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CARBOHYDRATE NUTRITION NEWS |
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Previous Years
- April 2012 - Reduction in energy intake most important determinant of fat loss rather than macronutrient composition
Effects of 4 weight-loss diets differing in fat, protein, and carbohydrate on fat mass, lean mass, visceral adipose tissue, and hepatic fat: results from the POUNDS LOST trial.
Russell J de Souza, George A Bray, Vincent J Carey, Kevin D Hall, Meryl S LeBoff, Catherine M Loria, Nancy M Laranjo, Frank M Sacks, and Steven R Smith
Department of Nutrition, Harvard School of Public Health, Boston, MA and Endocrine Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
Am J Clin Nutr. 2012 Mar;95(3):614-625.
Abstract
Background: Weight loss reduces body fat and lean mass, but whether these changes are influenced by macronutrient composition of the diet is unclear.
Objective: We determined whether energy-reduced diets that emphasize fat, protein, or carbohydrate differentially reduce total, visceral, or hepatic fat or preserve lean mass.
Design: In a subset of participants in a randomized trial of 4 weight-loss diets, body fat and lean mass (n = 424; by using dual-energy X-ray absorptiometry) and abdominal and hepatic fat (n = 165; by using computed tomography) were measured after 6 mo and 2 y. Changes from baseline were compared between assigned amounts of protein (25% compared with 15%) and fat (40% compared with 20%) and across 4 carbohydrate amounts (35% through 65%).
Results: At 6 mo, participants lost a mean (±SEM) of 4.2 ± 0.3 kg (12.4%) fat and 2.1 ± 0.3 kg (3.5%) lean mass (both P < 0.0001 compared with baseline values), with no differences between 25% and 15% protein (P = 0.10), 40% and 20% fat (P = 0.34), or 65% and 35% carbohydrate (P = 0.27). Participants lost 2.3 ± 0.2 kg (13.8%) abdominal fat: 1.5 ± 0.2 kg (13.6%) subcutaneous fat and 0.9 ± 0.1 kg (16.1%) visceral fat (all P < 0.0001 compared with baseline values), with no differences between the diets (P = 0.29). Women lost more visceral fat than did men relative to total-body fat loss. Participants regained ~40% of these losses by 2 y, with no differences between diets (P = 0.23). Weight loss reduced hepatic fat, but there were no differences between groups (P = 0.28). Dietary goals were not fully met; self-reported contrasts were closer to 2% protein, 8% fat, and 14% carbohydrate at 6 mo and 1%, 7%, and 10%, respectively, at 2 y.
Conclusion: Participants lost more fat than lean mass after consumption of all diets, with no differences in changes in body composition, abdominal fat, or hepatic fat between assigned macronutrient amounts.
Link to abstract
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- March 2012 - The British Nutrition Foundation, The Dietitians Association of Australia and The Australian Diabetes Council critique sugars "Commentary" published in Nature
The British Nutrition Foundation, The Dietitians Association of Australia, and The Australian Diabetes Council critique sugars “Commentary” published in Nature
A number of health professionals and Associations have responded to the misleading allegations in the commentary, "The toxic truth about sugar," which appeared in the February issue of the journal Nature. These include critiques from The British Nutrition Foundation and The Dietitians Association of Australia.
- British Nutrition Foundation: "Sugar is a source of energy in our diet and it is certainly not 'toxic' in the amounts on average consumed in the UK and other European countries…. Overall, the commentary by Lustig and colleagues, published in Nature, does not reflect the current state of evidence around sugar and its association with chronic disease, as shown in some recent major systematic reviews."
- Dietitians Association of Australia: "the Dietitians Association of Australia (DAA) believes it is simplistic and unhelpful to blame sugar alone for rising rates of obesity and other related health problems across the world…. Labelling sugar as 'toxic' and 'addictive' and placing it in the same boat as alcohol is incorrect and misleading."
- Australian Diabetes Council: "This commentary is a provocative piece intended to encourage debate.…'Sugar' is not the issue, it is far more complicated than that… the average Australian can do a lot to improve their diet, but casting sugar as the ultimate villain and calling for regulation is misleading, unfounded and unnecessary."
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- March 2012 - Various critiques of “Commentary” on sugar also published in Nature
Various critiques of “Commentary” on sugar also published in Nature
Several follow-up correspondences have recently been published in the journal Nature in response to the commentary, “The toxic truth about sugar,” which appeared in the February issue of the journal.
Responses from Ron Boswell (Government, Queensland, Australia);
John L. Sievenpiper, Russell J. de Souza and David J.A. Jenkins (St. Michael’s Hospital, Toronto, Ontario);
Christiani Jeyakumar Henry and Viren Ranawana (Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Singapore);
Saleem H. Ali (University of Vermont, Burlington, USA); and Richard C. Cottrell (World Sugar Research Organisation, London, UK) have all challenged the commentary.
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- February 2012 - "Commentary” on sugar (published in Nature) is not supported by scientific evidence
"Commentary” on sugar (published in Nature) is not supported by scientific evidence
The commentary, "The toxic truth about sugar," which appeared in the February issue of the journal Nature is inconsistent with the large body of scientific evidence regarding sugar consumption and health. Thorough scientific reviews such as the Institute of Medicine, Dietary Reference Intakes (DRI) report, does not support the view that sugar is "toxic" and a cause of non-communicable diseases, including obesity, hypertension or cardiovascular disease.
The DRI report, which forms the basis of Canada's dietary guidance, reviewed all available evidence on the effects of total and added sugars on chronic disease and concluded that there was insufficient evidence to set an upper level of total or added sugars. Current dietary recommendations suggest a maximum intake of added sugars of 25% of total calories. In Canada, added sugars consumption is estimated to be 10-13% of total energy intake, well below the recommended maximum.
Consumption of added sugars is not increasing as the authors suggest. In Canada, consumption of sugar (sucrose) has declined over the past 4 decades and consumption of total added sugars is estimated to be stable or modestly declining as a percentage of total calories. Recent literature has also reported added sugars consumption to have either remained stable or declined in countries such as Australia, the United Kingdom, and the United States. Obesity rates continue to rise, contrasting trends in added sugars consumption.
Added sugars and naturally occurring sugars are metabolized the same way in the body. Sugars (naturally occurring and added) are found in a wide variety of foods, such as fruits and vegetables, dairy products, cereals and grain products. Sugar plays a vital role in many sensory and food safety aspects of food - sugar contributes to the texture, flavour, and appearance of foods, acts as a natural preservative, enables the fermentation process to occur, and exhibits antioxidant functions.
Scientific background: Sugar is not toxic or addictive
"There is no support from the human literature for the hypothesis that sucrose may be physically addictive or that addiction to sugar plays a role in eating disorders."
Sugar consumption does not cause obesity and other chronic diseases
"Based on the data available on dental caries, behavior, cancer, risk of obesity, and risk of hyperlipidemia, there is insufficient evidence to set a UL for total or added sugars "
- Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients).
Institute of Medicine, Washington, DC: National Academies Press, 2005.
- Dietary Reference Intakes for Sugars, 2004 PDF format
Other reviews:
Sugar intake does not cause diabetes
"Studies failed to demonstrate an obvious relationship between the intake of total simple carbohydrates and glycaemic control or risk to develop a type 2 diabetes and particularly specific evidence is missing in terms of sucrose effect on diabetes."
Other Links:
Sugar intakes have been stable or declining while obesity rates have been increasing
No one macronutrient is uniquely responsible for the rise in obesity rates
Added sugars consumption in Canada is well below the DRI suggested maximum of 25% of energy intake and well within dietary recommendations for total carbohydrate (sugars and starches).
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- February 2012 - Popular Diet Books, Reviewed by Registered Dietitians
Popular Diet Books, Reviewed by Registered Dietitians
As obesity rates continue to climb, so do the number of “diet” books. A variety of approaches have been suggested to lose weight; some are well researched, while others are not. The Academy of Nutrition and Dietetics (formerly the American Dietetic Association) has published reviews by Registered Dietitians of several controversial diet books. Below are brief extracts from some of these reviews with a particular focus on carbohydrates.
The No Crave Diet
By Dr. Penny Kendall-Reed and Dr. Stephen Reed
RD Review - Bottom Line: The authors' own warning that during Phase 1 dieters may feel hungry, light-headed, irritable or nauseous seems to undermine the whole "No-Crave" premise. I would not recommend this book.
Highlights: “This book explains what, how and when to eat in order to reduce your desire to snack; arms you with a host of tips for switching off food cravings in any situation; reveals how managing stress, sleep and exercise will reduce cravings…Written by an orthopedic surgeon and a naturopathic doctor -- specialties not generally associated with weight-loss or nutrition expertise -- this book centers on the philosophy that certain carbohydrates, even high-fiber, healthy ones, raise blood sugar and will increase cravings. The first phase lasts six to eight weeks and limits carbohydrates, except for vegetables. No snacking is allowed during this phase and the authors warn that during Phase 1, dieters may feel hungry, light-headed, irritable or nauseous. Phase 2 is slightly more flexible and re-introduces some healthy carbohydrates. Phase 1 is unnecessarily extreme and many nutritious, low-calorie, high-fiber foods are not allowed or severely limited…foods such as legumes, beets and waxy beans are limited to two tablespoons every other day, as the authors claim they're too sugary… Phase 2 promotes an unnecessarily complicated "carbohydrates reintroduction order." Read the full Academy review.
The 4 Hour Body:
An Uncommon Guide to Rapid Fat–Loss, Incredible Sex, and Becoming Superhuman
By Timothy Ferriss
RD Review - Bottom Line: Most who attempt The 4-Hour Body will likely lose weight as they would when following any lower-calorie program that includes physical activity. However, strict deprivation diets are not the answer to lifelong health and happiness. Long-term success includes learning how to eat the foods we love as part of a healthy diet.
Highlights: “The diet plan, referred to as the Slow-Carb diet, claims to teach the reader how to lose 20 pounds in 30 days without exercise. The Slow-Carb diet encourages the consumption of lean proteins, legumes and green vegetables… It is easy to see how the simple plan may attract some readers who prefer simplicity and have a difficult time preparing meals or do not enjoy cooking…. Ferriss describes the changes dieters will make as being "small changes" although for many that will not be the case. The lack of variety may leave many dieters bored. Ferriss also fails to discuss the idea that taste is the major reason why we choose the food we eat. The reality of long-term behavior change, which most often requires identifying individual strategies for success and learning to eat the foods we love within the scope of a healthy diet, is also overlooked. … While Ferriss does refer to scientific research, he is not a qualified health professional and much of what he discusses is contradictory…” Read the full Academy review.
The 10-Step Nutrition Plan to Help Treat Your Child's Autism,
Asperger's or ADHD
By Elizabeth Strickland
RD Review - Bottom Line: This is a well thought-out review of the application of nutrition therapy in the treatment of children with autism and related disorders. Overall diet quality, focus on whole nutrient-rich foods, filling nutritional gaps with appropriate supplements and determining causes of feeding problems should be addressed before attempting more alternative approaches to treatment.
Highlights:“This is not a traditional diet plan but rather an approach for dealing with nutrition concerns and nutrition therapy strategies for children with autism. It includes 10 steps for spotting and addressing nutrition issues. The author recommends completing the steps in the order outlined; however, not all steps are needed for all kids if parents find symptoms and behaviors improve with the basic steps. … The author does include scientific evidence and rationale for recommendations where it is available. However, there is little research in this area of nutrition therapy. The author points out the lack of scientific evidence for many of the dietary and supplement practices promoted to parents of autistic children. Unnecessarily limiting foods from the diet may put these kids at nutrition risk and supplementing above the normal recommended amounts may lead to toxicity or over supplementation…” Read the full Academy review.
The 17 Day Diet
By Mike Moreno, MD
RD Review - Bottom Line: This is another diet that will add more confusion to the already confused, fat and malnourished country. Restrictive meal plans, no fruit after 2 p.m., demonizing food and the low calorie levels of this diet are a perfect combination for a good binge. Chocolate chip cookie lovers are at risk. Of course, you will lose weight by lowering your caloric intake and restricting food; however, you will be left with few options.
Highlights: “The 17 Day Diet is based on the idea of metabolic confusion, also known as calorie shifting...altering the way you eat every few days or weeks...to lose up to 10 to 15 pounds in the first 17 days. The 17 Day Diet focuses on clean eating, which means no sugar, no processed food and no fried food... Carbohydrates are restricted after 2 p.m... The science behind [the author`s] theories is not strong. There is no evidence you can "confuse your metabolism" to prevent plateaus by increasing and decreasing calories and changing the foods you eat... Of course, you will lose weight by lowering your caloric intake and restricting food; however, you will be left with few options. This diet does not quite teach participants how to incorporate all food groups at all times, thus it may not be a long-term lifestyle approach...” Read the full Academy review.
The Dukan Diet
By Dr. Pierre Dukan
RD Review - Bottom Line: Although The Dukan Diet is likely to help readers shed unwanted weight, the highly restrictive nature of the Attack and Cruise phases raise health concerns that make it difficult to recommend this diet.
Highlights: “The Dukan Diet claims it’s the ideal diet for people who want to lose weight quickly but can’t be bothered with counting calories or weighing their food. The author believes fast results are the key to weight-loss motivation. His high-protein, low-calorie plan is divided into four phases. The first two phases are geared toward helping readers shed pounds quickly, while the second two are designed to maintain weight loss permanently… The goal of the Attack phase is dramatic weight loss of four to 10 pounds in seven days or less. During this phase, readers eat a pure protein diet… The Cruise Phase, readers alternates pure protein days with days of pure protein and non-starchy vegetables until they reach their “true” or goal weight… The Dukan Diet may not be the healthiest or most versatile plan... By restricting carbohydrates, The Dukan Diet forces the body and brain to use fat for fuel. This pushes the body into a state of ketosis, which has been linked to health problems such as kidney damage and gout. …” Read the full Academy review.
Note: All material taken from Academy of Nutrition and Dietetics Consumer Diet and Lifestyle Book Reviews http://www.eatright.org/dietreviews/
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