maintain long-term weight loss. National Weight Control Registry members have lost an average of 33 kg and maintained the loss for more than 5 y. To maintain their weight loss, members report engaging in high levels of physical activity ( approximately 1 h/d), eating a low-calorie, low-fat diet, eating breakfast regularly, self-monitoring weight, and maintaining a consistent eating pattern across weekdays and weekends. Moreover, weight loss maintenance may get easier over time; after individuals have successfully maintained their weight loss for 2-5 y, the chance of longer-term success greatly increases. Continued adherence to diet and exercise strategies, low levels of depression and disinhibition, and medical triggers for weight loss are also associated with long-term success. National Weight Control Registry members provide evidence that long-term weight loss maintenance is possible and help identify the specific approaches associated with long-term success.

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Exp Clin Cardiol. 2004 Fall; 9(3): 200205.

Clinical Cardiology

1Departments of Surgery

2Medicine and

3Physiology, Faculty of Medicine, and

4Faculty of Allied Health Sciences, Kuwait University, Safat;

5Ministry of Health, Safat, Kuwait

Although various studies have examined the short-term effects of a ketogenic diet in reducing weight in obese patients, its long-term effects on various physical and biochemical parameters are not known.

To determine the effects of a 24-week ketogenic diet (consisting of 30 g carbohydrate, 1 g/kg body weight protein, 20% saturated fat, and 80% polyunsaturated and monounsaturated fat) in obese patients.

In the present study, 83 obese patients (39 men and 44 women) with a body mass index greater than 35 kg/m2, and high glucose and cholesterol levels were selected. The body weight, body mass index, total cholesterol, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, triglycerides, fasting blood sugar, urea and creatinine levels were determined before and after the administration of the ketogenic diet. Changes in these parameters were monitored after eight, 16 and 24 weeks of treatment.

The weight and body mass index of the patients decreased significantly (P<0.0001). The level of total cholesterol decreased from week 1 to week 24. HDL cholesterol levels significantly increased, whereas LDL cholesterol levels significantly decreased after treatment. The level of triglycerides decreased significantly following 24 weeks of treatment. The level of blood glucose significantly decreased. The changes in the level of urea and creatinine were not statistically significant.

The present study shows the beneficial effects of a long-term ketogenic diet. It significantly reduced the body weight and body mass index of the patients. Furthermore, it decreased the level of triglycerides, LDL cholesterol and blood glucose, and increased the level of HDL cholesterol. Administering a ketogenic diet for a relatively longer period of time did not produce any significant side effects in the patients. Therefore, the present study confirms that it is safe to use a ketogenic diet for a longer period of time than previously demonstrated.

Keywords: Diet, Ketosis, Obesity

Obesity has become a serious chronic disease in both developing and developed countries. Furthermore, it is associated with a variety of chronic diseases (14). It is estimated that in the United States alone approximately 300,000 people die each year from obesity-related diseases (5,6). Different methods for reducing weight using reduced calorie and fat intake combined with exercise have failed to show sustained long-term effects (79). Recent studies from various laboratories (10,11), including our own (12), have shown that a high fat diet rich in polyunsaturated fatty acids (ketogenic diet) is quite effective in reducing body weight and the risk factors for various chronic diseases. The ketogenic diet was originally introduced in 1920 (13). In this diet, the fat to carbohydrate ratio is 5:1. While there was a significant decrease in the weight of obese patients who were on a ketogenic diet (12), the reverse occurred when the diet changed to one high in carbohydrates (14).

It should be noted that the concept that fat can be eaten ad libitum and still induce weight loss in obese subjects is not a recent one (1333). Ketosis occurs as a result of the change in the bodys fuel from carbohydrate to fat. Incomplete oxidation of fatty acids by the liver results in the accumulation of ketone bodies in the body. A ketogenic diet maintains the body in a state of ketosis, which is characterized by an elevation of D-b-hydroxybutyrate and acetoacetate.

Mild ketosis is a natural phenomenon that occurs in humans during fasting and lactation (19,20). Postexercise ketosis is a well-known phenomenon in mammals. Although most of the changes in the physiological parameters induced following exercise revert back to their normal values rapidly, the level of circulating ketone bodies increases for a few hours after muscular activity ceases (21). It has been found that in trained individuals, a low blood ketone level protects against the development of hypoglycemia during prolonged intermittent exercise (22). In addition, ketosis has a significant influence on suppressing hunger. Thus, a ketogenic diet is a good regulator of the bodys calorie intake and mimics the effect of starvation in the body.

It is generally believed that high fat diets may lead to the development of obesity and several other diseases such as coronary artery disease, diabetes and cancer. This view, however, is based on studies carried out in animals that were given a high fat diet rich in polyunsaturated fatty acids. In contrast, our laboratory has recently shown that a ketogenic diet modified the risk factors for heart disease in obese patients (12).

Although various short-term studies examining the effect of a ketogenic diet in reducing the weight of obese patients have been carried out (10), its long-term effects in obese subjects are not known (15). Therefore, the purpose of the present study was to investigate the long-term effects of a ketogenic diet on obesity and obesity-associated risk factors in a large population of obese patients.

The prospective study was carried out at the Academic Department of Surgery, Consultation and Training Centre, Faculty of Medicine, Kuwait University (Jabriya, Kuwait) in 83 obese subjects (39 men and 44 women). The body mass index (BMI) of men and women was 35.91.2 kg/m2 and 39.41.0 kg/m2, respectively. The mean age was 42.61.7 years and 40.61.6 years for men and women, respectively. The mean age, initial height, weight and BMI for all patients are given in . Fasting blood tests were carried out for all of the subjects. Initially, all patients were subjected to liver and renal function tests, and glucose and lipid profiles, using fasting blood samples, and a complete blood count. Thereafter, fasting blood samples were tested for total cholesterol, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol, triglycerides, blood sugar, urea and creatinine levels at the eighth, 16th and 24th week. In addition, weight and height measurements, and blood pressure were monitored at each visit.

Patient data at baseline before treatment with the ketogenic diet

All 83 subjects received the ketogenic diet consisting of 20 g to 30 g of carbohydrate in the form of green vegetables and salad, and 80 g to 100 g of protein in the form of meat, fish, fowl, eggs, shellfish and cheese. Polyunsaturated and monounsaturated fats were also included in the diet. Twelve weeks later, an additional 20 g of carbohydrate were added to the meal of the patients to total 40 g to 50 g of carbohydrate. Micronutrients (vitamins and minerals) were given to each subject in the form of one capsule per day ().

Composition of the capsule*

Statistical differences between body weight, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, level of fasting blood sugar, and urea and creatinine levels before and after the administration of the ketogenic diet were analyzed using a paired Students t test using the Stat-view version 4.02 (Abacus Concepts Inc, USA). Weight, BMI and all biochemical parameters are expressed as mean SEM.

The mean initial weight of the subjects was 101.032.33 kg. The weight decreased significantly during all stages of the treatment period. The body weights at the eighth, 16th and 24th week were 91.102.76 kg, 89.393.4 kg and 86.673.70 kg, respectively (). Similar to the loss in body weight, a significant decrease was observed in the BMI of the patients following the administration of the ketogenic diet. The initial BMI, and the BMI after the eighth, 16th and 24th week were 37.770.79 kg/m2, 33.900.83 kg/m2, 33.241.00 kg/m2 and 32.061.13 kg/m2, respectively ().

Reduction in body weight at eight, 16 and 24 weeks following the administration of the ketogenic diet in obese patients. The weights are expressed as mean SEM

Decrease in body mass index at eight, 16 and 24 weeks during the administration of a ketogenic diet in obese patients. The values are expressed as mean SEM

The level of total cholesterol showed a significant decrease from week 1 to week 24 (). The level of HDL cholesterol significantly increased (), whereas LDL cholesterol levels significantly decreased with treatment (). The level of triglycerides decreased significantly after 24 weeks of treatment. The initial level of triglycerides was 2.750.23 mmol/L, whereas at week 24, the level decreased to 1.090.08 mmol/L (). The level of blood glucose significantly decreased at week 24. The initial blood glucose level and its level at the eighth, 16th and 24th week were 7.260.38 mmol/L, 5.860.27 mmol/L, 5.560.19 mmol/L and 5.620.18 mmol/L, respectively (). The changes in the levels of urea () and creatinine () were not statistically significant.

Decreased levels of total cholesterol (expressed as mean SEM) in obese patients at eight, 16 and 24 weeks during the administration of a ketogenic diet

Changes in the level of high density lipoprotein (HDL) cholesterol in obese patients during treatment with a ketogenic diet for a period of 24 weeks. Data are expressed as mean SEM

Changes in the level of low density lipoprotein (LDL) cholesterol during treatment with a ketogenic diet in obese patients at eight, 16 and 24 weeks. The values are expressed as mean SEM

Changes in the level of triglycerides in obese patients during treatment with a ketogenic diet over a period of 24 weeks. The values are expressed as mean SEM

Decreased levels of blood glucose (expressed as mean SEM) in obese patients at eight, 16 and 24 weeks during the administration of a ketogenic diet

Changes in the level of urea in obese patients during a 24-week ketogenic diet. The level of urea is expressed as mean SEM

Changes in the level of creatinine in obese patients during a 24-week ketogenic diet. Values are expressed as mean SEM

Until recently, ketosis was viewed with apprehension in the medical world; however, current advances in nutritional research have discounted this apprehension and increased public awareness about its favourable effects. In humans, ketone bodies are the only additional source of brain energy after glucose (23,24). Thus, the use of ketone bodies by the brain could be a significant evolutionary development that occurred in parallel with brain development in humans. Hepatic generation of ketone bodies during fasting is essential to provide an alternate fuel to glucose. This is necessary to spare the destruction of muscle from glucose synthesis.

A ketogenic diet is clinically and experimentally effective in antiepileptic and antiobesity treatments; however, the molecular mechanisms of its action remain to be elucidated. In some cases, a ketogenic diet is far better than modern anticonvulsants (25). Recently, it has been shown that a ketogenic diet is a safe potential alternative to other existing therapies for infantile spasms (27). It was further shown that a ketogenic diet could act as a mood stabilizer in bipolar illness (28). Beneficial changes in the brain energy profile have been observed in subjects who are on a ketogenic diet (28). This is a significant observation because cerebral hypometabolism is a characteristic feature of those who suffer from depression or mania (28). It has also been found that a ketogenic diet affects signal transduction in neurons by inducing changes in the basal status of protein phosphorylation (29). In another study (30), it was shown that a ketogenic diet induced gene expression in the brain. These studies provide evidence to explain the actions of a ketogenic diet in the brain.

One of the mechanisms of a ketogenic diet in epilepsy may be related to increased availability of beta-hydroxybutyrate, a ketone body readily transported through the blood-brain barrier. In support of this hypothesis, it was found that a ketogenic diet was the treatment of choice for glucose transporter protein syndrome and pyruvate dehydrogenase deficiency, which are both associated with cerebral energy failure and seizures (26).

One argument against the consumption of a high fat diet is that it causes obesity. The major concern in this regard is whether a high percentage of dietary fat promotes weight gain more than a low percentage of fat intake. Because fat has a higher caloric density than carbohydrate, it is thought that the consumption of a high fat diet will be accompanied by a higher energy intake (31). On the contrary, recent studies from our laboratory (12) and many other laboratories (24,3234) have observed that a ketogenic diet can be used as a therapy for weight reduction in obese patients.

It has been found that a sugary diet is the root cause of various chronic diseases of the body. A recent study (35) showed that sugar can accelerate aging. Several recent studies (36,37) have pointed to the fact that a diet with a high glycemic load is independently associated with the development of cardiovascular diseases, type II diabetes and certain forms of cancer. Glycemic load refers to a diet of different foods that have a high glycemic index. Glycemic index is a measure of the elevation of glucose levels following the ingestion of a carbohydrate. The classification of a carbohydrate based on its glycemic index provided a better predictor of risk for coronary artery diseases than the traditional method of classification of carbohydrate into simple or complex forms (38). In other studies (3846), it was shown that the risk of dietary glycemic load from refined carbohydrates was independent of other known risk factors for coronary diseases.

It is now evident that high carbohydrate diets increase fasting plasma triglyceride concentrations (4751) and decrease HDL cholesterol concentrations (5255). These changes are associated with enhanced atherogenesis (55). However, it has been shown that short-term ketogenic diets improve the lipid disorders that are characteristic of atherogenic dyslipidemia (56). It has also been found that sugary drinks decreased blood levels of vitamin E, thus reducing the amount of antioxidants in the body. It has been proven, beyond a doubt, that disrupting the oxidant-antioxidant status of the cell will lead to various diseases of the body (57).

The relation between a high fat diet and cancer is not conclusive. Recent epidemiological studies (17,5860) could not explain a specific causal relationship between dietary fat and cancer. It has been found that altered energy metabolism and substrate requirements of tumour cells provide a target for selective antineoplastic therapy. The supply of substrates for tumour energy metabolism can be reduced by dietary manipulation (eg, ketogenic diet) or by pharmacological means at the cellular level (eg, inhibitors of glycolysis or oxidative phosphorylation). Both of these techniques are nontoxic methods for controlling tumour growth in vivo (61). Sugar consumption is positively associated with cancer in humans and test animals (5861). This observation is quite logical because tumours are known to be enormous sugar absorbers. It has also been found that the risk of breast cancer decreases with increases in total fat intake (16). Further studies on the role of a ketogenic diet in antineoplastic therapy are in progress in our laboratory.

A link between low fat diets and osteoporosis has been suggested. Very low fat diets are considered to be low in calcium content. Women on low fat diets excrete most of the calcium they consume; therefore, they are more prone to osteoporosis. However, a high fat diet can rectify this situation (62).

In the present study, a control population on a low fat diet was not included due to the difficulties in recruiting subjects for a control group. However, several studies (63,64) with appropriate control groups that compared the effect of a low fat diet with a low carbohydrate ketogenic diet have recently been published. In this regard, these two recent studies are comparable with the present study. Brehm et al (23) showed that obese women on a low carbohydrate ketogenic diet lost 8.5 kg over six months compared with 4.2 kg lost by those in the low fat diet group (P<0.001). Twenty-two subjects from the low carbohydrate ketogenic diet and 20 subjects from the low fat diet completed the study, with both groups reducing their energy intake by approximately 450 kcal from the baseline level. In another study performed in 132 severely obese subjects for six months (24), there was greater weight loss in the low carbohydrate ketogenic diet group than in the low fat diet group (5.8 kg versus 1.9 kg, P=0.002). Both of these studies support the findings presented in the present paper.

The data presented in the present study showed that a ketogenic diet acted as a natural therapy for weight reduction in obese patients. This is a unique study monitoring the effect of a ketogenic diet for 24 weeks. There was a significant decrease in the level of triglycerides, total cholesterol, LDL cholesterol and glucose, and a significant increase in the level of HDL cholesterol in the patients. The side effects of drugs commonly used for the reduction of body weight in such patients were not observed in patients who were on the ketogenic diet. Therefore, these results indicate that the administration of a ketogenic diet for a relatively long period of time is safe. Further studies elucidating the molecular mechanisms of a ketogenic diet are in progress in our laboratory. These studies will open new avenues into the potential therapeutic uses of a ketogenic diet and ketone bodies.

6. Thomas PR, editor. Washington: National Academy Press; 1995. Weighing the Options: Criteria for Evaluating Weight-Management Programs.

9. Peni MG. Improving maintenance of weight loss following treatment by diet and lifestyle modification. In: Wadden TA, Van Itallie TB, editors. Treatment of the Seriously Obese Patient. New York: Guilford; 1992. pp. 45677.

11. Yancy WS, Jr, Guyton JR, Bakst RP, Westman EC. A randomized, controlled trial of a low-carbohydrate ketogenic diet versus a low-fat diet for obesity and hyperlipidemia. Am J Clin Nutr. 2002;72:343S.

13. Wilder RM. The effect of ketonemia on the course of epilepsy. Mayo Clin Proc. 1921;2:3078.

58. Kaaks R. Nutrition and colorectal cancer risk: The role of insulin and insulin-like growth factor-1. European Conference on Nutrition and Cancer. International Agency for Research on Cancer and Europe Against Cancer Programme of the European Commission; Lyon, France. June 21 to 21; 2001. A0.14. (Abst)

59. Berrino F, Bellati C, Oldani S, et al. DIANA trial on diet and endogenous hormones. European Conference on Nutrition and Cancer. International Agency for Research on Cancer and Europe Against Cancer Programme of the European Commission; Lyon, France. June 21 to 24; 2001. A0.27. (Abst)

60. Willett WC. Cancer prevention: Diet and risk reduction: Fat. In: DeVita V, Hellman S, Rosenberg S, editors. Cancer: Principles and Practice of Oncology. 5th edn. New York: Lippincott-Raven; 1997. pp. 55966.

Articles from Experimental & Clinical Cardiology are provided here courtesy of Pulsus Group

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Long-term effects of a ketogenic diet in obese patients

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The role of very-low-carbohydrate ketogenic diets (VLCKD) in the long-term management of obesity is not well established. The present meta-analysis aimed to investigate whether individuals assigned to a VLCKD (i.e. a diet with no more than 50 g carbohydrates/d) achieve better long-term body weight and cardiovascular risk factor management when compared with individuals assigned to a conventional low-fat diet (LFD; i.e. a restricted-energy diet with less than 30% of energy from fat). Through August 2012, MEDLINE, CENTRAL, ScienceDirect,Scopus, LILACS, SciELO, ClinicalTrials.gov and grey literature databases were searched, using no date or language restrictions, for randomised controlled trials that assigned adults to a VLCKD or a LFD, with 12 months or more of follow-up. The primary outcome was bodyweight. The secondary outcomes were TAG, HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C), systolic and diastolic blood pressure,glucose, insulin, HbA1c and C-reactive protein levels. A total of thirteen studies met the inclusion/exclusion criteria. In the overall analysis,five outcomes revealed significant results. Individuals assigned to a VLCKD showed decreased body weight (weighted mean difference 2091 (95% CI 2165, 2017) kg, 1415 patients), TAG (weighted mean difference 2018 (95% CI 2027, 2008) mmol/l, 1258 patients)and diastolic blood pressure (weighted mean difference 2143 (95% CI 2249, 2037) mmHg, 1298 patients) while increased HDL-C(weighted mean difference 009 (95% CI 006, 012) mmol/l, 1257 patients) and LDL-C (weighted mean difference 012 (95% CI 004,02) mmol/l, 1255 patients). Individuals assigned to a VLCKD achieve a greater weight loss than those assigned to a LFD in the longterm; hence, a VLCKD may be an alternative tool against obesity.

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Very-low-carbohydrate ketogenic diet v. low-fat diet for ...

Our country is obsessed with dieting and working out. But despite having the most gyms, diet books, and exercise DVDs, we are one of the heaviest, sickest nations in the developed world.

That's why, when it comes to weight loss, I believe we've got it all wrong.

Functional medicine recognizes that weight gain is a symptom, not the cause of health problems. In other words:

Weight-loss resistance is a sign that something is going on underneath the surface. And that can rarely be solved in the long term by just another fad diet. Research shows that calorie counting almost always fails when it comes to sustainable weight loss.

We need to ditch dieting and get healthy first. Then we'll reach our goal weight and look great, by accident. It will simply be a natural by-product of radiant health.

How do we do this? By healing. Here are the four key areas your mind, emotions, gut, and hormones that you need to heal first in order to reach your health goals.

The first step to healing yourself is to become aware that we spend most of our day lost in compulsive, unconscious thought.

In fact, Stanford research estimates that a staggering 90 percent of our thoughts are actually repetitive. Think about that: Nine out of 10 of your thoughts are ones you have constantly.

How can this harm your health? For many people these thoughts are not just repetitive, they're also negative. This chronic stress can raise inflammation in our bodies and could contribute to health problems in the long term unless it's kept in check.

Further, research out of Cornell University found that we make about 200 food-related decisions each day. The problem is that most of these food decisions, the researchers found, were made on mindless autopilot. We aren't consciously aware we're making most of them, which could be further contributing to poor eating habits.

That's why increased consciousness of our thoughts is the first step to healing and long-term health. Observing the presence of our thoughts brings us into the here and now, and breaks the addictive cycle of our past.

I recommend practicing mindfulness meditation as one way to become more aware of our health choices and eliminate negative, repetitive thought patterns. Read 11 Ways To Keep Negative Thoughts From Harming Your Health for more practical tips.

Anxiety, fear, and hate are some of the most common emotions that can keep you from reaching your health goals.

These emotions will flood the body with stress and stress hormones. And stress is linked to an increased risk of weight gain and many other heath conditions.

You can't heal a body you hate. So instead of punishing your body into submission by restricting foods, make food your friend.

The key is to eat it consciously and rationally. Your body is a gift that has taken care of you. Love yourself enough to nourish your body with good food medicine.

Further, try to pinpoint what you might be holding onto from your past that's keeping you from your goals. Forgiving yourself and others can be a revolutionary act of healing.

I consider this emotional healing to be vital in my work helping patients overcome their health obstacles.

Now we have to deal with the physical body itself recovering from years of unknowingly mistreating your body.

As Hippocrates said, "All disease begins in the gut." The health of our microbiome, the trillions of bacteria that live within us, determines many facets of our overall health, including our weight.

I often see weight gain as an underlying gut problem. Your microbiome could be damaged after years of junk food, toxins, stress, and harmful medications and you might be seeing the effects in your health.

Healing the gut is a process, which I go into more detail in other articles. But herbal medicines like slippery elm, marshmallow root, and deglycyrrhizinated licorice (DGL) can help. Nourishing bone broth is also on my list of favorite foodie ways to heal the gut.

We tend to think we crave foods or can't get healthy because of a lack of willpower. But often, it's really an underlying hormonal problem that's disabling you from making rational choices about food and keeping you stuck in a cycle.

For example, I often see brain-hormonal connection problems in my patients, such as thyroid conditions, adrenal fatigue, and leptin resistance (when your brain doesn't get the message from your hormones that your body is full).

Years of stress and poor diet can do a number on brain and hormonal health, further perpetuating hormonal dysfunctions. Many people struggling with health problems have some level of brain inflammation, which not only can contribute to anxiety, depression, and brain fog, but can also hurt your hormones.

Healing your hormones is often the first step to healthy weight loss and long-term wellness.

To find out more, check out my free guides to Heal Your Gut and Heal Your Hormones. You can also consider a free webcam or phone evaluation to talk about your specific case.

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What Actually Leads To Long-Term Weight Loss & Health ...

There is a general perception that almost no one succeeds in long-term maintenance of weight loss. However, research has shown that approximately 20% of overweight individuals are successful at long-term weight loss when defined as losing at least 10% of initial body weight and maintaining the loss for at least 1 y. The National Weight Control Registry provides information about the strategies used by successful weight loss maintainers to achieve and maintain long-term weight loss. National Weight Control Registry members have lost an average of 33 kg and maintained the loss for more than 5 y. To maintain their weight loss, members report engaging in high levels of physical activity ( approximately 1 h/d), eating a low-calorie, low-fat diet, eating breakfast regularly, self-monitoring weight, and maintaining a consistent eating pattern across weekdays and weekends. Moreover, weight loss maintenance may get easier over time; after individuals have successfully maintained their weight loss for 2-5 y, the chance of longer-term success greatly increases. Continued adherence to diet and exercise strategies, low levels of depression and disinhibition, and medical triggers for weight loss are also associated with long-term success. National Weight Control Registry members provide evidence that long-term weight loss maintenance is possible and help identify the specific approaches associated with long-term success.

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Long-term weight loss maintenance. - National Center for ...

A large new study compares the effectiveness of low-fat and low-carb diets for long-term weight loss.

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Trying to lose weight? Low-fat diets are not the way to go, according to a large new study.

"There is no good evidence for recommending low-fat diets," lead author Deirdre Tobias, of Brigham and Women's Hospital and Harvard Medical School, in a press statement.

The study, a meta-analysis of dozens of randomized controlled trials, showed low-fat diets were not effective for achieving long-term weight loss compared to higher far diets.

"Behind current dietary advice to cut out the fat, which contains more than twice the calories per gram of carbohydrates and protein, the thinking is that simply reducing fat intake will naturally lead to weight loss. But our robust evidence clearly suggests otherwise," said Tobias, whose research is published in The Lancet Diabetes & Endocrinology.

Tobias and her colleagues analyzed 53 studies -- all randomized trials comparing the effectiveness of low-fat diets to other types of diets -- that included more than 68,000 adults. The researchers found that reduced-fat diets only led to more weight loss when compared with no diet at all. People on low-carbohydrate diets lost substantially more weight than those who went the low-fat route.

The study results aren't really surprising, said endocrinologist Dr. Caroline Messer, medical director of the Center for Pituitary and Neuro-Endocrine Disorders at Lenox Hill Hospital and Manhattan Eye, Ear and Throat Hospital.

"It's nothing new, and similar to what we've always told our patients for all these years. Low-fat diets are not the key to sustained weight loss, despite the fact that a gram of fat has higher calorie content than a gram of carbohydrate. It's a confirmation of what we knew," Messer told CBS News.

"With low-fat versus low-carb, there was less weight loss with the low-fat diet. The only time the low-fat diet was useful was when it was compared to no diet. Low-carb wins out over a low-fat diet," said Messer.

Messer said cutting back on carbohydrates has already been the cornerstone of weight management for patients with type 2 diabetes. "It should similarly be emphasized for non-diabetic patients struggling to lose weight," she added.

The study authors' conclusion is clear: "Health and nutrition guidelines should cease recommending low-fat diets for weight loss in view of the clear absence of long-term efficacy when compared with other similar intensity dietary interventions."

2015 CBS Interactive Inc. All Rights Reserved.

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Low-fat diet no good for long-term weight loss ... - CBS News

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Diet Docs newly advanced diet plans have been redesigned to specifically target, attack and eliminate excess body fat in the hard to reach areas, such as the belly, hips, thighs, underarms and buttocks. The advanced no carb diet plans are by far the companys most effective to date, offering their patients a safe and natural solution to produce fast weight loss initially along with guidance and education to ensure long term weight loss.

Diet Docs team of expert weight loss doctors, nurses, nutritionists and coaches offer their knowledge, expertise and guidance to help their patients, not only melt excess body fat, but to manage their new slimmer body weight long term. New patients consult online with one of the companys doctors prior to working closely with a certified nutritionist who will customize meal and snack plans that are specific to each patients age, gender, activity level, nutritional and medical needs. The experts teach patients how and why specific foods cause a healthy weight reduction in the body. By placing renewed emphasis on teaching patients new eating habits, and providing increased services to guide patients to more effective long term weight loss, people throughout the country are turning to Diet Doc and looking and feeling better than ever before.

Because Diet Doc understands that eliminating carbohydrates from the diet can be challenging, often tempting the most motivated dieters to abandon their weight loss goals, they include prescription diet products that, when combined with the tailor-made meal and snack plans, signal the hypothalamus to target fat that has stored itself comfortably and dangerously in the cells and around the internal organs. This excess stored fat is forced into the bloodstream to be quickly flushed from the system. Patients who enhance Diet Docs best diet plans with prescription hormone treatments, exclusive diet pills, appetite suppressants and powerful fat burners notice the loss of pounds and inches within days of beginning the diet plans. And, because the prescription hormone treatments are enhanced with energy boosting Vitamin B12, patients do not report loss of energy or fatigue during dieting. While the prescription hormone treatments and powerful supplements help patients over initial weight loss hurdles, the reason for tremendous patient success is that Diet Docs best diet plans now include effective education on how to lose weight fast, while also teaching the best habits to help patients create a new, healthy lifestyle change for long term weight loss.

Diet Docs best diet plans to date are a safe, effective and affordable method of rapidly losing dangerous and embarrassing excess fat. The companys utilization of the most modern technology enables patients in any part of the country to consult with their doctor and nutritionist, schedule weekly checkup calls and reorder prescription products without leaving the comfort of their home, making location a non-factor and allowing clients nationwide the very real possibility of safe, effective and long term weight loss. Because Diet Doc offers only 100% pure prescription products that are manufactured in the U.S. in fully licensed, FDA approved pharmacies, the best diet plans that are unique to each patients specific body type and circumstance, comprehensive medical supervision, and a level of personal service that is unequaled by competitors, the company has become the most trusted and reliable source for fast and long term weight loss.

About the Company: Diet Doc Weight Loss is the nations leader in medical, weight loss offering a full line of prescription medication, doctor, nurse and nutritional coaching support. For over a decade, Diet Doc has produced a sophisticated, doctor designed weight loss program that addresses each individual specific health need to promote fast, safe and long term weight loss.

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Diet Doc: Fast and Long Term Weight Loss

Boca Health, which is the premier physician supervised metabolic and medical weight loss clinic offers a decided advantage to other methods of weight loss. For Boca Raton, as well as for many other areas in South Florida, the basic approach to weight loss, eat less and exercise more simply doesn't offer the results that you need.

The health care professionals at Boca Health understand that some medical conditions which are part of our lives can be a dramatic hindrance to our weight loss efforts. Physicians at Boca Health assist in the evaluation of your problems and in devising a program of weight loss that is workable for you.

Many people lose more muscle than actual fat when dieting. This is due to an industry which offers a vast array of bad information at every turn. The people who come to Boca Health are desirous of losing inches and losing fat, not losing or jeopardizing their lean muscle. The focus of our team of physicians and health care providers is that you will see the progress as quickly as possible and you'll begin to feel the effects that healthy weight loss can offer you. The BioSpace body scan will give you a detailed analysis of what you have to know about your body makeup.

Yes, of course the eat less, exercise more approach may in some cases be an effective way to lose weight. It may also help you to even keep the weight off for a time. The problem is that it is not effective for everyone and when it comes to taking off the weight and keeping off the weight, you may need a little more.

The advantages of a physician-overseen weight loss methodology are self-evident. The state of the art medical equipment, the highly-trained staff & specialized weight loss personnel are just a few of the reasons why medically based weight loss clinic methods are going to offer you the best weight loss methods and the best results.

Boca Health recently unveiled the hottest new diet to hit South Florida: the Boca Health Diet. The Boca Health Diet is a revolutionary new look at weight loss and good health. It is overseen and your health is monitored by medical weight loss physicians and the diet is customized to fit the individual weight loss needs of each of our clients.

The Boca Health Diet, contrary to the HCG diet, includes breakfast and snacks, has a higher calorie diet and a higher protein intake.

The Boca Health Diet is extremely safe, and results in greater weight loss than the HCG diet. Furthermore, because of the extra calories and proteins in the Boca Health Diet, patients are encouraged to work out for an even greater weight loss.

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