The Weight of Low Fat

A recent article by online news site, The Verge, discussed the widely accepted
low-fat diet to be unfounded and poorly studied (8). Many people have embraced
the mindset of consuming a low fat diet in means of achieving a desirable
nutritional status(7,2). People instinctively remove fat from their diet when they
attempt to achieve weight loss (9). Food companies produce low-fat alternatives to
attract consumers to indulge without guilt. However, many consumers continue to
struggle with weight management (10). It is important to note that an intake of
dietary fats increases satiety, leading to fewer impulses to eat and stabilizes blood
sugar levels(1), which may support weight stability. Although it has been a
common recommendation for the obese population, the low fat diet trend may not
be an effective therapy (4,5,6). The following studies were selected based on their
timeliness, similar sample size, and pertinent objectives.
Klempel et al (2012) found that an alternate-day fasting (ADF) high fat diet was
comparable to an alternate-day fasting low fat diet in obese subjects for weight
loss and improving CHD risk factors (4). The study was conducted in Chicago at
the University of Illinois, Chicago, funded by the Department of Kinesiology and
Nutrition within the university. The purpose was to determine if a beneficial effect
in body weight and CHD factors would be producible by a high fat diet compared
to a low fat diet during alternate day fasting. It included a randomized study of 32
obese female subjects (initially n=35) whom fit these criterias: 3 months weightstable (<5kg loss or gain), aged 25-65yrs, non-perimenopausal, BMI 3039.9kg/m2, non-diabetic, no history of CVD, sedentary or lightly active for 3

months prior to the beginning of the study, non-smoking, and not consuming
weight loss, glucose and/or lipid-lowering supplements/medications.
Postmenopausal women on hormone replacement therapy were required to
maintain their regimen. Subjects were randomly assigned into two groups: ADF
high fat (n=17, n=15 completed) and ADF low fat (n=18, n=17 completed). Study
subjects were provided meals prepared by the metabolic kitchen within the Human
Nutrition Research Unit at the university. In addition, they were given specific meal
times and instructions to ensure similar and consistent fasting and intake periods.
Calorie needs were accounted for utilizing the Mifflin-St. Jeor equation. The
subjects were on the diets for 10 weeks, with the initial two weeks focusing on
weight maintenance and the remaining weeks to weight loss. Adherence was
monitored closely and their results showed that the ADF-high fat group had
comparable differences in the reduction of weight, fat mass, waist circumference,
plasma lipids and blood pressures. The author concluded that fat composition in
dietary restriction was insignificant to facilitate weight loss and CHD risk.
Ebbeling et al (2012) examined the effects of three different dietary
compositions on change in energy expenditure of subjects post weight loss (3).
The data collection occurred at Childrens Hospital Boston and Brigham and
Womens Hospital in Boston, Massachussetts from June 2006 to June 2010.
Study subjects included males and females aged 18 to 40 years with a BMI of 27
or higher. They began with n=32 and eventually n=21 completed the study to be
analyzed. The study consisted of a run-in and test phase, with the run-in phase
initially inducing a 12.5% decrease in body weight (with increased protein intake

consistent with the AMDR established by the IOM) and the test phase being a 3way crossover design of three test diets low fat (20% fat), low-glycemic index
(40% fat), and very low carbohydrate (60% fat) each lasting four weeks utilizing
a feeding protocol. Diets were formulated with healthy components respective to
their typical guidelines but without long-term practicality. Subjects were measured
for serum leptin, thyroid function (TSH and T3), insulin sensitivity (peripheral and
hepatic), cholesterol (HDL and non-HDL), TAGs, blood pressure, CRP, cortisol,
and resting and total energy expenditure. The results from this study showed that
both resting and total energy expenditure decreased the greatest on a low-fat diet
(-205 /d REE and -423kcal/d TEE), with the least change in the very low
carbohydrate diet (-138kcal/d REE and -97kcal/d TEE). The authors concluded
that a low fat diet may be counter intuitive to promote long-term weight loss
maintenance.
Gathering from the conclusions on these two studies, it is probable that a low
fat diet will not produce maximum results in weight management. The first study
showed that the high fat diet had very little impact on weight loss outcomes similar
to the low fat diet while also resulting in negative CHD risk factors. The second
study showed that a low fat diet would result in the greatest decrease in energy
expenditures, which would actually hinder weight loss. However, these studies
contained a small sample size, which may not be representative of a larger
population. Their population size also lacked diversity; the first study had an
African American (n=24) and Hispanic female population (n=8), while the second
study had a greater diversity males and females, Whites (n=4), Blacks (n=8),

Asians (n=4), and Others (n=4). More studies with a greater sample size and
population variety may provide stronger support, but the current evidence
suggests low fat diets are not the most effective at promoting weight loss. It is also
important to note that the subjects were provided with meals, which may not be
realistic outside of the study. The greater population is made up of different
cultures with unique dietary habits and varied lifestyles. People may be more or
less familiar with certain foods that were not considered in the study. There was
also a lack of specificity on the type of dietary fat the subjects consumed.
Determining the types of fat consumed may be more informative to the general
public to distinguish those that should remain in the diet.
Based on these two studies, I would recommend that those considering a low
fat diet may find better results with a more liberal approach that meets the
recommended fat intake. As dietary fat is evidently not a culprit, reducing it from
the diet may have adverse effects on weight management as the second article
demonstrated with the reduction in energy expenditure (3). Therefore, low fat diets
may not be the best initial approach for weight loss therapy.

References
1.

[Effect of dietary fat on blood sugar levels and insulin consumptio... - PubMed - NCBI Retrieved from
http://www.ncbi.nlm.nih.gov/pubmed/6386412

2.

Fats and cholesterol: Out with the bad, in with the good | the nutrition source | harvard T.H. chan school of
public health Retrieved from http://www.hsph.harvard.edu/nutritionsource/fats-full-story/

3.

JAMA | effects of dietary composition on energy expenditure during weight-loss maintenance Retrieved from
http://jama.jamanetwork.com/article.aspx?articleid=1199154

4.

Klempel, M. C., Kroeger, C. M., & Varady, K. A. (2013). Alternate day fasting (ADF) with a high-fat diet
produces similar weight loss and cardio-protection as ADF with a low-fat diet. Metabolism, 62(1), 137-143.
doi:http://dx.doi.org/10.1016/j.metabol.2012.07.002

5.

Moloo, J. (2014). Weight loss is greater with low-carbohydrate than with low-fat diets. NEJM Journal
Watch.General Medicine, , n/a. doi:http://dx.doi.org.libproxy.usc.edu/10.1056/nejm-jw.NA35578

6.

Shai, I., Schwarzfuchs, D., Henkin, Y., Shahar, D. R., Witkow, S., Greenberg, I., . . . Dietary Intervention
Randomized Controlled Trial (DIRECT) Group. (2008). Weight loss with a low-carbohydrate, mediterranean,
or low-fat diet The New England Journal of Medicine, 359(3), 229-241. doi:10.1056/NEJMoa0708681 [doi]

7.

P. Schieberle, V. Somoza, M. Rubach, L. Scholl, M. Balzer; Identifying substances that regulate

satiety in oils and fats and improving low-fat foodstuffs by adding lipid compounds with a high satiety
effect; Key findings of the DFG/AiF cluster project Perception of fat content and regulating satiety:

8.

an approach to developing low-fat foodstuffs, 2009-2012.

Low-fat diet advice was based on undercooked science | the verge Retrieved

9.

from http://www.theverge.com/2015/2/9/8003971/low-fat-dietary-health-goals-bad-science
The fattening - did the low-fat era make us fat? | diet wars | FRONTLINE | PBS Retrieved
from http://www.pbs.org/wgbh/pages/frontline/shows/diet/themes/lowfat.html

10. Kraschnewski JL, Boan J, Esposito J, et al. Long-term weight loss maintenance in the United States.
Int J Obes (Lond). 2010;34(11):1644-1654.