MICHAEL FUMENTO: The Atkins diet just won't go away

Scripps Howard News Service

Published: May 29, 2003, 12:01:00 PM PDT

link to article

(SH) - Nutritionists have long said that any fad diet can shed weight quickly, but the pounds are soon regained. Now two studies in a prestigious medical journal have caused a media maelstrom. They show that the Atkins regimen can shed weight quickly ... but the pounds are soon regained.

Both studies appeared in the New England Journal of Medicine (NEJM), with each randomly dividing subjects into two groups. In each study, one group was told to reduce caloric intake while the other wasn't expressly told to cut calories but rather instructed to keep carbohydrate intake extremely low as dictated by the late Dr. Robert Atkins' books.

One, conducted at the Philadelphia Veterans Administration Hospital, lasted six months and comprised subjects with an initial average weight of about 215 pounds. The other, conducted at three different centers, lasted 12 months and comprised subjects with an initial average weight of about 290 pounds.

The six-month study found that Atkins dieters lost weight at about twice the rate as the higher-carb group - for two months. Thereafter neither group lost much weight. By the end of half a year the Atkins dieters, however, had still managed to keep off about twice as much weight as the higher-carb group - for what it was worth. The average loss was a mere 13 pounds from that original 290.

Further, the 12-month study indicates even that was probably a doomed effort. Here again, the Atkins group lost considerably more weight for the first half year. But thereafter not only did it begin packing the pounds back on, it did so faster than the higher-carb group. Ultimately, concluded the researchers, "the differences were not significant at the end one of year."

"The probable explanation" for the early weight loss said the chief researcher of the longer study (Gary Foster of the University of Pennsylvania), is that it while most calories in our diets are normally carbohydrates, with Atkins "You're left eating a lot of fat, and you get tired of that." So the Atkins plan is merely a low-calorie diet in disguise.

Soon though, Atkins dieters become so starved for carbohydrates that they either start cheating or quit the plan altogether. In fact, both studies were plagued by high drop-out rates from all sets of dieters. The only weight-control regimens that work require both eating in moderation and exercise.

The NEJM findings also belie a massively publicized New York Times Magazine cover story last year by Gary Taubes that rocketed Atkins diet book sales into the stratosphere and landed Taubes his own $700,000 book contract.

In the article, Taubes cited five then-unpublished studies claiming: "The results of all five of these studies are remarkably consistent. Subjects on some form of the Atkins diet," he insisted, "lost twice the weight as the subjects on the low-fat, low-calorie diets."

But two of those are the ones discussed here. Somehow, "The differences were not significant at the end of one year" doesn't seem to support "lost twice the weight."

Nevertheless, at least there seemed no evidence that all that saturated fat in the Atkins diet increases the risk of heart disease.

In neither study did the Atkins dieters have increased LDL or "bad cholesterol," and the 12-month one even found a small increase in HDL or "good cholesterol." Finally the triglycerides (fatty compounds in blood) of the Atkins dieters decreased. Lower triglyceride levels have been linked to lower rates of heart disease.

But not so fast, says Robert H. Eckel, professor of medicine at the University of Colorado Health Sciences Center in Denver.

Eckel says probably one reason for improved blood readings in the Atkins groups is that at least part of the time they did have greater weight loss. "Generally when people lose weight, both triglycerides and HDL improve," he says.

Indeed, even the higher-carb losers showed some improvement in both measurements.

Further, he says, not all HDL is created equal. Just as we once thought all cholesterol was bad, there is now evidence that some "good" HDL may not be good after all.

Finally, says Eckel, epidemiological studies indicate that triglycerides appear to have only a mild direct impact on heart disease; rather they are a marker for other factors that do impact it.

The Atkins Center was overjoyed that the new studies may indicate the regimen isn't dangerous. But how peculiar when the most you can say for the best-selling fad diet book of all time is that its recommendations probably don't kill people.

I am quickly tiring of all the Atkins bashing that nutritionists and researchers are doing. It amazes me we can have two totally seperate interpretations of the same data. The Atkins group claims success because the studies show cholestorol levels improved, and weight loss was double after 6 months. Anti Atkins groups point out most of the weight is regained after a year and still refuse to consider it a viable diet option. A few points in this article caught my attention, mainly because of the double standards.


Obviously the author is not impressed with only losing 13 pounds. However since the atkins group lost twice what the low cal group did we can infer that they only lost 6.5 pounds... funny the author didn't point that out.


So what he is saying is we are actually comparing two low cal diets, so the results should be relatively equal; but wait Atkins lost twice as much.... With wonderful deductions like this it is no wonder our nutritional information is so muddled.


Unfortunately few people have the resolve to stick with any improvement plan dietary or not. We are a society who have made "New Year resolutions" a yearly tradition. The majority of people who try Atkins will fail, simply because they view it as a short term proposition. Heck, many of the people I see doing it now haven't invested enough effort to read the book. (Obviously most people who frequent this board are interested enough to do research and view Atkins as a lifelong decision, and thus have a much better chance of success). However this lack of discipline is by no means limited to low carb, 90% of diets fail to have long term success. In fact in these two studies the drop out rate was nearly equal. I believe the Atkins lifestyle provides the best opportunity for success for someone dedicated and willing to sacrifice short term cravings for long term rewards.


Ok, so if I lose weight and then regain the weight I should expect my cholestorol to stay improved? You can't have your cake and eat it too... if you are going to bash Atkins for not having significantly improved weight loss after 12 months, you cannot then try to explain away the improved bloodwork with weight loss. We hear for years how our cholestoral is going to increase, and now studies are coming out which disproves their forcast. Now suddenly we are hearing about how the only way our numbers are decreasing is because of the lost weight...
It is also amazing that triglycerides suddenly are not important.... that could not have been influenced by the drastically reduction that Atkins provides. If the game isn't working out the way you want, I guess you just change the rules.

Fumento has made his distaste for Atkins well known, he brings nothing new in this article. Why doesn't Fumento just go away?

I think that one reason the "weight loss" slows down with low-carbing, when you stick to it, is that you are replacing excess weight with new muscle. I wish they did their studies by measuring the people's body fat ratios (not BMI, which is just a ratio of weight to height). I think it would be even more conclusive that low-carbing works.

;-Deb

You know it interests me that each time they talk about low-carb eating they always talk about putting the weight back on. There-in lies this country's obesity problem....

We think that if we lose weight, regardless of how we do it, we should be able to go back to eating Krispy Kreme three times a day and not gain anything back. And if we do gain, the diet must be a failure.

I am fairly liberal with my eating, I will occassionally have breading on my meat or carrots. I try to make low-carb choices the rest of the time. Other than typical flucuations I have not gained back anything if I am off. But I know that if I camped out at Dunkin Donuts for a few hours that weight would come back. That's common sense and has nothing to do with Dr. Atkins and his evil plan to ruin the "diet" monopoly.

Shelly, that was great! And also what they do is slant their reporting to make it look like only people who stop low-carbing gain the weight back. When we all know it happens whenever you go back to your old over-eating (dare I say high-carb) ways.

;-Deb