Redemption For The Atkins Diet?
by Jennifer Wider, M.D.
New research suggests that the highly controversial and often criticized Atkins
diet may prove to be a viable option for people struggling with obesity. Two
new studies in the May 22, 2003 issue of the New England Journal of Medicine
reveal that patients on a low-carbohydrate diet lost more weight than those
on traditional diet plans. The first study conducted by Gary Foster, PhD and
colleagues set out to determine the efficacy of a low-carbohydrate diet and
the second study by Frederick Samaha, MD and colleagues compared a low-carbohydrate
diet with a low-fat diet in obese individuals. The Foster, et al. study even
suggested that people on a low-carbohydrate, high-protein and high-fat diet,
the cornerstone of the Atkins diet, showed improvement in some risk factors
for heart disease.
Foster and colleagues conducted a clinical controlled trial with 63 obese men
and women in an attempt to analyze the effectiveness of a low-carbohydrate,
high fat diet. Participants were randomly assigned to two different diet plans:
a high-fat, high-protein, low-carbohydrate diet or a more conventional low-calorie,
high-carbohydrate, low-fat diet. In addition to a greater weight loss, people
on the low-carbohydrate diet had greater increases in their high-density lipoprotein
cholesterol (HDL) concentrations and larger decreases in their triglyceride
concentrations, both of which can be beneficial in reducing the risk of heart
A diagnosis of high cholesterol usually refers to a person's total blood cholesterol.
Fat and cholesterol travel in the blood stream in different forms. High levels
of low-density lipoproteins (LDLs or "bad cholesterol") and triglycerides
cause plaque build-up in the arteries. High-density lipoproteins (HDLs or "good
cholesterol") remove the buildup from the lining of the artery and can
protect against heart disease. Therefore, a high level of HDL is desirable.
It seems counterintuitive that consuming high-fat foods could lead to significant
weight loss and a decrease in cholesterol, but these findings do not come as
a surprise to some nutrition experts. Samuel Klein MD, one of the researchers
involved with the Foster, et al. study and Professor of Medicine and Nutritional
Science at Washington University School of Medicine in St. Louis explains: "It
has been established that when you reduce carbohydrates in the diet, there is
a decrease in triglycerides and an increase in HDLs, the two go together."
Therefore, a person on a low-carbohydrate diet may experience an improvement
of several heart disease risk factors.
Participants on both diet plans also experienced a notable decrease in diastolic
blood pressure. According to Dr. Klein, this finding can be directly attributed
to weight loss; "the more weight a person loses, the more favorable the
change in blood pressure." Although the low-carbohydrate dieters experienced
a greater weight loss in the study, the key to blood pressure control is maintaining
a normal weight.
In the Samaha, et al. study, researchers used a randomized controlled trial
to compare a low-carbohydrate diet with a low-fat diet in severely obese people
for six months. This study yielded similar results with low-carbohydrate dieters
losing more weight than the low-fat, low-calorie dieters. In addition, participants
on the low-carbohydrate diet experienced similar decreases in their triglyceride
Before the public fills their plate with burgers, bacon, butter and cheese,
however, the researchers warn that their findings should be interpreted with
discretion. The sample populations of both studies were relatively small; larger
and longer duration studies are necessary to properly determine the long-term
effects of a low-carbohydrate, high-protein, high-fat diet regimen. In addition,
there may be sex differences in the response to different diets. According to
Dr. Klein, researchers would need a larger study to evaluate these variations.
The Society for Women's
Health Research is the nation's only not-for-profit organization
whose sole mission is to improve the health of women through research. Founded
in 1990, the Society brought to national attention the need for the appropriate
inclusion of women in major medical research studies and the resulting need
for more information about conditions affecting women. The Society advocates
increased funding for research on women's health, encourages the study of sex
differences that may affect the prevention, diagnosis and treatment of disease,
and promotes the inclusion of women in medical research studies. Dr. Donnica
Moore has been a member of the Society since 1990 and is a past member of its
Board of Directors.
Created: 6/12/2003  - Jennifer Wider, M.D.