So many of us spend all of our free time reading and watching videos about the latest science in nutrition, training, and lifestyle.
We carefully calculate how many grams of carbs, protein, and fat to eat in order to lose fat, excel in our training, and prevent disease.
We stress over exactly which foods to eat, when to eat them, and how to cook them in an attempt to maximize their effects on our fat loss, performance, and health goals.
Often, though, what holds us back from getting lean, strong, and healthy AF isn’t some magical macronutrient ratio we’re not hitting, a missing superfood, or some adverse reaction we’re overlooking (although these factors may matter in some contexts).
Many of us are actually ignoring what may be the most overlooked factor in physical transformation.
Rather, what’s holding us back is that we’re not sticking to our routines.
That is, we’re just not consistent.
We eat nutritious, satisfying meals throughout the day, but then get derailed by happy hours, “special occasions”, dining out, mindless snacking, and cravings.
We dial in our eating habits are on point during the week, but then we say, “eff it”, and go ham on the weekends.
We jump from one strategy or another, not giving any single approach enough time to determine whether it’s a good fit for us or not.
We don’t see the progress we expect and throw in the towel.
There are at least three – although likely more, about which I personally am not aware – studies that demonstrate this concept that are worth exploring.
In each of these examples, our problem may not be the specific dietary approach we’ve chosen, but rather our adherence.
“Comparison of the Atkins, Ornish, Weight Watchers, and Zone Diets for Weight Loss and Heart Disease Risk Reduction”
In the first study, published in the Journal of the American Medical Association (JAMA) in 2005, researchers randomly assigned 160 participants to one of four dietary strategies – Atkins (carbohydrate restriction), Weight Watchers (calorie restriction), Ornish (fat restriction), or Zone (balanced macronutrients).
The results indicated that participants in all four groups saw similar weight loss as well as improvement in cardiovascular risk factors, that the amount of weight loss correlated with improvement in risk factors, and that there was a positive correlation between successful outcomes and self-reported dietary adherence.
The researchers found also that there was no significance difference between the outcomes of the diets, and that those participants who were most successful were those who actually stuck to their routine.
Furthermore, the researchers observed that the participants who didn’t complete the study often cited that “the assigned diet was too hard to follow or not yielding enough weight loss.”
Thus, it appears that consistent adherence is more important than whether one focuses on carb restriction, fat restriction, macronutrient balance, or calorie restriction (although all groups saw reduction in caloric intake), and that the factor often cited for inconsistency was perceived difficulty of adhering to the diet.
“Comparison of Weight-Loss Diets with Different Compositions of Fat, Protein, and Carbohydrates”
A study similar to the one just discussed was published in New England Journal of Medicine (NEJM) in 2009, and didn’t look solely at different carbohydrate levels, but also varying protein and fat levels.
In this study the researchers assigned 811 participants to one of four diets of varying macronutrient composition:
- 20% fat, 15% protein, 65% carbohydrate
- 20% fat, 25% protein, 55% carbohydrate
- 40% fat, 15% protein, 45% carbohydrate
- 40% fat, 25% protein, 35% carbohydrate
All four diets were designed for similar fiber intake and calculated caloric deficit per participants’ reported resting energy expenditure and activity levels (750 kcal).
The participants were provided meal plans with some flexibility and shopping lists to help them achieve these target macronutrient intakes, and were encouraged to attend regularly scheduled meetings with other participants and participating dietitians to support adherence to their assigned diet.
After two years, the researchers concluded that weight loss was not significantly impacted by high vs. low protein, high vs. low fat, or high vs. low carbohydrate.
Similar to the first article we discussed, the authors observed an association between adherence and weight loss, suggesting adherence to be a more important factor in success than macronutrient composition.
On a related note, attendance at the group sessions was also associated with adherence and weight loss, suggesting that support is another important factor in dietary success.
Finally, we’ll talk about another study that took into account a few additional considerations.
“Effect of Low-Fat vs Low-Carbohydrate Diet on 12-Month Weight Loss in Overweight Adults and the Association With Genotype Pattern or Insulin Secretion”
The next study we’ll look at was published in JAMA in February 2018, and looked not only at the effects of different dietary strategies on weight and cardiovascular risk outcomes, but also looked at the interaction between genetic and metabolic characteristics with respect to success of the strategy implemented.
609 participants were randomly assigned to either a fat-restriction intervention or a carbohydrate-restriction intervention, and then after two months were instructed to gradually add incremental amounts of the restricted macronutrient back into their diets until they reached a balance they felt they could maintain indefinitely.
Additionally, the participants were instructed not to eat in a way that made them feel hungry or deprived and encouraged to focus on minimally processed foods.
One thing that really sets this study apart, though, is that the participants were screened at the beginning of the experiment for genetic patterns and insulin profiles that might suggest better suitability for either a low-carbohydrate or low-fat approach.
The results showed that both groups saw statistically similar weight loss and improvement in health risk factors, regardless of either the dietary strategy chosen or genetic and metabolic profiles, with the primary indicator of success being adherence.
Again, the researchers found that those who saw the most success over the course of the intervention were those who adhered to their routines for the duration of the study.
What this means for you
I’m by no means a statistician or nutrition researcher, so much of my interpretation of these studies is admittedly based on the interpretation of the studies’ authors and of other health and fitness writers who’ve explored them.
Moreover, these studies were conducted on overweight or obese individuals, most of whom were free of chronic disease, so details like carbohydrate and fat balance may matter more for those of us who are closer to our ideal body composition, have performance goals, or exhibit adverse health conditions like diabetes.
However, what these three studies seem to indicate is that consistency and adherence appear to be more important than macronutrient composition when it comes to long term improvement to both body composition and health.
Finding an approach that we can adhere to for the long run is an important factor in how consistently we stick to a given dietary strategy.
Consistency is critical to success not only when it comes to how we eat, but also in how we train or work towards any goal in life.
Now, there are many other benefits to consistency that aren’t explicitly explored in these studies that I’d like to cover, and for many of us being consistent is often easier said than done.
We’ll explore these points more in the future, I assure you.
For now, though, you might take start asking yourself a few questions:
“Is my strategy my limiting factor, or is it my adherence?”
“If the strategy that I’m implementing is working for me now, will I be able to adhere to it for the long run?”
“If I’m having trouble sticking to my habits, what might I adjust to make my approach more manageable?”
Oh, and don’t forget to ask yourself if what you’re doing is actually working for you 🙂
Until next time, have a most excellent day!