The trick here is not only to avoid all obvious sources of carbohydrate (sweets, bread, spaghetti, rice, potatoes), but also to be careful with your protein intake. If you eat large amounts of meat, eggs and the like, the excess protein will be converted into glucose in your body. Large amounts of protein can also raise your insulin levels somewhat. This compromises optimal ketosis.
The low fat mantra has been the heartbeat of most of our public health recommendations for several decades, under the assumption that dietary fat caused heart disease and obesity. However, it seems much of that information was based on faulty science as even the recommendation of reducing saturated fat has fallen under scrutiny in multiple meta-analyses.
The study began with 609 relatively healthy overweight and obese people, and 481 completed the whole year. For the first month, everyone did what they usually did. Then, for the next eight weeks, the low-fat group reduced their total fat intake to 20 grams per day, and the low-carb group reduced their total carbohydrate intake to 20 grams per day. These are incredibly restricted amounts, considering that there are 26 grams of carbs in the yogurt drink I’m enjoying as I write this, and 21 grams of fat in my half of the dark chocolate bar my husband and I split for dessert last night.
If Nutrisystem does encourage weight loss, it may be attributable to calorie restriction and portion control, a well-supported mechanism of weight loss. A 2013 article in the New England Journal of Medicine, for example, concluded that provision of meals and meal-replacement products promote greater weight loss than "seemingly holistic" programs based on balance, variety and moderation. While Nutrisystem once touted low-GI foods as a key element of the program, the company says it no longer claims GI to be the mechanism of weight loss.
Unintentional weight loss may result from loss of body fats, loss of body fluids, muscle atrophy, or even a combination of these. It is generally regarded as a medical problem when at least 10% of a person's body weight has been lost in six months or 5% in the last month. Another criterion used for assessing weight that is too low is the body mass index (BMI). However, even lesser amounts of weight loss can be a cause for serious concern in a frail elderly person.
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 inflammation. It is possible that there could have been little difference in weight loss between the two diets but big differences in the impact on risk factors related to diabetes.
"Crash diets (dramatically cutting down how much you eat) might help you to lose a few pounds at first, but they’re hard to sustain and won’t help you keep the weight off. It might seem like a quick and easy option, but eating too few calories can actually do more harm than good. If your calorie intake dips too low, your body could go into starvation mode. This will slow down your metabolism, making it harder for your body to lose weight. Make sensible, healthy changes to your lifestyle that you can stick to and avoid the fad diets."