4/9/2018 ¿Qué dieta es mejor para perder peso a largo plazo?

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¿Qué dieta es mejor para perder peso a largo plazo?

PUBLICADO EL 9 DE ABRIL DE 2018 A LAS 10:30 A.M.

Monique Tello, MD, MPH

Editora colaboradora

Mucho se ha hablado de los resultados recientemente publicados del estudio DIETFITS (Intervención de la
dieta examinando los factores que interactúan con el éxito del tratamiento). La mayoría de los titulares
enfatizaba el hecho de que las dos dietas involucradas, bajas en grasas y bajas en carbohidratos,
terminaban teniendo los mismos resultados en casi todos los puntos nales estudiados, desde la pérdida
de peso hasta la disminución del azúcar en la sangre y el colesterol.

Lo más interesante, sin embargo, es cómo estas dos dietas son similares.

Los autores querían comparar dietas bajas en grasa versus bajas en carbohidratos, pero también querían estudiar maquillajes genéticos y físicos
que supuestamente (su palabra) podrían in uir en la e cacia de cada tipo de dieta para las personas. Estudios previos habían sugerido que una
diferencia en una secuencia genética particular podría signi car que ciertas personas lo harían mejor con una dieta baja en grasas. Otros
estudios han sugerido que la sensibilidad a la insulina puede signi car que ciertas personas lo harán mejor con una dieta baja en carbohidratos.

¿Qué DIETEAS revelaron sobre la pérdida de peso?

El estudio comenzó con 609 personas con sobrepeso y obesas relativamente sanas, y 481 completas durante todo el año. Durante el primer mes,
todos hicieron lo que solían hacer. Luego, durante las siguientes ocho semanas, el grupo bajo en grasa redujo su ingesta total de grasas a 20
gramos por día, y el grupo bajo en carbohidratos redujo su ingesta total de carbohidratos a 20 gramos por día. Estas son cantidades
increíblemente restringidas, teniendo en cuenta que hay 26 gramos de carbohidratos en la bebida de yogur que disfruto mientras escribo esto, y
21 gramos de grasa en mi mitad de la barra de chocolate oscuro que mi esposo y yo partimos como postre anoche.

Ese tipo de restricción dietética es imposible de mantener a largo plazo y, como este estudio mostró, innecesario. Los participantes recibieron
instrucciones de volver a agregar lentamente las grasas o los carbohidratos hasta que alcanzaran un nivel que sentían que se podría mantener
de por vida . Además, ambos grupos recibieron instrucciones de

comer tantas verduras como sea posible

elija alimentos enteros nutritivos de alta calidad y limite todo lo procesado
preparar la comida ellos mismos en casa
evite las grasas trans, los azúcares añadidos y los carbohidratos re nados como la harina.

A las personas no se les pidió contar calorías en absoluto. En el transcurso de un año, ambos grupos asistieron a 22 clases reforzando estos
sólidos principios, y todos los participantes tuvieron acceso a educadores de salud que los guiaron en estrategias de modi cación del
comportamiento, como conciencia emocional, establecimiento de objetivos y desarrollo de autoe cacia (también conocido como fuerza de
voluntad), y utilizando redes de apoyo social, todo para evitar caer en patrones de alimentación poco saludables.

Los participantes en ambos grupos también fueron alentados a mantener las recomendaciones actuales de actividad física del gobierno de los
EE. UU., Que son "150 minutos de actividad física aeróbica de intensidad moderada (2 horas y 30 minutos) cada semana".

Dos dietas diferentes que no son tan diferentes después de todo

Obtener todo eso? Básicamente, las diferencias entre los grupos fueron mínimas. Sí, el grupo bajo en grasa disminuyó su ingesta diaria de grasas
y el grupo bajo en carbohidratos disminuyó su ingesta diaria de carbohidratos. Pero ambos grupos terminaron consumiendo de 500 a 600
calorías menos por día que antes, y ambos perdieron la misma cantidad promedio de peso (12 libras) en el transcurso de un año. Esos
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maquillajes
4/9/2018 genéticos y físicos tampoco dieron
¿Qué dieta lugarpara
es mejor a ninguna diferencia.
perder peso a largoLa única- medida
plazo? que fue
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LDL (lipoproteína de
baja densidad) fue signi cativamente menor en el grupo con poca grasa, y la HDL (lipoproteína de alta densidad) fue signi cativamente más alta
en el grupo con bajo contenido de carbohidratos.

Me encanta este estudio porque examinó un cambio de estilo de vida realista en lugar de solo una dieta de moda. Ambos grupos, después de
todo, fueron etiquetados como dietas saludables , y lo fueron, porque los investigadores del estudio alentaron a comer alimentos integrales
nutritivos de alta calidad, verduras ilimitadas y evitar las harinas, azúcares, grasas malas y alimentos procesados. Todos fueron alentados a ser
físicamente activos en un nivel que la mayoría de los estadounidenses no tienen. Y, este es uno grande, todos tuvieron acceso a consejería
conductual básica dirigida a reducir la alimentación emocional .

Cuando se trata de dieta, todo lo viejo vuelve a ser nuevo

Todo este estudio bien podría llamarse un estudio del cambio de estilo de vida saludable y sostenible. Los resultados se relacionan mucho con
investigaciones anteriores sobre un estilo de vida saludable. El mensaje nal es el mismo que usualmente terminamos con:

La mejor dieta es la que podemos mantener de por vida y es solo una parte de un estilo de vida saludable. Las personas deben tratar de comer
alimentos integrales de alta calidad y nutritivos, principalmente plantas (frutas y verduras), y evitar las harinas, azúcares, grasas trans y alimentos
procesados (cualquier cosa en una caja). Todos deberían intentar ser físicamente activos, con el objetivo de dos horas y media de actividad
vigorosa por semana. Para muchas personas, un estilo de vida saludable también signi ca un mejor manejo del estrés y tal vez incluso una
terapia para abordar problemas emocionales que pueden conducir a patrones de alimentación poco saludables.

Información relacionada: perder peso y no recuperarlo

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El rastreador de actividad puede no ser la clave para perder peso

COMENTARIOS TEMAS

18 Dieta y pérdida de peso | Salud | Alimentación saludable

Comentarios:
PUBLICADO EL 16 DE MAYO DE 2018 A LAS 4:34 P.M.

Carina
All the recipes you’ll ever need to live and eat well on the ketogenic diet! i was overweight,
exhausted, moody, and su ering from a range of physical discomforts when i found the ketogenic diet.
But all that changed once i adopted its high fat, low carb principles. You too can reap the bene ts of the
ketogenic diet with Bacon & Butter, my ultimate companion for keto cooking, today and every day. its free if you want to review it

POSTED MAY 7TH, 2018 AT 7:28 AM

Martin
The best way to long term weight loss is a good meal plan and workout every single day ! this message is just to wish you courage in your
change and achievement of your goals, you deserve to feel better in your body

POSTED APRIL 21ST, 2018 AT 1:57 PM

Laura Pagee
One year is not “long term.” Research has demonstrated that, ve years post-fad diet, almost everyone regains almost all, or even more, than
the weight they started at when they started their diet. Will this group be followed for at least 5 years?
https://www.health.harvard.edu/blog/weight-loss-for-life-the-dietfits-study-2018040913595?utm_content=buffer366f7&utm_medium=social&utm_sourc… 2/6
 Optimistically, the additional support
4/9/2018 and es
¿Qué dieta counseling
mejor parathat waspeso
perder provided
a largowhich
plazo?should improve
- Harvard Healththe chances
Blog forHealth
- Harvard long-term success, but a year
Publishing
is not enough to predict the future outcome.

Also demonstrated through research is the hugely detrimental e ect of sugar which is added to almost all processed foods. Sugar, not just
because of the calories, but because of the way it is processed, leads to more fat deposition and also wreaks havoc with the body’s insulin
level.

Exercise, along with sugar avoidance, seem to be the most important components to staying healthy.

POSTED APRIL 20TH, 2018 AT 3:21 AM

Dr Sangita Bhatia
Reduced 9 pounds weight and 3 inches in last two months by strictly leaving sugar , rice, potato and oil with one hour good workout six days
in a week
Diet taken maximum vegetables ,soup, salad and fruits
Good luck

POSTED APRIL 18TH, 2018 AT 7:17 AM

Mark
Over the last three months I’ve lost 22 pounds simply by upping my exercise and reducing bad calories. I’m 68 years old, always in good
shape, but added sedentary pounds as I aged. (6 feet tall, 212 pounds before — 190 pounds now) I’ve generally restricted my diet to about
1200 calories a day — 200 – 300 for breakfast, 200 for lunch, and about 700 or less for the rest of the day. I try to vary the foods, do as much
exercise as I can (biking, swimming, walking, weights). I drink as much non-caloric liquid as I can and I try to nd food that lls me up —
vegetables, fruits, mostly. I eat some cheese and a good hamburger occasionally, although I avoid most meat. I still work full time. I realize the
discipline necessary, but it’s not that hard to do. I rely on a good scale and moderate my diet each day to keep a constant weight. My blood
pressure has dropped from 130/80 to 117/72 and heart rate is resting 58. I’m lucky that my chronic diseases are not yet serious (osteoarthritis
and borderline cholesterol, although I dont take statins because of reactions). I’m not a diet fadder, but using common sense goes a long way.
Eat smart and work out. MM

POSTED APRIL 17TH, 2018 AT 5:27 PM

sharon
A common sense approach. However, one thing missing is the AGE of the participants. This may well work for younger folks seeking to lose
weight. However, not so much for those of us whose metabolisms have slowed with advancing years. Following these guidelines, which I do,
does not result in weight loss.

POSTED APRIL 16TH, 2018 AT 1:56 PM

Craig Robinson
Given that all participants in the study were overweight and “healthy”, what was not studied, and could have been very useful, was what was
the impact of the two diets on participants’ blood sugars (HbA1c), insulin levels, and on some measure of in ammation. It is possible that
there could have been little di erence in weight loss between the two diets but big di erences in the impact on risk factors related to
diabetes.
The success of the study’s two diets in sustaining weight loss is no doubt due to the excellent self-care support team. For a primary care
practice the challenge is to sustain the support team to enable patients to sustain the bene ts of the diet. C. Robinson at Cabin Creek Health
Centers, WV.

POSTED APRIL 16TH, 2018 AT 1:45 PM

Janet Wade
Eating is for nutrition. This study analyzes weight loss, but not nutrition. I would be interested in which diet meant people had no vitamin or
mineral de ciencies. Many people who eat low carbohydrate eat few vegetables and fruit because of their carbo content. I have a di cult
time believing that is healthy. The extreme, of course, is the Ketogenic diet.
https://www.health.harvard.edu/blog/weight-loss-for-life-the-dietfits-study-2018040913595?utm_content=buffer366f7&utm_medium=social&utm_sourc… 3/6
 I think the best diet is SMALL amounts
4/9/2018 of everything,
¿Qué dieta soperder
es mejor para we canpeso
gather di plazo?
a largo erent bene ts from
- Harvard di Blog
Health erent foods. Health Publishing
- Harvard
SMALL amounts is hard for us in the USA. WE are used to huge portions.
I would like to know if science would back up my intuition.

I am currently on weight watchers, because it allows small amounts of anything.

POSTED APRIL 16TH, 2018 AT 1:13 PM

Ella

@Jack I, too, am skeptical – I don’t believe there is evidence that quick diets will do good over the long-term. Instead focusing on losing
weight we need to change our mindset and aim for a healthy lifestyle. As well, I would avoid using the (buzz)word diet. It has a negative
connotation and it implies restrictions.

@Monique, I would also add the environment on that list. Make sure our physical and social environment inspire us to stay healthy. But that’s
another post .

POSTED APRIL 16TH, 2018 AT 12:59 PM

Chris
Keto diet is good for some who do moderate exercise, and I’ve used it to “jump start” some weight loss (something I didn’t have to worry
about till putting on some after being injured and not exercising for 18 months).
However, if one is going to do heavy exercise, after a week or so one “bonks,” meaning they hit the wall and have no energy, even from the fat
in the Keto diet.
Again, I have used it to jump start my diet, then a hybrid of it — still low carbs but slightly increased while at gym for a few weeks, but riding
150-200 miles a week outdoors one has to have more carbs. The good side is I am burning more. Several Saturdays ago on a 70 mile ride I
burned 5000 calories. Weight is coming o .
I did see weight loss start to happen with Keto, and it’s healthy anyone to eat less carbs, and thus low Glycemic index.
Good luck everyone

POSTED APRIL 16TH, 2018 AT 12:43 PM

Dr Mark Rowe
Hi Monique,
Greetings from Ireland !
Great article, once agin further evidence of the bene ts of sustainable positive lifestyle changes
Best wishes

Mark Rowe

POSTED APRIL 11TH, 2018 AT 4:38 PM

Mike Flajole
Very good article. Many of the people I work with have health issues related to type 2 diabetes so this article gives excellent direction for
those struggling to manage their health condition with an appropriate diet that they can sustain. Counting calories is not necessarily the
answer. Often times, people cannot understand why they just cannot lose weight or how they became diabetic or what to do about it. Thanks
a lot.
Michael Flajole Author of Diabetic and Medical Condition Life Insurance

POSTED APRIL 10TH, 2018 AT 8:08 AM

Carolyn C. Shank
Hi Monique!
This blog was really informative for the new-bees to start with I also want to share my experience also!
I have been on a low crab high protein diet for last six months or so and I lost up to 12 kilos, with that diet plane I was able to lose my body fat
https://www.health.harvard.edu/blog/weight-loss-for-life-the-dietfits-study-2018040913595?utm_content=buffer366f7&utm_medium=social&utm_sourc… 4/6
 only and as for as I think so it was
4/9/2018 really
¿Qué helpful
dieta for me
es mejor paranot to lose
perder pesobody muscles
a largo plazo?also. I want
- Harvard to shair
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Health that other can also get
there desired body shape and be happy when they look them self in mirror!

POSTED APRIL 10TH, 2018 AT 3:27 AM

Jack
Good article Monique! While I agree with on “The best diet is the one we can maintain for life” not everyone can start eating healthy right
away. In my opinion quick diets and fast weight losing methods have their own place. I studied in Harvard over ten years ago and have a
plenty of love for the school and community, but you should not say no to fast diets right away. I was overweight for a long time because I
just couldn’t change my habits. It was when I tried the 2 week diet plan that I started seeing results for the rst time. After losing few pounds I
became motivated and now I have lost a lot more weight. Even if you are skeptical I would recommend you checking it out, if you are
overweight.

POSTED APRIL 9TH, 2018 AT 5:42 PM

Regiane
have been on the low carb (Ketogenic diet) OVER A YEAR. 20-30 gr for the rst 6 months, currently about 40-70 grams daily since then. maybe
once a week 70-100gr; High fat (love my whole cream). moderate amount of protein. use coconut oil in decaf with the cream. Since increasing
carbs the weight loss has stayed about the same +/- 5lbs but waist size increased by 1-2inches. Noticed hair loss but I don’t know if it’s stress
related (husband died just before Christmas).

POSTED APRIL 9TH, 2018 AT 3:35 PM

Lorraine Marshall
Rather than “”diet “ consider “change in eating habits “ identify vegetables that u are willing to eat as well as fruits. At meals eat a protein of
choice and ll up on fruits and vegetables until u have eaten enough. You may also have one carbohydrate at each meal and drink any drink
that is sugar free( seltzer, unsweetened herbal tea with lemon, co ee with cream) eat well and watch the pounds fall o ! Gud luck

POSTED APRIL 9TH, 2018 AT 2:16 PM

KAT RN
have been on the low carb (Ketogenic diet) OVER A YEAR. 20-30 gr for the rst 6 months, currently about 40-70 grams daily since then. maybe
once a week 70-100gr; High fat (love my whole cream). moderate amount of protein. use coconut oil in decaf with the cream. Since increasing
carbs the weight loss has stayed about the same +/- 5lbs but waist size increased by 1-2inches. Noticed hair loss but I don’t know if it’s stress
related (husband died just before Christmas).
can’t do statins: recent Labs Total cholesterol elevated 300 (Yikes) but ratio is good. HDL very high (MD said he’s not seen that high in any of
his pts.) and LDL very low.

hated giving up fruit (both fresh and dried). Hate not indulging in veggies. what am I to do with the peaches and tomatoes I canned?

POSTED APRIL 9TH, 2018 AT 2:00 PM

sam
Hola Monique, ¿tienes alguna investigación sobre la dieta cetogénica?

Los comentarios se han cerrado para esta publicación.

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