From Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana; Kaiser Permanente Southern California, Pasadena, California; and Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. 
 
 Acknowledgment: The authors thank the study participants for their cooperation. 
 
 Grant Support: From the National Center for Research Resources of the National Institutes of Health (NIH/NCRR P20-RR017659) to the Tulane University Hypertension and Renal Center of Excellence. 
 
 Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M14-0180. 
 
 Reproducible Research Statement:Study protocol and data set: Not available. Statistical code: Available from Dr. Bazzano (e-mail, lbazzano@tulane.edu). 
 
 Requests for Single Reprints: Lydia Bazzano, MD, PhD, MPH, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, SL-18, Suite 2000, New Orleans, LA 70112; e-mail, lbazzano@tulane.edu. 
 
 Current Author Ad dresses: Drs. Bazzano, Hu, Yao, Whelton, and He; Ms. Bunol; Ms. Liu; and Ms. Chen: Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, SL-18, Suite 2000, New Orleans, LA 70112. 
 
 Dr. Reynolds: Kaiser Permanente Southern California, 100 South Los Robles, 2nd Floor, Pasadena, CA 91101. 
 
 Dr. Klag: Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Room W1041, Baltimore, MD 21205. 
 
 Author Contributions: Conception and design: L.A. Bazzano, T. Hu, K. Reynolds, L. Yao, M.J. Klag, J. He. 
 
 Analysis and interpretation of the data: L.A. Bazzano, T. Hu, Y. Liu, C.S. Chen, M.J. Klag, P.K. Whelton, J. He. 
 
 Drafting of the article: L.A. Bazzano, T. Hu. 
 
 Critical revision of the article for important intellectual content: L.A. Bazzano, T. Hu, K. Reynolds, L. Yao, P.K. Whelton, J. He. 
 
 Final approval of the article: L.A. Bazzano, K. Reynolds, M.J. Klag, P.K. Whelton, J. He. 
 
 Provision of study materials or patients: L.A. Bazzano, C. Bunol. 
 
 Statistical expertise: T. Hu, C.S. Chen. 
 
 Obtaining of funding: L.A. Bazzano. 
 
 Administrative, technical, or logistic support: L.A. Bazzano, L. Yao, C. Bunol. 
 
 Collection and assembly of data: L.A. Bazzano, L. Yao, C.S. Chen, J. He. ||||| Cutting Back On Carbs, Not Fat, May Lead To More Weight Loss 
 
 Enlarge this image toggle caption eyecrave LLC/iStockphoto.com eyecrave LLC/iStockphoto.com 
 
 We've reported a lot this year about how there's a major rethinking of fat happening in the U.S. 
 
 Turns out, eating foods with fat — everything from avocados and nuts to dairy fat — doesn't make us fat. 
 
 But eating too many carbohydrates — particularly the heavily refined starches found in bagels, white pasta and crackers — does our collective waistlines no favors. 
 
 A new study published in the Annals of Internal Medicine adds to the body of evidence that cutting back on carbs, not fat, can lead to more weight loss. 
 
 Researchers at Tulane University tracked two groups of dieters for one year. The participants ranged in age from their early 20s to their mid-70s and included a mix of African-Americans and Caucasians. 
 
 The low-carb group, which reduced their carb consumption to about 28 percent of their daily calories, lost almost three times as much weight as the low-fat dieters who got about 40 to 45 percent of their calories from carbs. 
 
 The low-fat group lost about 4 pounds, whereas the low-carb group's average weight loss was almost 12 pounds. Participants in the two groups were eating about the same amount of calories. 
 
 The study showed that modest reductions in carbohydrate consumption, down to about 28 to 30 percent of diet, could help tip the scales to weight loss. The makeup of the low-carb group's diet was: 28 percent carbs 40 to 43 percent fat (twice as much poly and monounsaturated compared to saturated) about 28 percent protein The makeup of the low-fat group's diet was: 28 percent fat 40 to 45 percent carbs 28 to 32 percent protein 
 
 Lydia Bazzano, one of the study authors and an associate professor of epidemiology at Tulane, says she had anticipated some difference in weight loss between the two groups. But the size of the effect — the nearly 8-pound difference in weight loss — was surprising, she says. 
 
 So, what kinds of meals were the low-carb dieters eating? 
 
 "Typically in the morning they were eating eggs," says Bazzano. Other breakfast items included small portions of high-protein, high-fiber bread, with either butter or other kinds of oily spread. 
 
 As for lunch and dinner, the low-carb dieters ate lots of vegetables, salads and protein, including fish, chicken and some red meat. They had generous portions of healthy fats such as olive oils, canola and other plant-based oils. 
 
 Fat accounted for a sizable part of their diet: from 40 percent to 43 percent of their total daily calories, including about 12 percent from saturated fat. 
 
 Bazzano says with so many people still abiding by low-fat recommendations, a diet so high in fat might not sound like a good weight-loss strategy. "It's not the general perception," she says. 
 
 But, in fact, there are a spate of studies that have come to the same conclusion about the benefits of swapping a low-fat, high-carb strategy for a pattern of eating that emphasizes healthy fats and lower carbohydrate consumption. 
 
 It's not just waistlines that respond. The low-carb, healthy fats approach has been shown to cut the risk of heart disease. 
 
 One big study published in the New England Journal of Medicine found that a Mediterranean diet rich in olive oil cut the risk of heart attacks and strokes by 30 percent, compared to a low-fat diet. 
 
 Research published last year in the Journal of the American Medical Association, which compared a low-glycemic-index diet — which minimizes refined starches — with a more traditional low-fat diet, also documented advantages. 
 
 "We saw improvements in triglycerides, [good] cholesterol, and the possibility of lower chronic inflammation" among the lower carb group, JAMA study author David Ludwig of Harvard Medical School and Boston Children's Hospital told us. 
 
 Here's the fascinating part: Ludwig also found that when people stopped eating so many refined carbohydrates, they burned off about 150 more calories per day, compared to those eating a higher carb, lower fat diet. 
 
 "Too much refined carbohydrates — white bread, white rice, potato products — all the foods that crept into our diets as we've followed the low-fat craze has undermined our metabolism," says Ludwig. 
 
 In other words, the high-carb, low-fat pattern of eating "caused us to become hungrier and burn off fewer calories," he says. 
 
 What's happening in the body when we follow this pattern of eating is still the subject of much research, but Ludwig says the thinking goes like this: Eating too many carbs can overstimulate the release of insulin and direct more calories into storage in the fat cells. 
 
 "It's a double-whammy for weight gain," Ludwig says. "We've been told for decades that if you don't want fat on your body, don't put fat into your body. It's a very appealing notion, but the problem is it's wrong." ||||| A low-carbohydrate diet is better for losing weight and may also be better for lowering the risk of heart disease than a low-fat diet, according to a new study. 
 
 While low-carb diets have outperformed other diets when it comes to weight loss, some researchers feared they might be worse for heart health because they tend to be high in fat. 
 
 The new study shows that with proper nutritional counseling, people can lose more weight and lower their risk factors for heart disease on a low-carbohydrate diet, said the lead author, Dr. Lydia Bazzano of Tulane University in New Orleans. 
 
 "This study shows if you are overweight and have cardiovascular disease risk factors and haven't had success on other diets, certainly a low-carbohydrate diet is worth a try," said Bazzano. 
 
 Carbohydrates are found in food and include sugar, fiber and starches that give the body energy. Some carbs - like those in whole grains and fruits - are healthier than others - like those in white bread and other processed foods. 
 
 Bazzano and her colleagues write in Annals of Internal Medicine that low-carb diets have become popular weight loss strategies in recent years. Studies on their effects on cardiovascular risk factors have produced mixed results, however. 
 
 For the new study, she and her colleagues recruited 148 obese men and women between the ages of 22 and 75. None of the participants had heart disease or diabetes. 
 
 Half were randomly assigned to follow a low-carbohydrate diet for a year, and the other half were assigned to a low-fat diet for a year. They were told to not change their physical activity throughout the trial. 
 
 All participants attended regular meetings where they learned about portion control, healthy eating and overall nutrition. They were also offered one meal-replacement bar or shake per day. 
 
 The only difference between the groups was the proportions of carbohydrate and fat in their diets. 
 
 Those in the low-carbohydrate group were told to eat at no more than 40 grams of digestible carbohydrates per day. ("Digestible carbs" equals total carbs minus total fiber.) 
 
 Those in the low-fat group were told not to get more than 30 percent of their daily energy from fat and no more than 55 percent of their daily energy from carbohydrates. 
 
 Overall, about four of every five participants were still following the diets 12 months later. 
 
 During that time, the researchers found, people on the low-carbohydrate diet lost more weight and more body fat than those on the low-fat diet. 
 
 The difference in lost weight between the two groups would represent about eight additional pounds. 
 
 Additionally, the researchers saw no increases in total cholesterol or "bad" LDL cholesterol between the two groups. Bazzano said that's good news since some thought a low-carbohydrate diet would increase cholesterol levels. 
 
 Those in the low-carbohydrate group had lower levels of fat circulating in their blood and had lower scores on a measure often used to predict the risk of a heart attack or stroke within the next 10 years. 
 
 "I thought that was a very striking finding," Bazzano said. She added that the score that predicts risk of future heart attacks and strokes was computed after the study was finished and is less reliable than the other risk factors they measured. 
 
 Dr. David Jenkins, who wasn't involved in the study, told Reuters Health, "This doesn’t look to me to say 'eat all the meats you want to lower your carbohydrates.' That’s just one way to do it." 
 
 Instead, Jenkins said, people in this study appeared to improve their overall diets. For example, they were eating foods with healthier fats, such as nuts and beans. 
 
 He also said they seemed to eat more fiber and cut down on processed foods with more carbohydrates. 
 
 "I think it’s another testament to what one can do with a more plant-based diet using the right macronutrient profile," said Jenkins of the Department of Nutritional Sciences at the University of Toronto and the Keenan Research Centre at St. Michael's Hospital. 
 
 Bazzano agreed that the overall diets improved among the participants and they were encouraged to eat healthier forms of protein like chicken, fish, nuts and beans. 
 
 She also said her team is not sure why people on the low-carbohydrate diets lost more weight and had lower risk factors for heart disease after one year. It's not clear, she added,if there would still be a difference after a longer period. 
 
 SOURCE: bit.ly/1qjI8OG Annals of Internal Medicine, online September 1, 2014.
– If you're trying to lose weight on a low-fat diet and it's not working, here's why. Refined carbohydrates—found in processed foods like white breads, white rice, and pastas—tend to be loaded with sugar, which messes with our metabolisms, making it harder to burn calories. Eating nearly half your calories via healthy fats, on the other hand—think salmon, avocados, nuts, and vegetable oils—has been shown in a recent study to result in twice as much weight loss as seen in those assigned to low-fat diets. "It's a double-whammy for weight gain," one researcher tells NPR. "We've been told for decades that if you don't want fat on your body, don't put fat into your body. It's a very appealing notion, but the problem is it's wrong." What's more, the researchers say there was no increase in total or bad cholesterol between the groups, which has been feared would be the case in higher-fat diets, reports Reuters. It remains unclear precisely why people on lower-carb diets not only lost more weight but had lower heart disease risk factors. It's something the researchers say will need to be studied more and for longer than the one-year period of this investigation. (Welcome back, butter—even saturated fats might not be as bad as once thought.)