text: A study from the US National Institutes of Health presents some of the most precise human data yet on whether cutting carbs or fat has the most benefits for losing body fat. In a paper published August 13 in Cell Metabolism, the researchers show how, contrary to popular claims, restricting dietary fat can lead to greater body fat loss than carb restriction, even though a low-carb diet reduces insulin and increases fat burning. 
   
   Since 2003, Kevin Hall, PhD--a physicist turned metabolism researcher at the National Institute of Diabetes and Digestive and Kidney Diseases--has been using data from dozens of controlled feeding studies conducted over decades of nutrition research to build mathematical models of how different nutrients affect human metabolism and body weight. 
   
   He noticed that despite claims about carbohydrate versus fat restriction for weight loss, nobody had ever measured what would happen if carbs were selectively cut from the diet while fat remained at a baseline or vice versa. His model simulations showed that only the carb-restricted diet would lead to changes in the amount of fat burned by the body, whereas the reduced-fat diet would lead to greater overall body fat loss, but he needed the human data to back it up. 
   
   "A lot of people have very strong opinions about what matters for weight loss, and the physiological data upon which those beliefs are based are sometimes lacking," Hall says. "I wanted to rigorously test the theory that carbohydrate restriction is particularly effective for losing body fat since this idea has been influencing many people's decisions about their diets." 
   
   Studying the effects of diet on weight loss is often confounded by the difficulty in measuring what people actually eat--participants may not adhere to meal plans, misjudge amounts, or are not truthful in follow-up surveys. To counter this, Hall and colleagues confined 19 consenting adults with obesity to a metabolic ward for a pair of 2-week periods, over the course of which every morsel of food eaten was closely monitored and controlled. 
   
   To keep the variables simple, the two observation periods were like two sides of a balance scale: during the first period, 30% of baseline calories were cut through carb restriction alone, while fat intake remained the same. During the second period the conditions were reversed. Each day, the researchers measured how much fat each participant ate and burned and used this information to calculate the rate of body fat loss. 
   
   At the end of the two dieting periods, the mathematical model proved to be correct. Body fat lost with dietary fat restriction was greater compared with carbohydrate restriction, even though more fat was burned with the low-carb diet. However, over prolonged periods the model predicted that the body acts to minimize body fat differences between diets that are equal in calories but varying widely in their ratio of carbohydrate to fat. 
   
   "There is one set of beliefs that says all calories are exactly equal when it comes to body fat loss and there's another that says carbohydrate calories are particularly fattening, so cutting those should lead to more fat loss," Hall says. "Our results showed that, actually, not all calories are created equal when it comes to body fat loss, but over the long term, it's pretty close." 
   
   Hall does caution against making sweeping conclusions about how to diet from this study. The study's purpose was to explore the physiology of how equal calorie reductions of fat versus carbs affect the human body. The research is limited by its sample size; only 19 people could be enrolled due to the expense of such research and the restrictiveness of the carefully controlled protocol. However, this study clearly reaches statistical significance. In addition,, the menu that the participants followed does not emulate normal dieting and does not account for what diet would be easier to eat over extended periods. 
   
   "We are trying to do very careful studies in humans to better understand the underlying physiology that will one day be able to help generate better recommendations about day-to-day dieting," Hall says. "But there is currently a gap between our understanding of the physiology and our ability to make effective diet recommendations for lasting weight loss." 
   
   Hall recommends that for now, the best diet is the one that you can stick to. His lab will next investigate how reduced-carbohydrate and reduced-fat diets affect the brain's reward circuitry, as well as its response to food stimuli. He hopes these results might inform why people respond differently to different diets. 
   
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   This work was supported by the Intramural Research Program of the National Institutes of Health and the National Institute of Diabetes and Digestive and Kidney Diseases. 
   
   Cell Metabolism, Hall et al.: "Calorie for calorie, dietary fat restriction results in more body fat loss than carbohydrate restriction in people with obesity" http://dx. doi. org/ 10. 1016/ j. cmet. 2015. 07. 021 ||||| NIH study finds cutting dietary fat reduces body fat more than cutting carbs 
   
   In a recent study, restricting dietary fat led to body fat loss at a rate 68 percent higher than cutting the same number of carbohydrate calories when adults with obesity ate strictly controlled diets. Carb restriction lowered production of the fat-regulating hormone insulin and increased fat burning as expected, whereas fat restriction had no observed changes in insulin production or fat burning. The research was conducted at the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. Results were published August 13 in Cell Metabolism . 
   
   “Compared to the reduced-fat diet, the reduced-carb diet was particularly effective at lowering insulin secretion and increasing fat burning, resulting in significant body fat loss,” said Kevin Hall, Ph.D., NIDDK senior investigator and lead study author. “But interestingly, study participants lost even more body fat during the fat-restricted diet, as it resulted in a greater imbalance between the fat eaten and fat burned. These findings counter the theory that body fat loss necessarily requires decreasing insulin, thereby increasing the release of stored fat from fat tissue and increasing the amount of fat burned by the body.” 
   
   The researchers studied 19 non-diabetic men and women with obesity in the Metabolic Clinical Research Unit at the NIH Clinical Center in Bethesda, Maryland. Participants stayed in the unit 24 hours per day for two extended visits, eating the same food and doing the same activities. For the first five days of each visit they ate a baseline balanced diet. Then for six days, they were fed diets containing 30 percent fewer calories, achieved by cutting either only total carbs or total fat from the baseline diet, while eating the same amount of protein. They switched diets during the second visit. 
   
   The researchers had previously simulated the study with a math model of human metabolism, whose body fat predictions matched the data later collected in the study. When simulating what might happen over longer periods, the model predicted relatively small differences in body fat loss with widely varying ratios of carbs to fat. Those results suggest the body may eventually minimize differences in body fat loss when diets have the same number of calories. More research is needed to assess the physiological effects of fat and carb reduction in the long term. 
   
   “This NIH study provides invaluable evidence on how different types of calories affect metabolism and body composition,” said NIDDK Director Griffin P. Rodgers, M.D. “The more we learn about the complicated topic of weight loss, the better we can find ways to help people manage their health.” 
   
   More than two-thirds of American adults are overweight or obese. Maintaining a healthy weight can help prevent complications related to overweight and obesity such as heart disease, type 2 diabetes and certain types of cancer, some of the leading causes of preventable death. 
   
   “Our data tell us that when it comes to body fat loss, not all diet calories are exactly equal,” Hall said. “But the real world is more complicated than a research lab, and if you have obesity and want to lose weight, it may be more important to consider which type of diet you’ll be most likely to stick to over time.” 
   
   The NIDDK, a component of the NIH, conducts and supports research on diabetes and other endocrine and metabolic diseases; digestive diseases, nutrition and obesity; and kidney, urologic and hematologic diseases. Spanning the full spectrum of medicine and afflicting people of all ages and ethnic groups, these diseases encompass some of the most common, severe and disabling conditions affecting Americans. For more information about the NIDDK and its programs, visit http://www.niddk.nih.gov. 
   
   About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov. 
   
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target: – Think carbs are a dieter's enemy? It turns out restricting one's fat intake leads to a 68% greater loss of body fat than restricting the same amount of calories through carbohydrates in obese adults on strictly controlled diets—and this is in spite of the fact that a low-carb diet reduces insulin and increases fat burning. So says a physicist turned metabolism researcher at the National Institute of Diabetes and Digestive and Kidney Diseases who wanted to test a mathematical model he devised that projected similar results. Reporting in the journal Cell Metabolism, Kevin Hall says that while many believe that cutting carbs reduces fat faster, none had actually tested the impact of cutting carbs while keeping fat at a base line or vice versa. So he checked 19 consenting non-diabetic adults with obesity into to a metabolic ward for two 2-week periods, controlling and accounting for every single bite they ate. As his model predicted, people lost more body fat when their dietary fat was restricted than when carbs were, even though a low-carb diet does indeed burn more fat. But his model also predicted that in the long term, these differences would become less pronounced for diets that have the same number of calories, according to the press release. "Over the long term, it's pretty close," Hall says. He used data from dozens of controlled feeding studies from decades of nutrition research to develop the model, but he cautions that the study is both small and highly controlled, meaning people's unrestricted diets may cause them to eat differently. "The real world is more complicated than a research lab, and if you have obesity and want to lose weight, it may be more important to consider which type of diet you’ll be most likely to stick to over time," he tells the National Institutes of Health. (See how carbs mess with our metabolism.)