The three diet studies everyone is talking about (DiReCT, PURE, and Virta)

None of them have particularly great study designs, but that hasn’t prevented the buzz. Here is a summary of the strengths and weaknesses.

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Tl;dr:

DiReCT (Diabetes Remission Clinical Trial): randomized. N=306, 1-year. 3-5 months ultra-low calorie weight loss diet (~850 kcal/d) followed by 2-8 weeks of guided food reintroduction and then weight maintenance counseling.

PURE (Prospective Urban Rural Epidemiology): n=135335, 7.4 years follow-up. The dreaded Food Frequency Questionnaire, although they were comparing lowest with highest quintile… I think I can accurately recall if I’ve had more than 5 servings of something today or none in the past month. They’re not asking what I had to eat August 25th 2017 for lunch.

Virta: low carb, calorie restricted. N=262, 1 year long. They had a weight maintenance control group, which is good, but it’s not hard to beat a weight maintenance control group with any diet. A low fat comparison group would’ve been more informative.


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