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In what ways do low-carbohydrate diets impact weight?

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Those who follow a low-carb, mostly plant-based diet are more likely to prevent weight gain, According to a recent study.

Less refined carbohydrates, fat, and plant-based protein made up the most effective low-carb diet that was ever researched.

The study shows that it’s important to consider not just the quantity but also the kind and quality of carbohydrates a person eats.

A low-carb diet is likely to cause the majority of weight lost to return within two years and almost all of it to return within five years, according to previous study.

A recent study conducted by scientists at Harvard T.H. Chan’s School of Public Health (HSPH) in Boston, Massachusetts, may be helpful for those trying to avoid weight gain by following a low-carb diet. It finds that the amount of weight one regains is influenced by the nature and quality of one’s low carb diet.

The least amount of weight was likely to be gained back by those whose low-carb diets prioritised high-quality proteins, lipids, and carbohydrates from whole grains and other healthful plant-based foods.

On the other hand, individuals who consumed higher amounts of refined carbs, animal-sourced lipids, and proteins were more likely to put on weight.
The study’s conclusions are based on data from three extensive U.S. studies, the Nurses’ Health Study (NHS) and Nurses’ Health Study II (NHSII), and the Health Professionals Follow-up Study (HPFS). The studies cumulatively extended from 1986 to 2018, with a total of 123,332 participants. Their mean age was 45, and 83% of participants were women.

Their food consumption was scored for its adherence to one of five low carb diet types:

a general, or total, low-carb diet (TLCD)
an animal-based low-carb diet (ALCD) emphasizing animal-based protein and fat
a vegetable-based low-carb diet (VLCD) emphasizing plant-sourced protein and fat
a healthy low-carb diet (HLCD) involving less-refined carbohydrates and a focus on plant protein and healthy fat
an unhealthy low-carb diet (ULCD) diet incorporating less-healthful carbohydrates along with more animal protein and unhealthy fat.
The researchers found that people who had obesity and more strictly followed a healthy low-carb diet experienced 1.63 kg less weight gain compared with people who had no change in their diet.

The study is published in JAMA Network Open.

Dr. Qi Sun, the study’s senior author and associate professor at HSPH, said, “It’s well-appreciated that body weight maintenance after significant weight loss is challenging.”

“It’s not necessarily due to the lack of willpower. Instead, after significant weight loss, changes in multiple hormones and systems happen and together these changes lead to reduced resting metabolic rate, enhanced appetite, increased energy intake, and ultimately weight regain,” Dr. Sun said.

“For most long-term weight loss trials, it is typical that most weight loss is achieved at about six months, and after that, there is a steady weight regain.”
— Dr. Qi Sun

Michelle Routhenstein, a preventive cardiology dietitian nutritionist, who was not involved in the study, mentioned another obvious reason for weight regain:

“Maintaining weight after losing it can be tough because oftentimes weight loss plans involve depriving oneself.” Doing without may be acceptable for a short duration but is difficult to sustain permanently.

As a cardiology-focused clinician, Routhenstein is also reluctant to prescribe low carb weight-loss regimens in any event.

“I do not recommend low-carbohydrate diets for weight loss because low-carb diets may pose heart related risks like increased coronary artery calcium, potential atrial fibrillation, and nutrient deficiencies.”
— Michelle Routhenstein

Another reason we tend to regain weight is the “set point theory.” It suggests one’s body may have a pre-set weight to which it ultimately gravitates.

Another finding of the study is that those on an HLCD diet did even better than those on a VLCD diet. An important distinction between the two diets is that HLCD emphasizes less-refined carbohydrates.

According to Dr. Sun, “Refined carbohydrates and added sugars — especially those from sugar-sweetened beverages, are known to contribute empty calories without other nutrients — and “do not quickly lead to satiety.”

“They induce more rapid changes in postprandial glucose and insulin levels, lead to the feeling of hunger earlier than the intake of the same amount of calories in the form of whole grains,” he explained.

What does a successful weight maintenance strategy look like?

“I think ‘quality,” said Dr. Sun, “is the keyword in our take-home message.”

“When the low carb diets emphasize the quality of food sources of macronutrients,” he noted, “we see that such diets lead to most favorable outcomes of weight management, whereas the unhealthy version of the low carb diets show the opposite health effects.”

“As such, low-carb diets may or may not help with weight management unless they emphasize a high diet quality.”
— Dr. Qi Sun

“Transitioning from weight loss to maintenance is about making lasting habits. Create an adaptable plan, stay reflective, and lean on support systems. Staying resilient and kind to yourself is also an important component for long-term success,” Routhenstein pointed out.

Dr. Sun said that low carb diets also had to think about macronutrients “increasing macronutrients to make the total energy constant.”

“Plant-based diets, whether very low calorie or higher-calorie, may lead to less weight gain over time compared to animal-derived low carb diets due to their high fiber content fostering satiety, lower energy density enabling larger portions with fewer calories, and lower saturated fats,” said Routhenstein.

“Additionally, their nutrient richness and potential positive impact on the gut microbiome contribute to better weight management,” she said.

Additionally, Routhenstein highly advises consulting a trained healthcare provider, such as a certified dietitian, to create a personalised eating plan.

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