Study Tips Scales In Atkins Diet's Favor

Low-Carb Regimen Better Than Low-Fat Diet For Weight And Cholesterol, Major Study Shows

(CBS/ AP)  The Atkins diet may have proved itself after all: A low-carb diet and a Mediterranean-style regimen helped people lose more weight than a traditional low-fat diet in one of the longest and largest studies to compare the dueling weight-loss techniques.

A bigger surprise: The low-carb diet improved cholesterol more than the other two. Some critics had predicted the opposite.

"It is a vindication," said Abby Bloch of the Dr. Robert C. and Veronica Atkins Foundation, a philanthropy group that honors the Atkins' diet's creator and was the study's main funder.

However, all three approaches - the low-carb diet, a low-fat diet and a so-called Mediterranean diet - achieved weight loss and improved cholesterol.

The study is remarkable not only because it lasted two years, much longer than most, but also because of the huge proportion of people who stuck with the diets - 85 percent.

Researchers approached the Atkins Foundation with the idea for the study. But the foundation played no role in the study's design or reporting of the results, said the lead author, Iris Shai of Ben-Gurion University of the Negev.

Other experts said the study - being published Thursday in the New England Journal of Medicine - was highly credible.

"This is a very good group of researchers," said Kelly Brownell, director of Yale University's Rudd Center for Food Policy and Obesity.

The research was done in a controlled environment - an isolated nuclear research facility in Israel. The 322 participants got their main meal of the day, lunch, at a central cafeteria.

"The workers can't easily just go out to lunch at a nearby Subway or McDonald's," said Dr. Meir Stampfer, the study's senior author and a professor of epidemiology and nutrition at the Harvard School of Public Health.

In the cafeteria, the appropriate foods for each diet were identified with colored dots, using red for low-fat, green for Mediterranean and blue for low-carb.

As for breakfast and dinner, the dieters were counseled on how to stick to their eating plans and were asked to fill out questionnaires on what they ate, Stampfer said.

The low-fat diet - no more than 30 percent of calories from fat -- restricted calories and cholesterol and focused on low-fat grains, vegetables and fruits as options. The Mediterranean diet had similar calorie, fat and cholesterol restrictions, emphasizing poultry, fish, olive oil and nuts.

The low-carb diet set limits for carbohydrates, but none for calories or fat. It urged dieters to choose vegetarian sources of fat and protein.

"So not a lot of butter and eggs and cream," said Madelyn Fernstrom, a University of Pittsburgh Medical Center weight management expert who reviewed the study but was not involved in it.

Most of the participants were men; all men and women in the study got roughly equal amounts of exercise, the study's authors said.

Average weight loss for those in the low-carb group was 10.3 pounds after two years. Those in the Mediterranean diet lost 10 pounds, and those on the low-fat regimen dropped 6.5.

More surprising were the measures of cholesterol. Critics have long acknowledged that an Atkins-style diet could help people lose weight but feared that over the long term, it may drive up cholesterol because it allows more fat.

But the low-carb approach seemed to trigger the most improvement in several cholesterol measures, including the ratio of total cholesterol to HDL, the "good" cholesterol. For example, someone with total cholesterol of 200 and an HDL of 50 would have a ratio of 4 to 1. The optimum ratio is 3.5 to 1, according to the American Heart Association.

Doctors see that ratio as a sign of a patient's risk for hardening of the arteries. "You want that low," Stampfer said.

The ratio declined by 20 percent in people on the low-carb diet, compared to 16 percent in those on the Mediterranean and 12 percent in low-fat dieters.

The study is not the first to offer a favorable comparison of an Atkins-like diet. Research published in the Journal of the American Medical Association last year found overweight women on the Atkins plan had slightly better blood pressure and cholesterol readings than those on the low-carb Zone diet, the low-fat Ornish diet and a low-fat diet that followed U.S. government guidelines.

The heart association has long recommended low-fat diets to reduce heart risks, but some of its leaders have noted the Mediterranean diet has also proven safe and effective.

The heart association recommends a low-fat diet even more restrictive than the one in the study, said Dr. Robert Eckel, the association's past president who is a professor of medicine at the University of Colorado-Denver.

It does not recommend the Atkins diet. However, a low-carb approach is consistent with heart association guidelines so long as there are limitations on the kinds of saturated fats often consumed by people on the Atkins diet, Eckel said.

The new study's results favored the Atkins-like approach less when subgroups such as diabetics and women were examined.

The Mediterranean diet - rich in fish, vegetables, and olive oil - was best at lowering blood sugar in diabetics, reports CBS News medical correspondent Dr. Jon LaPook.

Among the 45 women, those on the Mediterranean diet lost the most weight.

This study may lead doctors to start personalizing diets depending on what kinds of problems patients have, reports LaPook.

"I think these data suggest that men may be much more responsive to a diet in which there are clear limits on what foods can be consumed," such as an Atkins-like diet, said Dr. William Dietz, of the Centers for Disease Control and Prevention.

"It suggests that because women have had more experience dieting or losing weight, they're more capable of implementing a more complicated diet," said Dietz, who heads CDC's nutrition unit.

What a joke. The lead researcher works for Atkins. We fondly refer to the Atkins Diet in the Nutrition World as the Atkins Death Diet.

[smurfcrusher]

Why can''t there be independent studies??

Funding by groups with vested interests taints the science.

[medmom04]

you could never convince me that this is true. i''m sure that not a single epidemiologist or ethics committee has investigated this. and to claim a ''controlled'' environment? pleeeez. this is all ridiculous.

[jankebenz]

The way the economy is going, obesity and dieting will be things of the past soon.And that nice steak in the picture will cost $100.

[ltthomas13]

As a physician who understands biochemistry, it is easy for me to understand why the "Atkins" diet would lead to weight loss and glycemic control. My and other physicians have feared that this would only come at the expense of a worsening lipid profile. It is good to see a long-term, rigorous, and well-designed prospective study prove us all wrong. This may be the way to go for a great many people.

[cyberus-2009]

---
As a physician who understands biochemistry, it is easy for me to understand why the "Atkins" diet would lead to weight loss and glycemic control. My and other physicians have feared that this would only come at the expense of a worsening lipid profile. It is good to see a long-term, rigorous, and well-designed prospective study prove us all wrong. This may be the way to go for a great many people.

Posted by ltthomas13
---
Too bad the inertia of the good ole boy network will require years of continuing proof before it can admit what they learned in school 40yrs ago is obsolete.
In the meantime any pharma-corp wanting to sell stronger and stronger diabetes drugs, weight loss and cholesterol control drugs will simply trot out a "clinical" study of some 20 college kids to dispute the results of this study.

[shanev137]

It depends a lot on the size of portions you eat.

Sure the Atkin''s is great....but if you''re eating a side of beef, a dozen eggs, and a pound of cheese at each meal, you''re not going to lose weight.

[josuanna]

Why is research funded by the Atkins-foundation more questionable than those by others?

[josuanna]

Why is research funded by the Atkins-foundation more questionable than those by others?

quote. tkins was 258 when pronounced dead from cardiac arrest. Supposedly his week in a coma put 60 pounds of water weight on him? Anyone know if this is within reason, otherwise he was very much overweight at the time of death.

Seems like a double whammy for the Atkins Diet."

...Atkins was a trim, slim man two months before his death, as is documented. The weight gain was due to medical complications. And has often been used as a o so scientific argument against his diet.

"controlled environment" - how would you conduct a study with 330 people for two years? Put them all away in a prison-like environment? Wouldn''t stress disturb the outcome of the study?

"deadly Atkins Diet": Who has lost a patient due to complications after the Atkins-Diet? The only study proving a higher cardiac risk was one were the patients stayed on the very limited phase I-regimen without the recommended vitamin supplements to prevent homocystein levels rising.

the negative comments on this site reek of prejudice and lack of actual experience and knowledge.

[josuanna]

Why is research funded by the Atkins-foundation more questionable than those by others?

quote. tkins was 258 when pronounced dead from cardiac arrest. Supposedly his week in a coma put 60 pounds of water weight on him? Anyone know if this is within reason, otherwise he was very much overweight at the time of death.

Seems like a double whammy for the Atkins Diet."

...Atkins was a trim, slim man two months before his death, as is documented. The weight gain was due to medical complications. And has often been used as a o so scientific argument against his diet.

"controlled environment" - how would you conduct a study with 330 people for two years? Put them all away in a prison-like environment? Wouldn''t stress disturb the outcome of the study?

"deadly Atkins Diet": Who has lost a patient due to complications after the Atkins-Diet? The only study proving a higher cardiac risk was one were the patients stayed on the very limited phase I-regimen without the recommended vitamin supplements to prevent homocystein levels rising.

the negative comments on this site reek of prejudice and lack of actual experience and knowledge.

[sport035]

Diet Diet Diet - Wow, what a joke. I smoke like a chimney, drink four cups of coffee a day, three or four cups of hot tea, eat and drink what I want when I want - but I am also an active guy who does not live a ''sit on the porch'' lifestyle. I outwork people (male & female) half my age and laugh at them being winded - these are the same gym nuts I see jogging each day ruining their joints. I never get sick and haven''t used a sick day in years. So much for the ''experts'' telling us how to live our lives. Stop dieting and get a real life rather than complaining about ''advertising'' and ''marketing'' to blame for your lifestyle.

[pollroller1]

My grandmother used to tell me that, "too much of anything is not good for you."

[displeased]

Fat is better than carbs? I don''t believe it. And I''m highly skeptical of this research funded by the Adkins Foundation. I''m fortunate to have the discipline to eat healthy and the desire to exercise everyday which enables me to not have to pay attention to these silly diets.

[mswolfestock]

I think the real point is moderation and common sense.

What you eat (or not) should be determined by simple math -

IN ORDER TO AVOID GAINING WEIGHT, YOUR INTAKE OF CALORIES MUST BE LESS THAN THE CALORIES YOU BURN THROUGH EXERCISE AND ACTIVITY. PERIOD. THIS IS NOT SUBJECT TO NEGOTIATION, BARGAINING, PRAYER, ETC. THIS IS INDISPUTABLE SCIENCE. AS LONG AS YOU ARE IN DENIAL RE: CALORIE INTAKE VS. CALORIES BURNED, YOU WILL CONTINUE TO GET FAT.

Take the stairs a couple of times every day, especially after lunch. You''ll avoid the urge to take a mid-afternoon nap when you get a little cardio-workout.

You can put small amounts of "extra" walking into your daily routine - park your car as far away from your building as possible. Park your car "out in the boonies" when you visit the Mall. Those few extra steps WILL add up, trust me. Another bonus is your car''s paint job will hold up better. Fewer dings and scrapes when you avoid the high-demand spaces closer to the building.

[missybelle-2009]

I''''m fortunate to have the discipline to eat healthy and the desire to exercise everyday which enables me to not have to pay attention to these silly diets.

Posted by Displeased at 09:24 AM : Jul 17, 2008

Yes, aren''t you fortunate. Some of us work at it, and some people aren''t as fortunate. Whatever works to get the weight off, and keep it off is better than nothing.

[medmom04]

As a physician who understands biochemistry, it is easy for me to understand why the "Atkins" diet would lead to weight loss and glycemic control. My and other physicians have feared that this would only come at the expense of a worsening lipid profile. It is good to see a long-term, rigorous, and well-designed prospective study prove us all wrong. This may be the way to go for a great many people.

Posted by ltthomas13
*******
this was not a good study. this study was funded by the atkins foundation. serious conflict of interest, and every physician I have spoken with finds this ridiculous.

[becksteen]

I tried to lose weight for years and always gained more than I when I started after the diet ended. For two decades my weight went up and up and I went from being normal just not slender when I started the diet roller coaster to being obese. Three years ago I went on the Atkins diet for a few months and lost five sizes (I wasn''t weighing myself then). I have kept that off for all this time and have lost more since then. It was a diet I could live with and it taught me to make changes I could stick with. And I wasn''t hungry and lost my cravings for certain foods. Many people who criticize it don''t read the whole program and have no idea of all that is involved, such as eating whole grains instead of white bread and white rice (in small portions). And thinking about portion control. Right away it had me eating more vegetables than I normally do. I don''t even love meat. To me it was is something to go with the other stuff. Only now there''s a lot more vegetables with my other stuff and lot less sugar and other bad carbs (like white bread).

[becksteen]

I mean over the three years I lost 5 dress/pant sizes, not during the three months when I considered myself to be on the diet.

[displeased]

Some of us work at it, and some people aren''''t as fortunate.
Posted by missybelle

How do you work at it? Do you exercise a lot? And if you don''t exercise, do you eat small healthy meals so you don''t consume more calories than you burn? A big problem with today''s society is portions are huge. And then people don''t work off the extra calories.

[noprejudice]

to lose weight: EXERCISE!!!!!!!!!! and a walk around the block won''t cut it. if you''re not sweating, you''re not working. and i don''t mean a bead or two of sweat on your forehead or armpit. i mean, you actually have to work hard to lose that metabolism-lacking fat tissue. good luck with this ridiculous dieting game.