Today’s NEJM major diet study from Harvard University confirms:
it doesn’t matter what the weight-loss diet composition is so long as calories are down:
Each participant’s diet prescription represented a 750kcal/day deficit; with 90mins moderate exercise a week. .
mean previous baseline intake was 2000 kcals/day- 18% protein (ie +- 90gm) , 37% fat ie +-70gm) , 45% carbs (ie +-200gm). No initial trial diet had less than 1200 kcal/d.
RESULT: weight loss is +- 6kg by 6months but only +- 4kg (4.3%) by 2yrs , with waist loss +- 4cm – whether FAT intake was 20 or 40%, PROTEIN 15 or 25%, CARBS 65 or 35%.
The bad news remains that, despite participants attending regular motivation, on average weight rose steadily after more than 6 months on diet.
This confirms what is constantly urged in this column, that since titrated metformin consistently maintains about 6% better weight reduction than sustainable diet alone- without any serious adverse risks whatsoever, just +-50% reduction in diabetes and all major chronic degenerative diseases – metformin to tolerance should always be added to prudent diet where overweight needs to be reversed or at least stopped.
It is folly to delay metformin till the features of PCOS or metabolic syndrome, let alone diabetes, cancer, CVD , damaged joints and minds appear. It is criminal to allow average patients of any age to become increasingly overweight without adding the safest chronic drug ever discovered (metformin* 1922), the only drug that has been proven 100% safe from serious adverse effects n sensible use in controlled & followup trials of up to 30years- and in major prevention trials lower new diabetes by up to 90%.
*Of course metformin is not the only effective agent- it is merely the only registered prescription drug that safely reverses both appetite overeating, insulin resistance and all the complications. And many doctors and administrators perversely, dangerously will not read the evidence, they insist that it may not be prescribed just for overweight- they demand that the patient must first take ill.. A broad combination of natural alternatives that this column regularly lists can do better- but has to be both sourced and paid for.