The Holy Basil: Tulsi

Holy Basil also known as Tulsi or Tulasi

Scientific name: Ocimum sanctum, O. tenuflorum, O. gratissimum

Family: Lamiaceae (mint family)

Parts used: Aerial portions

Plant Properties: Adaptogen, anti-microbial, aromatic digestive, relaxing nervine, cardiovascular tonic, expectorant, neuroprotective, radioprotective, antioxidant, immunomodulating, analgesic

Plant Uses: Stress, anxiety, high blood pressure, viral infections, fungal infections, depression, colds and flus, herpes virus, radiation exposure, high blood sugar, allergic rhinitis, ulcers, pain

Plant Preparations: Tea, decoction, tincture, fresh juice, poultice, powder, infused into ghee or honey

Holy basil is classified as a rasayana, an herb that nourishes a person’s growth to perfect health and promotes long life.

David Winston and Steve Maimes

from the book Adaptogens

Holy basil, sometimes referred to as tulsi, is a sacred plant in the Hindu religion and grows abundantly in India, western Asia, Malaysia, Central and South America, and even Puerto Rico. Its species name, sanctum, refers to this sacredness. In sanskrit, tulsi means “beyond compare”. It is also referred to as an elixir of life, queen of herbs and mother nature of medicine.

My friend from New Delhi tells me that he was taught to give reverence to this plant every morning before his feet even touch the earth. Many Hindu families grow their own tulsi plant in their home, for spiritual as well as medicinal purposes.

An altar with tulsi for daily worship in a courtyard in India

This plant is sacred to the Hindu god Vishnu. Vishnu’s wife, Tulasi, took the form of this herb when she came to earth. Besides being used in morning prayers, the wood of tulsi is used as beads in meditation, similar to how the Catholics use rosaries.

I know some of you are wondering if our common culinary plant, basil, is the same as tulsi or holy basil and the answer is no. Our culinary plant, Ocimum basilicum, is a different species although they do have some overlapping properties and uses. There are over 60 different species in the Ocimum genus.

There are at least three different types of holy basil, and while they can be used  somewhat interchangeably, they also have their slight differences.

Rama Tulsi (Ocimum sanctum) has green leaves and is the most commonly cultivated holy basil and the easiest to find in commerce.

Krishna Tulsi (Ocimum sanctum) has leaves that are more purple in color.

Vana Tulsi (Ocimum gratissimum) is a perennial basil that is hard to find in commerce. In India it grows in the wild.

You can buy seeds or even potted plants of all these varieties at Horizon Herbs.

Ocimum gratissimum. Photo by Forest and Kim Starr

I cultivate both Ocimum sanctum (annual) and Ocimum gratissimum (perennial).  To me, O. gratissimum is more bitter, colder. O. sanctum is more warming, more adaptogenic. I am thinking of using O. gratissimum for a messed up enteric influencing central nervous system, due to its more bitter nature. But that is just a gut feeling.

Christophe Bernard, Herbalist

For over three thousand years Holy Basil has been revered as one of India’s most sacred and powerful plants.

Really think about that.

Ayurveda, one of the oldest and most sophisticated systems of medicine in the world reveres this plant. That is saying a lot! As you might imagine, a plant that holds such high esteem throughout an entire culture must be an amazing plant. And it is! This is yet another herb with powerful properties that will leave you asking, “What can’t it do?”

Adaptogen
Tulsi’s main claim to fame in the western world is its use as an adaptogen. (See this herbal glossary episode to learn more about adaptogens.) In Ayurveda they refer to it as a rasayana. This term is similar to the Chinese term tonics. It basically means that this is a transformative herb and, when taken daily, it moves a person towards health. These are generally building and nourishing herbs.

I often hear people say that they don’t want to be taking herbs for the rest of their life, the idea being that if they were healthy, they wouldn’t need to take herbs. In this sense, people are equating herbs with pharmaceutical drugs. However, in other systems of healing like Traditional Chinese Medicine and Ayurveda, specific herbs are taken for a lifetime to ensure vibrant health and longevity. Holy basil is one of these herbs.

It brings me back into my body, from the overactive Vata part of me. When there is a whirlwind of ideas and planning of future projects, when I am gardening but not even there, lost in my head, it brings me back into my body. Mind clarity, yes, but a clarity of the present moment, and a sharpening of all the senses. I see and hear more sharply, I feel the sun on my skin, the weight of my body. I am more in tune with intuition. Things slow down a bit. What Matt Wood uses wood betony for, I would use holy basil for (reconnecting with your enteric nervous system). 

Christophe Bernard, Herbalist

Holy basil not only helps the body adapt to stress, it can also promote energy and endurance. One way it does this is by increasing the body’s ability to efficiently use oxygen.

Holy basil is a relaxing nervine that can help calm the mind and recover from our hustle and bustle culture. It has also been shown to positively effect people who are diagnosed with chronic fatigue syndrome.

David Winston refers to holy basil as a cerebral stimulant and uses it for people with mental fog.

It can be combined with other cerebral stimulants such as rosemary, bacopa, and ginkgo to help people with menopausal cloudy thinking, poor memory, attention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD) and to speed up recovery from head trauma. 

David Winston and Steven Maimes

from the book Adaptogens

Aromatic digestive
Like our common culinary basil, holy basil has many positive effects on the digestive system. As a slightly warming and aromatic herb it is used to promote stagnant digestion and it is often paired with dried ginger for this purpose. Stagnant digestion is when you eat a meal and feel like it is stuck. One might also experience bloating, gas, decreased appetite and nausea. Tulsi is also helpful for heartburn and can help to heal ulcers.

The fresh juice sweetened with honey is used for intestinal parasites. And it is considered to be an hepatoprotective herb, or an herb that protects the liver from harm.

Blood glucose regulating
Holy basil has been shown to help regulate blood sugar in diabetics and specifically can lower fasting blood glucose significantly. One reasoning for this ability may be its high antioxidant levels. Someone who is taking insulin to control their diabetes might need to approach this herb with caution and adjust their insulin levels accordingly.

Cardiovascular tonic
Tulsi has many beneficial actions on the heart. It is slightly blood thinning and promotes good circulation. It can lower stress-related high blood pressure and taken daily it can help optimize cholesterol levels. Stress can play an ugly role in overall cardiovascular health and the adaptogenic properties of tulsi can help mediate stress-related damage.

In Ayurveda, a formula that is balancing to all who take it (tridoshic) is made up of tulsi, arjuna and hawthorne.

For musculoskeletal pain
In scientific studies, holy basil has been shown to be a COX 2 inhibitor (many modern pain medications are COX 2 inhibitors), making it useful against arthritis and other inflammatory conditions. Tulsi is high in eugenol, a constituent also found in cloves, which is helpful to decrease pain.

Immunomodulator
Holy basil helps to strengthen and modulate the immune system. It can be taken to both prevent and address current upper respiratory viruses like the cold or flu. This expectorant herb also has an affinity for the lungs and can be used for bronchitis as well as pulmonary weakness. Taken over time it can have a beneficial effect on asthma and has also been shown helpful in alleviating allergic rhinitis symptoms like seasonal hay fever.

Add some ginger and honey to tulsi tea to help soothe an irritated sore throat.

As an anti-microbial herb it can be used topically or internally to treat bacterial, viral and fungal infections. It is frequently used for herpes sore outbreaks (viral infection) and can also be applied externally to ringworm infections and eczema. (Taken internally its effects on the liver and digestion also help with eczema.)

Tulsi has the ability to reduce cancerous tumors and can also protect healthy cells from radiation and chemotherapy treatments.

Botanically speaking
For this botanical section let’s concentrate on Ocimum sanctum, Rama Tulsi. This is the easiest herb to find in commerce and if you can grow basil, then you can grow this one.

As a member of the mint family it has the characteristic square stem and opposite leaves.

Photo by Forest and Kim Starr

The flowers have the familiar lipped shape of the mint family.

It likes to grow in full sun with moderate water and fertile well-draining soils.

As the plant forms flowers, gently pluck these off to avoid the plant going to seed too early in the season. Also, by occasionally plucking off these flowers you will encourage the plant to branch and continue growing. If you are wanting to collect the seeds for next year’s crop you can grow a special plant just for seed production, or stop plucking the flowers early enough in the season that the seeds will develop.

Normally, it’s an annual plant that needs about 80 days until maturity. In some tropical climates it may grow for five years.

Preparing holy basil as medicine
The most common way to prepare holy basil is as a tea. Because of its high volatile oil content it is steeped for 5-10 minutes covered. You can start with 1 tsp of the leaf and increase as desired. I’ve seen recommendations of up to 4 ounces per day so this will be difficult to take too much of.

In Ayurveda the fresh juice is often used for remedies and my friend and herbalist Christophe (who adores holy basil) says that he strongly prefers fresh leaves for tea or as a fresh tincture.

As a fresh herb tincture one could start with 40 – 60 drops of a 1:2 tincture, 2 – 3 times a day.

Special Considerations
Tulsi might have an anti-fertility effect on both men and women and thus should not be taken by couples wishing to conceive or by pregnant women. It is slightly blood thinning and should not be taken by those who are currently taking warfarin. Those who are taking insulin to control their diabetes may need to adjust their insulin levels while taking tulsi.

Resources

• Adaptogens: Herbs for Strength, Stamina, and Stress Relief by David Winston and Steven Maimes
• Holy Basil Monograph by Steven Maims
• Personal correspondence with herbalist and holy basil aficionado Christophe Bernard
• Tulasi Devi: Goddess of Devotion by Sarvaga and Gunavati

This article was originally written for  www.herbmentor.com

Study: Autralopithecus Diet "Almost Exclusively" Plant Food – Researcher Says "Humans Are Basically Grass-Eaters"

Australopithecus Sediba Preferred Forest Foods, Fossil Teeth Suggest - NYTimes.com

New research on the diet of Australopithecus Sediba has revealed another beautiful fact undermining the ugly Paleo Diet^TM theory.  This recently discovered  possible human ancestor that lived about 2 million years ago appears to have eaten an "almost exclusively" plant-food diet:

"Almost two million years after their last meals, two members of a prehuman species in southern Africa left traces in their teeth of what they had eaten then, as well as over a lifetime of foraging. Scientists were surprised to find that these hominins apparently lived almost exclusively on a diet of leaves, fruits, wood and bark." 

This NYT article discussing the research contains an interesting comment from Benjamin H. Passey, a geochemist at Johns Hopkins University, who conducted the tests determining the high ratio of carbon isotopes indicating a diet mostly of plant foods:

"“One thing people probably don’t realize is that humans are basically grass eaters,” Dr. Passey said in a statement. “We eat grass in the form of the grains we use to make breads, noodles, cereals and beers, and we eat animals that eat grass. So when did our addiction to grass begin? At what point in our evolutionary history did we start making use of grasses? We are simply trying to find out where in the human chain that begins.”"[Emphasis added]

It doesn't look like anyone presenting at the upcoming 2012 Ancestral Health Symposium will be discussing the reality that humans evolved as primarily plant- and probably, grass-product eaters.  In fact, it looks like someone there considers plants "A Little Shop of Horrors."  Sigh. 
 
Science like this shows that so-called "Paleo diet" advocates are way off track if they still think that grains, i.e. seeds of grasses, are only a recent addition to the diet of humans.  The idea that an almost purely carnivorous species with no experience eating grass seeds just suddenly adopted a grain-based diet only 10K years ago, after more than 2 millions of years completely grain-free, simply strains credulity.

Put otherwise, the agricultural revolution must have been preceded by a long, increasingly symbiotic relationship between human ancestors and seed-bearing grasses. Although ancestral humans did  consume variable quantities of meat, meat-consumption probably did not provide the key to human brain expansion or significantly alter human physiology from its baseline adaptation to a plant-based diet. 

This new research reminds me of my June 19, 2011 post entitled "Gathering Wild Grains,"  wherein I wrote

"Put this together with evidence that Paranthropus boisei, a human relative dating to 1.4 to 1.9 million years ago,  grazed on grass [2].  Paranthropus and humans both descended from Australopithecus, but the Paranthropus went extinct.  To several scientists working with this information, this new data on Paranthropus suggests a reinterpretation of previously collected data on Australopithecine diet, i.e. that Australopithecus may also have eaten grasses.

"Perhaps we can start to put together a plausible path for the incorporation of cereal grains--grass seeds--into human diets.  Perhaps human ancestors used grasses as food more than 2 million years ago. Human evolution might look something like this: the grass-eaters went extinct, but the grass-seed eaters thrived."

I am now even more confident that a grain-based, legume-enhanced diet is likely more ancestral than the Paleo Diet^TM .  To celebrate, I am going to eat a big bowl of grass seeds and fruits, topped with legume milk, as soon as I finish this post.

Cheers!

Low Fat Diet Suppresses Metabolism?

JAMA Network | JAMA: The Journal of the American Medical Association | Effects of Dietary Composition on Energy Expenditure During Weight-Loss MaintenanceDietary Composition During Weight-Loss Maintenance

This new study published in JAMA is being reported as evidence that a low (20% energy) fat diet suppresses metabolism, increases heart disease risk, and predisposes people to weight regain, and that a higher (40% energy) fat, low-glycemic diet is superior. 

After reading the article in full, I have some questions about it. 

According to the full text, "The low-fat diet, which had a high glycemic load, was designed to reflect conventional recommendations to reduce dietary fat, emphasize whole grain products, and include a variety of vegetables and fruits,"  while "The low–glycemic index diet aimed to achieve a moderate glycemic load by replacing some grain products and starchy vegetables with sources of healthful fat and low–glycemic index vegetables, legumes, and fruits."  

So the low-fat diet both "had a high glycemic load" and was designed to "emphasize whole grain products"?  Since whole grains have a relatively low glycemic load, I was curious to see how they managed to put together a diet that achieved two opposite goals.


According to Table 1 of this paper, the low (20%) fat diet, supposedly emphasizing whole grains, vegetables, and fruits, supplied only 30 g of fiber per 2000 kcal, but the low glycemic diet, containing fiber-free olive oil and more fiber-free animal products (evidenced by twice as much cholesterol) to boost fat level to 40% of energy, supplied 33 g of fiber per 2000 kcal.

So I wondered, why does the LF diet, supposed to "emphasize" fiber-rich whole grains, vegetables, and fruits, have less fiber that the LG diet, which included fiber-free oils and animal products to double the fat and cholesterol content while keeping caloric content constant?

Does a low fat diet have to be low in fiber and high in glycemic load?

If not, why call it a "low fat" diet and not call it a "high glycemic load" diet?

Notably, the authors  fail to provide example menus, instead opting to provide only the claimed nutrient analysis of each diet prescription.

Here's about half a 2000 kcal diet, emphasizing commonly available and consumed whole grains, vegetables, and fruits:



And here is the macronutrient and fiber analysis:

 

So 1100 kcal coming from four slices of whole wheat bread, one cup of cooked oatmeal, one cup of cooked lentils, one white potato, one cup of broccoli, one apple, and one banana supplies ~39 grams of fiber.  That is about twice the fiber density of the low-fat diet prescribed by the authors of this study.

This selection of foods supplies less than 15% of calories from fat.  This means that a 2000 kcal low-fat diet composed of whole grains, legumes, vegetables, and fruits could supply about 80 grams of fiber.  Yet theirs supplies only 30 g of fiber, indicating that it doesn't even have the amount of whole grains, vegetables, and fruits that I have in this 1100 kcal menu, despite supposedly "emphasizing" whole grains, vegetables, and fruits.

They state that their low-fat diet supplied about 105 g protein and 140 mg of cholesterol per 2000 kcal, while the LG diet had 280 mg cholesterol.  As shown above, a reasonable selection of whole plant foods supplies about 40 g protein per 1000 kcal.  Animal flesh supplies 30 to 60 mg cholesterol per 100 kcal, eggs supply about 250 mg cholesterol per 100 kcal, and one percent and non-fat milk supply 0-10 mg cholesterol per 100 kcal.   So their 2000 kcal LF diet could have supplied only about 250 to 460 kcal from animal flesh and essentially no eggs.

That means that they could have included at least 1500 kcal worth of low-fat whole plant foods, and if they did, they would have had a diet supplying more than 50 grams of fiber, yet still very low in fat.  Instead they chose to include low-fiber high-glycemic load foods, most likely refined carbohydrates.  Again, in their publication, presss release, and interviews they should have called this a high-glycemic load diet, not a low-fat diet, because the defining feature is the high glycemic load, not the low fat content. 

As they did it, they imply and give the public the impression that any harms that came from their low fat diet were due to the low fat content, rather than from the low fiber, refined character of the carbohydrate-rich foods they included.  This makes it look, to me, like they had an axe to grind against any diet low in fats; or, conversely, that they had a bias in favor of high-fat pseudo-Mediterranean diets.

Next, looking at Table 3 I find more curious data.  When they measured resting energy expenditure during each of the three diets (low-fat, low-glycemic, and very low carb; LF, LG, and VLC respectively), they found no significant difference.  During the LF, LG, and VLC phases, the average REEs were 1576, 1614, and 1643 kcal, respectively.  The VLC and the LF numbers differ by 67 kcal, which is only four percent (relative to the LF).  The ranges also overlap significantly:

LF:  1528 to 1624
LG:  1566 to 1662
VLC:  1595 to 1691

Since the final study included only 21 people, and the low-fat arm is clearly rigged to have a low fiber content, and the ranges of REE in each phase significantly overlapped, I don't think we can make very much of this four percent difference in REE.

The press is reporting that the participants burned 300 kcal more per day on VLC diet and 150 kcal more per day on the LG diet compared to the LF diet.  In the full text the authors state:

"TEE [total energy expenditure] differed by approximately 300 kcal/d between these 2 diets [LF and VLC], an effect corresponding with the amount of energy typically expended in 1 hour of moderate-intensity physical activity."

 The actual figures in the study are 3013 kcal per day expended in the VLC phase, 2926 in the LG phase, and  2767 in the LF phase, resulting in a difference of 246 kcal between VLC and LF, and a difference of 159 between LG and LF.

The difference between 300 and 246 is 54, and 246 is closer to 200 than to 300.  It would have been much more scientifically accurate to round 246 to 250, rather than up to the next hundred.  Using the figure 300 overstates the supposed increased metabolic effect of the VLC by about 22 percent, which again suggests that the authors have bias against low-fat diets and attempt to put the approach in the worst possible light when opportunity presents. 

Of interest, the authors appear somewhat at a loss to explain this large difference in total energy expenditure given the rather small difference in resting energy expenditure, which indicates insignificant differences in basal metabolic rates between the groups.  Total energy expenditure consists of basal metabolic rate plus energy expended in activities of daily living, physical activity, and digestion and metabolism (i.e. thermic effect) of food.

The REE of the VLC and LG phases appeared to be 67 kcal and 38 kcal more than the REE of the LF phase, respectively.  Since the TEE of the VLC and LG phases appeared to be, respectively, 246 and 159 kcal greater than that of the LF phase, something else must account for the VLC and LG groups burning another 179 and 121 extra kcalories daily.  The authors comment thus:

"Triiodothyronine was lowest with the very low-carbohydrate diet, consistent with previously reported effects of carbohydrate restriction²³ ; thus, changes in thyroid hormone concentration cannot account for the higher energy expenditure on this diet. The thermic effect of food (the increase in energy expenditure arising from digestive and metabolic processes) dissipates in the late postprandial period and would not affect REE measured in the fasting state. Because the thermic effect of food tends to be greater for carbohydrate than fat,^{24 - 25} it would also not explain the lower TEE on the low-fat diet. Although protein has a high thermic effect of food,¹⁶ the content of this macronutrient was the same for the low-fat and low–glycemic index diets and contributed only 10% more to total energy intake with the very low-carbohydrate diet compared with the other 2 diets. Furthermore, physical activity as assessed by accelerometry did not change throughout the study."

According to their data, thyroid hormone levels were 11 percent higher during the LF phase than during the VLC phase.  In short, none of the well-established mechanisms affecting TEE could account for their reported difference; in fact, since, as they admit, the thermic effect of carbohydrate is greater than that for fat, their results contradict the expectation of a higher TEE for the diet highest in carbohydrate, i.e. the low-fat diet.  As they state, since the LF and LG diets were 20% energy from protein, and the VLC was 30% energy from protein, differences in protein content were not capable of explaining such a large difference.  They offer the following:

"Alternative explanations for the observed differences in REE and TEE may involve intrinsic effects of dietary composition on the availability of metabolic fuels^{13 - 14} or metabolic efficiency, changes in hormones (other than thyroid) or autonomic tone affecting catabolic or anabolic pathways, and (for TEE) skeletal muscle efficiency as regulated by leptin.^{26 - 29"}

The studies to which they refer with footnotes 13 and 14 also compared metabolic effects of low-fat to low-glycemic diets.  In one [full text], "The low-fat diet was low in fat, high in carbohydrate and glycemic load, and generally consistent with National Cholesterol Education Program guidelines for a heart healthy diet." In the other, the low-fat diet was also high-glycemic load (i.e. low fiber) and contained white bread, non-fat milk, frozen yogurt, and angel food cake.  These studies collectively rest on and promote the misconception that eating a low-fat diet means eating a high-glycemic index diet. 

As I have shown above, it is quite easy to create a very high fiber, low glycemic, low fat, high carbohydrate diet, so I wonder why all of these researchers seem fixated on conflating low-fat with high-glycemic, and talking as if their version of low-fat diet is the only possible to compare with their apparently preferred high fat diets?

 In any case, all claims these authors make about low-fat diets apply only to their specially selected  low-fat diet that is astoundingly low in fiber considering their claim that it emphasized whole grains, vegetables, and fruits.

In the press release announcing the results of the study, the authors claim that the "low-fat" diet caused "an unhealthy lipid pattern and insulin resistance."  Looking at the data in the paper, while some signs of insulin resistance did increase during the LF phase, the total cholesterol during low fat phases was 149, a level associated with a very low risk of cardiovascular disease, compared to 156 for the LG phase and 175 for the VLC phase.  These data actually provide another study (of hundreds) supporting the notion that dietary cholesterol raises blood cholesterol.  The dietary cholesterol for LF, LG, and VLC phases were respectively 140, 280, and 978 mg per day, and the diets with the higher dietary cholesterol produced higher blood cholesterol in a dose-response fashion.

The HDL levels during LF, LG, and VLC phases were 40, 45, and 48 respectively, and this apparently contribute to their claim that the LF diet causes "an unhealthy lipid pattern."  However, this reduction of HDL is simply a part of the pattern of lower total cholesterol, as evidenced by the fact that HDL as a percent of total cholesterol did not  signficantly differ between phases, at 27%, 29%, and 27% for LF, LG, and VLC phases respectively.  Moreover, the idea that a high HDL protects against cardiovascular disease has suffered a major setback with the finding that people who have genetic variations producing naturally higher HDL levels do not enjoy greater protection from cardiovascular disease as a result.

Triglycerides measured 107, 87, and 66 mg/dL in the LF, LG, and VLC phases respectively, apparently also contributing to the authors' idea that the LF diet produced an unhealthy lipid pattern.  The American Heart Association recommends people keep their triglyceride levels under 100 mg.  Despite feeding these people a low fiber low fat diet, rich in refined carbohydrates, their triglycerides were only slightly elevated above desired levels.

During the LF and LG phases, the subjects had similar C-reactive protein levels, but during the VLC phase C-reactive protein increased about 13 percent, suggesting that the VLC diet supported a higher level of systemic inflammation than either the LF/refined carb diet or the LG diet.

Finally, since the study design involved feeding each type of diet to each individual for only one month at a time, this study does not provide any evidence for long-term effects or adaptations to any of the three diets studied, so the authors really have no warrant to assert that this study shows that any of the diets supports long-term weight stability better than any of the others.    However, in their press release they appear bent on implying that "low-fat diets" will cause people to quickly regain lost weight and that their higher fat, low-glycemic diet is easier to sustain.   From their press release:

“In addition to the benefits noted in this study, we believe that low-glycemic-index diets are easier to stick to on a day-to-day basis, compared to low-carb and low-fat diets, which many people find limiting,” says Ebbeling. “Unlike low-fat and very- low carbohydrate diets, a low-glycemic-index diet doesn’t eliminate entire classes of food, likely making it easier to follow and more sustainable.”

Which makes me wonder who they are referring to when they say ".....which many people find limiting."  Perhaps themselves?  Also, Ebbeling (one of the authors) implies that a low-fat diet eliminates entire classes of food.   Is he referring to vegetable oils and animal fats?  Can these really be considered "classes of food"?  In any case, his low-fat diet did not eliminate animal products supplying fat.  As I indicated above, a selection of low-fat plant foods will typically supply less than 15 percent of energy from fat, so a 20 percent fat allows use of some higher fat foods. 

While Ebbeling et al believes that a pseudo-Mediterranean 40 percent fat is "easier to stick to on a day-to-day basis" and "easier to follow and more sustainable" and will produce less or no weight gain compared to a low fat diet. Due et al compared people randomly assigned to a diet providing a moderate amount of fat (35–45% of energy) and about 20% of fat as monounsaturated fatty acids (MUFA diet; n = 54) to a "low-fat" (20–30% of energy) diet (LF diet; n = 51)."  Their results?  More people dropped out of the MUFA group (28%) than out of the LF group (16%), and the MUFA group regained more weight than the LF group (2.5 vs. 2.2 kg respectively).  Apparently the MUFA diet isn't necessarily easier to follow, more sustainable, or more effective at preventing weight regain than a low fat.

In short, this study, touted as showing the deleterious metabolic and cardiovascular effects of a low-fat diet, and the benefits of eating a diet supplying 40% of energy from fat, used a low fat diet unnecessarily low in whole unrefined plant foods,.  Since it did not compare the LG diet to a low-glycemic low-fat diet composed of unrefined plant foods,  I think it fails to show any long-term metabolic or health advantage of any moderately high fat pseudo-Mediterranean diet laced with oils, fats, and animal products over a low-fat diet composed of unrefined plant foods.