The Carb-Sane Asylum

S ummary: Continuing on with discussion of:   Effects of a low carbohydrate diet on energy expenditure during weight loss maintenance: randomized trial Previous posts in this series: Part I: Critique of the Study Design Part II: $12 Million for 12% Weight Loss? Part III: Some "Early" Lessons Part IV: Insulin Resistance Does Not Hamper Weight Loss This post should perhaps have come first, but it has taken a while to look deeply at the data for the primary outcome -- total energy expenditure measured by doubly labeled water -- and related outcomes of intake and resting energy expenditure. In this study, all participants were paid to participate, AND provided free food for ~8 months.  Said food was professionally and meticulously prepped, weighed, measured, individualized to provide each subject with some pretty exact caloric level and macronutrient composition.  The test phase (in other words, the study proper) involved maintaining a consiste...

       C ontinuing on with discussion of: Effects of a low carbohydrate diet on energy expenditure during weight loss maintenance: randomized trial No summary for this post.  Here are links to earlier parts in this series: Part I: Critique of the Study Design Part II: $12 Million for 12% Weight Loss? Part III: Some "Early" Lessons :   In this most recent post, I discussed the relationship between measures of insulin (both fasting and 30 minute OGTT response) and weight loss during the Run-In Phase.  

S UMMARY Continuing on with discussion of: Effects of a low carbohydrate diet on energy expenditure during weight loss maintenance: randomized trial In Part I , I discussed some issues with methodology, mostly focusing on the reduced Run-In Phase that likely compromised the outcomes irreparably. In Part II ,  I highlighted a serious issue with the Run-In Phase, the purpose of which was to produce a somewhat homogeneous "reduced weight state" to test various diets in maintenance of that state. Ultimately,  randomization to the various test diets occurred after weight loss (PWL) all subjects lost weight on the same 45% Carb / 30% Fat / 25% Protein diet targeting a weight loss of 12% ± 2% initial body weight. The researchers do not appear to have made many adjustments in the weight loss phase to produce a more uniform weight loss.   Rather than 12% ± 2%  (from 10% to 14%)  losses, the actual outcome was roughly 10.5% ± 5% (actual ...

U PDATE:   12/17/2018      Original Posting: 12/3/2018    During the writing of a new installment in this se ries, I revisited the following paper: A randomized study of dietary composition during weight-loss maintenance: Rationale, study design, intervention, and assessment Yes, folks, so full of themselves were these researchers, that they felt the need to write an entire paper (submitted approx. one year in advance of the "real study") outlining their amazing study. Regarding this post, focusing on the OUTRIGHT FAILURE TO IMPLEMENT THEIR STUDY DESIGN AS STATED , I stress the following from the previous paper. ONCE AGAIN, the stated goal of the weight loss run in is 12% ... not 10 or 5 or 15 or whatever ... 12%.  I'm just going to quote the relevant part here (cleaned of references, etc. and formatted for readability, all emphasis mine) Energy intake was restricted to 60% of estimated needs to achieve a target weight loss equ...