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Item #14
After
years of dismissing the Atkins diet, the medical establishment is at
last putting it to a careful test and finding it might not be the
nutritional foolishness they long assumed.
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:
American Diabetes Association Publication date: 2002-11-21
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