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High-Fat Atkins Diet Shows Small Cholesterol Benefit

March 23, 2001 (Orlando) -- You can't have your cake and eat it, too, but depending on which best-selling diet guru you choose to believe, you can have your cheeseburger -- or your fruits and vegetables. Robert C. Atkins, MD, a proponent of high-fat, low carbohydrate diets, squared off against Dean Ornish, MD, advocate of low-fat, high-fiber, low-meat diets here this week at a meeting of the American College of Cardiology.

The two physicians, whose views on what constitutes a heart-healthy diet could not be more different, argue passionately about the relative merits of their own plans for saving us from ourselves and what we eat.

"One hundred years ago, we didn't have any heart attacks," Atkins says. It's a statement that raises more than a few eyebrows, and it's only common sense to think that as long as humans have had hearts, there have probably been heart attacks.

But Atkins contends that heart attacks are a monster created by our modern diet and lifestyle, and that this monster is part triglycerides -- a category of harmful blood fat -- and part insulin -- the hormone that controls how the body uses blood sugar.

He claims that people lose weight on his high-fat, low-carbohydrate diet because it sends the body along an "alternate metabolic pathway," causing it to stop burning the blood sugar glucose as a fuel and forcing it to burn fat stores instead.

Ornish, however, says that a diet heavy in animal proteins can be hazardous to your health. He points to China, where the consumption of meat has soared in recent years, as has the incidence of heart disease. "In Asian countries where they're starting to live like us, they're starting to die like us," he asserts.

Ornish sums up his philosophy as "Eat more, weigh less" -- he even got a book title out of it. He advocates a diet in which fat represents not more than 10% of total calories -- and beans, fruits, vegetables, and whole grains make up the rest. But Ornish goes further, adding exercise, stress management, dietary fish-oil supplements, and support groups to help dieters lose weight and reduce cardiovascular risk factors. He also decries the use of simple sugars and discourages alcohol consumption.

And because fat has 9 calories per gram, vs. 4 per gram for carbohydrates, "you can eat the same amount of food and get fewer calories," Ornish tells WebMD.

So, who's right?

The answer probably lies somewhere in the middle, says Christie Ballantyne, MD, professor of medicine and director of the center for cardiovascular disease prevention at Baylor College of Medicine in Houston.

"We are all in agreement that large amounts of saturated fats in the diet are harmful; there's a very extensive amount of scientific data about that," Ballantyne tells WebMD. "Dean Ornish wants you to cut the fat content down to less than 10%. I have seen that his diet can be very effective in patients who have very high levels of LDL cholesterol [the bad kind], but what it tends to do is raise triglycerides."