At long last, the results of a head-to-head battle among the most commonly recommended diets were published in the prestigious New England Journal of Medicine. Amazingly, researchers found that no specific diet was overwhelmingly better than the rest, but rather, each diet, when followed in a measured and healthful manner, could lead to long-lasting change. The results of this intensive study provide some major insight about how to develop and maintain a healthy diet.

Researchers followed 322 moderately overweight workers at a plant in Israel. Participants were placed on a low-fat diet, a low-carbohydrate diet or a typical Mediterranean diet. The diets were not meant to lead to dramatic weight loss but rather to create a healthful diet that the participants could stay on for life.

The low-fat diet recommended 30 percent of daily calories from fat, derived from healthy choices such as lean meats and monounsaturated plant fats. The diet encouraged the consumption of low-fat grains, fruits and vegetables and avoided unhealthy sweets, high-fat snacks and saturated fats.

The Mediterranean diet, however, placed a stronger emphasis on obtaining "good fat," such as omega-3 fatty acid through fatty fish, olive oil and a handful of nuts. It was also rich in fruit, vegetables and lean meat.

Finally, the low-carbohydrate diet initially restricted carbohydrate intake to 20 grams daily to stimulate weight loss and then increased to 120 grams daily to maintain weight loss. The participants were encouraged to use vegetarian sources for fat and protein and to avoid trans fats.

To maintain structure, most meals were consumed in the cafeteria and all foods were carefully labeled to indicate the total calorie content, fat content and recommendations to either "feel free to consume" or "eat in moderation." For the first three months a dietitian closely monitored and counseled each of the participants weekly and then every six months thereafter. They were required to keep very accurate diet records and were weighed frequently.

This study offered some truly amazing results. Most remarkably, perhaps, was the fact that 95 percent of the participants remained on the diets at the end of one year and 85 percent were adherent at the end of two years. When it came to weight loss, the low-carbohydrate group fared best with an average of 10 pounds over two years, followed by the Mediterranean diet with participants averaging nine pounds. The least weight loss occurred in the low-fat group, with only seven pounds after two years. The low-carbohydrate diet also seemed to have the greatest impact on cholesterol, but the total impact of any of the diets on cholesterol was quite small. In relation to diabetes, the Mediterranean diet appeared to offer the greatest benefit.

Most importantly, this study offers potential solutions to dealing with America's obesity problem. First and foremost, the diets employed a balanced mix of fats, carbohydrates and protein. In each of the diets, healthy food choices were encouraged. For example, the low-carbohydrate diet urged avoidance of food rich in saturated fats and cholesterol (eggs, high-fat snacks and red meat), the Mediterranean diet urged starches in moderation and encouraged the healthiest of fats, and the low-fat diet was truly prudent in its choices of food.

Just as importantly, the healthy food choices were offered in the workplace with clearly labeled foods. Labels that gave consumption recommendations and clearly listed the nutritional content definitely helped participants make healthier choices. In addition, such labels also helped participants develop healthier habits, a difficult barrier on the road to lifelong health. Combined with education, close monitoring and coaching afforded an incredible success rate regardless of the specific diet.

Based on these observations, it is clear that attacking obesity is not just about food. Healthy choices must be offered in an accessible and educational environment. To be successful, close monitoring by health professionals is key. There is no one perfect diet. Each person should be evaluated to create a meal plan that fits personal preference and the presence or absence of medical problems. We must create an active community-wide commitment to pay attention to diet, exercise and all aspects of health.

Dr. David Lipschitz is the author of the book "Breaking the Rules of Aging." To find out more about Dr. David Lipschitz and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at www.creators.com. More information is available at www.drdavidhealth.com.

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