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Low-Carbohydrate Diet Study Has Serious Flaws

Low-Carbohydrate Diet Study Has Serious Flaws I believe the editors did the ARCHIVES and the public trust a disservice by publishing the article by Aude et al.1 While it is possible that this research has something useful to add to the important debate on how to promote weight loss in the United States, the glaring flaws in the study protocol (as published) make its findings entirely speculative. Specifically, the authors make no mention of controlling for physical activity differences between groups other than to note their inclusion criteria included “willingness and stated ability to adhere to a prescribed diet for 3 months at home without alteration in levels of physical activity.”1(p2142) Nowhere in the article is any mention made as to whether participants were tracked to ensure that their “willingness” translated into action. What proof is there that the modified low-carbohydrate group did not engage in more physical activity compared with the National Cholesterol Education Program group? Second, the authors suggest in the “Comment” section that one confounding variable may have been “small” differences in caloric intake between the 2 groups “because of limitations inherent in food diaries and calorie counts.”1(p2145) This suggests the authors used food diaries, but where are the data that demonstrate how many calories each group consumed? Third, there was no measurement of body composition. Who is to say the 6-pound weight loss difference had anything to do with fat loss, which should be the goal of any credible weight loss program? The only data that address this (waist-hip ratio) suggest that the weight loss difference was not, in fact, due to any greater fat loss in one group vs the other (no between-group difference). This article does not include enough data for any person to make a rational assessment of what effect either diet therapy had on body weight, and more importantly, on body composition. More information should have been included. The tone of the article suggests that the authors had some agenda to promote. Differences supporting the supposed advantage of the modified low-carbohydrate diet were consistently emphasized, whereas differences supporting the supposed advantage of National Cholesterol Education Program diet were consistently played down. The editors of the ARCHIVES failed in their duty when they allowed publication of this study as written. I expect better from the professional publications in my field. Correspondence: Dr Schlicht, Department of Health Promotion and Exercise Sciences, Western Connecticut State University, Danbury, CT 06810 (schlichtj@WCSU.edu). References 1. Aude YWAgatston ASLopez-Jimenez F et al. The national cholesterol education program diet vs a diet lower in carbohydrates and higher in protein and monounsaturated fat: a randomized trial. Arch Intern Med 2004;1642141- 2146PubMedGoogle ScholarCrossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Low-Carbohydrate Diet Study Has Serious Flaws

Schlicht, Jeff
Archives of Internal Medicine , Volume 165 (18) – Oct 10, 2005
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Low-Carbohydrate Diet Study Has Serious Flaws

Abstract

I believe the editors did the ARCHIVES and the public trust a disservice by publishing the article by Aude et al.1 While it is possible that this research has something useful to add to the important debate on how to promote weight loss in the United States, the glaring flaws in the study protocol (as published) make its findings entirely speculative. Specifically, the authors make no mention of controlling for physical activity differences between groups other than to note their inclusion...
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References (1)

Publisher
American Medical Association
Copyright
Copyright © 2005 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.165.18.2170-a
Publisher site
See Article on Publisher Site

Abstract

I believe the editors did the ARCHIVES and the public trust a disservice by publishing the article by Aude et al.1 While it is possible that this research has something useful to add to the important debate on how to promote weight loss in the United States, the glaring flaws in the study protocol (as published) make its findings entirely speculative. Specifically, the authors make no mention of controlling for physical activity differences between groups other than to note their inclusion criteria included “willingness and stated ability to adhere to a prescribed diet for 3 months at home without alteration in levels of physical activity.”1(p2142) Nowhere in the article is any mention made as to whether participants were tracked to ensure that their “willingness” translated into action. What proof is there that the modified low-carbohydrate group did not engage in more physical activity compared with the National Cholesterol Education Program group? Second, the authors suggest in the “Comment” section that one confounding variable may have been “small” differences in caloric intake between the 2 groups “because of limitations inherent in food diaries and calorie counts.”1(p2145) This suggests the authors used food diaries, but where are the data that demonstrate how many calories each group consumed? Third, there was no measurement of body composition. Who is to say the 6-pound weight loss difference had anything to do with fat loss, which should be the goal of any credible weight loss program? The only data that address this (waist-hip ratio) suggest that the weight loss difference was not, in fact, due to any greater fat loss in one group vs the other (no between-group difference). This article does not include enough data for any person to make a rational assessment of what effect either diet therapy had on body weight, and more importantly, on body composition. More information should have been included. The tone of the article suggests that the authors had some agenda to promote. Differences supporting the supposed advantage of the modified low-carbohydrate diet were consistently emphasized, whereas differences supporting the supposed advantage of National Cholesterol Education Program diet were consistently played down. The editors of the ARCHIVES failed in their duty when they allowed publication of this study as written. I expect better from the professional publications in my field. Correspondence: Dr Schlicht, Department of Health Promotion and Exercise Sciences, Western Connecticut State University, Danbury, CT 06810 (schlichtj@WCSU.edu). References 1. Aude YWAgatston ASLopez-Jimenez F et al. The national cholesterol education program diet vs a diet lower in carbohydrates and higher in protein and monounsaturated fat: a randomized trial. Arch Intern Med 2004;1642141- 2146PubMedGoogle ScholarCrossref

Journal

Archives of Internal Medicine – American Medical Association

Published: Oct 10, 2005

Keywords: carbohydrate restricted diet

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