All diets are equally good … or are they?


How should you eat for weight loss?

In the past, many people used to believe that all fat was bad for you. Today, almost everyone knows that this was a mistake.

The question is what is to come instead? The conventional wisdom today is fraught with confusion and a belief that it doesn’t matter at all what you eat weight-wise – “all diets are equally good”. A new scientific review of selected previous weight studies claims to confirm this… but it turns out not to be that simple.

BBC News: Any diet will do, say researchers, if you stick to it

It really wasn’t “all” diets that were equally good in the review, but low-carb or low-fat. But wait a minute, and let’s look at how they grouped different diets:


So, what most would call a low-fat diet, as in the old official or Weight Watcher’s dietary guidelines, turned out to be the worst in this review. It’s what they call “moderate macronutrients in the table above.

This despite the fact that the journalists wrote that all diets were equally good!

The diet groups that shared the first place were either…

  1. The average of all low-carb diets advising up to 40 % carbohydrates (Low-glycemic index diet)
  2. A strict low-fat diet, such as Ornish with less than 20 % fat.

A bit of an unfair comparison, it may seem. What if we instead compare advice on a more efficient strict low-carb diet, such as Atkins or LCHF (below 10–20% carbohydrates) with advice on a strict low-fat diet? Not many studies have compared the two, but by far the largest of them is Gardner and colleages’ study from 2007. Here’s the result:


When it comes to more moderate low-fat diets, the difference is even more obvious – and they even had the worst results in this comparison! Advice about low-carb diets has won over that for conventional low-fat diets in so many comparative studies  – as recently as earlier this week – that it’s becoming more and more embarrassing to pretend otherwise.

Even a new Swedish government expert committee reached the conclusion that a low-carb diet provides more weight loss.

At children’s birthday parties we may feel free to pretend that all participants are doing equally well. But when it comes to scientific studies on different diets for weight loss it becomes more and more contrived to even try.


Swedish Expert Committee: A Low-Carb Diet Most Effective for Weight Loss

New Major Study: A Low-Carb Diet Yet Again Best for Both Weight and Health Markers!


Top comments

  1. Paul the rat
    I can not vouch for members/contributors to this blog who follow LCHF lifestyle because I do not know them in person, however I know more than 30 people personally who follow LCHF lifestyle some for more than 1 year some close to 20 years, as it is case with me (and as you know by now).

    What is that troubles you Wade? are you jealous of our health and the fact that we do not go to our family medical professionals anymore?. Tell us please. What are you trying to convince me of - that my 20 years of personal experience is nothing because of a study, which in your understanding is not random, too random or does not account for smoking, swimming, norse-bathing or has too fat or too skinny people in it?

    Read more →
  2. erdoke
    By now it should be perfectly clear to everyone having any interest in nutrition and weight loss diets that the key word is ADHERENCE.
    Then adherence consists of other key words such as satiety, hunger, tasty, etc. We can argue about the exact role of calorie restriction (CICO) until our Sun will become a supernova, the fact is that regardless of the outcome, low carb diets have the definitive advantage of conquering all the areas that above key words cover.
    So why don't we just move over to the discussion about the effect on cardiovascular health now and close the weight loss debate?
    Quite honestly, I believe that a 10 % fat diet is extremely difficult to adhere to simply because it is not what the big majority of humans is adapted to. It is also clear by now that CVD is not caused by natural fats, so why should we attempt to cure it with a low fat diet in the first place?
    Reply: #10
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All comments

  1. erdoke
    Quite seriously: forget about that Coke Zero! That's the worst type of artificial sweetener packed into it. You might need to do nothing else, just get rid of the soda.
    I assume no need to further reduce calories even when introducing IF.
  2. Gillian
    Thank you, (and Francois) for your help. My husbands heart attack was a silent one he had no symptoms at the time, it showed up in routine tests.Doctors said that he could have another at any time if he didn't have the triple bypass op. He is now 67 since 3 years ago has type II diabetes, (slightly high, he takes 1 Metformin tab not sure of the amount), and has slight breathlessness on climing a large flight of stairs, apart from this he regularly tills, (with pusher rotatiller), and looks after our large veggie garden, (4000 sqmeter), eats a lowish carb meditereanean diet,(we live in Spain) and feels fine so hoping things will stay that way. Will look into Nattokinase and Serrapeptase as you say this could be helpful.
    Reply: #54
  3. murray
    Wade, in response to
    "Now, I do wish you could include something you allude to when you say the following...

    "I would never claim that the low-fat regimes of Ornish and others cannot have positive effects. Perhaps they do. But that does not in any way dispel ketogenic LCHF as an effective dietary lifestyle, either in terms of preventative or restorative treatment."

    "either in terms of preventative.....or ---RESTORATIVE treatment---"

    Regarding coronary stenosis, do you have any link to a study showing that LCHF dieting will halt or hopefully reverse a stenosis over 2 or 5 or more years?"

    No, I don't have such a study. All I have is anecdote and holistic inference from various sources, such as the metabolics of ketones and caloric deprivation. Obviously this is not scientifically definitive and I would certainly bow to more elucidating research. But as you apparently appreciate, things are more complex than the science has progressed. I note that I would not expect to see such a study in the current funding context, as no one would have had a serious prospect to get funding approval for such a study given the dominant paradigm. I doubt the ethical review committees would allow treatment of high-fat to patients with narrowed arteries. The absence of such a study is thus a neutral consideration. This has been the difficulty (and art) of low-carb, high-fat diet investigation with respect to weight loss and other issues, one has had to learn to infer from indirect evidence. The recent NIH study was significant because NIH is finally funding such studies, albeit still behind the curve and biased against existing work (as Dr. Feinman has griped). So we cannot realistically expect studies that require massive capital to test LCHF scientifically. This, however, does not mean it is not true.

    My point in the quoted passage was that the effectiveness of one does not preclude the effectiveness of the other. I don't mean to say the evidence shows low-fat is ineffective; only that I don't find it more convincing than the totality of evidence in favour of calorically restricted keto-LCHF.

    So reasonable minds can differ on this. I can say I would literally bet my life on the efficacy of keto-LCHF, but as you rightly observe, I am in the preventative side not the restorative side, so it is still moot. Before I went keto-LCHF I did have a scare with a treadmill stress test, but subsequent testing (ultrasound video, etc.) showed it was just a false positive on the stress test, which apparently was common. Nonetheless, it was a disconcerting couple of weeks. Seeing the video of blood flows through the heart chambers was cool . The software added little red and blue arrows to highlight the direction of flow and I was shown videos of hearts with problems, to gain a sense of what they were looking for. It is a fine thing that biology and the science of it are so fascinating.

    Reply: #56
  4. François

    May I suggest you "youtube" Jason Fung? He's a Canadian nephrologist who got tired of his patients destroying their kidneys with diabetes. He is director of the only inpatient program - as far as I know - to reverse diabetes with diet and part fasting (16/8 fasting if I remember correctly).

    He has a number of great videos I strongly suggest you look at.

    Good luck to your husband and yourself.

  5. Galina L.
    My father died at the age 51 more than 25 years ago from a heart arrest, after 10 years of being diagnosed with ischemia and one heart attack six years before he died. He was never overweight except for a brief period when he was prescribed a low-fat/ no red meat/limited meats diet after the heart attack. He couldn't stop eating without meat and fat,so he returned to his normal way of eating considering that gaining weight was not healthy as well. Ok, some people could successfully follow a 10% fat diet, and they could provide us with many personal anecdotes, no less than LCarbers. However, there are people like my dad. I wish he was offered a very low-carb option as well to try. It looks like he had nothing to loose.
  6. Wade Henderson

    " So we cannot realistically expect studies that require massive capital to test LCHF scientifically. This, however, does not mean it is not true."

    I think we both agree about that and the same holds true for a "real" low-fat diet.
    No one is going to fund a large low-fat study where 10% is used as the mark to hit.

    There are even bigger problems. Even if you could get substantial funding, to do a randomized study of that nature would have you end up with 80% of the low-fat wing dropping out or falling so short of the 10% goal as to make the results meaningless, except as a demonstration of non-compliance.

    No, I've never doubted that only highly informed or highly motivated individuals will follow that degree of low-fat diet.
    However when you have a group of motivated people, I think there is some evidence it does in fact work as advertised.

    There was a large nurses study, well funded. Their aim for the low fat wing was 20%, but by the end, they were right up there at 29%...not far below their baseline. Just as was the case in the recent NIH study.

    Here is a study, a real study though small, that was not designed for heart reversal or for weight loss. Rather it was a 12 month low-fat study to examine the impact on multiple sclerosis.
    They aimed at 10% and ended up the year at 15%.
    The intervention arm, did not get the results they were hoping for regarding MS.

    Still they did report, weight loss, total cholesterol, and LDL cholesterol.
    They look to be similar or actually better than the recent low-carb NIH results.

    I only present it here for interest. I'm not trying to compare the two to make a point.
    Only something you might find interesting.
    BTW, the small Ornish studies, Lancet 1990, and JAMA 1998 are interesting reads, even for those who don't accept that premise. As is the "outcomes" portion of the recent Esselstyn study of nearly 200 individuals. Again, they are small and imperfect, but I as a interested person don't have huge perfect studies to go on.

    The only huge studies in this area are the massive statin studies, funded by guess who?
    I read them,... and throw them into the mix.

    I read everything I can and the go with what I feel gives me the best shot at avoiding a heart attack and reducing any angina.
    It may well be that different diets work better for different people as long as they are followed strictly.

    Reply: #58
  7. Karen
    I have been trying diligently to loose 20 pounds for the past 10 years. Now that I'm over 50, it was getting even more difficult. Despite being in good physical shape from lots and lots of regular walking and swimming, I've not been able to loose more than 5 pounds, and even then, it was creeping back on, even with what I considered to be a very low carb diet (30-50 net grams per day.) Within the last few months, I changed the ratio of fat/protein/carbs dramatically (for me): 70 to 80% fat, about 20-25% protein, and 5% carbs. Finally, the weight is shifting. Perhaps because I was already eating low carb, the change has not been that hard--it just takes a bit more research and planning. I can definitely eat this way for life, and I plan to. Down 10 pounds and weighing less than I did 20 years ago, the next 10 to 15 pounds won't be a problem. And the biggest difference: I feel confident and motivated. I've done WW and I've done something like Ornish, but that's just not how my body seems to work.
  8. erdoke
    You might have read everything you could, but you still seem to have failed to draw the right conclusions. Let me help you out a bit with two questions. I will even answer the first, so that your job is only to guess the second right.
    1. Q: What is the metabolic/catabolic pathways are being turned on in your body when you fast and when you limit your consumption of dietary fat to well below the levels of what is obviously needed?
    A: You ignite fat metabolism and catabolism respectively. In the first case fat is sourced from adipose stores while in the second it is synthesized from carbohydrates.
    2. What type of fat is utilized and transported in the blood in both cases and what type is missing in greater amounts?
    If you guess it right you immediately know why a very low fat diet might benefit patients with existing atherosclerosis. An extra help attempt: Yes, this substance is of course linked to LDL particles and well in line with what we know about the formation of atherosclerotic plaques.
  9. erdoke
    An interesting paper to Wade's attention:
    Dietary fats, carbohydrate, and progression of coronary atherosclerosis in postmenopausal women
    Replies: #60, #61
  10. Paul the rat
    We discussed this paper over a year ago at, but seems that some of us here are very selective in what we want to read.
    (I'll stick to the conclusions drawn from research based on McDougall diet, sponsored by McDougall)
    Reply: #62
  11. Wade Henderson
    erdoke, thank you for the link to that study. That is the kind of thing I have been looking for.

    It will take me some time to go over it as I like to read these things in depth.
    I do wish it was not limited to postmenopausal women but then again, most of the other studies are done mostly on men.

    In my brief review I did find one unusual bit of data. The one in table 4 where smokers seemed to do best? Am I reading that wrong?

    Also interesting, those taking statins.

    All in all, this is very interesting, even though they didn't include men and even though they didnt' do a 10% example. Even less than 20% is better than most studies include.

    I read through it as I get more time.
    See, I knew someone would come up with something.

  12. Wade Henderson
    Paul the Rat.... "We discussed this paper over a year ago at, but seems that some of us here are very selective in what we want to read."

    Well despite what you may think, I don't come here every week or even every month over the past two years. I had never read or seen mention of the study erdoke linked us to above.
    More recently, yes... I have been reading daily.

    Despite what you may think, I do in fact want to read good science from both sides.
    My feet are not in cement as most seem to be.
    On the other hand, no single study completely sways me.
    We've all seen multiple studies contradicting each other.

    interestingly, the lead author of this study, in a separate non-medical article, tells us what he thinks is the best diet.

    Replies: #63, #65
  13. Paul the rat

    "The “evil” food showing up in Mozaffarian’s study is clearly the potato, which wasn’t known to the world outside the Western Hemisphere until 400 years ago. But all types of prepared potatoes were not equal. Boiled, baked and mashed potatoes promoted weight gain, but potato chips were rated three times as bad and French fries six times as bad as boiled, baked or mashed potatoes."

    Well, this is what the author of the article you provided link to says. Yet you quote McDougall (whose diet is based on potatoes) and link to his website as a.... exactly - as a what, Wade?

    Replies: #66, #79
  14. FrankG
    Why are we still feeding this troll?

    "Oh I'm too busy just now to do a full critique of this study but meantime I did just happen to find an opinion-piece, by the lead author, in this obscure Iranian newspaper; in which he seems to discredit his own study... weird eh???"

    Lead author or no, his opinion counts as much as mine does. The scientific method does not allow for editorialising. That said, I probably agree with his opinion that any traditional diet is preferable to the SAD but that has no bearing on what was actually observed in this study.

    Oh but it is all about an unbiased appraisal of the totality of the science... balls it is... the scientific method is NOT about consensus, or who has the most studies... it only takes ONE study to disprove centuries of prior ones.

  15. erdoke
    There is a good assessment of this paper from Chris Masterjohn over on the WPF's website. I believe he even compares it to one of Esselstyn's studies. I'm not sure about the title though, but it is about essential fatty acids.
    Reply: #67
  16. erdoke
    I read somewhere that raw potatoes contain up to 80 % resistant starch (from all starches). That's a huge difference even to boiled and then cooled potatoes that contain something like 20 %.
    This is of course not to suggest that anyone should base his diet on raw potatoes...
    We still miss Wade's answer to my second question. :)
  17. Wade Henderson
    You guys need to relax... as though a "troll" might poison your minds or impressionable others.
    Funny, I've had the same response from the Low-fat sites... where the true believers feel it is their duty to warn others.
    I'm actually looking for the facts.
    Yes I read several other sites from the "no-fat" perspective, but I have a mind that is open to interesting facts.
    On a brief first read, that study is interesting, though I am having some trouble with the measurements they use and how to compare them with those in other studies.
    I am working on it. Eventually I'll have some questions and comments on what it says.... which by the way, the authors indicate and admit is contrary to most of the other "mostly male" studies.
    I don't just go to the conclusion and say.... "There, thats proof everyone else is wrong" because it fits into what I want to believe.
    Again, it is interesting, even if it was done on all post menopausal women. That is not a small group in our society.

    So just relax, no one is storming your gates.

    OH yes... about the comments you mention by Chris Masterjohn... What or where is WPF's ?
    I have no idea what that is?

    OK, here is another place where Chris Masterjohn discusses that study.

    The section begins with
    "Putting It All in Context — Laboratory Evidence and Clinical Experience" and down 60% of the way through that section he mentions that study on post menopausal women.

    He makes some interesting comments in that section before getting to the study part.

    "Despite the lack of high-quality evidence, I have little doubt that many people would improve their health on Esselstyn's plan, and especially on Fuhrman's plan, which emphasizes nutrient density to a greater degree than does Esselstyn's. "

    Interesting. Seems the man has a open mind and is actually looking for the facts, rather than just blindly thrashing anything that even hints at being of the opposite opinion.

    Again, lots there to read, then to re-read that study to see if I can make sense of the numbers and the particular group of women that were studied.

    Replies: #69, #70
  18. FrankG
    Just picked up on this presentation thanks to Dr Malcolm Kendrick's site...

    Truth That Lasts: David Newman at TEDxColumbiaEngineering

    "Published on 29 Sep 2012

    Dr. Newman is the Director of Clinical Research in the Emergency Department at the Mt. Sinai School of Medicine, and an Iraq war veteran. In addition to being widely published in medical journals he has written health care articles for the New York Times and is the author of Hippocrates' Shadow: Secrets From the House of Medicine. For the past ten years he has concentrated his work in medical evidence translation and appraisal. He is also the editor-in-chief for two online publications,, a resource for health care evidence summaries, and SMART-EM, a monthly audio review. He lives in New York City with his wife and teaches at both Mount Sinai School of Medicine and at Columbia University."

  19. erdoke
    I do apologize, but Chris Masterjohn usually writes on WPF (The Weston Price Foundation).
    It seems that you still found the right article though. I recommend his assessments in general.
  20. Zepp
    "Despite the lack of high-quality evidence, I have little doubt that many people would improve their health on Esselstyn's plan, and especially on Fuhrman's plan, which emphasizes nutrient density to a greater degree than does Esselstyn's. "

    Dont I say the same.. over and over again.. for some years?

    If one dont get on a nutrient diet.. it doesnt matter if its low carb, low fat or plant based!

    Then.. if one get the nutrients.. frome plants or animal sources (preferably frome both).. then we got the probem whit hyperglycemia and hyperinsulinemia!

    Its another question.. but a very big question today.. probably one of the big questions!

  21. Christian
    i heard the main reason for problems is the citric or phosphoric ACID which inhibits the ketosis through the krebs cycle

    does someone has information of this??

    my progress:
    my weight just goes up and down for no reason..
    cut cheese, aspartam and nuts nearly completely but gained again after losing a lot after i cut the soda.. maybe just usual fluctuation??

    i had a bit more on kcal and gained 600g??
    i know a bit salt on my eggs but
    seriously food? seriously? :)

    could someone look over this??

    Reply: #72
  22. Zepp
    "i heard the main reason for problems is the citric or phosphoric ACID which inhibits the ketosis through the krebs cycle"

    I wouldnt pay that much attention on such a claim!

    Ketosis is lack of carbs in your food, thats what we aim at!

    If there was a thing that counterregulated this.. you would drop dead or at least faint!

    Ketosis doesnt nessecery mean that you lose weight.. but it put you in a different metabolic state!

    It put you in a state there fatburning is predominant.. and often one need/like to lose fat weight!

    I looked at some of your diagrames.. it looks normal for a LCHF beginner.. noting strange at all and the trend on weight is good.

    If one manage to do this life style change that make one lose small amounts of stored fat in a reasonably pace.. thats the life style that one can keep on!

    Anybody can lose a lot in a short time by going starving.. thats not sustanible.. its not a life style change, its a path to chronic dieteters syndrome!

    Soo.. to get rid of 1 Kg of body fat one need to burn 7000 extra Kcalories!

    And your body have regulations that dont allow you to starv.. it means that losing 0,5 kilos a week is very fast!

    One thing I didnt figure out frome your diagrames is your veggies consumtion.. if I look at the carbs it seems that you dont eat any veggies at all!

    Dont cut out low starch veggies.. it get you in trouble in the long end!

    Rather do increas green leafy veggis.. eat as much as you can chew.. for a few carbs!

  23. Christian
    thanks for the help!

    one question more:

    is nutritional ketosis or carb cycling (cheat day or refeed day) better than the other?

    I heard carbs push hormones which shred faster...

    Reply: #74
  24. Zepp
    Soo.. you want to know if there is any cheap trick to reverse your metabolic condition?

    There are no "one sise fits all diets" thats revert any metabolic deranglement!

    I dont know.. but your problem is moste likely metabolic syndrome/hyperinsulinemia and/or malnutrition.

    First of all.. one have to eat a healty diet.. if one dont do this it doesent matter if its low carb or high or even ketogenic!

    Carb cycling and reefeding is for athlets.. that use more glucose for excersise.. then sedentary people does!

    And it comes in anyhow on social happenings and when one falls out.. wich happens for all of us.. one dont need to have plan for this, rarther a plan to avoid it or to coop whit it so it dont happens to often!

    SKD is standard ketogenic diet.. that means one try to limit the carbs on a daily basis to about 5-10 E%.. or for moste people 25-50 grams a day.. as a mean value!

    Even 100-50 grams a day for a person of your weight is a very small amounts of carbs!

    Dont seek those corner cuting approches, try to find wish life style/diet that promote your healt and nomalise your weight!

    It seems that you are German, at least german speaking?

    Heres a german LCHF, I dont know if its good.. but mayby you can pick up some thoughts or find some that got your specefic metabolic problem and shear adviceses and both shortcomings and benefits.

  25. Christian

    german? yes :)

    already checked it out but wasnt that helpful...maybe also asked the wrong questions...

    so I need to focus on a more NK diet approach?
    carb wise I am good.. even with low veggies...I have nearly NO exceptions...

    I could already reverse the metabolic damages with the ketogenic diet.. had insulin resistance and could reduce it to normal blood sugar range (yeah!) also tryglicerides are great again (~70 i think with last report of the doc)

    still have metabolic syndrom of course.... 30kg overweight.. 100kg would be great..

    Like I said. just heard that it is necessary to use carbs to raise general hormones to further slim down... but honestly I dont care which diet I follow.. low carb is great and calories are already quite low.. so no idea what to further adjust.....

    do you offer a coaching/counceling for me?

    Reply: #76
  26. Zepp
    Well you are on the right track anyhow.. it take time for new things to happen.. perticaly to lose weight in a healty manner.

    Keep on to what you are doing.. I think your body need to get time to fully recover.

    I dont think you need a coaching.. you probably alredy have reveled the magic thing.. real whole food whit lot of nutrients and not to much carbs and enough of healty fat for energy.

    You know this LCHF/ATKINS/Low carb have come to be that big that there is a lot of tips.. even like ordanary banting tips for the last kilo!

    You know whats your problem and that is your healt.. your weight is most probably a result of that.. keep refining your healt.. and your weight shall probably go away.

    But to be serious.. if one can lose 30 Kg in 1,5 years.. its fast!

    And keep in mind that LCHF is one of the few "diets" there you can change your old food to food thats tastyer!

  27. Christian
    Honsetly I believe I do :(

    dropped now nearly 2kg because I ate 1500kcal yesterday.. I know when I eat 1800 today I raise the weight tomorrow again :/

    and it seems regardless the macros... I always hoped I could reach NK for a guaranteed weight loss but couldnt get such high keton readings... ever... maybe the blood ketone strips show something next week, when they arrive....

    Is it just the calories then? And why so low? I always thought my BMR/RMR is more 2200kcal. and TDEE about 2500-2800kcal... So I shoudl shred a lot more so I can than upregulate again to a health middle on kcal... right now its more starving starving just in case the deficit is high enough :/

    Has really nothing to do with fun... I am just googling bodybuilding and LCHF stuff and studies all day long.....

    Reply: #78
  28. Zepp
    That seems to be a reasonably energy consumtion.

    And yes its about calories.. but what one aim at with LCHF is that insulin get normal and even so lipolysis get uppregulated and one use more fat frome fat tissuie betwen meal.

    Ofcourse its about calories.. but just saying that eat less and run more is a tautology.. its obvius!

    No help at all.. better to say that every calorie affect your body differently.. and the trick is to find that diet that make one eat less.. without hunger and starving!

    And LCHF is focusing on insulin.. that in higher doses cut out fat oxidation and lipolysis!

    If one get extra energy from fat tissuie, one dont get that hungry, or one eat more seldome.. ie a energy defiency!

    Measuring ketones is a tool.. it says that you eat what you think you eat and that means not to much carbs.

    Ketosis isnt a safe way to predict that one lose weight.. its easy to eat all the fat ones body need.. making ketones from eaten fat.

    It took med three months befor anything happen.. I think it was the mindshift that have to take time?

    Have you read this.. its another way to say it!

    Make special attention on the "on demand feding"!

    Its for you to get contact whit your buildt in caloriecounter!

  29. rexar
    Bullshit that you are blaming potatos for weight gain
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