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Thread: Atkins Fares Best in Study Of Four Weight-Loss Regimens

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    Default Atkins Fares Best in Study Of Four Weight-Loss Regimens

    Women Lost Slightly More, Had No Ill Effects From Very Low-Carb Diet

    By Sally Squires
    Washington Post Staff Writer
    Wednesday, March 7, 2007; Page A03

    A year-long, head-to-head study of four widely used diets found that overweight women who followed the very low-carbohydrate Atkins diet had no adverse health effects and lost slightly more weight than women on the other three.

    The study by Stanford University researchers compared the Atkins approach with three others: the standard low-fat, reduced-calorie regimen long recommended by many physicians and weight-loss experts; the Zone, a reduced-carbohydrate approach developed by author Barry Sears; and the very low-fat, high-carbohydrate regimen created by Dean Ornish.

    Diet ComparisonA head-to-head study of four popular diets gave a slight weight-loss edge to the Atkins diet. The study tracked the effects of the diets on 311 overweight or obese women over one year.

    Average weight loss (in pounds) after 12 months:

    Atkins Very low-carbohydrate, high-protein, high-fat approach. Popularized before his death by physician Robert Atkins, this diet has been known in nutrition circles since the mid-20th century = 10.4 lbs

    The Zone A low-carbohydrate approach that emphasizes plenty of fruits and vegetables, some lean protein and small amounts of healthful fat, such as olive oil, nuts or avocados. Developed by Barry Sears = 3.5 lbs

    LEARN Developed by Yale University’s Kelly Brownell, this traditional behavior-modification approach underscores lowering fat and calories and increasing physical activity = 5.7 lbs

    Ornish This very low-fat — 10 percent of daily calories — approach includes plenty of healthful complex carbohydrates, lean protein mostly from vegetables, as well as daily meditation and physical activity. It was developed by physician Dean Ornish = 4.9 lbs

    The latest findings add to a growing body of evidence that the high-protein Atkins diet does not cause the harmful heart and artery effects long feared by many researchers.

    Women who followed the Atkins plan had a significant drop in triglycerides, one of the unhealthful blood fats linked to a higher risk of heart disease. Their blood pressure also dropped the most of the four groups, a finding that the researchers think may relate to their slightly greater weight loss. Those in the Atkins group also experienced the largest increase in high-density lipoprotein (HDL), a protective type of cholesterol.

    Most important, the Atkins group did not develop the soaring levels of low-density lipoprotein (LDL) that some experts have thought might result from eating a diet rich in saturated fat and cholesterol found in fatty cuts of meat, butter and cream. High levels of LDL are a major risk factor for heart disease. The study found that while LDL rose slightly for those in the Atkins group, their blood levels did not differ statistically from the other groups.

    "This is the best study so far to compare popular diets," said Walter Willett, chair of the department of nutrition at the Harvard School of Public Health, because of its size, duration and the small number who dropped out. The findings confirm, he said, that reducing carbohydrates, "especially those with refined starch and sugar like that found in the U.S. diet, has metabolic benefits." It also shows that replacing these carbohydrates with either fat or protein "can improve blood cholesterol fractions and blood pressure," he said.

    The findings "are pretty much in line with what all the other studies have shown comparing Atkins and low-fat diets," said Bonnie Brehm, assistant professor of nutrition at the University of Cincinnati College of Nursing and co-author of two, independent studies of the Atkins diet. "We have found the same thing with all of our trials."

    As for weight loss, the goal that concerns dieters the most, none of the groups managed to shed the large numbers of pounds touted by weight-loss programs and television shows such as "The Biggest Loser."

    All the participants reported eating about 2,000 calories a day when the study began. All also reported having cut their intake -- some by as much as 500 calories per day at two to six months -- but then gradually adding back many of those calories. But as researchers noted, if participants ate as little as they said, all the groups would have lost much more weight.

    At first, the Atkins group lost weight faster. But as in previous studies, the pounds shed began to even out across the four groups. After a year, women in the Atkins group averaged a modest 10-pound loss compared with about six pounds for those in the other groups.

    Both the authors and other weight-loss experts were quick to note that the new findings did not answer the question of what is the best way for most people to shed weight.

    "This isn't a study testing how well you would do if you followed these diets to the letter," notes Christopher Gardner, assistant professor of medicine at the Stanford Prevention Research Center and lead author of the study, which appears in tomorrow's Journal of the American Medical Association. "This is a study that shows what happens if you bought the book and tried to follow" the diets, as most dieters do.

    The 311 overweight and obese women in the study were randomly assigned to one of the four groups. Each received a book detailing her prescribed diet. For the first eight weeks, the women also attended one-hour weekly group sessions with a registered dietitian trained to explain the diet in detail. Participants received follow-up phone calls and e-mails to remind them of appointments, and they were paid $25 to $75 for each appointment they made.

    Reactions to the findings were mixed.

    "It's bad science, good publicity," said the Zone's Sears.

    "For all practical purposes, the programs all worked about the same," said Kelly D. Brownell, director of Yale University's Rudd Center for Food Policy and Obesity and creator of the Lifestyle, Exercise, Attitudes, Relationships and Nutrition (LEARN) program for weight management, one of the diets studied. The extra four pounds lost by the Atkins group are not very meaningful, Brownell said.

    Others were more critical.

    "This study is seriously flawed, and its conclusions misleading," said Ornish, clinical professor of medicine at the University of California at San Francisco. A careful read of the study shows "no significant difference in weight loss between the Atkins and Ornish or LEARN diets after one year!" he noted in an e-mail. "There was significantly more weight loss on the Atkins diet after one year only when compared with the Zone diet. This directly contradicts their primary conclusion."

    All low-carbohydrate diets are not necessarily created equal, however. A study last year by Willett and his colleagues in the New England Journal of Medicine found that women on low-carb diets who ate mostly animal fat and animal protein did not reduce their risk of heart disease. But those who ate vegetable forms of protein, such as soy, and fat, such as olive oil, did reduce their risk of heart disease. As Willett said yesterday, "lower-carbohydrate diets look like a good option, but if you consider them, eat olive oil and fish rather than butter and sausage."

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    Default High-fat Atkins diet damages blood vessels: study

    WASHINGTON (Reuters) - The high-fat Atkins diet can cause long-term damage to blood vessels, as well as some of the inflammation linked with heart and artery disease, U.S. researchers reported on Tuesday.

    In contrast, low-fat regimens such as the South Beach and Ornish diets lowered cholesterol and appeared to benefit artery function, they said.

    "It really is the Atkins diet that is the worst," Dr. Michael Miller, director of preventive cardiology at the University of Maryland Medical Center in Baltimore, said in a telephone interview.

    "The Atkins diet caused the LDL levels to go up by about 7 percent, whereas in the Ornish and South Beach diets ... they went down 7 to 10 percent."

    Low density lipoprotein or LDL is the "bad" cholesterol that clogs blood vessels.

    Various researchers have tested the benefits of the popular diets and reached wildly differing conclusions. Miller designed what he said was a unique approach -- to see how people fared once they stopped losing weight on any of the diets.

    Studies show that people usually lose weight rapidly on any diet if they follow it properly and the weight loss itself can cause cholesterol to plummet.

    "When you lose weight everything looks good but after a while you plateau and you hit a maintenance stage," said Miller, who presented his findings to a meeting of the American Heart Association in Orlando, Florida.

    His team studied 18 people, each of whom completed a full month on each of the three diets. They were carefully monitored to ensure that they did not lose weight.

    The Atkins diet was set to deliver 50 percent of calories as fat, the South Beach was 30 percent fat and the Ornish diet, designed by nutritionist Dr. Dean Ornish, was 10 percent fat.

    While on each diet the volunteers were tested for levels of blood fats, including cholesterol and markers for inflammation.

    The researchers used ultrasound scans to measure the flexibility and dilation of blood vessels and measured proteins in the blood that can indicate inflammation.

    "Some markers of inflammation were increased by as much as 30 to 40 percent during the Atkins phase, whereas during the South Beach and Ornish phases, the markers either were stable or went down, some by as much as 15 to 20 percent," Miller said.

    Most studies have shown that diets that stress vegetables, low-fat sources of protein such as beans and legumes, and whole grains provide the best long-term weight loss. Many low-fat diets allow processed carbohydrates such as white flour, which have also been shown to be unhealthy, experts agree.

    "We don't recommend the Atkins diet," Miller said. "Why not start out with a diet that will be healthier for you in the long run after weight loss?"

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