A small study released
Monday found that contrary to expectations, dieters' cholesterol levels do not
shoot through the roof, and they take off more weight — at least in the short
term — than do people on a standard low-fat regimen.
The researchers feel
that "more study is necessary before such a diet can be recommended,"
Experts caution that
the number of overweight people studied on the Atkins diet is small, and the
research does not examine possible long-term ills or advantages, including how
long people keep the pounds off.
At least three formal
studies of the Atkins diet have been presented at medical conferences over the
past year, and all have reached similar results. The latest, conducted by
Westman, was presented at the annual scientific meeting of the American Heart
Association long a stronghold of support for the traditional low-fat approach.
Westman, an internist
at Duke's diet and fitness center, said he decided to study the Atkins approach
because of concern over so many patients and friends taking it up on their own.
They studied 120
overweight volunteers, who were randomly assigned to the Atkins diet or the
heart association's Step 1 diet, a widely used low-fat approach. On the Atkins
diet, people limited their carbs to less than 20 grams a day, and 60 percent of
their calories came from fat.
After six months, the
people on the Atkins diet had lost 31 pounds, compared with 20 pounds on the AHA
diet, and more people stuck with the Atkins regimen.
Total cholesterol fell
slightly in both groups. However, those on the Atkins diet had an 11 percent
increase in HDL, the good cholesterol, and a 49 percent drop in triglycerides.
On the AHA diet, HDL was unchanged, and triglycerides dropped 22 percent. High
triglycerides may raise the risk of heart disease.
While the volunteers'
total amounts of LDL, the bad cholesterol, did not change much on either diet,
there was evidence that it had shifted to a form that may be less likely to clog
the arteries.
No single study is
likely to change minds on the issue, especially since an initial weight loss is
hard to maintain on any diet. Some answers could come from a yearlong study
being sponsored by the NIH. That experiment, being directed at the University of
Pennsylvania, will test the Atkins diet on 360 patients.
Dr. Sidney Smith, the
heart association's research director, said it was a surprise that the Atkins
diet did not raise LDL cholesterol. "One small study like this flies in the face
of so much evidence. We can't change dietary recommendations on the spot," he
said.
Dr. Alice
Lichtenstein, a nutrition expert at Tufts University, said she thinks too much
is made of the amounts of carbohydrates and fats in people's diets as they try
to shed weight.
"There is no magic combination of fat versus carbs versus protein," she said. "It doesn't matter in the long run. The bottom line is calories, calories, calories."
Source: Diabetes In Contol Dot Com: American Diabetes Association Publication date: 2002-11-21.
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