Breaking Bread

Two studies yield good news about protein. But yes, there are caveats

By SANJAY GUPTA, M.D.

Monday, Jun. 02, 2003

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It pays to tell people what they want to hear. Witness the continuing popularity of the Atkins diet, the granddaddy of nearly all the low-carbohydrate, high-protein regimens clamoring to banish your love handles. Here's a plan that promises you can eat pork rinds and Brie and still lose weight. Dr. Robert Atkins' books have sold some 15 million copies over the past 30 years, and his potential audience just keeps growing. More than 60% of American adults are overweight or obese, according to the latest estimates.

On some level, most of us figure the low-carb message has to be too good to be true. Certainly that's what we've heard over and over from the medical and nutritional establishments, which still maintain that the healthiest way to lose weight is to adopt a low-fat, high-carbohydrate diet. But Atkins, who died earlier this year after a fall, may yet get the last laugh. Two new studies in the New England Journal of Medicine suggest that there may be more health benefits to a low-carb diet than mainstream researchers had previously thought possible.

The results are preliminary but nevertheless intriguing. In both studies, test subjects who followed a low-carb diet lost at least twice as much weight as those on a conventional high-carb, low-fat diet after six months. Even at that, the average weight loss for the low-carb dieters, all of whom were obese, was a modest 13 lbs. in the first NEJM study and 15 lbs. in the second. Forty percent of the subjects dropped out of the experiments before completing them. Both studies also showed that the Atkins-style diet boosted the levels of high-density lipoprotein (HDL), the so-called good cholesterol, in the blood and lowered the amount of potentially dangerous fats called triglycerides.

But don't reach for those pork rinds just yet. While the new studies showed an initial benefit, the advantages gradually disappeared over the long term. After a year, folks on the low-carb diet had regained much more weight than those on low-fat diets. And as Dr. Dean Ornish — on the opposite side of many a debate with Atkins — points out, you would expect HDL levels to go up with a low-carb diet, since HDL acts as a kind of dump truck for scavenging fatty compounds. It will also take years to determine whether low-carb diets — which stint on carbohydrate-laden fruits and vegetables — increase the risk of kidney or bone damage, cancer and other conditions.

Even with the publication of these two studies, most health professionals, including me, still won't feel comfortable recommending an Atkins-style diet. Good health consists of more than a few positive numbers on a blood test or a bathroom scale. There are just too many unknowns about the long-term impact of a low-carb diet on your health.

Plus, if we've learned anything over the past several decades of fighting the battle of the bulge, it's that short-term diets are no substitute for what should be lifelong changes in your habits. You have to move to maintain a healthy weight — hard enough to break a sweat at least 30 minutes a day most days of the week (45 minutes if you're trying to lose weight). You have to eat those fruits and vegetables — five to nine servings the size of your fist — every day. And while you're at it, it doesn't hurt to simplify your life and strengthen your bonds with family and friends.

That may not be the kind of advice most of us want to hear. But that doesn't make it any less the truth.

Dr. Gupta is a neurosurgeon and CNN medical correspondent

— With reporting by A. Chris Gajilan/New York

From the Jun. 02, 2003 issue of TIME magazine