Is a high protein, low carbohydrate and low sugar diet most effective for weight loss?

From the Guidelines

A high protein, low carb, and low sugar diet can be effective for weight loss, but it's not necessarily the "most successful" approach for everyone. This dietary pattern works well because protein increases satiety, helping you feel fuller longer while preserving muscle mass during weight loss, as noted in various studies 1. The reduction in carbohydrates, particularly refined carbs and sugars, helps lower insulin levels, which can reduce fat storage and curb hunger. For implementation, focus on lean protein sources like chicken, fish, eggs, and plant proteins; non-starchy vegetables; healthy fats from avocados, nuts, and olive oil; and limited amounts of complex carbohydrates from whole food sources.

• Aim for approximately 25-30% of calories from protein,
• under 100-150g of carbohydrates daily (with minimal added sugars),
• and moderate healthy fats. However, the most successful diet for weight loss is ultimately one you can sustain long-term. Some individuals may find moderate carbohydrate approaches more sustainable, while others thrive with different macronutrient distributions. Factors like personal food preferences, lifestyle, cultural considerations, and any existing health conditions should guide your dietary choices for successful, sustainable weight loss, as emphasized by the American Heart Association 1.

It's also important to consider that diets should be individualized, as those that provide the same caloric restriction but differ in protein, carbohydrate, and fat content are equally effective in achieving weight loss, according to the 2018 standards of medical care in diabetes 1. Ultimately, the key to successful weight loss is finding a diet that you can maintain in the long term, with a focus on overall nutritional adequacy and a balanced eating plan that supports weight maintenance and lowers chronic disease risk.

In terms of specific recommendations, the 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults suggests that a variety of dietary approaches can produce weight loss in overweight and obese adults, including higher-protein diets, low-carbohydrate diets, and low-fat diets, as long as there is a reduction in dietary energy intake 1. However, it's crucial to prioritize a balanced and sustainable approach, rather than focusing solely on a specific macronutrient distribution.

Overall, while a high protein, low carb, and low sugar diet may be effective for some individuals, it's essential to consider individual needs and preferences, and to prioritize a balanced and sustainable approach to weight loss, as supported by the most recent and highest quality evidence 1.

From the Research

Diet Composition and Weight Loss

• A high protein, low carb, and low sugar diet may be beneficial for weight loss, as studies have shown that high protein diets can increase thermogenesis and satiety, leading to reduced energy intake 2.
• Replacing refined carbohydrates with protein sources low in saturated fat may be beneficial for weight loss and weight maintenance 2.
• High-protein low-carbohydrate diets have been shown to have positive effects on reducing body weight and other risk factors for heart disease, particularly in subjects with type 2 diabetes 3.

Mechanisms of Weight Loss

• High-protein diets can increase satiety signaling and reduce food intake by increasing levels of anorexigenic hormones such as glucagon-like peptide-1, cholecystokinin, and peptide tyrosine-tyrosine, while decreasing orexigenic hormone levels 4.
• High-protein diets can also increase energy expenditure by increasing diet-induced thermogenesis and preventing a decrease in fat-free mass, which helps maintain resting energy expenditure despite weight loss 4.

Comparison of Low-Carbohydrate and Balanced-Carbohydrate Diets

• Low-carbohydrate diets may be effective for short-term weight loss, but their long-term consequences are not well understood, and they may have adverse health effects, such as increased mortality, when carbohydrates are severely restricted 5.
• A systematic review of 61 randomized controlled trials found that low-carbohydrate diets and balanced-carbohydrate diets resulted in similar weight loss and changes in cardiovascular risk factors over a period of up to two years, in both participants with and without type 2 diabetes 6.

Limitations and Uncertainties

• The evidence for the effectiveness of high-protein, low-carb, and low-sugar diets for weight loss is not consistent, and more rigorous longer-term studies are needed to investigate their effects 2, 4.
• The certainty of the evidence for the comparison of low-carbohydrate and balanced-carbohydrate diets is moderate to very low, due to the high risk of bias and limitations in the included studies 6.