Tuesday, April 24, 2007

Weight Loss, Cholesterol and Blood Sugar Improvements - What's the Wonder Drug Now?

While the media is hot and heavy to lead their headlines with junk science complete with amateurish conclusions, a study was quietly published Friday in the journal, Molecular and Cellular Biochemistry - Beneficial effects of ketogenic diet in obese diabetic subjects (abstract) - that's remains ignored.

No fanfare, no ballyhoo, in fact, not one headline to call attention to the significant findings, over the course of a year, of a dietary trial in obese subjects with and without type II diabetes.

Findings that included:

For both groups, diabetic and normal glucose:
  • Weight loss of 24.55kg in 56-weeks (that's 54-pounds)
  • Total Cholesterol down 19.3%
  • LDL down 28.2%
  • HDL up 52.3%
  • Triglycerides down 59%
  • Fasting Blood Glucose down 31%

For those with type II diabetes:

  • Weigth loss of 24.4kg in 56-weeks (that's 53.7-pounds)
  • Total Cholesterol down 28.5%
  • LDL down 33%
  • HDL up 63.4%
  • Triglycerides down 40.8%
  • Fasting Blood Glucose down 50.9% (yes, glucose fell more than 50%)

So, what exactly did the researchers have these subjects do that led to such impressive improvements over the course of 56-weeks?

Sixty-four subjects were divided into two groups - thirty one had abnormal glucose levels (type II diabetes) and the remaining thirty-three had normal glucose levels. Both groups were instructed to modify their diet to include only 20g of carbohydrate a day from a list of foods allowed along with 5-tablespoons of olive oil on salads, and allowed 80g-100g of protein from meat, eggs, fish, poultry and full-fat cheese each day. No alcohol was consumed by participants. At week 12, participants were allowed to increase carbohydrate to 40g per day. Throughout the 56-weeks some foods were forbidden - flour, bread, rice, macaroni, noodles, honey, sugar, sweets, cakes, potatoes, all fruit juices and all soft drinks.

Yes, shocker - the study was designed to measure the effects of a ketogenic diet in subjects with and without type II diabetes.

So, with the above findings, it's no wonder this one is being quietly ignored.

While the media, government policy makers and leading health organizations keep wishing for negative findings from studies of low carbohydrate diets, the opposite keeps happening - the pile of studies finding significant improvement keeps growing higher and higher.

How profound were the changes in real numbers?

Those with diabetes had baseline fasting blood glucose levels of 188.64mg/dl; by the end of the trial, at week 56, their fasting blood glucose averaged 87.66mg/dl. Even those with normal blood glucose, who started with a baseline fasting blood glucose of 92mg/dl, saw improvement; at the end of the trial they had a fasting blood glucose of 85mg/dl.

There is not one drug on the market today, recommended for those with diabetes, that shows such significant improvement in fasting blood sugar, sustained over a period of more than a year!

Oh, but it gets better. Cholesterol improvements in this trial were unmatched by any drug trial.

Those with diabetes:

Baseline Week-56

Total Cholesterol 265 190
LDL 203 131
HDL 39 62
Triglycerides 418 89

Those with normal glucose:

Baseline Week-56

Total Cholesterol 214 181
LDL 156 109
HDL 47 63
Triglycerides 160 77

No cholesterol medication reduces LDL by 33% while also increasing HDL by 63.4%; and reducing triglycerides by 59%.

If the above finding were for a new drug, not only would the headlines be screaming for everyone with dyslipidemia to be prescribed it immediately, but every last expert in the country would be making the rounds in the media to be heard about this new wonder drug!

Sadly this isn't a new wonder drug rich with potential for profits. Instead it's simple dietary therapy, with no bottomline enhancement for anyone, save for a few farmers and ranchers.

So no headlines, no urgent call to take a look at the data which validates previous studies, no demands for reviewing the evidence; nope, the powers that be will continue along, fingers in ears, singing "La La La" as they hope no one notices the mountain of evidence growing.

If you have diabetes, or are at risk for developing diabetes, get to know what a carbohydrate restricted diet is and how to integrate it into your health management, it may save your life.

UPDATE 4/24/2007

A reader brought to my attention a pretty glaring error in reporting of reduction of triglycerides. I posted the numbers from the full-text above as published - a reduction in triglycerides in those with high blood glucose = -40.8%

A review of the actual numbers shows a reduction over the 56-week period from 4.681mmol/l to 1.006mmol/l - a 78.72% reduction in those with high blood glucose; and from 1.827mmol/l to 0.861mmol/l in those with normal blood glucose - a 54.01% reduction.


  1. If you don't get the results you want, ignore the evidence. If this had beens a low fat or vegan study with these results, it would have made headlines. I've seen similar results in myself from a low carb lifestyle.

    The evidence is out there, but the ADA and other groups don't want to admit they are wrong.

  2. Anonymous1:18 PM

    Kinda of confused on the Trig. ratios for Type II. 418->89 would be a 78% reduction but it says 40.8% above.

  3. But all physicians know that the brain, liver and kidneys will fall out of a body that doesn't consume lots of carbs.

  4. Do you know what the drop out rate was? If it's even modest, you KNOW that will be the reason why ketogenic diets don't work!

  5. Very interesting reading!
    I´m just a little confused: did they only consume 80-100g of meat etc. a day, or was it 80-100g of each meat, fish etc. a day (400-500g all together)? Since English is not my native tounge, perhaps there wouldn´t be any confusion at all if it was. But still, I´d like to know...

  6. The paper reports in the Materials & Methods that 64 were recruited to participate and explained how subjects qualified for inclusion/exclusion. It appears all 64 completed the term of the study....with no drop-outs reported.

  7. The researchers reported the subjects were instructed to consume 80g to 100g of protein each day...so that would be their total intake each day, not each meal.

  8. Kathy W.7:54 PM

    Wow--great study.

    I think the confusion in the posting is that the study allowed up to 100 grams of protein a day, not 100 grams of meat/eggs/etc. If it were 100 grams of meat, that would be only a little over 3 oz. total...But 100 grams of protein in, say, lean chicken might be 14-15 oz. of chicken.

  9. Great news!

    I think where the confusion is coming from is this:

    and allowed 80g-100g of meats, eggs, fish, poultry and full-fat cheese each day.

    The quote says 80g-100g of meats etc but I assume is mean't to say 80g-100g of protein from meats, eggs, fish etc

  10. oh =)

    Now it reads "...and allowed 80g-100g of protein from meat, eggs, fish, poultry and full-fat cheese each day."

  11. Great read Regina. Thanks. One question as my computer screen cuts off the first letter on each line, how much olive oil did they consume a day? Which brings me to a topic a little off of what the post is. When one is maintaining there weight how many tablespoons of good oilshould one consume per day minimum?

  12. Five tablespoons of olive oil was included in the diet.

    How much oil/fat you consume at maintenance is dependent on your calorie needs.

  13. Anonymous9:16 AM

    My main problem is that you put a lot of faith in lipid levels, false surrogate endpoints. [Dr. Malcomb Kendrick's work, for example, explains.]
    What were the long-term clinical outcomes for the patients? That's what matters, not yet another short-term diet study. 56 weeks is too short a period to determine much of anything during a period of weight loss but changes in intermediate lab values.

    But I completely agree that if this was a drug, PHARMA would be all over it. :)

  14. Anonymous3:25 PM

    I really like the results of this study, especially the HDL numbers. However I've got a problem with the percentages you report, none of them agree with the cholesterol numbers (although the corrected TG numbers are OK).

    For example, total-C, diabetic group, 265 to 190 is a reduction of 28.3%, not 19.3%. LDL, diabetic group, 203 to 131 is a reduction of 35.5%, not 28.2%. HDL, diabetic group, 39 to 62 is an increase of 59.0%, not 52.3%. Furthermore, the VLDL, diabetic group should be 84 baseline, 18 at 56-weeks, which means the total baseline cholesterol should be 326, not 265, using the Friedewald equation. And the 56-week total cholesterol should be 211, not 190. All the normal glucose results you report have similar problems.

    It sounds like the report used the European convention of mmol/l rather than mg/dl. Is the Kuwaiti report inconsistent, or is there a discrepancy in converting to mg/dl or calculating percentages? Do they say that they used the Friedewald equation to determine LDL, or some other method?

  15. Anonymous6:45 PM

    The full study is available at http://ca.geocities.com/eepobee/cq1l10803t1j9621.pdf

  16. Okay. Pulling my hair out over diet sodas.

    Diet sodas and citric acid: Does citric acid really kick you out of ketosis? What are good substitutes? I am good on no carbs, mostly until I get home at night when I busy myself with various projects, but the taste of sweet and sour in a soda is sorely missed. Plus, it keeps my throat cleared out and water does not.

    ...and carbs are monstrously good Friday night.



  17. Anonymous5:01 PM

    Uhm, what is the calorie consumption in this diet? Unless I am making some stupid mistakes (quite likely), we are talking about what 1000 Calories a day?

  18. No, Anonymous, there would be more than 1000 calories.

    100g protein = 400 calories
    40g carbs = 160 calories
    5 T olive oil = ~500 calories

    for a total of 1060 calories
    BUT that is not counting the fat calories in the 100g of protein.

    So the caloric intake will vary depending on factors such as how much of the protein was, say, eggs vs. chicken.

    So, for example, 100g of protein from eggs will include 77g of fat for another 693 calories, making a total of 1753 calories. Since eggs (as far as I know) are the most fatty of the protein foods, that would assumedly be the calorie ceiling for the study's diet.

  19. Anonymous10:34 PM

    I am 6 feet 178 (bmi of about 24). I exercise a lot and have realy bad pains from @#$$%^&*!! statins. In last 7 years I have dropped 27 lbs. My bp and other vitalsimproved. A drop of 54 lbs is truly huge and well beyond so called "normal" weight loss. Can someone comment on say 10 lb weight loss? Presumably this not a ratio and proportion thing.

  20. You are a great journalist, and I know you have put some thoughts into writing this article

  21. Anonymous6:36 AM

    thanks for share.

  22. Anonymous7:05 AM

    thanks for share.

  23. Anonymous10:07 PM

    FYI the study was done in Kuwait . Interesting tidbit I thought !