16 comments

  1. Paul the rat
    Well done Dan,
    weight loss can be achieved in many ways, but LCHF also makes us healthy.

    Ann Intern Med. 2010 Aug 3;153(3):147-57. doi: 10.7326/0003-4819-153-3-201008030-00005.

    Weight and metabolic outcomes after 2 years on a low-carbohydrate versus low-fat diet: a randomized trial.

    Foster GD, Wyatt HR, Hill JO, Makris AP, Rosenbaum DL, Brill C, Stein RI, Mohammed BS, Miller B, Rader DJ, Zemel B, Wadden TA, Tenhave T, Newcomb CW, Klein S.
    Author information

    Abstract
    BACKGROUND:
    Previous studies comparing low-carbohydrate and low-fat diets have not included a comprehensive behavioral treatment, resulting in suboptimal weight loss.
    OBJECTIVE:
    To evaluate the effects of 2-year treatment with a low-carbohydrate or low-fat diet, each of which was combined with a comprehensive lifestyle modification program.
    DESIGN:
    Randomized parallel-group trial. (ClinicalTrials.gov registration number: NCT00143936)
    SETTING:
    3 academic medical centers.
    PATIENTS:
    307 participants with a mean age of 45.5 years (SD, 9.7 years) and mean body mass index of 36.1 kg/m(2) (SD, 3.5 kg/m(2)).
    INTERVENTION:
    A low-carbohydrate diet, which consisted of limited carbohydrate intake (20 g/d for 3 months) in the form of low-glycemic index vegetables with unrestricted consumption of fat and protein. After 3 months, participants in the low-carbohydrate diet group increased their carbohydrate intake (5 g/d per wk) until a stable and desired weight was achieved. A low-fat diet consisted of limited energy intake (1200 to 1800 kcal/d; <or=30% calories from fat). Both diets were combined with comprehensive behavioral treatment.
    MEASUREMENTS:
    Weight at 2 years was the primary outcome. Secondary measures included weight at 3, 6, and 12 months and serum lipid concentrations, blood pressure, urinary ketones, symptoms, bone mineral density, and body composition throughout the study.
    RESULTS:
    Weight loss was approximately 11 kg (11%) at 1 year and 7 kg (7%) at 2 years. There were no differences in weight, body composition, or bone mineral density between the groups at any time point. During the first 6 months, the low-carbohydrate diet group had greater reductions in diastolic blood pressure, triglyceride levels, and very-low-density lipoprotein cholesterol levels, lesser reductions in low-density lipoprotein cholesterol levels, and more adverse symptoms than did the low-fat diet group. The low-carbohydrate diet group had greater increases in high-density lipoprotein cholesterol levels at all time points, approximating a 23% increase at 2 years.
    LIMITATION:
    Intensive behavioral treatment was provided, patients with dyslipidemia and diabetes were excluded, and attrition at 2 years was high.

    CONCLUSION:
    Successful weight loss can be achieved with either a low-fat or low-carbohydrate diet when coupled with behavioral treatment. A low-carbohydrate diet is associated with favorable changes in cardiovascular disease risk factors at 2 years.

  2. Paul the rat
    We all know here that LCHF is not high protein, however it is my experience that patients would say: "so and so told me that my kidneys will suffer", well here it is folks…. even on high protein diet kidneys are just fine
    (in fact I am aware of 3 cases where patients were cured of chronic kidney stones by LCHF)

    Clin J Am Soc Nephrol. 2012 Jul;7(7):1103-11. doi: 10.2215/CJN.11741111. Epub 2012 May 31.

    Comparative effects of low-carbohydrate high-protein versus low-fat diets on the kidney.
    Friedman AN, Ogden LG, Foster GD, Klein S, Stein R, Miller B, Hill JO, Brill C, Bailer B, Rosenbaum DR, Wyatt HR.
    Author information

    Abstract
    BACKGROUND AND OBJECTIVES:
    Concerns exist about deleterious renal effects of low-carbohydrate high-protein weight loss diets. This issue was addressed in a secondary analysis of a parallel randomized, controlled long-term trial.
    DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS:
    Between 2003 and 2007, 307 obese adults without serious medical illnesses at three United States academic centers were randomly assigned to a low-carbohydrate high-protein or a low-fat weight-loss diet for 24 months. Main outcomes included renal filtration (GFR) indices (serum creatinine, cystatin C, creatinine clearance); 24-hour urinary volume; albumin; calcium excretion; and serum solutes at 3, 12, and 24 months.
    RESULTS:
    Compared with the low-fat diet, low-carbohydrate high-protein consumption was associated with minor reductions in serum creatinine (relative difference, -4.2%) and cystatin C (-8.4%) at 3 months and relative increases in creatinine clearance at 3 (15.8 ml/min) and 12 (20.8 ml/min) months; serum urea at 3 (14.4%), 12 (9.0%), and 24 (8.2%) months; and 24-hour urinary volume at 12 (438 ml) and 24 (268 ml) months. Urinary calcium excretion increased at 3 (36.1%) and 12 (35.7%) months without changes in bone density or clinical presentations of new kidney stones.

    CONCLUSIONS:
    In healthy obese individuals, a low-carbohydrate high-protein weight-loss diet over 2 years was not associated with noticeably harmful effects on GFR, albuminuria, or fluid and electrolyte balance compared with a low-fat diet. Further follow-up is needed to determine even longer-term effects on kidney function.

  3. Paul the rat
    No change in glucose/insulin is due to still too much sugar in the diet to my likening, still reduction in metabolic syndrome markers even with considerable amount of sugar.

    Nutrition. 2014 Jan;30(1):61-8. doi: 10.1016/j.nut.2013.06.011.

    Moderate replacement of carbohydrates by dietary fats affects features of metabolic syndrome: A randomized crossover clinical trial.

    Rajaie S, Azadbakht L, Khazaei M, Sherbafchi M, Esmaillzadeh A.
    Author information

    Abstract
    OBJECTIVE:
    Earlier studies on the management of metabolic syndrome (MetS) have mostly focused on very low carbohydrate diets, whereas long-term adherence to such diets is difficult for apparently healthy people. The aim of this study was to examine the effects of moderate replacement of carbohydrates by dietary fats on insulin resistance and features of MetS among women.
    METHODS:
    This randomized crossover clinical trial was performed with 30 overweight or obese (body mass index [BMI] > 25 kg/m(2)) women with MetS. After a 2-wk run-in period, participants were randomly assigned to consume either a calorie-restricted high-carbohydrate (HC) diet (60%-65% of energy from carbohydrates and 20%-25% from fats) or a calorie-restricted moderately restricted carbohydrate (MRC) diet (43%-47% of total calories as carbohydrate and 36%-40% as dietary fats) for 6 wk. Protein contents of both diets were 15% to 17% of total energy. A 2-wk washout period was applied following which participants were crossed over to the alternate treatment arm for an additional 6 wk. Anthropometric, blood pressure, and biochemical measurements were performed before and after each phase of intervention.
    RESULTS:
    Mean age and BMI of study participants was 42.4 y and 33 kg/m(2), respectively. A trend toward greater reduction in waist (-3.9 versus -2.6 cm; P = 0.07) and hip circumferences (-2.7 versus -1.5 cm; P = 0.07) as well as serum triglyceride (TG) levels (-31.3 versus 0.13 mg/dL; P = 0.07) was observed after consumption of an MRC diet compared with an HC diet. The TG to high-density lipoprotein cholesterol (HDL-C) ratio had a tendency to improve with the MRC diet rather than the HC diet (-0.9 versus -0.1; P = 0.06). Consumption of the MRC diet resulted in a greater reduction of systolic blood pressure (-8.93 versus -2.97 mm Hg; P = 0.06) and diastolic blood pressure (-12.7 versus -1.77 mm Hg; P = 0.001) compared with the HC diet. The prevalence of MetS was significantly decreased following the consumption of the MRC diet (P = 0.03). The two diets were not significantly different in terms of their effect on fasting plasma glucose, serum HDL-C, low-density lipoprotein cholesterol, and total cholesterol, insulin levels, and Homeostasis Model Assessment-Insulin Resistance.

    CONCLUSION:
    Moderate replacement of carbohydrates by dietary fats was not associated with statistically different changes in fasting plasma glucose, insulin, or atherogenic dyslipidemia among individuals with the metabolic syndrome; however, it resulted in decreased diastolic blood pressure and lower prevalence of the metabolic syndrome.

  4. Bill UK
    Thanks for the articles Paul. Don't stop posting....
  5. Zell
    Dr. E, his success is impressive, but it doesn't speak to my experiences doing lchf. I love lchf for how it has weaned me away from a lifetime of intense binging on desserts. Perhaps too much damage had been done by the time I started lchf, but my experiences are much different than the many success stories you post. Due to ongoing sugar cravings, I have started eating whole complex high fiber grains and much more fruit than I ate on lchf. Also, lchf is Extremely expensive if you try to eat only organic meats. I know that many, many low carbers turn to diet Soda to cope with sugar cravings, as well. There is theory of any given diet and then there is the actual practice of it. Given the realities I speak of, surely fruit and whole grains are a Much better choice for me than copious amounts of diet soda, a reliance on artificial sweeteners and processed, non organic meats, that so many low carbers seem to rely on. I've been eating fruit and whole grains, and so far, I appear to be doing ok. Soon, I'm going to start eating beans again, too. My MAIN GOAL is to Never binge again. Fruit and whole grains are real foods, pleasurable to eat, add diversity and do not induce cravings in me. Such real, whole foods help me cope with sugar cravings, which is of inestimable value to me.
    Reply: #12
  6. Sheryl
    Zell, good for you for finding what works for you. Frankly, after years of straying from LCHF, and trying every diet known to man, I am returning to it. It's been a decade. In 2003, I started reading Life Without Bread, a low carb classic, and Dr. E's recommendations are very similar. That's why I love this website.

    I need a lot of fiber too, but one thing Life Without Bread taught me was that one should go straight to the fiber source. For example, I take psyllium every day, much more helpful than "high fiber" grains ever were. And if you compare the fiber content of grains to pure fiber like wheat bran or psylllium (for those avoiding gluten like me), or even oat bran or polydextrose, the fiber is much higher if you go straight to the fiber source.

    For me, unfortunately, I've found I just can't eat a lot of fruit, It just intensifies my hunger and cravings. Now I am eat one or two pieces a day and am satisfied. There are many days that I don't eat any fruit. Years ago fruit was seasonal, now we get it all year round, shipped in from everywhere.

    It's good when we can all find what works for us. Personally, I'll never leave LCHF again.

  7. Daniel Ferreira
    Another success story, and a real good one, an older gentleman, extreamly overweight does what needs to be done.

    this is insperation and dedication. I hate when people use excuses or self limiting believes instead of just getting up, doing what is not easy but what is worth it.

    every excuse you give yourself is a shot in the foot.

  8. robert
    "Clearly, a genetic anomaly! Another N=1 purely anecdotal story, an isolated case without any bearing whatsoever on what happens to normal people on this diet. He surely can't get enough fiber and hearthealthywholegrains (6-10 servings per day)."
  9. Paul the rat
    I am not sure if I already posted this one, just in case.

    @ robert, "Dan might be ok now, but in few more years, he will be in big trouble - unless of cause, he reverses to eating healthy whole grains and plenty of fresh fruits"

    Nutrition. 2013 Nov 18. pii: S0899-9007(13)00377-8. doi: 10.1016/j.nut.2013.07.024. [Epub ahead of print]

    Tumor cell culture survival following glucose and glutamine deprivation at typical physiological concentrations.

    Mathews EH, Stander BA, Joubert AM, Liebenberg L.
    Author information

    Abstract
    OBJECTIVE:
    Most glucose (and glutamine)-deprivation studies of cancer cell cultures focus on total depletion, and are conducted over at least 24 h. It is difficult to extrapolate findings from such experiments to practical anti-glycolytic treatments, such as with insulin-inhibiting diets (with 10%-50% carbohydrate dietary restriction) or with isolated limb perfusion therapy (which usually lasts about 90 min). The aim of this study was to obtain experimental data on the effect of partial deprivation of d-glucose and l-glutamine (to typical physiological concentrations) during 0 to 6-h exposures of HeLa cells.
    METHODS:
    HeLa cells were treated for 0 to 6 h with 6 mM d-glucose and 1 mM l-glutamine (normal in vivo conditions), 3 mM d-glucose and 0.5 mM l-glutamine (severe hypoglycemic conditions), and 0 mM d-glucose and 0 mM l-glutamine ("starvation"). Polarization-optical differential interference contrast and phase-contrast light microscopy were employed to investigate morphologic changes.
    RESULTS:
    Reduction of glucose levels from 6 to 3 mM (and glutamine levels from 1 to 0.5 mM) brings about cancer cell survival of 73% after 2-h exposure and 63% after 4-h exposure. Reducing glucose levels from 6 to 0 mM (and glutamine levels from 1 to 0 mM) for 4 h resulted in 53% cell survival.

    CONCLUSION:
    These data reveal that glucose (and glutamine) deprivation to typical physiological concentrations result in significant cancer cell killing after as little as 2 h. This supports the possibility of combining anti-glycolytic treatment, such as a carbohydrate-restricted diet, with chemotherapeutics for enhanced cancer cell killing.

  10. Tania
    Hi Dan,
    Thanks so much for leaving me a message on my own featured story. I left you a reply in my story's comment section. You inspire me to continue what I'm doing. You look great! If you want to have a look at my weightloss page on Facebook, here's the link:

    https://www.facebook.com/tania.journey

    All the best to you! :)

  11. Marcy
    Zell, I am sort of with you on this. The only way LCHF helps me to lose weight or even not gain is if I also watch calories and intermittent fast, which when I do, I can also eat some fruit and whole grains successfully. And, I have the same problem with being able to afford the grass fed free range meats, I can't, and I don't like the organ meats some have suggested, just don't like them. So, in the end, as with all things in life, we do what works for us, everyone is different.
  12. Murray
    Zell, just avoiding flour and sugar would go a long way to better health for most people. Dr. Weston Price found that even cultures that consumed some whole grains (but did not have flour or sugar) were generally healthy and lacked the chronic diseases and other afflictions that characterize Western diet. Also, the EPIC study which analyzed Mediterranean diet and isolated those elements that contributed to longevity, included more vegetables, fruits, nuts, pulses, olive oil, moderate protein and moderate alcohol as adding to longevity. Adding cereals, adding fish or limiting dairy had no benefit. More than moderate alcohol or meat was detrimental.

    So I don't think your evolution to pulses and limited whole grains would be unhealthy, so long as calories from carbohydrates are under 40%. It might or might not be more difficult for weight loss for you. People's metabolisms differ. As Nietzsche observed, a vegetarian diet does not cause one to live longer: vegetarians need a vegetarian diet in order to live longer.

  13. Mienthu
    LCHF diet is a good way to help me lose weight. I believe that it will bring benefits fot other people. Thanks for the articles Paul. Don't stop posting....
    http://vkool.com/easy-ways-to-lose-weight-with-fat-loss-revealed/
  14. samc
    Good for Dan - I lost a lot of weight as well, not as much as he did. However I didn't set up a website hawking products. I'm just happy to be healthy.
  15. Roya
    I started LCHF about one year ago, i successfully lost about 10 pounds, It had numerous advantages such as:
    1- no more bloating and beauty (i was always bloating before which made me crazy)
    2- fast weight loss
    3- no more hunger
    4- simple and easy
    5- sticking into healthy options
    6- more confidence

    but i quit it and gained about 6 pounds again :(
    i read somewhere that LCHF could damage my body in long time, due to some problems. but here are some disadvantages i experienced:

    1- always felt dehydrated.
    2- problem in concentration and thinking (which i never had an issue, i also experienced the feeling of depletion in my brain. i could be angry easily)
    3- depression (which i never had this problem)
    4- skin acne (i also never had this)
    5- hair loss

    then i started some vitamin pills... but i started to feel the same as i was starting the LCHF.
    now i really want to start it again... but i'm afraid of the problems i explained... please help...

  16. Henrik
    I looked at the first study "Paul the rat" linked to, and what the low-carb group in that study ate.

    See: "A low-carbohydrate diet, which consisted of limited carbohydrate intake (20 g/d for 3 months) in the form of low-glycemic index vegetables with unrestricted consumption of fat and protein. After 3 months, participants in the low-carbohydrate diet group increased their carbohydrate intake (5 g/d per wk) until a stable and desired weight was achieved. "

    The first three months was it a low carb study. But not after the first three months. See:

    "the low-carbohydrate diet group increased their carbohydrate intake (5 g/d per wk) until a stable and desired weight was achieved. "

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