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New Study Backs Low-Carb Diets

Posted: Wednesday, December 10, 2003

A study by doctors at Christiana Care Health System shows that patients with medical problems lost weight safely on a low-carbohydrate, high-fat diet, similar to the popular Atkins plan.

The study, published in this month's issue of the Mayo Clinic Proceedings, is part of a growing body of research from respected institutions such as Harvard and Duke universities showing positive results, in the short term, from controversial Atkins-style diets.

Christiana Care doctors followed 17 men and six women with heart disease and showed that each lost 5 percent of body weight in six weeks, without adverse health effects, on a diet consisting primarily of red meat, cheese, eggs, and some fresh fruit and non-starchy vegetables. The participants were all obese and the study did not include the exact number of pounds lost by each individual.

The study also reported weight loss among two smaller groups that spent longer periods on the diet, said Dr. James Hays, the Christiana Care endocrinologist who led the study.

"The really surprising thing to me is that this very high fat intake appears not only to reduce weight but to control risk factors for heart disease and diabetes," Hays said.

An estimated 32 million people follow low-carbohydrate diets despite the fact the diets are derided by many nutritionists and doctors. Supporters said the studies back up their beliefs with science.

"I think it is wonderful to see yet another study validating the principle that controlling carbohydrates can positively impact health," said Dr. Stuart Trager, a Philadelphia physician and consultant on the Atkins weight loss plan. "It's not only effective, but it's safe."

But critics said many of the studies, including this one, have followed small numbers of people for relatively short periods of time and thus don't give a full picture of how the diet affects health. They said low-carb, high-fat plans are not a healthy way to eat and may cause health problems, especially if people follow them for a long time.

In the Christiana Care study, funded by the health system, success was not limited to patients with heart disease. Researchers also followed 15 obese women with an ovary disease who lost 15 percent of their body weight over six months; and eight women with a blood sugar problem called reactive hypoglycemia who lost 20 percent of their body weight over a year. The patients with heart disease were on cholesterol-lowering drugs called statins and the other patients were not, but none experienced cholesterol problems.

Officials at Atkins Nutritionals Inc., which sells products and services based on the low-carb approach, said the effectiveness and safety of such diets has been reaffirmed in 16 scientific studies published in peer-reviewed journals over the past three years. One was a 2002 study by Duke University Medical Center, funded by the Atkins Center for Complementary Medicine and published in the American Journal of Medicine. Another came from a visiting scholar in the Harvard School of Public Health, who presented her findings at the annual meeting of the North American Association for the Study of Obesity in October.

There also has been research in the mid-Atlantic region, including a May study in the New England Journal of Medicine by Dr. Frederick Samaha at the Philadelphia Veterans Affairs Medical Center. Samaha found that people lost about 13 pounds on a low-carb diet, more than twice as much weight as they lost on a low-fat, calorie-restricted diet over six months.

Kim Westcott, a registered dietitian at Beebe Medical Center in Lewes, said the U.S. Department of Agriculture Food Guide Pyramid provides a better model for healthy eating. The bread, cereal, rice and pasta group forms the bottom of the pyramid, followed by fruits and vegetables, with the meat group smaller and closer to the top. Westcott said she is especially concerned about the lack of fiber in many low-carb diets, which can lead to constipation as well as other digestive problems.

Hays said none of his patients reported gastrointestinal problems, and some saw improvements in conditions such as heartburn and irritable bowel syndrome. Hays and other researchers agreed with critics that more research is needed, especially larger studies following people for longer periods. "The long-term effects are not known," Westcott said.  

Source: Diabetes In

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