Knives drawn over Atkins diet study
Experts doubt benefit of high-fat, low-carb

Kim Severson, Chronicle Staff Writer Tuesday, November 19, 2002

In the ongoing battle over America's bulge, all it takes is one little study about the nation's most popular fad diet for the gloves to come off.

Research released Monday at the annual scientific meeting of the American Heart Association showed that in a pound-for-pound contest, people on the Atkins low-carb diet lost more weight and had better cholesterol and triglyceride counts than people on a traditional Heart Association-approved low-fat diet.

But them's fighting words to many of the Bay Area's top heart, nutrition and weight-loss experts. They say the study is flawed and can only mislead an already-fat, confused public.

"When I saw this come out, I just cringed," said UC Berkeley's Joanne Ikeda,

one of the nation's leading nutrition experts. "I think this stuff makes money for Dr. Atkins and not much more than that. If he was right, the Italians who have twice as much carbohydrates in their diet would be worse off than we are. But they have half the obesity compared to us. The epidemiological evidence is just not there."

At issue is the small number of people in the study and the fact that neither the participants' diets nor their exercise levels were monitored according to accepted nutrition study standards. Critics also point out that the study was funded by the Dr. Robert C. Atkins Foundation, a private nonprofit organization that funds research on carbohydrates and was founded by the author of the Atkins diet.

But study or no study, health professionals say Atkins is simply an unhealthy approach that can't work in the long run.

The Atkins diet, which requires limiting carbs in favor of meals based on big portions of protein and fat, and small amounts of vegetables and other carbohydrate-rich foods, was pioneered in the 1970s by Dr. Robert Atkins. It later fell out of favor but has had a resurgence in popularity, and Atkins' books are back at the top of the best-seller list.

From four-star San Francisco restaurants to In-N-Out Burger drive-throughs, cooks have been creating menus that forgo potatoes, pasta and hamburger buns. Most people know at least one smug neighbor or co-worker who has gotten thin scarfing T-bones and dodging bread.

HEALTH EXPERTS IRKED

The Atkins high-fat approach goes against traditional nutritional research. And this latest study -- one of at least three presented at medical conferences over the past year, with the same promising results -- has served only to irritate mainstream health experts.

"Hepatitis C is effective at helping people lose weight, too, but that's no more healthy than suggesting people should not eat a basic balanced diet with lots of fruits and vegetables and grains," said Gail Woodward-Lopez, associate director of the Center for Weight and Health at UC Berkeley.

Noting that the study was only six months in duration, she said, "Americans are really good at losing weight. The problem is they can't keep the weight off, and there certainly is no proof they can keep it off with the Atkins approach."

Judith Levine, a San Francisco registered dietitian with the American Heart Association, said the study will simply serve to further confuse an already- confused public. "It's such a scam," she said.

The study was conducted by Dr. Eric Westman, an internist at Duke's diet and fitness center, who was concerned about the increasing numbers of patients and friends taking up the Atkins diet on their own. He approached the Robert C.

Atkins Foundation in New York City to finance the research.

The study featured 120 overweight volunteers, who were randomly assigned to the Atkins diet or the heart association's Step 1 diet, a widely used low-fat approach. On the Atkins diet, participants limited their carbohydrates to less than 20 grams a day -- a fraction of what's generally recommended -- while 60 percent of their calories came from fat. Most nutritionists recommend a diet with around 30 percent calories from fat.

After six months, the people on the Atkins diet had lost an average of 31 pounds, compared with 20 pounds on the heart association diet. More people stuck with the Atkins regimen.

IMPROVED CHOLESTEROL

Atkins' critics always have argued that the high-fat approach could lead to heart disease. But in this study, total cholesterol fell slightly in both groups. However, those on the Atkins diet had an 11 percent increase in HDL -- the good cholesterol -- and a 49 percent drop in triglycerides, another indicator for heart disease. On the heart association diet, HDL levels were unchanged, and triglycerides dropped 22 percent. The volunteers' total amounts of LDL -- the bad cholesterol -- did not change much on either diet.

The study adds more fuel on the growing debate over whether fat is really all that bad, and it heightens the anticipation over the results of an extensive National Institute of Health study. The results of that yearlong study of 360 patients are expected sometime next year.

The heart association's president, Dr. Robert Bonow of Northwestern University, said the organization will reconsider the Atkins diet as more research results become available.

"Having our top academic centers look at this is wonderful," he said. "We are still dealing with small numbers of patients. We just need more data."

The best advice might come from Dr. Stanley Rockson, chief of consultative cardiology at Stanford University School of Medicine. He says Atkins has some appeal in that the weight loss is quick and eating a high-fat diet naturally curbs appetite. But it can restrict blood vessels in a way that won't show up by simply reading cholesterol levels.

In the same way, an extremely low-fat diet means that extra carbohydrates replace the calories normally supplied by fat. That can lead to insulin resistance, which is part of what causes diabetes and other diseases. A low- fat diet can also be extremely hard to follow.

"The low, low-fat high-carb diet that's been trendy for 15 years is the pendulum swinging too far in one direction," he said. "Atkins is too far a swing in the other direction."

Despite America's desire for a quick solution to obesity, the solution is much simpler, he said.

"It gets back to what grandmothers said. Do everything in moderation. If you eat a balanced diet with fat drawn from the highest possible caliber, meaning limiting animal fat, and you keep fat calories at or under 30 percent of the total diet, that is the very healthy way to lose weight."

The Associated Press contributed to this report.

©2002 San Francisco Chronicle.

http://www.sfgate.com/cgi-bin/artic...19/MN166042.DTL

Well dern they just might lose some $$$$ if people can follow Atkins instead of paying them for their golden advice.
Nutritionist wrong?? NEVER! They know everything because their paycheck depends on it.(ROTFL) I stayed thin for 2 years on low fat and I was hungry every day for 2 years which is how I got in my present condition. When I could no longer hold back the flood of food cravings I ballooned! Funny, less that a week in Atkins and the food cravings are gone. Coincidence? I don't think so - maybe, just maybe the scientist and Dr's in favor of low carb are right! Bet ya soon the nutritionist will be recommending it.
Follow the $$$
Erika

What I love about the profesional nay-sayers is that they never have any evidence to back up their statements. They merely speak as if from on high to those of us, their ignorant audience.
Could it be that they have no scientific evidence and the empeor has no clothes? DLB

Thanks for posting that, Tamarian. I'd heard about the article, but hadn't seen it. Great read!

We were discussing in another thread what we refer to as the government's great "Pyramid Scheme". You don't suppose that this is yet another so-called government conspiracy put in place initially to promote the country's wheat industy at a time when they were in serious trouble. And now the fast-food and convenience-food industries are big business. VERY odd that there's so much anger surrounding this subject. You'd think that there just might be some big money at risk if we all get healthy and live longer. So let's see here... Department of Agriculture, McDonalds, Sara Lee, Nabisco, Mars, medicine.... and so on.

Seriously... I don't know if there's a real conspiracy happening. Stranger things have happened... and I'll just bet.. truth be known... that there's HUGE money at stake here... vs. at steak here. Tell you what... I'd rather think it's a conspiracy than think that our medical community is THIS ignorant and arrogant! But I don't have a great love for doctors... so my opinion would be biased. A friend of mine was recently diagnosed with diabetes. His doctor put him on drugs that made him GAIN weight. When he asked why, the doctor just waved him off. It made sense to my friend that gaining weight would only make his diabetes worse! He was right, of course. He took matters into his own hands... limited carbs... lost weight... and he is now diabetes AND drug free.

This is a VERY interesting subject.

I should point out to everyone that the one dietician's comment about the Italians eating twice as many carbs as us, but having lower obesity rates is nothing but an absolute LIE. I know because I've lived and traveled thru Italy. Its true that they do include starchy foods like bread, pasta, and beans, but not in the amounts claimed by this dingbat. The Italians love their pork sausages and the fats used in cooking (depending on the area) are butter, lard, and poultry fats.

Typically, only the poorer people eat lots of pasta. You may want to read "The Mediterranean Diet: Pasta or Pastrami?" posted in the "Traditional Diets" section at http://www.westonaprice.org.

Another thing that ticked me off about the article was that it seemed to imply that the term "nutritionist" was a synonym for "registered dietician," something which is false. I'm a nutritionist, but not an RD--thank God.

This is a great post, Tamarian.



Here we go again. For years they have been criticizing Dr. Atkins on TV for NOT running a study and providing proof his low-carb diet increases health and achieves more weight loss. Now they criticize him for doing it. The low-fat, high-carbohydrate diet professional nutritionists are certainly in PANIC mode.



Another LIE by the high-carbohydrate diet promoters. I started on PROTEIN POWER in June 1999 with awesome results. Great weight loss, great cholesterol improvements, blood pressure drop from high normal to normal, strengthened back and knees, awesome endurance, etc. Keeping it off is no challenge at all by simply NOT going back to the unhealthy high-carb diet that made me fat and sick in the first place. Eating is a wonderful pleasure now as you can see below:

Breakfast: Two fried eggs with three extra thick slices of bacon. I cook the bacon on low heat and stop while still floppy with white fat showing. The fat is delicious. Add a few slices of green pepper.

Lunch: I will have a lamb shoulder blade steak on the grill cooked rare on low heat to avoid melting away the delicious fat. It will be dark red in the center. Generous green salad with walnut oil and red wine vinegar dressing for some Omega-6 fatty acids. Two tablespoons of Carlson's lemon flavored cod liver oil for some Omega-3 fatty acids.

Dinner: Rack of beef ribs on the grill cooked rare on low heat to avoid melting away the fats. Yummmy. A few more low-carb veggies and that's it.

Evening Dessert: Small bowl of no-sugar jello with a special 24-hour home made low-carb yogurt. You can find the yogurt recipe on http://www.scdiet.org/2recipes/scdyogurt.html

Vitamins: I take a good assortment of vitamins as recommended by Dr. Atkins for good measure.

Kent

Tradition? What's traditional is low-carb and predominantly fat and protein. There was already research supporting it. Thirty years of junk-science low-fat propaganda is not long enough to count as traditional.



Why is animal fat not "the highest possible caliber"? Their own research does not indict animal fat. In fact, it goes in the other direction.

Sheldon

Re animal fats and health, see this article by Stephen Byrnes. Scroll down to "High Protein Diets: Separating Fact From Fiction."

For a rebuttal, see this.

Sheldon

For Byrnes's surrebuttal, see this. Scroll down to the words, "SPECIAL EXTRA ARTICLE."

It's worth reading.

Sheldon

smug?

are we smug?

successful weight losers, yes, but do we have to be described as "smug?"

I just want to know a few basic facts:

1. Why do they say that grains are a basic nutritional component of our diet? If I took my regular meal of meat and vegetables and LC fruit (a bit of raspberries in heavy cream are my absolute fave!) and put it next to their low fat pasta with low fat sauce and no cheese and low fat bread, and apple or orange (because we all know that those are the major fruit people chuck down their throats), who is getting more vitamins?

2. Speaking of those many fruits they recommend, why aren't our LC berries considered when they look at the LC lifestyle as acceptable?

3. When they say we don't get enough Calcium, why don't they consider all of my green leafy veggies and cream and cheese as acceptable forms instead of trying to gulp down three glasses of milk?

4. Finally, why doesn't anybody consider writing the guidelines of a LC "diet" correctly? Even if they use Atkins as a punching bag, three cups of veggies is considerable, and this is only on Induction. I eat anywhere from 3 to 5 cups a day, and I know that I'm probably on the low end of normal here!

Goodness, I hope people realize that it's the money that "doth protest too much".

Amber

Thanks Sheldon for posting the links to Dr Byrnes's articles. Very interesting.
I find it humorous that as the proof mounts that the "Food Pyramid" approach is bad advice the more vehemently some "Dieticians" and "Nutrition Professionals" protest. Change can be scary, but you can't deny proof.

Imagine that your entire career has been based on a lie, that almost everything you have learned in school is wrong and that you have been dispensing bad, even dangerous, advice ever since you started your job.

Guess if that happened to me, I would be in denial big time too.

I am still trying to figure out why we made the leap of having diabetics, who we KNOW have impaired sugar metabolism and told them to eat a diet 75 percent of which breaks down into sugar.
I have another board that I post on ..and how many of those women are afraid of the fat in a tablespoon of flax seed meal.. that is right.. FAT in the flax seed meal scares them. That is sad.
But the orange juice they use to take that flax seed meal.. JUST fine.. even though that is probably the substance their body is using to keep up with their fat storage.
We are getting fatter and fatter and someone once said "insanity is doing the same thing and expecting a different result"..
We have turned into a country of insanity!
The poster making the point about the nutritional value of the meals is right on.
The other question..which meal sounds more filling.. more enjoyable! For me the answer is easy :-)
The result is worth it. I eat enough each day.
I eat like a normal person.. not the carb addicted trying to do the right thing soul I was.
I have been able to keep up with workouts.. because I have a fed body...its not scared about what i am putting it through and how is it going to survive this..
I am starting to sleep consistently now at 7 hours a night..and sometimes I even make it to 8.
I still have oatmeal that I love. I can eat it.
I just don't eat the huge quantities the powers that be would have me eat.
Yes.. if I had based my education and dispensed advice based on that wrong information.. Angeline.. your right.. I would be scared, angry and in denial too.
Poofie

A lady at work had decided to try Atkins, based on my success. She mentioned it to a staff nutritionist and was informed that she would be destroying her internal organs. She said she learned to not talk to the nutritionists. DLB