A Low-Carb Diet Works—If It Suits You

Picking a diet because it worked for your friend (or a celebrity) always seemed to me like borrowing their clothes: Unless the two of you are built very similarly, it's not going to work out well. So the recognition—in the New England Journal of Medicine, no less!—that individual preferences should be taken into account when planning a weight-loss program is a welcome one. After all, you can lose weight following pretty much every diet on the bookstore shelf. The problem is that unless the diet fits your lifestyle, you're not likely to stick to it for the long term, and the weight will creep back on. "You want a diet you can live with," says Meir Stampfer, senior author of the diet study in the NEJM and associate director of Brigham and Women's Hospital's Channing Laboratory in Boston.

The study, out this week, found that among moderately obese people in Israel, mostly men, the Mediterranean diet (which emphasizes fish, sources of "good" fat like olive oil and nuts, veggies, and whole grains) and the low-carb Atkins diet actually outperformed a low-fat diet (no more than 30 percent of daily calories from fat) at promoting weight loss over a two-year period. And, the three diets produced similar improvements in things like liver function and indicators of cardiovascular health, which have been a concern for the Atkins diet. So all of the eating plans look like viable options from both a weight-loss and health standpoint, the authors say.

The less-than-great news is that none of the diets produced huge weight loss: Among the more than 300 people in the study, those assigned to the low-fat group lost the least, about 6.4 pounds, while the Mediterranean diet group lost an average of 9.7 pounds and the low-carbers lost 10.4 pounds. And this was from a starting weight of about 200 pounds. (The findings are similar to those of a study published last year that compared a low-carb plan with three other diets strategies.) Given that the study participants got great support in the form of regular contact with a dietitian, guidance on food choices in their work cafeteria, and even education for their spouses, the findings underscore what most people who have tried already know—that losing weight is really tough.

But what if the subjects had been allowed to pick which diet fit in best with their preferences? If you're trying to lose weight, you have that option. Someone who orders a burrito mainly for the tortilla is probably not going to be able to easily stick to a low-carb diet. If you hate counting calories and find it much easier to make rules—like steer clear of carbs—Atkins may be for you. And if you really love your olive oil, the Mediterranean diet guidelines may work better than a low-fat approach. (I wrote about the Mediterranean diet and other eating patterns based on ancient food traditions earlier this year.)

The point is, as long as you're working within some basic parameters—opting for mono- and polyunsaturated fats over saturated and transfats, focusing on lean proteins, picking whole grains over processed carbs, getting plenty of fruits and veggies, controlling your portions to some degree—you're probably on the right track. Do what works for you, including the occasional indulgence in whatever floats your boat.

Respect your other preferences, too. If you know you're hungriest during the lunch hour, plan to make that your biggest meal of the day and ease up at dinner. In an earlier post, I talked about one easy way to target a few changes in your eating and exercise patterns if you're trying to lose weight.