According to research, a low carb diet benefits weight maintenance by focusing on meal quality rather than quantity.
Variations on thelow carb diet have long been popular strategies for losing weight. Still, a recent study suggests that the quality of meals, rather than the amount of carbs, fats, and proteins, is essential in maintaining weight off.
The study, published on December 27, 2023, in JAMA Network Open, followed patients for decades to determine how five low carb diets affected weight.
"The key takeaway from our study is that not all low-carbohydrate diets are created equal when it comes to long-term weight management — food quality is critical," says the study's lead author, Binkai Liu, PhD, a research assistant in the nutrition department at Harvard T.H. Chan School of Public Health in Boston.
Researchers discovered that diets low in carbohydrates but high in good-quality proteins, lipids, and a modest quantity of carbs from nutritious plant-based sources such as whole grains and legumes were associated with slower weight gain. "On the other side, low carb diets high in animal proteins and fats or refined carbs, such as those from red and processed meat, dairy products, and sugar-sweetened beverages, may lead to faster weight gain," says Dr. Liu.
"This study is fantastic in demonstrating that 'low carb' is a basic word with much oversimplification. "There are many low carb eating options," says Christopher Gardner, MD, a nutrition expert and professor at Stanford Medicine in Palo Alto, California.
This large, long-term observational study reveals that, according to Dr. Gardner, who was not involved in the study, the only method that is definitely related to and has the most benefit for weight management is healthy and plant-based.
Study Followed the Eating Patterns of 120,000 People Over 30 to 40 Years
Numerous studies have demonstrated the advantages of reducing carbs for short-term weight reduction. A meta-analysis of 25 studies published in April 2022 in Diabetes, Obesity, and Metabolism discovered that low carb diets resulted in "greater short-term weight loss than non-carbohydrate restricted diets."
However, this study aimed to fill a knowledge vacuum by investigating how well low carb diets work for long-term weight reduction and if food quality is essential. Researchers used data from the first and second Nurses' Health Studies and the Health Professionals Follow-Up Study to monitor over 120,000 healthy people from 1986 to 2018.
Every four years, participants self-reported their meals and weights using a survey that comprised over 130 food items, over 70 of which contained animal protein.
The researchers graded individuals' diets based on how well they followed five types of low-carbohydrate diets, all of which contained 30 to 40 percent carbs:
- A completely low-carbohydrate diet focused on macronutrients that prioritized decreased carbohydrate consumption.
- An animal-based low-carbohydrate diet with an emphasis on animal-based proteins and lipids.
- A vegetable-based low-carbohydrate diet that emphasizes plant-based proteins and lipids, including sugar and refined white flour, both plant-based.
- A nutritious, low-carbohydrate diet that emphasizes plant-based proteins, healthy fats, and less processed grains and added sugars
- A harmful low-carbohydrate diet emphasizing animal-based proteins, bad fats, and carbs obtained from unhealthy sources such as processed breads and cereals
A Healthy Low Carb Diet Was Better for Keeping Weight Off
The study discovered that diets high in plant-based proteins, lipids, and healthy carbs were substantially related to slower long-term weight gain than the other four eating patterns.
Over four years, people who ate bad low-carb diets gained an average of 5.1 pounds, while those who ate healthy low carb diets lost an average of 4.9 pounds, for a total difference of 10 pounds.
These connections were highest among persons under 55, overweight or obese, less physically active, or a combination of these variables.
According to Julia Zumpano, RD, a registered dietitian at Cleveland Clinic in Ohio, this study addresses a need for evaluation in food and nutrition. "The popularity of [low carb diets] has increased over the past decade, and initially, it was focused on reducing carbs by replacing them with meats and high fat processed foods," according to her.
However, Zumpano, who was not part of the study, argues that weight gain occurs when these diets are not followed due to poor food choices and too stringent criteria.
"I found the results to be validating. We need to focus on diet quality, reducing processed meals and increasing whole foods and lean protein sources from plants and animals," she says.
Findings Complement and Confirm What’s Been Seen in Randomized Controlled Trials
This is observational research, so while it reveals that a better low carb diet is connected with weight loss, it does not establish that eating the lower-carb diet produces favorable benefits.
Randomized controlled trials (RCTs) of dietary treatments are difficult to perform, particularly those lasting longer than six months, since participants frequently do not wish to modify their eating habits for an extended time.
Still, Gardner believes the study is unusual and valuable since it tracked so many people for 30 or 40 years. He claims this study addresses the most crucial issue: long-term and lifelong weight maintenance, which cannot be repeated in an interventional randomized controlled trial.
"These findings complement the many RCTs that have come to the same conclusion: quality of diet matters, too, not just the number of carbs," Gardner states.
Gardner coauthored a 12-month randomized controlled dietary experiment published in November 2023 in the American Journal of Clinical Nutrition, which examined patients on various low carb diets. The researchers also discovered that quality mattered: People who ate a higher-quality low carb diet had a considerably more significant average drop in BMI than those who ate a low-quality diet.
Expert Advice on How to Eat a Healthy Low Carb Diet
According to Zumpano, low carb diets may be quite effective for weight reduction and maintenance, especially when people eat primarily plant-based meals. She advises consulting a trained dietician to create a strategy tailored to one son's circumstances.
She recommends the following foods to get started on a healthy, low carb lifestyle.
- Nonstarchy vegetables (not potatoes, peas, or corn)
- Lean animal protein sources include skinless poultry, shellfish, Greek yogurt, cottage cheese, eggs, and restricted red meat.
- Quinoa, wild rice, brown rice, bulgur, or millet should be consumed in tiny quantities (1 cup cooked once or twice daily).
- Few or no processed meals or "low carb" baked products.
- Extra virgin olive oil, avocado oil, avocados, nuts, and seeds are all examples of plant-based fats.
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