Atkins Diet Heart-Healthy After All?

Unexpected Findings Require More Study

Nov. 19, 2002 (Chicago) -- Fire up the barbee! Researchers from Duke University say that six months on the high-fat, low-carbohydrate Atkins Diet adds up to more weight loss and better cholesterol than a low-fat, high-carbohydrate diet.

And if that isn't surprising consider this: Those researchers delivered the burger-friendly news at the American Heart Association's Scientific Sessions 2002.

Eric Westman, MD, Duke University obesity researcher, says he decided to study the Atkins Diet after treating several patients who were "losing significant weight using the Atkins diet." But Westman says he didn't expect the high-fat regimen to do better than "the standard low-fat, high-carbohydrate diet that we use at the Duke Diet Center." The study was funded by the Robert Atkins Foundation.

Westman assigned 120 obese volunteers -- 75% of them women -- to either the Atkins diet or to a low-fat diet that restricts fat to less than 30% of total calories. The participants following the Atkins diet got less than 10% of calories from carbohydrates, while 60% came from fat. The Atkins diet also includes the use of fish oil, borage oil, and flaxseed oil supplements.

After six months the Atkins diet group lost about 14% of their starting weight or an average of 30 pounds, which was considerably better than the 20-pound or 9% loss for the low-fat dieters.

Moreover, the Atkins group posted an impressive 11% increase in HDL "good" cholesterol compared to just a 1% improvement for people on the low-fat diet. At the same time triglycerides -- another blood fat and suspected risk factor for heart disease -- decreased a whopping 49% on the Atkins diet.

Neither diet had any significant effect on LDL "bad" cholesterol.

Westman tells WebMD that he thinks the Atkins diet "works" because people stay on it and lose more weight. Weight, he says, appears to be the real key to reducing heart disease risk factors. But he says that he still doesn't recommend the Atkins diet. "We really need a large, well designed study," he says. The National Institutes of Health is expected to start such a study early next year.

Nutritionist Alice H. Lichtenstein, DSc, senior scientist and director of the Cardiovascular Nutrition Research Program at Tufts University and a member of the AHA's nutrition committee, says she still has real doubts about the value of the Atkins diet. She pointed out, for example, that "only the people on the Atkins diet received fish oil supplements." The AHA recommends fish oil as part of its heart healthy lifestyle plan.

"If this really worked, we would have at least a dent in the obesity epidemic. Everyone would be on it," says Lichtenstein, who adds that a "calorie is a calorie and losing weight is all about calories." She says that people who lose weight on the Atkins diet simply take in fewer calories.

She says, too, that there are no data about the long-term effects of high-fat, high-protein diets.

Lichtenstein says the high-fat/low-fat battle has heated up since mid-summer when a widely read article in The New York Times Magazine touted the value of high-fat regimens like the Atkins diet.

But Lichtenstein says the AHA dropped its support for a low-fat diet a few years ago and now supports a well-balanced diet that includes lots of fruits, vegetables, whole grains, and at least two servings a week of fish -- fatty fish. But "it isn't just diet. We promote a healthy lifestyle that means a good well balanced diet, exercise and no smoking."

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SOURCES: American Heart Association's Scientific Sessions 2002, Chicago, Nov.17-20 • Eric Westman, MD, Duke University obesity researcher • Alice H. Lichtenstein, DSc, senior scientist and director of the Cardiovascular Nutrition Research Program, Tufts University
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