Low-carb diet deemed safe over short term
 

Last Updated: 2002-10-21 11:25:16 -0400 (Reuters Health)

By Alison McCook

PHILADELPHIA (Reuters Health) - People who follow a low-carbohydrate, high-protein diet for 6 months may lose more weight than those on a standard low-fat diet, and they appear to experience no cardiovascular problems as a result.

However, study author Dr. Bonnie J. Brehm of the University of Cincinnati in Ohio told Reuters Health that despite the apparent short-term benefits of the low-carbohydrate, high-protein (LCHP) diet, this option may not be healthy in the long run.

Following the diet for 3 or 4 months may be fine, Brehm said. "But long-term? We don't know," she added.

One example of a LCHP diet is the Atkins Diet, which first gained popularity during the 1970s. Limited evidence suggests it may help people lose weight, but many experts remain concerned about the long-term health effects of the diet, which can contain high levels of fat and cholesterol.

The current study is based on results from 53 obese women, half of whom were asked to follow the LCHP diet, in which less than 10% of their calories came from carbohydrates. The rest of the women followed a standard low-fat diet, in which fat made up only 30% of their total calories. Both groups consumed the same number of calories each day.

After 6 months, Brehm and her colleagues found that women on the LCHP diet lost 10 more pounds of body weight and 6 more pounds of body fat than did those following the low-fat diet. Blood pressure and blood sugar levels--which can indicate increased risk for cardiovascular disease--were within normal ranges for both groups.

However, as the authors reported here on Sunday at the 85th Annual Meeting of the American Dietetic Association (ADA), those on the LCHP diet ate less carbohydrate and fiber and more protein, fat and cholesterol than did the low-fat diet followers. The ADA is a professional organization representing the nation's licensed nutritionists and dietitians.

So why did a seemingly unhealthy diet not affect indicators of cardiovascular risk? In an interview with Reuters Health, Brehm suggested that the benefits of losing more weight may offset the disadvantages associated with high fat and cholesterol. "Perhaps it's weight loss that causes the positive results (in cardiovascular risk factors)...and it isn't dependent on the diet," she said.

Although the LCHP diet helped dieters shed more pounds than the low-fat regimen, Brehm cautioned that much more research is needed before consumers can consider this program to be safe and effective. "More research does need to be done before I think you can make any kind of recommendation as to what you should follow," she said.

The study was supported by funds from the American Heart Association.

In an interview with Reuters Health, Dr. Meir Stampfer of Harvard University said that the current study was well conducted, but he agreed that 6 months is not long enough to determine if the LCHP diet is safe over the long term.

However, he added that low-fat diets are often unsatisfying for dieters, because many carbohydrates--a common source of low-fat foods--cause a rapid rise and fall of blood sugar, leaving eaters hungrier sooner than after eating protein and other foods with the same number of calories.

But the alternative does not have to be diets that are high in protein and fats, he added. Rather, Stampfer said that he recommends that people follow a reasonable diet, consisting of moderate levels of protein and fat.

http://www.reutershealth.com/archiv...021elin019.html

Re: Low-carb diet deemed safe over short term
 

What does he suggest people eat, then? :lol:

So they run in circles chanting "Our research doesn't really mean what it says". This is done to scare away the Demon Atkins, and the lesser fiend, oopswwewerewrong.
DLB

This is a grand slam milestone study! :thup: While it stresses that it is a short-term bla bla bla, and try to "water-down" the findings, no none can question the funding! It was funded by the #1 Anti-Atkins/ Low-Carb organization: the American Heart Association

I'm sure they're kicking themselves in the butt, for not getting what they paid for ;)

Wa'il

Re: Low-carb diet deemed safe over short term
 

An equally pertinent and maybe more urgent question is to ask "is a low fat diet healthy over the long term". No one seemed to require proof before it was pretty much shoved down the throat of an entire unsuspecting population.

Which is a pertinent question
 

We are so quiet in the voice of authority.. or have been in the past.
When they said.. oh yes.. feed diabetics sugar..they can have it.. I questioned in my brain..but not outloud the logic of that. WHY
NOT?? And since the medical establishment was so illogical
about them, why didn't I question them when they said "fat is what makes you fat?"
Poofie! :spin:

" Limited evidence suggests it may help people lose weight, but many experts remain concerned about the long-term health effects of the diet, which can contain high levels of fat and cholesterol."

Limited evidence???? Anyhow, I bought the new book by Diana Schwarzbein yesterday. The Schwarzbein Priciple II. In the book she hints at findings that external cholesterol sources react differently in the body. It's the cholesterol that your body produces from excessive carbohydrate intake that is damaging to your body and can increase your risk of heart disease.

the 'health experts' ' way of slow rubbing into the fact that low-carb diet is the sole right way of eating.....

if they accept it totally at one go.......no one will trust them anymore. :o

maybe next time the title changes to : "Low-carb diet deemed safe over long term"

give them all the time to find out.......we have already gotten the enlightenment. :D

Fascinating. Note what the study confirms: given an equal amount of calories, people on low-carb diets lose more weight than people on high-carb diets. May I inquire what has become of the laws of thermodynamics? Did the scientists suspend them for the duration of the study? (That in itself should have caused headlines.)

It is a myth that an Atkins-style diet is high-protein. Relatively high-fat? Yes. But not high-protein. This was affirmed by Stefansson. On his all-meat diet, which he stayed on for a year, most of his calories came from fat, not protein, even if the volume of protein was greater.

I like this one: "'Perhaps it's weight loss that causes the positive results (in cardiovascular risk factors)...and it isn't dependent on the diet,' she said." If that is so, then it is overweight--not cholesterol and fat--that causes negative cardiovascular results. This is a major concession to our position.

Very interesting. We're making progress, folks.

Sheldon

Re: Low-carb diet deemed safe over short term
 

My wife just brought something else to my attention. Note the phrase "moderate levels of protein and fat." May we conclude that the era of the LOW-fat commandment has come to an end?

If so, hurrah!

Sheldon

We might see some more out of Dr Brehm.

Although she is quite LC-skeptical in Fitness Central: Protein Power , she has been funded by the AHA for three years on Effects Of A Ketogenic Diet On Body Weight And Cardiovascular Risk Factors (a pdf file) at Cincinnati Children's

She still had her funding as of August, and in March she said the one-year and two-year results would be written up.

Sure, a year and two years will not be "long enough to determine if the LCHP diet is safe over the long term", and who knows what her LCHP diet is (where ARE the details in that Reuters article?). Nevertheless, this might be a crack in the wall...

Thanks seyont :thup: I've been trying to find more info. about this particular study, and only coming up with dead ends. Now I see that it's still ongoing, so likely why there's nothing written in any journals yet. The above Reuters' report stated only that Brehm introduced these study results in a presentation to the Annual Meeting of the American Dietetic Association.

Doreen

Perhaps her study is the one mentioned in today's Experts Ping-Pong on Protein Advice by someone reporting on the doings of the 85th ADA meeting:



The HP diet mentioned could be an active person's Zone diet if they get at least 50 grams of fat. The second diet is close to the USDA's 2000 calorie 56 g P: 300 g C or more: 65 g F or less recommendations.

According to the Reuters article posted at the top, the women in the study who were following the low-carb, high-protein diet were consuming no more than 10% of their calories from carbs. Of course the article doesn't state what the daily calorie intake is ... but even at 2000 cal. per day, 10% would be 200 calories, or 50g carbs. So the LCHP diet in Brehm's study would be at or below 50g carbs per day. Which makes it ketogenic.

Doreen

You're right- these have to be different studies. That's good news. Can't wait for the full proceedings of that 85th ADA meeting to be made available...

AHA
 

The AHA lost any shred of credibility they had with me when I saw them promoting sugary cereals (I think it was cocoa puffs or something like that) as part of a balanced breakfast! :exclm: Their logo was on the side of the cereal box along with a written approval. Unbelievable!

Washington Post's take
 

Score One For Low- Carb Diet
Atkins Adherents Lose More in Brief Study

By Sally Squires
Washington Post Staff Writer
Tuesday, October 29, 2002; Page HE01


In a head-to-head comparison between two popular and distinctly different eating plans, the Atkins diet trimmed significantly more pounds and body fat in obese but otherwise healthy women than a traditional low-fat diet, according to a report released last week at the annual meeting of the American Dietetics Association.

The study enrolled 53 women, aged 31 to 59, for six months. Half followed a low-fat approach, eating 30 percent of calories from fat. The other half ate according to the very-low-carbohydrate diet popularized by physican Robert Atkins.

Those in the Atkins group shed on average 18.5 pounds -- about 10 of it from body fat. (The rest was due to loss of water and lean muscle.) By comparison, the low-fat group lost about nine pounds, about five of them from body fat.

Despite the results, the study's lead author cautioned against drawing too many conclusions or abandoning a low-fat approach to weight loss. "I'm not sure that there is a take-home message from this study, except that there is more research needed," said registered dietitian Bonnie Brehm, assistant professor in the College of Nursing at the University of Cincinnati. "This is one, relatively short-term study. Our conclusions are that in the short term, a low-carbohydrate diet produces loss of weight and body fat. . . . We by no means are recommending the Atkins diet from this one study."

The new findings are part of the effort to examine the widely used but little researched Atkins diet. Atkins diet books and cookbooks have sold more than 10 million copies, but the program has often been criticized for not having undergone scientific scrutiny. Scientists and physicians have also expressed concern that there might be health consequences for those who follow the Atkins approach, which allows foods high in saturated fat that could potentially raise blood cholesterol levels and heart disease risk. During the two-week induction phase of the Atkins diet, carbohydrates are limited to 20 grams a day -- about the amount found in one medium apple and less than a sixth of the 130-gram daily minimum recently set by the National Academy of Sciences. Prohibited are carbohydrates rich in fiber, vitamins and minerals such as fruit, bread, grains, starchy vegetables and any dairy products other than cheese, cream or butter.

In "Dr. Atkins New Diet Revolution," Atkins contends that excess calories can "certainly cause you to pile on the pounds," but added weight occurs "only when you are eating a lot of carbohydrate along with fat." He says his program induces ketosis, a physiological state in which blood sugar levels drop so low that fat stores are broken down and converted by the liver to ketone bodies, which are used for energy. Even eating a small amount of carbohydrates -- from a single piece of fruit, say -- can shift the body out of ketosis. After the two-week induction phase, the Atkins program allows up to 60 grams of carbohydrates a day (about half of the NAS minimum), provided that ketone bodies are still present in the urine. (Dieters can buy strips to test their urine at most pharmacies.)

University of Cincinnati researchers found that the women randomly assigned to follow the Atkins approach, who had an average BMI of 34, did go into ketosis, as documented by daily urine tests performed at home and by a blood test run by researchers at the three-month point of the study. Daily food records indicated that at three months, "women were taking about 41 grams of carbohydrates a day, or about 15 percent of their total calories," Brehm said.

By comparison, food records showed that the low-fat diet group, while consuming about the same number of calories, took in about 169 grams a day of carbohydrates.

"We were surprised that women could adhere to it [the Atkins diet] as well as they did," she said.

At least, that is, while they met weekly with a registered dietitian during the first three months of the study. For the second three-month phase, both groups of women were told to adhere to their diets, but were left on their own to do so. "During the second three-month phase, the low-fat group maintained their nutrient intake, while the low-carb group began to add back carbohydrates," Brehm said. In other words, the Atkins group found it more difficult to stay with their low-carb regimen than the low-fat dieters did with theirs.

Constipation was a big complaint for those in the Atkins group, Brehm said, noting that "at six months, they were taking about 30 percent of their calories as carbohydrates and were no longer in ketosis. Many said that they just could not live any longer without fruit, fruit juice and some of the grains, like pasta or bread." And some took laxatives, as Atkins suggests in recent editions of his book.

The findings (which had to undergo peer review to be presented at the American Dietetics Association meeting but have not yet been accepted for publication in a journal) also showed that people in both groups ate the same amount of calories daily -- about 1,200 to 1,500 calories a day. That's a level designed to produce a slow but steady weight loss of about half a pound to a pound per week. The groups adhered to the calorie limits equally well, but the low-fat group lost about half the weight as the those in the Atkins group.

Why Atkins participants lost more weight and body fat than women on the low-fat diet is a question that Brehm hopes to answer in a follow-up study. For example, physical activity was not an official part of the study. Women were simply told to continue doing whatever type and amount of exercise they had been doing when the study began. Could there have been differences in activity levels between the two groups?

"This study produced more questions than answers," Brehm said. "Is [the Atkins diet] safe in other populations? In diabetics? In people with cardiovascular disease? This was a relatively healthy population. And what are the long-term effects? We know that short term can be very different in terms of safety."

For short-term use, however, the findings echo those of other recent studies. "This is very similar to two studies that we have done," said Eric Westman, associate professor of medicine at Duke University and lead author of a study sponsored by the Atkins Foundation. "It looks like the findings are consistent."

Two abstracts drawn from the Veterans Administration Low Carbohydrate Study and presented a year ago at the annual meeting of the North American Association for the Study of Obesity also point to beneficial effects of a very-low-carbohydrate approach. Linda Stern, a co-author of both abstracts, reported that severely obese patients lost more weight without detrimental effects to their cholesterol or trigycleride blood levels than a similar group assigned to follow a low-fat diet.

Even so, Westman and other nutrition experts cautioned that these and other recent findings should not be viewed as the answer to the obesity epidemic. "The sum of people who have been on low-carbohydrate diets in research is probably on the order of 200 to 250 people," Westman said. "To have a new drug approved for use, you want to have about 1,000 people on it, and even then you can find out problems" once the drug goes on the market.

Besides, there's a lot of evidence to suggest that diets rich in fiber, fruit and vegetables are associated with lower rates of disease. Still unstudied is whether long-term use of the Atkins diet may result in higher rates of illness -- cardiovascular disease and kidney disease, for example -- linked to consumption of saturated fat and protein. The National Weight Control Registry, a listing of "successful losers" who have lost an average of 60 pounds and kept it off for about five years, include many who follow a low-fat approach but very few who adhere to the Atkins diet.

Despite the questions raised by the latest findings, experts said they welcomed these new results. "This is good because it says that people can lose weight on the Atkins diet," said James Hill, Director of Clinical Nutrition at the University of Colorado and part of a team of scientists about to start a National Institutes of Health study of the Atkins diet. "But we've seen this on almost any diet that has come along. You can go out and lose weight, but two to three years later, it has no effect. Atkins has been selling books for a bunch of years. I haven't seen much that says it has had a whole lot of impact on obesity."

It may be, said Hill, that some people do better with the Atkins approach and others lose more weight on a more traditional, low-fat diet, such as that recommended by the National Institutes of Health, the American Heart Association and the American Diabetes Association.

"We still know so little about weight loss," he said, "that I am willing to accept that we don't yet know the best way to help people succeed."•



© 2002 The Washington Post Company

Re: Washington Post's take
 

An open mind coupled with a good dose of humilty. If that attitude was more prevalent maybe more progress would have been made.

Well that's on the part of the researchers, at least.

Sally Squires seems to have come down from her high horse somewhat, compared to her previous rants against Atkins. Her article was almost fair.

I still wish.. :-)
 

that they would get less wishy washy about admitting that some of what they have been pushing the last few years is wrong..
IE: like cocoa puffs being endorsed by the AHA...or whoever..
I remember thinking while starting to study all this.. that all the BEST food is in the outside of the supermarket..
:-) But I don't think many processed food people would like me saying that too loud anywhere!
Poofie

It's interesting how they say a six month long study cannot prove that Low Carb is healthy over the long run....I agree that, of course, a 6 month study is a very short time period...HOWEVER, when the medical establishment started telling us to eat high carb, low fat diets, there were virtually NO STUDIES to back up the "fat makes you fat" diet. Not to mention the fact that, without doing a scientific study, you can tell just by looking at the weight gain trend over the past 40 years to see that it is sugar and refined carbs that are making us fat, since North Americans are apparently eating less fat, but they are the fattest they have ever been in history!

I guess what I wish was
 

I wish that people actually understood what was being said by "low carbohydrate" eating.
Even with this excellent company I get exercise tapes with..their suggestion is 65% carbs as your basis.
Then the women that are trying to follow that are wondering what is wrong..and why they are binging.
Could it be that there are NO essential carbs.but there are essential fats and protiens and by eating so much of a basis of carbs..your body is telling you its STARVING for what it needs?
I don't know.I wish I knew
I wish they understood that your either eating as many veggies (if your from a family like mine that has always loved their veggies) or MORE than you have ever eaten before.
I with they understood its doing without the candy and the cake and cookies..
By the way WHEN did Pasta become the savior food of the world??
The Italians that eat that stuff like crazy are sure not known for being slim ect....
They should be the leaders of slim health in the world. and I don't think they are top of that list!
I guess the other thing I wish they knew is what few carbs I do choose to eat they are GOOD ones.. oatmeal, potatoes, squash, sweet potatoes and yams, and brown rice..
I really wish they understood from that one study " that the more saturated fat that were eaten, that they were slimmer and healthier"
Oh well. off my soap box again!

As far back as thalidomide...
 

Re: I guess what I wish was
 

:thup: :D Exactly, kiddo! I too, wish there was some place I could contact to put in my 2 cents about what, exactly, Low Carb is to me -- because what I have found, personally, is that if I cut out the *SUGAR* and the *STARCH*, I eat more of those vitamin and mineral-rich veggies than I ever did before. I eat berries, full of Vitamin C, as well. And it's not the *fiber* that is high-carb, as we all know, it is the starch and refined carbs that accompany it. Good grief, plain old lettuce acts as a wonderful laxative in many, many people -- and you can have virtually as much lettuce as you want. I think many of us are hooked on smooth, creamy foods vs. crunchy, chewy ones whether they are low carb or not. Personally, I have found that my own "regularity" problems have *improved* with the Atkins diet; what people forget is that oils, such as olive oil and clarified butter, also help relieve constipation. I eat my daily carbs, and I usually get them in the form of high-fiber protein breads (such as the Atkins one, haven't been able to find an alternative, and no more than 2 slices per day), lettuce, spinach, broccolli, and other salad greens; mustard and turnip and other cooked greens, and a wide variety of cooked, allowable veggies. I am at the point now where I make an effort to include those good carbs, and I would suspect that many people who are having constipation problems on Low Carb diets are just not getting their good carbs in, or are still trying to limit their oils and fats. Old habits die hard.

For short-term use, however, the findings echo those of other recent studies. "This is very similar to two studies that we have done," said Eric Westman, associate professor of medicine at Duke University and lead author of a study sponsored by the Atkins Foundation. "It looks like the findings are consistent."


Is three the magic number that changes everyone's mind. Or seven? Or what? Still, this repitition is really getting great. And from what I read in the other posts in this thread, it looks as if other low-carb studies are being funded, and are going to draw some longer term conclusions in the next few years.

The glass is getting fuller. Not half full, maybe 10% full. But the momentum is with us.

What is really great about having 3 studies is that I can take these to my regular physician, and he will listen

Also re constipation. I find that low-carb food is dense, and I do not eat the same volumn of the stuff. Less in - less out. Also I think that my body uses the stuff more efficiently. Same in - less out. Oils seem to help. Also I usually have 2 or more cups of wine on Friday night, and that really helps.

It Figures...
 

Every single licensed nutritionists and/or dietitians I've ever been sent to see either looked like a cadaver or was more over weight than I ever was, and that’s saying a lot (without being to rude).

These folks just can't stand to have anyone win in this WOL, it really seems to bother then when I tell them I've lost 140 pounds in 11 months, and when the review my chart, they have nothing to say.

I had a pharmacist, Ph.D. type, tell me the benefits are only fleeting and “You’ll just gain the weight when I go off the diet”. I told her thank you for your concern and I’m sure that is your experience, isn’t that what happened when you went off your diet? She reluctantly confided that it was true. I said how sorry I was for her experience, but if she would follow this WOE she would have great success, if she would only do it 100%.

I told her that for the last five years I was an insulin dependant diabetic and that I had not used insulin or any oral medication in the last year, my blood glucose level is 101. She flatly said that was impossible and that I must be mistaken.

I left her sitting there in the exam room with a dumb look on her face. It just goes against everything they know and learned and they are so invested in being right there is so little room for what is possible.

Re: It Figures...
 

Isn't it irritating when "professionals" tell you that your experience is impossible? I had a doctor pretty much tell me the same thing: "People don't go off medication for diabetes once they start taking them." He wasn't too pleased when I replied, "That's because 'people' follow a recommended diet that keeps them on medication. I don't."
Simply amazing...he actually went so far as to tell me that I must never have had diabetes if I was able to get off medication again just because my experience didn't fit with his.

Wow! I have so much to say that I need to sort it out. ;)

First, dear Sally WAS almost fair but her story still has it's barbs. She suggests that some of the weight lost by low-carbers in the study is muscle loss. I didn't see that mentioned in the study. Is she reading a different study? Is there something left out of ours? Also she slyly puts in the suggestion that perhaps the activity levels were different in the groups, resulting in more loss for low-carbers.

Now, for the study itself. It was mentioned that they were suprised that low-carbers could adhere to the plan. ??? And that as the plan went on they ate more and more carbs. ??? Which has been harder to stick to in reality for all of you? Low-fat or low-carb? I can speak for myself in that I'd much rather eat sunflower seeds, veggies, omletes and prime rib than dry toast and rice cakes.

Third, regaining of weight after loss. What is it that dieticians tell you about losing weight? That it has to be a lifestyle change. When low-fat dieters lose all their weight what happens when they go back to eating normal? They gain it back. So why is the fact that low-carbers gain the weight back if they go back to eating unhealthfully being used as a selling point for not doing the WOE??? It seems to me that it stands true for any WOE change. The beauty with low carb is that you find a balance. You add carbs back in until you stop losing and can maintain your weight. On low-fat... well, you just get to eat cardboard for the rest of your life to maintain.

Fourth... physicians and pharmacists... You need to remember that if you don't need your medication for diabetes anymore, you are taking bread off their table.... or more specifically... you aren't funding their tee times and Mercedes budgets anymore. I really hate to say it (or even think it) but there is not a lot for the medical community to gain by finding medical and health solutions.

Now to the positives.... :) :) :)

I know that I eat healthier. I am eating about the same amount of protien and fat that I was before changing my WOE. I am drinking MUCH more water. I am eating more veggies. I am not eating as many carbs but what that means is that I am not eating ice cream every night, 6-8 Dr. Peppers a day, candy bars, chips, pie, cake, french toast drenched in syrup.......

Also, I wanted to mention how happy I am that the AHA is funding studies. Even if they are doing it for the wrong reasons. :thup:

I think we are making progress.