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THURSDAY, Dec. 28, 2023 (HealthDay News) -- New research offers yet more evidence that veggies, whole grains and low-fat dairy products are good for you in the long run.

"Our study goes beyond the simple question of, 'To carb or not to carb?'" said lead study author Binkai Liu, a research assistant in the nutrition department at Harvard T.H. Chan School of Public Health in Boston.

"It dissects the low-carbohydrate diet and provides a nuanced look at how the composition of these diets can affect health over years, not just weeks or months," Liu explained in a Harvard news release.

The key takeaway: Not all low-carb diets are the same when it comes to managing weight over the long haul.

In the study, researchers analyzed data from more than 123,000 healthy adults who were part of major research studies between 1986 and 2018.

Participants reported on their diets and weights every four years, and they were scored based on adherence to five types of low-carb diet. They included ones based on animal proteins, plant-based proteins and ones that emphasized animal proteins, unhealthy fats and processed grains.

Low-carb regimens high in proteins, fats and carbs from healthy, plant-based sources were linked to slower long-term weight gain.

Participants who stuck with total low-carb or animal-based eating regimens gained more weight, on average, than those who followed a healthy low-carb eating plan over time.

These links were strongest for participants who were overweight or obese, younger than 55 and/or less physical active, the study found.

The findings were published Dec. 27 in the journal JAMA Network Open.

"Our findings could shake up the way we think about popular low-carbohydrate diets and suggest that public health initiatives should continue to promote dietary patterns that emphasize healthful foods like whole grains, fruits, vegetables and low-fat dairy products," said senior study author Dr. Qi Sun, an associate professor of nutrition at Harvard.

More information

The Mayo Clinic has more about low-carb diets.

SOURCE: Harvard University T.H. Chan School of Public Health, news release, Dec. 27, 2023

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Going Low-Carb? Avoid Meat to Keep the Weight Off Long-Term - HealthDay

The world of diets is a confusing one, filled with countless theories and strategies, each claiming to be the ultimate solution for weight loss and health. Among the most popular are low-carb and no-carb diets. However, these diets may lead us to miss out on many delicious and healthy foods. It is crucial to understand the difference between healthy carbohydrates, often found in whole foods, and less healthy ones, typically found in processed foods. This article aims to provide valuable insights for those considering a low-carb or no-carb diet.

Refined carbohydrates, also known as simple carbs, come in two forms: refined grains and sugars. The refining process eliminates the bran and germ, leaving only the endosperm, which significantly reduces the nutritional value. Consumption of too many refined carbs is associated with an increased risk of obesity, heart disease, metabolic syndrome, and type 2 diabetes. Common examples of refined carbohydrates include white bread, white rice, and white flour. Hence, it is advisable to consume these foods in moderation and opt for complex carbohydrates, which are digested more slowly and are richer in nutrients.

A study conducted by Harvard found that the quality of foods, not just the quantity of carbohydrates, fats, and proteins, makes a difference in maintaining weight. The research, which followed the eating patterns of 120,000 people over 30 to 40 years, found that diets composed of plant-based proteins and fats, and healthy carbohydrates were significantly associated with slower long-term weight gain than unhealthy low-carb diets. This study confirms that the quality of diet matters, not just the number of carbs.

Complex carbs digest or absorb more slowly than simple carbs, which can aid in weight control and maintaining stable blood sugar levels. They are also more filling, which can help prevent overeating. The timing of consuming carbs can also play a role, with simple carbs being suggested for energy before or after intense workouts, and before bed for faster digestion and energy.

A study of nearly 125,000 healthy adults showed that replacing refined carbs with whole-grain foods and reducing animal-based fats and proteins lessened the amount of weight people gained over four years. The research emphasized the importance of high-quality carbohydrates such as whole grains, healthy fats, and plant-based proteins. Moreover, it showed that diets heavy on healthy carbohydrates and plant-based proteins and fats are associated with significantly slower long-term weight gain. However, even healthy choices can become unhealthy depending on how they are served.

Reducing refined carbs can lead to weight loss and decrease the risk of heart disease. Consuming fibrous vegetables and natural fats can also aid in weight loss and disease prevention. However, it is crucial to note the potential risks of low-carb diets and the dangers of increasing carbohydrate intake to very high levels. The connection between carbs and weight loss is complex and depends on the quality and quantity of the carbs consumed.

While low-carb and no-carb diets can seem attractive for quick weight loss, its essential to consider the long-term effects and benefits of whole, unprocessed foods. By focusing on the quality of carbohydrates and including a balance of healthy fats and proteins in our diet, we can enjoy delicious food, maintain a healthy weight, and reduce the risk of chronic diseases.

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The Role of Carbohydrates in Weight Loss and Disease Reduction - Medriva

Low-carbohydrate diets comprised mostly of plant-based proteins and fats with healthy carbohydrates such as whole grains were associated with slower long-term weight gain than low-carbohydrate diets comprised mostly of animal proteins and fats with unhealthy carbohydrates like refined starches, according to a new study led by Harvard T.H. Chan School of Public Health.

The study will be published on December 27, 2023, inJAMA Network Open.

Our study goes beyond the simple question of, To carb or not to carb? said lead author Binkai Liu, research assistant in the Department of Nutrition. It dissects the low-carbohydrate diet and provides a nuanced look at how the composition of these diets can affect health over years, not just weeks or months.

While many studies have shown the benefits of cutting carbohydrates for short-term weight loss, little research has been conducted on low-carbohydrate diets effect on long-term weight maintenance and the role of food group quality.

Using data from the Nurses Health Study, Nurses Health Study II, and Health Professionals Follow-up Study, the researchers analyzed the diets and weights of 123,332 healthy adults from as early as 1986 to as recently as 2018. Each participant provided self-reports of their diets and weights every four years. The researchers scored participants diets based on how well they adhered to five categories of low-carbohydrate diet: total low-carbohydrate diet (TLCD), emphasizing overall lower carbohydrate intake; animal-based low-carbohydrate diet (ALCD), emphasizing animal-based proteins and fats; vegetable-based low-carbohydrate diet (VLCD), emphasizing plant-based proteins and fats; healthy low-carbohydrate diet (HLCD), emphasizing plant-based proteins, healthy fats, and fewer refined carbohydrates; and unhealthy low-carbohydrate diet (ULCD), emphasizing animal-based proteins, unhealthy fats, and carbohydrates coming from unhealthy sources such as processed breads and cereals.

The study found that diets comprised of plant-based proteins and fats and healthy carbohydrates were significantly associated with slower long-term weight gain. Participants who increased their adherence to TLCD, ALCD, and ULCD on average gained more weight compared to those who increased their adherence to HLCD over time. These associations were most pronounced among participants who were younger (<55 years old), overweight or obese, and/or less physically active. The results for the vegetable-based low carbohydrate diet were more ambiguous: Data from the Nurses Health Study II showed an association between higher VLCD scores and less weight gain over time, while data around VLCD scores from the Nurses Health Study and Health Professionals Follow-up Study were more mixed.

The key takeaway here is that not all low-carbohydrate diets are created equal when it comes to managing weight in the long-term, said senior author Qi Sun, associate professor in the Department of Nutrition. Our findings could shake up the way we think about popular low-carbohydrate diets and suggest that public health initiatives should continue to promote dietary patterns that emphasize healthful foods like whole grains, fruits, vegetables, and low-fat dairy products.

Other Harvard Chan authors included Molin Wang, associate professor in the Departments of Epidemiology and Biostatistics, and Yang Hu, research scientist; Sharan Rai, postdoctoral research fellow; and Frank Hu, professor, in the Department of Nutrition.

The study was funded by research grants from the National Institutes of Health: UM1 CA186107, U01 CA176726, U01 CA167552, P01 CA87969, R01 HL034594, R01 HL035464, R01 HL60712, R01 DK120870, R01 DK126698, R01 DK119268, U2C DK129670, DK119268, R01 ES022981, and R21 AG070375.

Low-Carbohydrate Diet Macronutrient Quality and Weight Change, Binkai Liu, Yang Hu, Sharan K. Rai, Molin Wang, Frank B. Hu, Qi Sun,JAMA Network Open, December 27, 2023, doi: 10.1001/jamanetworkopen.2023.49552

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Low-carbohydrate diets emphasizing healthy, plant-based sources associated with slower long-term weight gain - ScienceBlog.com

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The current class of anti-obesity drugs is proving remarkably effective at removing excess pounds. However, a phase 3 randomized clinical trial led by researchers at Weill Cornell Medicine and NewYork-Presbyterian found that people who stopped taking the medication regained much of that weight within a year. At the same time, the study shows that remaining on the drug not only promotes additional weight loss but preserves improvements in metabolic and cardiovascular health.

The results from the SURMOUNT-4 study, which appeared Dec. 11 in JAMA and was sponsored by Eli Lilly and Company, demonstrated that the drug can substantially help people struggling with health issues related to their weight, but it is not a quick-fix to weight loss.

Obesity is a leading driver of many diseases that we spend our time treating in medicine; illnesses like hypertension, heart disease, diabetes and fatty liver disease are either caused by or worsened by obesity, said lead study author Dr. Louis Aronne, the Sanford I. Weill Professor of Metabolic Research and director of the Comprehensive Weight Control Center, which is part of the Division of Endocrinology, Diabetes, and Metabolism at Weill Cornell Medicine. The fact that we now have drugs that are proving to be effective is exciting and rewarding.

Tirzepatide is part of a new class of drugs called called GLP-1 receptor agonists that were developed to treat type 2 diabetes. Besides controlling blood sugar, the drugs also resulted in weight loss, so pharma companies created specific formulations to help patients shed pounds.

In 2022, a phase 3 randomized, controlled clinical trial demonstrated that tirzepatide led to a 20 percent reduction in body weight over 72 weeks. The findings prompted the U.S. Food and Drug Administration to approve the drug last month, with the trade name Zepbound, for weight loss in individuals with a body mass index (BMI) of 30 or higheror for those with a BMI of 27 or greater who also had health conditions such as high cholesterol or hypertension.

Although the initial effects were dramatic, the researchers were uncertain whether the weight loss would persist beyond the period of active treatment. To find out, they launched the SURMOUNT-4 trial, which was conducted at 70 sites in Argentina, Brazil, Taiwan and the United States between March 2021 and May 2023. The participants took a maximum tolerated dose of tirzepatide for 36 weeks, which yielded the expected weight reduction of 20.9 percent with improvements in blood pressure, blood sugar metrics and lipid levels.

Then 670 eligible participants were randomly assigned to either continue with the tirzepatide for an additional year (52 weeks) or to switch to a placebo. Those who continued on tirzepatide lost an additional 5.5 percent versus the placebo group which regained 14 percent of their weight.

Though the placebo group was still almost 10 percent lighter than their initial weight, the improvements in cardiometabolic risk factors had been reversed. Relative to placebo, tirzepatide was associated with significant improvements in BMI, lipid levels, diabetes indicators and blood pressure.

Dr. Louis Aronne

Those who went on the placebo regained about half the weight they had lost, said Dr. Aronne, who is also an internist specializing in diabetes and obesity at NewYork-Presbyterian/Weill Cornell Medical Center. Whereas those who continued on the drug lost another 5 percent, so their overall weight loss was about 25 percent.

The findings indicate that people may need to remain on tirzepatide to keep off the pounds. If you stop the medication, you regain the weight. Theres no question that will happen, said Dr. Aronne. But that shouldnt be surprising. Obesity is a chronic condition, like diabetes or high blood pressure. So, it must be treated chronically.

The researchers noted that they didnt evaluate the effects of intensive behavioral therapy on the maintenance of body weight reduction, which could make a difference in preventing weight regain after coming off the drug.

Tirzepatide works by mimicking the GLP-1 and GIP hormones that are naturally secreted by the intestine after a meal, which prompts insulin secretion. It also reduces appetite by slowing down the time it takes the stomach to empty and interacting with areas in the brain harboring GLP-1 receptors to signal satiety.

Instead of counting calories, the medicine helps a person eat less because it signals to the brain that youre full, said Dr. Aronne. The dual mechanism of action helps overcome the plateau phenomenon that is seen at some point and produces additive weight loss.

Since the drug mimics hormones that are produced in the gastrointestinal system, side effects tended to be nausea, vomiting, diarrhea or constipation and resolved with time. The study had few people dropout because of side effects.

People feel much better when they lose this kind of weight, so they are extremely enthusiastic about these treatments. But they also should realize this may require them to stay on the drug long term, said Dr. Aronne. Further studies will need to assess the long-term risks and benefits associated with these drugs, especially considering the potential for their lifelong use.

Many Weill Cornell Medicine physicians and scientists maintain relationships and collaborate with external organizations to foster scientific innovation and provide expert guidance. The institution makes these disclosures public to ensure transparency. Dr. Louis J. Aronne serves as a paid advisory board member for Eli Lilly and Company. For further information, see the profile for Dr. Louis Aronne.

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Tirzepatide Enhances Weight Loss with Sustained Treatment but Discontinuation Leads to Weight Regain - Weill Cornell Medicine Newsroom

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Weight-loss drugs long-term impact 'all bark and no bite': Analyst  Yahoo Finance

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Weight-loss drugs long-term impact 'all bark and no bite': Analyst - Yahoo Finance

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