I recently came across a criticism of the AWLR from the carbsanity blog, criticizing the scientific method and overall veracity of this website. She describes it as a "JOKE", condemning the fact that I describe it as an "international assembly" or that I am interested in hearing from those who have gained or maintained their weight while eating a carb-restricted diet as well:
"They want to hear if you've gained weight! Yeah ... right ... LOL."
This registry is then compared to the National Weight Control Registry (NWCR), describing how inferior our data is, praising the fact that the NWCR only accepts registrants who have lost weight and kept it off for at least a year.
Strength of the data
Speaking specifically to the fact that the data created from this site is of poor quality, I say you are absolutely correct. This is conspicuously explained on the about page. The Ancestral Weight Loss Registry is self-selected, self reported data and should not be interpreted as a scientific study. Of course, people can "pad their stats", saying they've lost more weight than they actually did. They can lie, or they may enter false data. This is a simple fact that plagues all self-reported data. The carbsanity author eloquently describes this fact in her post:
"Feel free to fill out this survey from each email you own or don't own. Make shit up all you want ... just beware, we have very special double secret statistical methods to catch you if you lie! Really!! No ... really really!! Don't lie or we will send out the fraud patrol to spam your fake email address. What a JOKE. "
I would simply hope that the same criticism be conjured up when describing the NWCR data. The fact that the NWCR require their registry members to mail in a packet of information and provide their home address does not necessarily improve the quality of self-selected, self-reported data.
The carbsanity author describes the NWCR, saying "In a word, there's a lot of ACCOUNTABILITY. You have to give them your mailing address, and as memory serves you must provide some visual verification of your weight loss. Not a lot of optional there."
In fact, her memory may not be entirely correct. You can give a visual verification of your weight loss (before and after pictures), as you can with the AWLR, but it is not required. As Dr. Wing explains in their published findings, "19% (145 subjects) were unable to provide any source of documentation" verifying their weight loss.
Exclusion criteria
Carbsanity criticizes me for allowing anyone, whether they have lost, gained, or maintained their weight to join the registry and share their story, as opposed to only allowing those who were successful to join:
"Let's see what we need to join NWCR. For one thing, you have to have lost a minimum of 30 lbs and KEPT IT OFF for at least a year. The criteria for joining the AWLR? Laughable -- we don't care how much you've lost or gained, we want to hear from you? This IS a joke ... right?"
No it isn't a joke. Only allowing people who have lost 30 pounds and kept it off for over a year is like Yelp.com only allowing you to review a restaurant if you are going to give it 5-stars. Excluding those who may have been less successful biases the data to immeasurable proportions. Those people who are most successful at losing weight and qualify for the NWCR may be systematically different in ways uncaptured by the registry questionnaire, further confounding the already weak data these questionnaires can provide.
In contrast, I specifically want to incorporate all people who have tried a carb-restricted or paleo diet, whether they lost weight or gained it. I believe this will provide a deeper insight into the most effective ways to lose weight and improve health.
What I hope for this registry to become is not proof that carb-restricted diets are more or less effective than a low-fat diet, or any other way of eating. It is not meant to belittle the findings of the NWCR. Far from it. What I do hope it can be is a lens by which the clinical data can be viewed. The most rigorous data we have on effective dietary practices is the randomized clinical trial. Since the early 90s the potential benefits of a carb-restricted or low fat diet have been tested, and there have been a few consistent findings:
While I agree with Carbsanity that the strength of data created in the Ancestral Weight loss registry is weak, I don’t think Rose or Jackie or the hundreds of people throughout the world signing up to AWLR each day, many of which have tremendously inspiring stories of weight loss and improved health without calorie counting and devoid of hunger, would agree that carb-restricted eating is a “joke”.
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Tried a carb-restricted or paleo diet? Whether you lost or gained weight, we want to hear about it! Join today.
"They want to hear if you've gained weight! Yeah ... right ... LOL."
This registry is then compared to the National Weight Control Registry (NWCR), describing how inferior our data is, praising the fact that the NWCR only accepts registrants who have lost weight and kept it off for at least a year.
Strength of the data
Speaking specifically to the fact that the data created from this site is of poor quality, I say you are absolutely correct. This is conspicuously explained on the about page. The Ancestral Weight Loss Registry is self-selected, self reported data and should not be interpreted as a scientific study. Of course, people can "pad their stats", saying they've lost more weight than they actually did. They can lie, or they may enter false data. This is a simple fact that plagues all self-reported data. The carbsanity author eloquently describes this fact in her post:
"Feel free to fill out this survey from each email you own or don't own. Make shit up all you want ... just beware, we have very special double secret statistical methods to catch you if you lie! Really!! No ... really really!! Don't lie or we will send out the fraud patrol to spam your fake email address. What a JOKE. "
I would simply hope that the same criticism be conjured up when describing the NWCR data. The fact that the NWCR require their registry members to mail in a packet of information and provide their home address does not necessarily improve the quality of self-selected, self-reported data.
The carbsanity author describes the NWCR, saying "In a word, there's a lot of ACCOUNTABILITY. You have to give them your mailing address, and as memory serves you must provide some visual verification of your weight loss. Not a lot of optional there."
In fact, her memory may not be entirely correct. You can give a visual verification of your weight loss (before and after pictures), as you can with the AWLR, but it is not required. As Dr. Wing explains in their published findings, "19% (145 subjects) were unable to provide any source of documentation" verifying their weight loss.
Exclusion criteria
Carbsanity criticizes me for allowing anyone, whether they have lost, gained, or maintained their weight to join the registry and share their story, as opposed to only allowing those who were successful to join:
"Let's see what we need to join NWCR. For one thing, you have to have lost a minimum of 30 lbs and KEPT IT OFF for at least a year. The criteria for joining the AWLR? Laughable -- we don't care how much you've lost or gained, we want to hear from you? This IS a joke ... right?"
No it isn't a joke. Only allowing people who have lost 30 pounds and kept it off for over a year is like Yelp.com only allowing you to review a restaurant if you are going to give it 5-stars. Excluding those who may have been less successful biases the data to immeasurable proportions. Those people who are most successful at losing weight and qualify for the NWCR may be systematically different in ways uncaptured by the registry questionnaire, further confounding the already weak data these questionnaires can provide.
In contrast, I specifically want to incorporate all people who have tried a carb-restricted or paleo diet, whether they lost weight or gained it. I believe this will provide a deeper insight into the most effective ways to lose weight and improve health.
What I hope for this registry to become is not proof that carb-restricted diets are more or less effective than a low-fat diet, or any other way of eating. It is not meant to belittle the findings of the NWCR. Far from it. What I do hope it can be is a lens by which the clinical data can be viewed. The most rigorous data we have on effective dietary practices is the randomized clinical trial. Since the early 90s the potential benefits of a carb-restricted or low fat diet have been tested, and there have been a few consistent findings:
- The carb-restricted, calorie unlimited diet usually - but not always - results in more weight (and fat) loss, than a low calorie, low-fat diet. This has been demonstrated at least 14 times. Whether they spontaneously eat less calories because of the satiating nature of a high fat, high protein diet, or they lose weight due to the net reduction in insulin levels, they consistently lose more weight. You can see all the clinical trials (both successful and unsuccessful here). Each study is linked to its original source in the medical literature.
- The people consuming a carb-restricted diet consistently report feeling full between meals, often eat less at subsequent meals.
- A carb-restricted diet consistently reduces triglyceride levels, increases HDL levels, and improves the atherogenicity of LDL-C, by morphing these particles from small and dense - associated with high carbohydrate diets, to the large and buoyant LDL particles associated with a decreased risk of heart disease.
While I agree with Carbsanity that the strength of data created in the Ancestral Weight loss registry is weak, I don’t think Rose or Jackie or the hundreds of people throughout the world signing up to AWLR each day, many of which have tremendously inspiring stories of weight loss and improved health without calorie counting and devoid of hunger, would agree that carb-restricted eating is a “joke”.
--
Tried a carb-restricted or paleo diet? Whether you lost or gained weight, we want to hear about it! Join today.
