Qual tipo de dieta é mais eficiente para emagrecer?
Como já escrevi em outras postagens (veja aqui e aqui) a alimentação é fundamental para o emagrecimento.
Muitas pessoas me perguntam o seguinte:
- Ok, mas qual tipo de dieta é mais efetiva?
Bem primeiro preciso dizer que devemos pensar não em dieta, como algo temporário, mas devemos sim pensar em alimentação. O que quero dizer é que devemos buscar alterar o nosso estilo de alimentação e ao mesmo tempo nos tornarmos responsáveis por isso.
Para nos tornarmos responsáveis pela nossa alimentação é necessário aprendermos a cozinhar e/ou sabermos como comer fora.
O primeiro passo para isso é entender que o tipo de alimentação mais efetiva para emagrecer é um dieta reduzida em carboidratos, também conhecida como lowcarb.
As vezes quando falo sobre isso, algumas pessoas me perguntam se exsistem evidências sobre essa maior efetividade.
Bem! Vou mostrar para vocês as informações de 57 trabalhos científicos que comparam dietas lowcarb (com até 130 gramas de carboidratos por dia) com dietas reduzidas em gordura (até 35% das calorias diárias de gordura [lowfat].
Esse levantamento foi realizado por um grupo chamado Public Health Collaboration, que é uma instituição dedicada a informar e implementar decisões saudáveis para melhorar a saúde pública.
Nesse levantamento foram analisados 57 trabalhos experimentais (quer saber o que são trabalhos experimentais clique aqui) e os dados mostraram o seguinte:
Em 48 a alimentação lowcarb gerou maior redução de peso;
A alimentação lowfat gerou maior redução em 7;
Em 2 a redução foi igual;
Dos 48 em que a lowcarb gerou maior redução, 27 a diferença foi estatisticamente significativa (no final do texto explico o que isso representa);
Em nenhum dos 7 em que a lowfat foi mais eficiente a diferença de redução de peso foi estatisticamente significativa.
As figuras a seguir mostram as algumas informações de cada um desses trabalhos.
Assim, do ponto de vista das evidências científicas, as informações são incontestáveis uma alimentação lowcarb é a mais efetiva para emagrecer. E além disso ela também pode gerar uma série de outros benefícios para a saúde.
O que significa "estatisticamente significativo"?
É o conceito usado para dizer se a diferença gerada por um medicamento e um placebo, por um tipo de dieta ou entre as esperanças de vida de dois grupos de pessoas pode ou não ser consequência do acaso. Isso significa que uma diferença tão grande como a que foi observada é improvável que tenha ocorrido somente por acaso. Os estatísticos usam níveis padrão de ‘improvável’. Geralmente, usam significativo no nível 5% (por vezes escrito como p = 0,05). Nesse caso, uma diferença é considerada ‘significativa’ porque tem probabilidade de menos de 1 em 20 de ocorrer somente por obra do acaso.”
Grande abraço, Carlinhos.
Referências
[1] A Randomized Trial Comparing a Very Low Carbohydrate Diet and a Calorie-Restricted Low Fat Diet on Body Weight and Cardiovascular Risk Factors in Healthy Women. Brehm et al. http://press.endocrine.org/doi/full/10.1210/jc.2002-021480
[2] A Randomized Trial of a Low-Carbohydrate Diet for Obesity. Foster et al.
http://www.nejm.org/doi/full/10.1056/NEJMoa022207
[3] A Low-Carbohydrate as Compared with a Low-Fat Diet in Severe Obesity. Samaha et al.
http://www.nejm.org/doi/full/10.1056/NEJMoa022637
[4] Effects of a low-carbohydrate diet on weight loss and cardiovascular risk factor in overweight adolescents. Sondike et al. http://www.sciencedirect.com/science/article/pii/S0022347602402065
[5] The National Cholesterol Education Program Diet vs a Diet Lower in Carbohydrates and Higher in Protein and Monounsaturated Fat A Randomized Trial. Aude et al. http://archinte.jamanetwork.com/article.aspx?articleid=217514
[6] A Low-Carbohydrate, Ketogenic Diet versus a Low-Fat Diet To Treat Obesity and Hyperlipidemia: A Randomized, Controlled Trial. Yancy et al. http://annals.org/article.aspx?articleid=717451
[7] Comparison of energy-restricted very low-carbohydrate and low-fat diets on weight loss and body composition in overweight men and women. Volek et al.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC538279/
[8] Comparison of a Low-Fat Diet to a Low-Carbohydrate Diet on Weight Loss, Body Composition, and Risk Factors for Diabetes and Cardiovascular Disease in Free-Living, Overweight Men and Women. Meckling et al. http://press.endocrine.org/doi/full/10.1210/jc.2003-031606
[9] Lack of suppression of circulating free fatty acids and hypercholesterolemia during weight loss on a highfat, low-carbohydrate diet. Hernandez et al. http://ajcn.nutrition.org/content/91/3/578.long
[10] Perceived Hunger Is Lower and Weight Loss Is Greater in Overweight Premenopausal Women Consuming a Low-Carbohydrate/High-Protein vs High-Carbohydrate/Low-Fat Diet. Nickols-Richardson et al.
http://www.sciencedirect.com/science/article/pii/S000282230501151X/
[11] Short-term effects of severe dietary carbohydrate-restriction advice in Type 2 diabetes—a randomized controlled trial. Daly et al. http://onlinelibrary.wiley.com/doi/10.1111/j.1464-5491.2005.01760.x/abstract
[12] Separate effects of reduced carbohydrate intake and weight loss on atherogenic dyslipidemia. Krauss et al. http://ajcn.nutrition.org/content/83/5/1025.full
[13] Comparison of the Atkins, Zone, Ornish, and LEARN Diets for Change in Weight and Related Risk Factors Among Overweight Premenopausal Women The A TO Z Weight Loss Study: A Randomized Trial. Gardner et al. http://jama.jamanetwork.com/article.aspx?articleid=205916
[14] Low- and high-carbohydrate weight-loss diets have similar effects on mood but not cognitive performance. Halyburton et al. http://ajcn.nutrition.org/content/86/3/580.long
[15] A low-carbohydrate diet is more effective in reducing body weight than healthy eating in both diabetic and non-diabetic subjects. Dyson et al. http://onlinelibrary.wiley.com/doi/10.1111/j.1464-
5491.2007.02290.x/full
[16] The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus. Westman et al. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2633336/
[17] Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet. Shai et al.
http://www.nejm.org/doi/full/10.1056/NEJMoa0708681
[18] Effects of weight loss from a very-low-carbohydrate diet on endothelial function and markers of cardiovascular disease risk in subjects with abdominal obesity. Keogh et al.
http://ajcn.nutrition.org/content/87/3/567.long
www.PublicHealthCollaboration.org
[19] Metabolic Effects of Weight Loss on a Very-Low-Carbohydrate Diet Compared With an Isocaloric High-Carbohydrate Diet in Abdominally Obese Subjects. Tay et al.
http://www.sciencedirect.com/science/article/pii/S0735109707032597
[20] Carbohydrate Restriction has a More Favorable Impact on the Metabolic Syndrome than a Low Fat Diet. Volek et al. http://link.springer.com/article/10.1007/s11745-008-3274-2
[21] Long-term effects of a very-low-carbohydrate weight loss diet compared with an isocaloric low-fat diet after 12 mo. Brinkworth et al. http://ajcn.nutrition.org/content/90/1/23.long
[22] Efficacy and Safety of a High Protein, Low Carbohydrate Diet for Weight Loss in Severely Obese Adolescents. Krebs et al. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2892194/
[23] In type 2 diabetes, randomisation to advice to follow a low-carbohydrate diet transiently improves glycaemic control compared with advice to follow a low-fat diet producing a similar weight loss. Guldbrand et al. http://link.springer.com/article/10.1007/s00125-012-2567-4/fu lltext.html
[24] A Randomized Pilot Trial of a Moderate Carbohydrate Diet Compared to a Very Low Carbohydrate Diet in Overweight or Obese Individuals with Type 2 Diabetes Mellitus or Prediabetes. Saslow et al.
http://www.plosone.org/article/info:doi/10.1371/journal.pone.0091027
[25] Effects of Low-Carbohydrate and Low-Fat Diets: A Randomized Trial. Bazzano et al.
http://annals.org/article.aspx?articleid=1900694
[26] The Role of Energy Expenditure in the Differential Weight Loss in Obese Women on Low-Fat and Low-Carbohydrate Diets. Brehm et al. http://press.endocrine.org/doi/full/10.1210/jc.2004-1540
[27] Effects of a Low Carbohydrate Weight Loss Diet on Exercise Capacity and Tolerance in Obese Subjects. Brinkworth et al. http://onlinelibrary.wiley.com/doi/10.1038/oby.2009.134/full
[28] Comparative Study of the Effects of a 1-Year Dietary Intervention of a Low-Carbohydrate Diet Versus a Low-Fat Diet on Weight and Glycemic Control in Type 2 Diabetes. Davis et al. http://care.diabetesjournals.org/content/32/7/1147
[29] Weight and Metabolic Outcomes After 2 Years on a Low-Carbohydrate Versus Low-Fat Diet: A Randomized Trial. Foster et al. http://annals.org/article.aspx?articleid=745937
[30] Effects of a Low-intensity Intervention That Prescribed a Low-carbohydrate vs. a Low-fat Diet in Obese, Diabetic Participants. Iqbal et al.
http://onlinelibrary.wiley.com/doi/10.1038/oby.2009.460/full
[31] Consuming a hypocaloric high fat low carbohydrate diet for 12 weeks lowers C-reactive protein, and raises serum adiponectin and high density lipoprotein-cholesterol in obese subjects. Ruth et al.
http://www.metabolismjournal.com/article/S0026-0495(13)00223-0/abstract
[32] Comparison of isocaloric very low carbohydrate/high saturated fat and high carbohydrate/low saturated fat diets on body composition and cardiovascular risk. Noakes et al.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1368980/
[33] Long-term Effects of a Very Low-Carbohydrate Diet and a Low-Fat Diet on Mood and Cognitive Function. Brinkworth et al. http://archinte.jamanetwork.com/article.aspx?articleid=1108558
[34] The effects of low-carbohydrate versus conventional weight loss diets in severely obese adults: one-year follow-up of a randomized trial. Stern et al. http://www.ncbi.nlm.nih.gov/pubmed/15148064
[35] A Randomized Trial of a Low-Carbohydrate Diet vs Orlistat Plus a Low-Fat Diet for Weight Loss. Yancy et al. 2010. http://www.ncbi.nlm.nih.gov/pubmed/20101008
[36] A randomized controlled trial of low carbohydrate and low fat/high fiber diets for weight loss. Baron et al.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1646726/
[37] A very low-carbohydrate, low-saturated fat diet for type 2 diabetes management: a randomized trial. Tay et al. http://www.ncbi.nlm.nih.gov/pubmed/25071075
[38] Randomised controlled trial of four commercial weight loss programmes in the UK: initial findings from the BBC “diet trials”. Truby et al. http://www.bmj.com/content/332/7553/1309
www.PublicHealthCollaboration.org
[39] Comparison of the Atkins, Ornish, Weight Watchers, and Zone Diets for Weight Loss and Heart Disease Risk Reduction:A Randomized Trial. Dansinger et al. http://jama.jamanetwork.com/article.aspx?
articleid=200094
[40] Very Low-Carbohydrate and Low-Fat Diets Affect Fasting Lipids and Postprandial Lipemia Differently in Overweight Men. Sharman et al. http://jn.nutrition.org/content/134/4/880.long
[41] Comparison of high-fat and high-protein diets with a high-carbohydrate diet in insulin-resistant obese women. McAuley et al. http://link.springer.com/article/10.1007/s00125-004-1603-4/fulltext.html
[42] Diet-Induced Weight Loss Is Associated with Decreases in Plasma Serum Amyloid A and C-Reactive Protein Independent of Dietary Macronutrient Composition in Obese Subjects. O'Brien et al. http://press.endocrine.org/doi/10.1210/jc.2004-1011
[43] Advice to follow a low-carbohydrate diet has a favourable impact on low-grade inflammation in type 2 diabetes compared with advice to follow a low-fat diet. Jonasson et al. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4025600/
[44] A non-calorie-restricted low-carbohydrate diet is effective as an alternative therapy for patients with type 2 diabetes. Yamada et al. http://www.ncbi.nlm.nih.gov/pubmed/24390522
[45] Low-Fat Versus Low-Carbohydrate Weight Reduction Diets Effects on Weight Loss, Insulin Resistance, and Cardiovascular Risk: A Randomized Control Trial. Bradley et al.
http://diabetes.diabetesjournals.org/content/58/12/2741.long
[46] Weight loss with high and low carbohydrate 1200 kcal diets in free living women. Lean et al. http://www.nature.com/ejcn/journal/v51/n4/abs/1600391a.html
[47] Evaluation of weight loss and adipocytokines levels after two hypocaloric diets with different macronutrient distribution in obese subjects with rs9939609 gene variant. De Luis et al. http://onlinelibrary.wiley.com/doi/10.1002/dmrr.2323/abstract
[48] Enhanced weight loss with protein-enriched meal replacements in subjects with the metabolic syndrome. Flechtner-Mors et al. http://onlinelibrary.wiley.com/doi/10.1002/dmrr.1097/abstract
[49] Long-term effects of a low carbohydrate, low fat or high unsaturated fat diet compared to a nointervention
control. Lim et al. http://www.nmcd-journal.com/article/S0939-4753(09)00124-0/abstract
[50] A randomized study comparing the effects of a low-carbohydrate diet and a conventional diet on lipoprotein subfractions and C-reactive protein levels in patients with severe obesity. Seshadri et al.
http://www.amjmed.com/article/S0002-9343(04)00344-4/abstract
[51] Comparison of low- and high-carbohydrate diets for type 2 diabetes management: a randomized trial. Tay et al. http://ajcn.nutrition.org/content/early/2015/07/29/ajcn.115.112581.abstract
[52] Weight loss on low-fat vs. low-carbohydrate diets by insulin resistance status among overweight adults and adults with obesity: A randomized pilot trial. Gardner et al.
http://onlinelibrary.wiley.com/doi/10.1002/oby.21331/abstract
[53] Metabolic impact of a ketogenic diet compared to a hypocaloric diet in obese children and adolescents. Partsalaki et al. http://www.ncbi.nlm.nih.gov/pubmed/23155696
[54] A randomized controlled trial of 130 g/day low-carbohydrate diet in type 2 diabetes with poor glycemic control. Sato et al. http://www.clinicalnutritionjournal.com/article/S0261-5614(16)30169-8/pdf
[55] Short-term safety, tolerability and efficacy of a very low-calorie-ketogenic diet interventional weight loss program versus hypocaloric diet in patients with type 2 diabetes mellitus. Goday et al.
http://www.nature.com/nutd/journal/v6/n9/full/nutd201636a.html
[56] Visceral adiposity and metabolic syndrome after very high–fat and low-fat isocaloric diets: a randomized controlled trial. Veum et al. http://ajcn.nutrition.org/content/early/2016/11/30/ajcn.115.123463.abstract
[57] An Online Intervention Comparing a Very Low-Carbohydrate Ketogenic Diet and Lifestyle Recommendations Versus a Plate Method Diet in Overweight Individuals With Type 2 Diabetes: A Randomized Controlled Trial. Saslow et al. https://www.ncbi.nlm.nih.gov/pubmed/28193599