It’s all a Matter of Taste, and a Touch of Common Sense

In the 17 July 2008 issue of the New England Journal of Medicine there is an article which adds one more nail in the coffin of the hypothesis that only a low-fat diet is effective for weight loss. Data from the Dietary Intervention Randomized Controlled Trial (DIRECT) Group indicates that a Mediterranean diet and a low-carbohydrate diet can be just as effective, if not more effective, than a low-fat diet over a two year intervention period. Among the 272 participants who finished the study, the mean weight losses were 3.3 kg, 4.6 kg and 5.5 kg for the low-fat (30% fat, 10% saturated fat), Mediterranean (35% fat with added olive oil) and low-carbohydrate diet (120 g/day carbohydrate) groups respectively. Of greater significance was the observation that the reductions in the total-cholesterol to HDL-cholesterol were 1.1 for the low-carbohydrate diet group, 0.9 for the Mediterranean diet group and 0.6 for the low-fat diet group. The low-carbohydrate diet group also had the largest decrease in high-sensitivity C-reactive protein levels and the largest increase in adiponectin concentrations. The authors concluded that “The more favorable effects on lipids (with the low-carbohydrate diet) and on glycemic control (with the Mediterranean diet) suggest that personal preferences and metabolic considerations might inform individualized tailoring of dietary interventions.”

Does this predict the end of the “one diet fits all” mantra that we’ve heard for forty years? “Individualized tailoring” sounds like an insidious plot to ruin the pedestal status of the universally revered low-fat, low-saturated fat, low-cholesterol diet-dictator. Now that half the supermarket is low-fat and everyone has accepted the saw dust and wood chips cuisine of the 90s we find out that (hold on for a bumpy ride) some fats are okay–maybe even good for you–and your diet can actually be tailored to fit what you like. Those who so long ago suggested that this was the case are just loving our bafflement—our cautious and guarded acknowledgements that maybe they were right (although most of them have passed on… these views are held dear by only a few remaining iconoclasts). I guess that’s what happens when policy is derived from guesses and opinions rather than hard science, and when questioning that policy is considered heresy against the church of the holy diet. So the dogmatic nutrition know-it-alls must now take the stance of that well known expert on many topics Emily Litella, the elderly woman who gave angry and misinformed editorial replies on “Weekend Update” on topics such as “violins on television,” the “Eagle Rights Amendment,” “presidential erections,” and “protecting endangered feces.” Once corrected on her misunderstanding, Ms. Litella would end her segment with a polite “Never mind.” So to our exceedingly overweight population who for decades have banished fat from their plates we simply say – “Never mind.”