Are low carb diets are easier or harder to follow than other diets?
February 22, 2018 12:40 PM   Subscribe

Low carb diets have some true believers. These believers believe in the carbohydrate-insulin hypothesis. So far, studies have failed to support this hypothesis. Anecdotally, I've had success with low carb diets. My hypothesis is that low carb diets work not because the whole carbohydrate-insulin thing, but rather because low carb diets are more easily followed than an "everything in moderation" diet. Has this hypothesis been tested? Can this hypothesis be tested?

The link above goes to a Vox piece discussing a study where researchers "confined 17 overweight and obese patients to the hospital for two months, where they measured their every movement and carefully controlled what they were eating." The had people do a "baseline" diet for a month then a low carb diet for a month. The result was "the researchers did not find evidence of any dramatic effects after switching to a low-carb diet."

I guess based on my experiences, that result did not surprise me. I remember having success on Whole 30 and thinking to myself that the diet was really just portion control masquerading as a carbs and sugar restrictive diet. But on Whole 30, the portion control was pretty easy. I just ate meat and veggies--with the occasional fruit and nut--and didn't have to think about anything. I was usually satiated and rarely over-ate. My diet was sort of a "set it and forget it" type of experience.

I could probably be successful on "baseline" diet if I was in a hospital for a month and researcher were controlling everything I ate. But out in the wild, I'd have to make decision after decision and would eventually fail due to the constantly having to think about if I should eat something or not.

My main problem in the past on low carb diets was the lingering feeling that it was unsustainable because eventually I'd want a beer at a ballgame again or a piece of cake at a birthday party or tacos on my beach vacation or BBQ on date night, and that would end the diet. And when I was on the diet, I'd actually dread those aforementioned special occasions.

But I've solved for that by making my low carb diet fairly sustainable by allowing for a cheat meal or day once a week. I used to be resistant to the concept in the past, but it's really helped me make low carb a lifestyle. I had dessert on Valentine's Day. I have a resort night with my wife coming up in a few weeks which means drinks by the pool. A week after that, I'm going to a hockey game which means a few beers. I am looking forward to those events, knowing I'll use those as my cheat meals. Plenty of weeks go by where I don't use a cheat meal, but I know they're available to me.

Can anyone point me toward empirical analysis of my anecdotal experience? Proving and disproving equally welcomed!
posted by glenngulia to Health & Fitness (14 answers total) 9 users marked this as a favorite
I saw this just last week. Low carb - high carb. It doesn't matter.
posted by COD at 1:19 PM on February 22, 2018 [1 favorite]

“The Hungry Brain” is a good book. It argues all calories are pretty much equivalent, metabolically. However, different foods make us more or less hungry — in particular, salty, sweet, and fat foods fill us up less and make us want to eat more, by the effects they have on the hormonal system (involving leptin and other things) that controls hunger and satiety. In particular eating hyper palatable food over time can result in the “set point” of weight that our bodies want to maintain drifting slowly upward.

It’s a good book and I found it persuasive. Low carb implicitly avoids a lot of foods that trigger hunger, but the carbs aren’t the important thing.

I don’t know if he mentions cheat days in the book but it absolutely fits with his hypothesis.
posted by vogon_poet at 1:29 PM on February 22, 2018 [1 favorite]

This has been my anecdotal experience, too - that low-carb is just easier. I mostly just count calories when I diet, and it's way easier for me to be happy and well-fed-feeling on a low calorie, low carb diet vs. a low calorie, low fat diet. I've never tried a super-low-carb keto diet or anything though - I think if you're actually in ketogenesis there are other factors in play.
posted by mskyle at 1:30 PM on February 22, 2018

I do find I am less hungry feeling on a low-carb diet after the first few days of keto flu, compared to any other calorie-restricted higher-carb diet. The fat and protein really keeps the hunger pangs down.
posted by joan_holloway at 1:35 PM on February 22, 2018 [1 favorite]

I suspect "easy to follow" is a fairly individual metric, as every online discussion on diet results in a slew of people offering their personal One True Way to lose weight.
posted by noxperpetua at 1:54 PM on February 22, 2018 [12 favorites]

The article states that the study did find that insulin secretion plummeted when the participants switched to the low-carb diet. It's been a while since I read Good Calories, Bad Calories, but what part of the Carb-Insulin hypothesis did that prove false?

It really does boil down to calories in, calories out. It's just that the basal calories out part is incredibly difficult to determine or control since it's impacted by hormones and an infinite number of other factors.

If you can eat a dessert every once in a while and you can get right back on the low-carb wagon, there aren't that many calories in one cheat day. For me, though, having a desert sets me off course for two weeks because the cravings come back with a vengeance.

Good luck with the empirical studies, though. I don't think they've definitively come up with anything to-date or else there wouldn't be that much controversy in diet types.
posted by hwyengr at 2:06 PM on February 22, 2018 [2 favorites]

Seconding "easy for some, not all." I do very low carb and love it, but it was easier for me to give up bread, cookies, cake etc than to give up cheese, bacon, and butter. Some people will not be happy in their life if they can't have bread or potatoes, and that's fine; keto is not good or sustainable for them, but they have plenty of other ways to eat which will be fine for health.
posted by The otter lady at 2:10 PM on February 22, 2018 [3 favorites]

I'm not sure that a low carb diet with a "carb cheat day" would really help much unless you were doing serious portion control on all days. And if you're doing that, what's the point of cutting carbs six days a week?

One of the things pointed out by the Tufts University School of Nutrition is this explanation for why low carb dieting can result in dramatic fast weight loss, but tends to rebound immediately when the dieter eats carbs:
Consider that carbohydrates are stored in the body attached to water molecules. When carbs are not taken in with the diet, every carb that comes out of storage to fuel the various organs and other tissues releases water, which ends up in urine and creates weight loss on the scale that can be confused with fat loss.
Then, if the dieter takes in carbs, those get stored by the body along with all that water, thus creating equally dramatic fast weight gain.
posted by slkinsey at 2:25 PM on February 22, 2018 [1 favorite]

but rather because low carb diets are more easily followed than an "everything in moderation" diet.

This may be true for some people, or even a majority of people, but it is not at all true for me.

I mean yes, individual genetics and insulin and whatnot play into this kind of thing, but so does psychology.

My mother did not allow me any sugar growing up, to the point of taking away a candy bar I bought with my own money. Telling myself I'm not allowed to have sugar is unsustainable for me, it makes me feel deeply deprived. I do much better telling myself I can have whatever I want, just in moderation.
posted by mrmurbles at 8:22 PM on February 22, 2018

We randomly assigned 811 overweight adults to one of four diets ... At 6 months, participants assigned to each diet had lost an average of 6 kg, which represented 7% of their initial weight; they began to regain weight after 12 months. ... Satiety, hunger, satisfaction with the diet, and attendance at group sessions were similar for all diets; attendance was strongly associated with weight loss (0.2 kg per session attended). ... Reduced-calorie diets result in clinically meaningful weight loss regardless of which macronutrients they emphasize.
posted by ludwig_van at 10:06 PM on February 22, 2018 [1 favorite]

Anecdotally I am finding intermittent fasting (16/8) to be much easier to follow than low-carb. I kind of accidentally do low-ish carb a lot of the time anyway without trying on IF, while doing plain old low-carb seemed to take a lot more planning, effort, and will power.
posted by rabbitrabbit at 6:23 AM on February 23, 2018

The key thing that gets overlooked by those who say low carb is no better is that low carb diets work when people eat until they are satisfied. (Google "low carb ad libitum.") So yes, if you compare isocaloric low carb vs an alternative, it doesn't seem to shine that much. But if you want to lose weight while also feeling satisfied (i.e. not being hungry and cranky) low carb can do that.

(Lost 100 lbs and have maintained most of it for a few years now eating LCHF.)
posted by callmejay at 5:29 PM on February 23, 2018 [3 favorites]

(I see that that seems to contradict a conclusion of the study ludwig_van links to, so maybe you can be satisfied on other diets too. Still, it's got to mean something that you can lose weight eating ad libitum on low carb diets but not others.)
posted by callmejay at 5:30 PM on February 23, 2018

Here is a different recent comparison between low-carb and low-fat that also looks specifically at measures of dietary adherence, also finding "no significant difference in composite adherence score between groups." Of particular interest, in the low-carb group 73.9%, 59.7% and 44.8% of individuals met the carbohydrate goal (less than 40 g carbs) and 59.4% , 64.8%, and 55.6% of the low-fat group met their total fat goals (less than 30% of calories) at the same intervals.

Anecdotally, I find low carb to be both easier to follow than some people might imagine yet nowhere near as easy as a lot of low-carb evangelists claim. I think it may win out in terms of feeling physically satiated, but it is more challenging for me in terms of feeling mentally deprived of many favorite foods. Low-carb substitutes usually entail a costly and labor-intensive process that yields a culinarily disappointing product. I'm not sure I really get so much carby food "cravings" but rather wistful carb "longings" for something that is tasty and doesn't require any cooking that is not Another Fucking Salad. Several years ago I followed a portion-control-based diet and successfully lost 60 lbs over the course of a year. More recently I've been dabbling in low-carb for 4 months and have lost about 20 lbs. I've found that keto-level low carb is just not sustainably achievable for me and my own food habits/preferences/situation and what I am/am not willing to give up.
posted by drlith at 6:12 AM on February 27, 2018 [2 favorites]

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