Päiväkirja - Nimm, 02 elo 12

It's been a while, and this subject could use a more in-depth treatment than I have time to give it, but if I don't write a little about it now, it's going to be lost in the void.

Anyway, find a forum related to health, nutrition, or fitness, and you won't need to wait long before a very heated debate about carbohydrate (CHO) erupts. They happen here frequently. The debate usually breaks down into two camps: Reduction of dietary CHO is always better - even necessary - for fat loss vs. There is no benefit whatsoever to CHO reduction or limitation. There is a lot of middle ground between these positions, and I think the evidence most justifies an individualized approach. Regardless of the mechanisms for reducing body fat, out in the real world what matters the most is dietary adherence.

On the one hand, the unanimous conclusion of controlled, metabolic ward studies is that a calorie deficit is both necessary and sufficient to lose weight. Weight loss is entirely possible even with high-CHO diets. The frequent anecdotal claims that a given person "cannot" lose weight unless CHO is restricted below a certain amount have not been observed under controlled conditions. There is no reason to think the people making those claims are lying, however, so the simplest explanation is that as a strategy for achieving a sustainable, consistent calorie deficit, CHO restriction is effective for those people.

Does this mean that low-CHO or ketogenic diets are pointless and should be disregarded? Not at all. While there may not be any "magic" metabolic advantage to low-CHO dieting (there is some evidence that in certain populations such as the insulin resistant, there may be just such an advantage), what ultimately matters the most is a dietary strategy that you can adhere to.

Dietary adherence and weight loss success among overweight women
One group of researchers examined three popular weight-loss protocols: Atkins, the "Zone" diet, and Ornish (a low-fat, relatively high CHO diet). The authors' conclusions are exactly what you would expect, in light of the history of controlled trials:

This is an important conclusion - when you want to lose fat, what matters far more than the macronutrient composition of your diet, is simply whether you can stick to it over time. You can lose weight on a low-fat diet, and you can lose weight on a low-CHO diet. But you won't lose weight on a diet that you can't follow.

It is for this reason that I cringe when I see advice in a forum that someone looking to lose weight (or plateauing) should simply reduce CHO. Well...maybe. It depends on the individual. I have tried low-CHO dieting in the past and find it completely intolerable. And yet, many people report greater, more consistent satiety and improved mood on low-CHO/keto diets. I have no reason to doubt them, and see no reason why someone should categorically dissuade anyone else from experimenting with different strategies to find whatever is the most sustainable for them - assuming, of course, that the diet in question still meets macro- and micro-nutrient needs.

Nor am I aware of any strong evidence that adherence is categorically higher for any particular strategy. Adherence and Success in Long-Term Weight Loss Diets: The Dietary Intervention Randomized Controlled Trial (DIRECT)
If you look at "figure 2" in this study, you'll see that adherence to the low-CHO, "mediterranean," and low-fat diets all followed roughly the same trends, and didn't differ significantly. Atkins had the highest rate of compliance at 6 months, by a small margin, but the lowest at 12 and 24 months - but only by a small margin.

The bottom line, once again, is that there are many paths to reach the same goal, and there are relatively few dietary rules that must be followed in order to reduce body fat. Once those "musts" are satisfied, there is a lot of individual variation in response to different protocols. Because dietary adherence is one of the most significant factors (if not the most significant) in long-term weight reduction success, forcing individual square pegs into dietary round holes is counter-productive. Tailoring a dietary strategy to the individual is the better approach - even if "experiment and see what you like" may not be the answer that people looking for dietary advice want to hear.

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3040 kcal

Rasva: 97,23g | Prot: 193,37g | Hh: 398,96g.   Aamiainen: body fortress whey isolate, optimum casein, quaker oats, soy slender, 2% milk, tomato, kraft colby jack, monster rehab. Lounas: apple, cocoa roast almonds, jack link's original beef jerky, california stir fry, spinach, tomato, eggland's best large, bumble bee salmon. Päivällinen: blueberries, meijer cottage cheese, meijer colby jack, meijer chunky beef. Välipalat/Muut: raspberries, kashi golean crunch, dannon light & fit blueberry, dannon light & fit strawberry, carlson fish oil, dark chocolate dreams, fiber one chewy bar, plum, krema, banana peanut butter, sargento string cheese, kashi golean, extra gum. lisää...