In earlier articles, I've described anecdotal evidence that my current diet plan works, but those anecdotes are not what drew me to start this diet. My mother, for example, has been a low-carbohydrate dieter for some time, but I was uninterested despite her apparent success. What finally got my interest this year was a study from the Stanford University School of Medicine, released in March.
When considering diet changes for weight loss, the two issues I consider are efficacy and safety. I could starve myself, for example, but that would be neither efficacious (beyond the first couple of days, anyway) nor safe. Diet pills may work, but they tend to be quite dangerous. The safest approaches — simple limited-calorie plans — tend to work slowly, but they do work. As far as low-carb dieting, I could see that it worked for my mother, though I wasn't sure it worked for most people. I knew other people on low-carb diets who didn't seem to be losing weight well. It could be, I reasoned, that my mother is simply taking in fewer calories than those other people, and so her "low-carb" diet is working for her simply because it's also a low-calorie diet. I had also read scattered articles that claimed the Atkins diet was dangerous, so while I hadn't investigated in earnest, I had questions about both the efficacy and safety of the diet, and that was that — until I saw the Stanford study.
The Stanford study lasted a year, and split a group of 300 women into four groups, each pursuing a different diet. The people on the Atkins low-carb diet lost the most weight (there's the efficacy) and also benefited the most in terms of cholesterol and blood pressure (there's the safety). Since cholesterol had been one of my primary concerns, this study told me that I should at least look further. I searched further and found a multi-university study from 2003 that also compared different diet approaches over a year. They reported very high attrition rates, and (possibly as a result) that gains at six months flattened out to almost no difference in weight loss after a full year (little or no efficacy, perhaps related to attrition), but similar health benefits (safety). A 2000 study from "California researchers" described benefits of a low-carb diet on people with diabetes, but I don't have diabetes, and the article was fuzzy on the parameters or source of the study. Still, that's another vote in support of safety. A short-term 2007 study found that the low-carb group lost "significantly" more weight during the weight-loss portion of the study, though the differences appeared to balance out once that phase of the diet was done. Again, the "bad" cholesterol level was lower for people on the low-carb diet. A 2002 study from Duke University (funded by the Atkins Institute) found that over six months, the Atkins low-carb diet was effective in weight loss, and did improve cholesterol levels, but they did not study other potential heath issues. They also did not make clear in the excerpt how rigorously controlled the study was. A 2003 study from the U.S. Department of Veteran's Affairs compared low-carb and low-fat diets and found the low-carb diet significantly more effective in spurring weight loss and also results in lowering of triglycerides, though uniquely among the studies I found, they report no difference in cholesterol levels.
A pattern was forming through research, and it suggested several things: First, that my concern about safety appeared to be largely unfounded, as even the studies most skeptical about the long-term weight loss benefits had found no evidence of health issues and some evidence of health improvement. Second, that not all low-carb diets are the same. Some of the diets in the studies were described as "low-carb, high-fat, high-protein," while others started out very low-carb but then added low glycemic index carbs — understandable given the emphasis on blood sugar and diabetes, but largely irrelevant to me. Some considered 30 grams of carbohydrates per day to be "low-carb," while others didn't report the specific parameters at all, at least not in the freely-available abstracts.
After spending some time in May reading through all of these study abstracts and a few more, I began further research into ketosis, which I've largely generalized in a previous article. It was while researching ketosis that I was struck by two new thoughts: Firstly, that Dr. Atkins clearly underestimated the American public's ability to eat too much, and secondly, 35 years after Dr. Atkins first released his book, and with research continually supporting his assertions, low-carb dieting is hardly a fad or dramatically unsafe. Remaining fat is far more unsafe than any minor concerns about low-carb dieting. At that point, I decided that enough evidence existed — indeed, overwhelming evidence existed — for me to decide to try a low-carb diet myself, though there still remained the question of which one. Based on the newest studies, it seemed that the lowest-carb diets had the best results over the longest term, and I was still a bit concerned about fat intake. That was when I found that my mother had switched to a new diet, which is low-carb, low-fat, and low-calorie — exactly what my research had suggested.
I continued to investigate that diet specifically, writing up lists of specific concerns (including lack of fiber and what happens when people reach their goal weight and introduce carbs into their diet again — both issues often raised by critics of low-carb dieting, my best source of information on what to expect), and it was another three weeks before I finally started the diet myself.
I switched to weekly weigh-ins, and focused much more on exercise this week. Specifically, walking. I enjoy it, it's easy, and it's something I can do with my wife and three kids. I bought a cheap pedometer and aimed for 10,000 steps per day. I know that without effort, I can take as few as 2000 steps in a day — a result of my sedentary lifestyle and desk job. With effort, I can hit 10,000 steps every day, even if it sometimes means a late-night walk to top off the counter. As a result of this exercise — as well as some time on my elliptical machine (which hardly creaks at all at my current weight!) — I could see and feel a difference in muscle mass, primarily in my legs. I lost visible fat primarily from my arms and legs this week, leading to increased muscle definition in my arms, especially.
Of course, the gain in muscle offset some of my fat loss, so I "only" lost four pounds this week. I've threatened to lay off the exercise in order to maximize my weekly numbers, but my wife tells me that she doesn't like "scrawny" guys, and that I need to continue to build muscle, because she's liking what she's seeing. She's now pushing for me to join a gym, which I shall probably do within a week or two, as the weather finally heats up.
2007-07-03: 225, starting point for the week, 25 pounds lost total
2007-07-10: 221, -4 pounds this week, 29 pounds lost total