Magazine article Nutrition Action Healthletter

The Diet Wars

Magazine article Nutrition Action Healthletter

The Diet Wars

Article excerpt

It's spring, when a young (or not-so-young) person's fancy turns to ... bathing suits. It's one thing to put on a few extra pounds over the winter. It's quite another to share those pounds with the general public.

This hasn't been a blockbuster season for diet books. No one's come up with a brilliant new scheme (and publishers have to wait a decent interval before repackaging the old ones). Of course, diet books from previous years--like Dr. Atkins' New Diet Revolution, The Zone, and Dean Ornish's Eat More, Weigh Less--still do a brisk business. And millions of people still swear by whatever magic helped them shed those ten pounds (unless the pounds have returned).

But something has changed. Results from two not-yet-published studies may become big news. (With the dearth of good research on diets, any news is big news.)

In one study of obese people, those who were told to follow an Atkins diet lost more weight--and were more likely to stick to the diet--than those told to follow a lower-fat diet. (An Atkins diet is an all-you-can-eat buffet of red meat, cheese, eggs, butter, and other fatty protein foods but little or no carbohydrates.)

In the second study, overweight women who ate a very-low-fat vegan diet lost more weight than those who ate a typical lower-fat diet. (A vegan diet has no meat, poultry, seafood, eggs, or dairy foods. It's typically loaded with whole grains, beans, vegetables, and fruit--in other words, carbs.)

What's going on? Just another battle in the Diet Wars.

Atkins on Trial

"As a health professional, I was always being asked about the Atkins diet," says Gary Foster of the University of Pennsylvania. "Colleagues would tell me that they had patients who had lost weight on Atkins, but it was hard to recommend it knowing that a diet high in saturated fat can increase the risk of heart disease and cancer."

So Foster-and colleagues in Colorado and St. Louis randomly assigned 42 obese people to either an Atkins diet or a low-calorie, lower-fat, higher-carbohydrate diet. The researchers didn't feed the participants. They wanted to test the diets under real-life conditions.

After an initial visit with a dietitian, half of the dieters got a copy of Dr. Atkins' New Diet Revolution and half got a copy of a weight-loss manual that recommends a "conventional diet" that's low in calories and fat and high in carbohydrates.

So far, Foster has published only a brief summary of results from the first few months. (1) But the trends hadn't changed several months later.

"A third of those on the conventional diet--but only a tenth of those on the Atkins diet--dropped out," says Foster. And of those who remained, the Atkins group lost twice as much weight as the 3 other group.

"We were as surprised as anybody," says Foster. "I'm not ready to change our diet recommendations based on a study of 40 people. But the data are the data."

Does that mean we should all switch to an Atkins diet? Not quite.

Cholesterol Caveats

"I'd be very cautious about drawing conclusions because we're still looking at the weight-loss phase," says co-investigator James Hill of the University of Colorado. People lose weight on most diets.

"The Atkins diet may be a good way for some people to lose weight, because it may provide more satiety and people might like it better. The question is: Are they able to maintain the weight loss?"

Another concern: Does the Atkins diet boost blood cholesterol? In the first 12 weeks, LDL ("bad") cholesterol rose nine percent in the Atkins dieters and dropped 15 percent in those on the conventional diet. But over time, the difference in LDL between the two groups diminished.

What's more, any damage the Atkins dieters sustained from higher LDL might have been offset by a ten percent rise in their HDL ("good") cholesterol. …

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