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Showing posts from June, 2016

Two huge new studies further undermine the "obesity paradox"

The "obesity paradox" is the observation that people with higher fat mass sometimes have better health outcomes than lean people, including a lower overall risk of death.  Evidence has been steadily mounting that this finding may be a misleading artifact of the methods used to observe it.  Two massive new studies add to this evidence.

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A Serious Challenge to the 2012 Low-carbohydrate "Metabolic Advantage" Study

Warning: this post will be a bit more wonkish than usual, because I need to get detailed to make my points. To read a summary, skip to the end.

In 2012, David Ludwig's group published an interesting RCT that suggested a substantial "metabolic advantage" resulting from a high-protein, very-low-carbohydrate diet (VLC) (1).  In other words, this diet led to a higher energy expenditure relative to a normal-protein, low-fat diet (LF) over a one month period (a low-glycemic-load, normal-protein diet was in the middle and not significantly different from the other two).  Resting energy expenditure (REE) was slightly but significantly higher on the VLC diet, and total energy expenditure (TEE) was elevated by a whopping 300+ kcal/day!  I covered the study at the time, describing it as "fascinating" and "groundbreaking", and calling for the study to be replicated so we can be more confident in its unexpected result (2).

This finding has been used by Ludwig, Gary …