People on a low-fat, plant-based diet ate fewer daily calories but had higher insulin and blood glucose levels, compared to when they ate a low-carbohydrate, animal-based diet, according to a small but highly controlled study at the National Institutes of Health. 

Led by researchers at the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the study compared the effects of the two diets on calorie intake, hormone levels, body weight and more. The findings, published in Nature Medicine, broaden our understanding of how restricting dietary carbohydrates or fats may impact health.

“High-fat foods have been thought to result in excess calorie intake because they have many calories per bite. Alternatively, high-carb foods can cause large swings in blood glucose and insulin that may increase hunger and lead to overeating,” explains NIDDK Senior Investigator Kevin Hall, PhD, the study’s lead author. “Our study was designed to determine whether high-carb or high-fat diets result in greater calorie intake.”

Benefits to Both Diets—At Least in the Short Term

The researchers housed 20 adults without diabetes for four continuous weeks in the NIH Clinical Center’s Metabolic Clinical Research Unit. The participants, 11 men and nine women, received either a plant-based, low-fat diet or an animal-based, low-carbohydrate diet for two weeks, immediately followed by two weeks on the alternate diet. The low-fat diet was high in carbohydrates. The low-carbohydrate diet was high in fats. Both diets were minimally processed and had equivalent amounts of non-starchy vegetables. The participants were given three meals a day, plus a continuous supply of snacks, and could eat as much as desired. 

The main results showed that people on the low-fat diet ate 550 to 700 fewer calories per day than when they ate the low-carb diet. Despite the large differences in calorie intake, participants reported no differences in hunger, enjoyment of meals, or fullness between the two diets. Participants lost weight on both diets, but only the low-fat diet led to a significant loss of body fat.

“Despite eating food with an abundance of high-glycemic carbohydrates that resulted in pronounced swings in blood glucose and insulin, people eating the plant-based, low-fat diet showed a significant reduction in calorie intake and loss of body fat, which challenges the idea that high-carb diets per se lead people to overeat,” Hall says. “On the other hand, the animal-based, low-carb diet did not result in weight gain despite being high in fat.” 

These findings suggest that the factors that result in overeating and weight gain are more complex than the amount of carbs or fat in one’s diet. For example, Hall’s laboratory showed in 2019 that a diet high in ultra-processed food led to overeating and weight gain in comparison to a minimally processed diet matched for carbs and fat.   

The plant-based, low-fat diet contained 10.3% fat and 75.2% carbohydrate, while the animal-based, low-carb diet was 10% carbohydrate and 75.8% fat. Both diets contained about 14% protein and were matched for total calories presented to the subjects, although the low-carb diet had twice as many calories per gram of food than the low-fat diet. On the low-fat menu, dinner might have consisted of a baked sweet potato, chickpeas, broccoli and oranges, while a low-carb dinner might have been beef stir fry with cauliflower rice. Subjects could eat what and however much they chose of the meals they were given.

“Interestingly, our findings suggest benefits to both diets, at least in the short term. While the low-fat, plant-based diet helps curb appetite, the animal-based, low-carb diet resulted in lower and more steady insulin and glucose levels,” Hall explains. “We don’t yet know if these differences would be sustained over the long term.”

Study Was Not Designed for Weight Loss

The researchers note that the study was not designed to make diet recommendations for weight loss, and results may have been different if participants were actively trying to lose weight. Further, all meals were prepared and provided for participants in an inpatient setting, which may make results difficult to repeat outside the lab, where factors such as food costs, food availability and meal preparation constraints can make adherence to diets challenging. The tightly controlled clinical environment, however, ensured objective measurement of food intake and accuracy of data.

“To help us achieve good nutrition, rigorous science is critical—and of particular importance now, in light of the COVID-19 pandemic, as we aim to identify strategies to help us stay healthy,” says NIDDK Director Griffin P. Rodgers, MD “This study brings us closer to answering long-sought questions about how what we eat affects our health.”

What the Research Means to Health and Exercise Professionals

It is safe to say that just about anyone who has ever tried to lose weight has searched for an easy way to do it. And there is no shortage of plans and potions and formulas available that claim to be the “secret” to successful weight loss. In fact, your clients have probably asked you what diet they should be following to help them lose weight. As this study and previous research shows, it’s possible to lose weight on a wide range of diets, from low-fat to low-carb, but that doesn’t mean that one approach will work for everyone. If we’ve learned anything over the past several decades, it’s that achieving a healthy weight is a unique process for each individual, and depends on a whole host of factors, from genetics and childhood experiences to hormones and environmental factors. 

So many of these factors reside outside of an individual’s control, but making healthy lifestyle choices is not. As with so much related to health and wellness, knowledge is power. Informing your clients about the potential benefits of changing their lifestyles and making healthier choices is well within your scope of practice as a health and exercise professional.

While your ultimate goal is to help your clients achieve permanent lifestyle change, helping clients who struggle with obesity lose as little as 5% of their body weight can go a long way toward improving their health and well-being. For this reason, the best answer to the question of which “diet” is best for weight loss is the one that an individual will be able to stick to over the long haul.