Tag Archives: Atkins diet

Book Review: The New Atkins for a New You

Here’s my review of The New Atkins for  a New You, a weight-loss book by Dr. Eric Westman, Dr. Stephen Phinney, and Dr. Jeff Volek released a week ago.  The copyright holder is Atkins Nutritionals, Inc.  Under Amazon.com’s five-star rating system, I give it four stars (“I like it”).  

♦   ♦   ♦ 

The most exciting nutritional medicine development in recent memory is the fact that saturated fat consumption is not a significant cause of heart disease and premature death. The same goes for for total fat and cholesterol.  When enough physicians, nutritionists, and dietitians learn this, low-carb eating will take off like a rocket.

For those unfamiliar with the Atkins diet, it is designed for weight loss via high fat consumption and major carbohydrate restriction.  Protein intake is a bit higher than average.  As long as carbohydrates (carbs) are kept low, other foods are mostly unlimited.  Atkins has four phases.  As you graduate from one phase tothe next, more carbs are allowed, adding some carb sources before others (the Carb Ladder). 

Atkins has been around for years.  It’s not just a weight-loss diet; it’s a lifetime way of eating.

Doctors Westman, Phinney, and Volek are leaders in low-carb nutritional science.  The last time Atkins peaked (2003), we didn’t have the scientific studies backing up safety of the diet.  Now we do, in large part thanks to these guys. 

Physicians see beaucoup patients with overweight-related medical conditions.  We’re not going to recommend a diet that causes heart attacks, strokes, and other major medical complications.  Published research over the last eight years has established the relative safety of very low-carb diets, particularly Atkins.  Low-carb diets may even be healthier than the low-fat, high-carb diet that has been recommended by U.S. public health authorities for the last forty years.  Come to think of it, our current obesity and diabetes epidemics started around that same time.

The book covers nutrition basics, day-to-day practical application of Atkins eating, recipes and detailed meal plans, and the science behind the program.    

What’s New Since Dr. Atkins’ 2002 Book?

  • adaptations for vegetarians and vegans
  • adaptations for Latinos
  • coffee is now OK
  • introduction of the term “foundation vegetables” and almost doubling the amount of vegetables allowed in Phase 1: “approximately six cups of salad and up to two cups of cooked vegetables, depending upon the ones you select”
  • more flexility, such as the option to skip Phase 1 (induction)
  • focus on adequate protein intake, based on your height
  • emphasis on getting enough omega-3 fatty acids
  • no emphasis on supplements and low-carb products sold by Atkins Nutritionals,Inc.
  • diet journals—a personal record of your weight-loss journey—are recommended
  • eliminate or minimize “induction flu” and constipation (in Phase 1) by eating at least 1/2 teaspoon of salt daily [I’m skeptical.]
  • discussion of the trendy omega-6/omega-3 fatty acid ratio
  • favor monounsaturated fatty acids (e.g., olive oil, canola oil) over certain polyunsaturated fats, as in oils from corn, soybeans, sunflower, cottonseed, and peanuts
  • no mention of testing urine for ketosis
  • more discussion of psychological aspects of weight

The lack of ads for Atkins Nutritionals products is welcome and refreshing.  Too many of the official Atkins books read like infomercials, which diminishes credibility.

A vegetarian or vegan “Atkins diet” is just not something I can visualize.

What Could Have Been Done Better?

  • no specific amounts given for these recommended supplements: calcium, vitamin D, omega-3 fats, multivitamin, magnesium and other minerals (except “no iron”).  [Is the idea to encourage a visit the official Atkins website?]
  • little guidance for physicians who are to advise diabetics doing Atkins.  Few physicians are familiar enough with the program to make the necessary changes in particular diabetic medications.
  • little discussion of the constipation and leg cramps that often accompany very low-carb diets
  • the hype on the cover: “How would you like to LOSE UP TO 15 POUNDS IN TWO WEEKS!”  [To their credit, the authors note that such results are not typical.]
  • nearly all the measurements are U.S. Customary.  Metric users are out of luck.
  • four phases seem a bit much.  The beauty of Atkins Phase 1 is its simplicity. 

My favorite sentence: “White flour is better suited to glue for kindergarten art projects than to nutrition.”

My least favorite sentence: “We can’t stress strongly enough that the best diet for you is one composed of foods you love.”  I love apple pie and Cinnabon cinnamon rolls, but they won’t help me manage my weight.

The only error I found worth mentioning is minor.  The authors state that the American Heart Association recommends consumption of fish three times a week. The official policy is still “at least twice weekly.”

The book is very practical and easily understood by average people.  Most will skip the science chapters at the end.  I know the basic Atkins program works at least short-term; many of my patients have done it.

In summary, the book has nearly everything you need to be successful with the Atkins diet. 

As far as I know, there are no comprehensive long-term studies (e.g., 10+ years) regarding health outcomes of Atkins-style eating.  In other words, does Atkins have any effect on longevity, cancer, heart attacks, strokes, etc.?  But very few of the popular diets have these data either.  The best researched ways of eating in this respect are the Mediterranean diet and vegetarian diets.

Steve Parker, M.D.

Disclosure:  I was given nothing of value for this review by the authors, publisher, or Atkins Nutritionals, Inc.  I wrote it for the benefit of my patients and readers.

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Filed under Book Reviews, Carbohydrate, Fat in Diet, ketogenic diet, Weight Loss

Book Review: Atkins Diabetes Revolution

I must give credit to Dr. Robert C. Atkins for popularizing an approach – carbohydrate restriction – that helps people with diabetes control their disease, and likely helps prevent type 2 diabetes in others.  Mary C. Vernon and Jacqueline Eberstein do a great job explaining his program in their 2004 book, Atkins Diabetes Revolution: The Groundbreaking Approach to Preventing and Controlling Type 2 Diabetes

On the Amazon.com five-star rating scale, I give this book four stars.

I can best summarize this book by noting that it is the standard Atkins diet with a few modifications: 1) special supplements  2) you add additional carbs to your diet more slowly  3) the warning that diabetics may well end up with a lower acceptable lifetime carbohydrate intake level.

By way of review, the Atkins diet is a very low-carb diet, particularly in the two-week induction phase.  “Very low-carb” means lots of meat, chicken, fish, eggs, limited cheese, and 2-3 cups daily of salad greens and low-carb veggies like onions, tomatoes, broccoli, and snow peas.  After induction phase, you slowly add back carbs on a weekly basis until weight loss stalls, then you cut back on carbs.

As an adult medicine specialist, I have no expertise in pediatrics.  I didn’t read the two chapters related to children.

The authors present “complimentary medicine”in a favorable light.  Unsuspecting readers need to know that much of complementary medicine is based on hearsay and anecdote, not science-based evidence.  In that same vein, the two chapters on supplements for diabetes and heart disease recommend a cocktail of supplements that I’m not convinced are needed.  I don’t know a single endocrinologist or cardiologist prescribing these concoctions.  Then again, I could be wrong.   

Vernon and Eberstein provide two excellent chapters on exercise.

A month of meal plans and recipes are provided for 20, 40, and 60-gram carbohydrate levels.  [The average American is eating 250-300 g of carbs daily.]  The recipes look quick and easy, but I didn’t prepare or taste any of them.

The 5-hour glucose and insulin tolerance test (GTT, paged 61) that Dr. Atkins reportedly ran on all patients who came to him is rarely done in other medical clinics.  This doesn’t mean it’s wrong, but certainly out of the mainstream.  The authors admit that at least a few people will have to count calories – specifically, limit total calories – if the basic program doesn’t control diabetes, prediabetes, and the metabolic syndrome.  Limiting portion size will speed weight loss, they write.

What we don’t know with certainty is, will long-term Atkins aficionados miss out on the health benefits of higher consumption of fruits, vegetables, legumes, and whole grains?  Much of the scientific literature suggests, “Yes.”

What if we compare the long-term outlooks of a diabetic Atkins follower with a poorly controlled diabetic who’s 80 pounds overweight and eating a standard American diet?  The Atkins follower is quite likely to be healthier  and live longer.

Steve Parker, M.D.

 

 

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For Heart’s Sake, Should You Avoid Red Meat in a Low-Carb Diet?

Low carbohydrate diets tend to contain disproportionate amounts of fat from animal sources.  Red meat has long been vilified as a major source of saturated fat that some experts believe cause hardening-of-the-arteries (atherosclerosis) via elevations in LDL cholesterol.  Others disagree.  Poultry, fish ,and shellfish generally have lower amounts of saturated fat than red meat.  Would a low-carb diet with a predominance of poultry, fish, and shellfish lead to a more advantageous cholesterol profile?

A 2007 report from U.S. researchers found no lipid advantage to the poultry/fish/shellfish model.    In fact, despite high cholesterol and fat intakes, neither diet caused a significant change in total, HDL, or LDL cholesterol levels.  Triglycerides fell in both groups, but to a statistically significant degree only on the poultry/fish/shellfish group.

Fun Fact:  Did you know that four of every 10 women in the U.S. are trying to lose weight?  The figure for men is one in three.  

Methodology

Researchers in Minnesota and Iowa enrolled 18 subjects (6 males, 12 females) between the ages of 30 and 50 who wanted to lose weight.  Average body mass index was 31.7, which is mildly obese.  The were encouraged to eat an Atkins-style ketogenic diet with a maximum of 20 g carbs/day, providing 1,487 total daily calories, with 7% of calories from carbohydrate, 43% from protein, and 50% from fat.  This included two or three cups of salad greens and low-carb vegetables.  Three ounces of cheese daily was allowed.  Subjects were randomly assigned to eat either red meat or poultry/fish/shellfish.  Dietary intervention lasted 28 days.

[This is very similar to Atkins Induction Phase, although Atkins does not limit total calories.  The researchers did not say why they wanted to limit total calories.] 

Data were not used from six subjects for good reasons (see article).  So final data analysis included only 12 subjects.

Results

Both groups lost the same amount of weight: about 5.5 kg (12 pounds) over 28 days.

Average carbohydrate intake was about the same for both groups: 55 g/day.

Average total daily caloric intake was about the same for both groups: 1,380.

The poultry/fish/shellfish group ate 630 mg cholesterol daily, twice as much as the other group.  [Eggs and shrimp were popular.]

The difference in intake of saturated fat approached, but did not reach, statistical significance (32 g/day in the red meat group vs 25 g).

Neither diet caused a significant change in total, HDL, or LDL cholesterol levels.  Triglycerides fell in both groups, but to a statistically significant degree only on the poultry/fish/shellfish group.

Urine ketones at or above 5 mg/dl were detected on 75% of all dipstick tests.

My Comments

I’m skeptical about the accuracy of the calorie counts.  Most people eating Atkins-style take in about 1,800 cals/day.  The preponderance of females, however, may explain the unusually low average caloric intake.  They didn’t follow their carb restriction very closely, did they?  These were free-living subjects not locked in a metabolic ward.

The researchers note that the allowance of cheese in both groups may have sabotaged their efforts for a clear delineation of higher versus lower saturated fat groups. 

HDL cholesterol usually rises significantly on low-carb diets.  Lack of that here may just be a statistical aberration.

This is such a small study that it’s impossible to draw firm conclusions.  Nevertheless, if someone is losing weight on a low-carb diet, it may not matter much from a lipid viewpoint whether they eat a predominance of meat or a predominance of poultry, fish, and shellfish.  The study at hand cannot address the long-term consequences of such a choice.

Steve Parker, M.D.

Reference:  Cassady, Bridget, et al.  Effects of low carbohydrate diets high in red meats or poultry, fish and shellfish on plasma lipids and weight lossNutrition & Metabolism, 4:23   doi: 10.1186/1743-7075-4-23   Published October 31, 2007

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Filed under Carbohydrate, Fish, ketogenic diet, Overweight and Obesity

Low-Carb Ketogenic Diet Beats Low-Glycemic Index Diet in Overweight Type 2 Diabetes

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Avoid the needle with a low-carb ketogenic diet

Duke University (U.S.) researchers demonstrated better improvement and reversal of type 2 diabetes with an Atkins-style diet, compared to a low-glycemic index reduced-calorie diet.

Methodology

Ninety-seven overweight and obese adults, 78% women and 40% black, were randomly assigned to either:

  • a very low-carb ketogenic diet (Atkins induction phase, as in Atkins Diabetes Revolution) or
  • a low glycemic-index index calorie-restricted diet (The GI Diet by Rick Gallop). 

Thirty-eight were in the Atkins group; 46 in the low-glycemic index (low-GI) group.  Seventeen dropped out of each group before the end of the 24-week study.  Average weight was 234.3 pounds (106.5 kg); average body mass index was 37.  The Atkins group averaged 13% of total calories from carbohydrate; the low-GI cohort averaged 44%. 

Results

Both groups lost weight and had improvements in hemoglobin A1c, fasting insulin, and fasting glucose. 

The Atkins group lowered their hemoglobin A1c by 1.5% (absolute drop, not relative) versus 0.5% in the other group. 

The Atkins group lost 11.1 kg versus 6.9 kg in the other group. 

The Atkins group increased HDL cholesterol by5.6 mg/dl versus no change in the other group. 

All the aforementioned comparisons were statistically significant. 

Diabetes medications were stopped or reduced in 95% of the Atkins group versus 62% of the low-GI group.

Total and LDL cholesterol levels were unchanged in both groups. 

Triglycerides fell significantly only in the Atkins group.

My Comments

You may be interested to know that this study was funded by the Robert C. Atkins Foundation.

One strength of this study is that it lasted for 24 months.  Many similar studies last only eight to 12 weeks.  A drawback is that, with all the drop-outs,  the number of participants is low. 

The GI Diet performed pretty well, too, all things considered.  Sixty-two percent reduction or elimination of diabetes drugs—not bad.  For a six-year-old book, it’s still selling fairly well at Amazon.com.  That may be why they chose it as the comparison diet.

The diet with fewer carbohydrates—Atkins induction—was most effective for  improving control of blood sugars.  So effective, in fact, that the researchers sound a note of warning:

For example, participants taking from 40 to 90 units of insulin before the study were able to eliminate their insulin use, while also improving glycemic control.  Because this effect occurs immediately upon implementing the dietary changes, individuals with type 2 diabetes who are unable to adjust their own medication or self-monitor their blood glucose should not make these dietary changes unless under close medical supervision.  

[Not all insulin users were able to stop it.]

Overall, lipids were improved or unchanged in the Atkins group, despite the lack of limits on saturated fat intake.  A common criticism of the Atkins diet is that it has too much saturated fat, leading to higher total and LDL cholesterol levels, which might raise long-term cardiovascular risks.  Not so, here. 

When you reduce carbohydrate intake, the percentages of fat and protein in the diet also change.  In this Atkins diet, protein provided 28% of daily calories, and fat 59%.  In the low-GI diet, protein provided 20% of daily calories, fat 36%.  The beneficial effects of the Atkins diet probably reflect the low carbohydrate consumption rather than high protein and fat. 

The Atkins induction-phase diet was clearly superior to the low-glycemic index diet in this overweight diabetic sample, without restricting calories.

Steve Parker, M.D.

Reference:  Westman, Eric, et al.  The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitusNutrition & Metabolism 2008, 5:36   doi:10.1186/1743-7075-5-36

Additional Reading

Samaha, F., et al.  A low-carbohydrate as compared with a low-fat diet in severe obesity.  New England Journal of Medicine, 348 (2003): 2,074-2,081.

Boden, G., et al.  Effect of a low-carbohydrate diet on appetite, blood glucose levels, and insulin resistance in obese patients with type 2 diabetes.  Annals of Internal Medicine, 142 (2005): 403-411.

Vernon, M., et al.  Clinical experience of a  carbohydrate-restricted diet: Effect on diabetes mellitus.  Metabolic Syndrome and Related Disorders, 1 (2003): 233-238.

Yancy, W., et al.  A pilot trial of a low-carbohydrate ketogenic diet in patients with type 2 diabetes.  Metabolic Syndrome and Related Disorders, 1 (2003): 239-244.

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Filed under Carbohydrate, Glycemic Index and Load, ketogenic diet, Overweight and Obesity

My Ketogenic Mediterranean Diet: Day 29 and Week 4 Update

monument valley navajo tribal parkWeight: 160.5 lb (72.95 kg)

Waist circumference: 35¼ inches (89.5 cm)

Transgressions: not eating as much fish as I should, and ate 2-3 fl oz of barbecue sauce having unknown carb content

Exercise: none

Comments

Down 1.5 lb (0.68 kg) for the week.  Starting weight September 1 was 170 lb (77.3 kg).  Down a total of 9.5 lb (4.32 kg) over four weeks. 

Another 3-day out-of-town trip interfered with calorie counting and nutrient analysis since I was away from my computer.  But remember, the Ketogenic Mediterranean Diet doesn’t require calorie counting.  I’m just doing it for scientific purposes.  I fully expect at some point I will stop losing weight, and I want to know my daily caloric intake at that point.  Will it rise to the 2,200-2,400 range, which I believe to be my baseline?

I saw an interesting documentary on the Atkins diet posted by Dr. Dan at Darwin’s Table.  Dr. Dan is a paleo diet advocate.  From the documentary, apparently produced in the UK, I learned that feeling “peckish” means you are “somewhat hungry” (also means irritable) and a “stone” equals 14 pounds (6.4 kg).  The sound track reminds me of the Austin Powers movies. 

If you like barbecue and are ever in Wikiup, Arizona, USA, don’t miss “Eat at Joe’s Barbecue.”  It’s Texas-style BBQ.  Best barbecue brisket and ribs I’ve ever had outside of Texas.

I watched my wife and daughter eat ice cream at Baskin-Robbins, and had, surprisingly, no temptation.  I love BDR ice cream.  I ate 20 grams of Lindt dark chocolate with them instead.  I saw some sugar-free ice cream, so I asked the clerk, “Do you have nutritional analysis info on that?”  She replied, “Sir, this is an ice cream store…” 

This is a typical days’ food:

  • Breakfast: eggs and meat (beef, sausage, bacon, or ham).  I fry eggs in olive oil or butter.  Occassionally sauté tomatoes or onions in olive oil.
  • Lunch and Dinner: Salad dressed with extra virgin olive oil vinaigrette, with added fish (usually canned) or chicken.
  • Glass of red wine with dinner.
  • Snack: Nuts, cheese, or both.

Daily average nutrient analysis for four days:

  • Macronutrients as percentage of total energy: 7% carbohydrate, fat 59%, protein 26%, alchohol 8%
  • Digestible carbohydrate: 25 g
  • Fiber: 9 g
  • Calories: 1650
  • Looking at % Daily Values for a 2,000 calorie diet, this diet may be deficient in vitamins and minerals: C, D, E, thiamine, B6, folate, pantothenic acid, iron, manganese, magnesium, potassium, sodium, copper, and calcium.  [However, I am taking two Centrum multivitamin/multimineral supplements plus extra vitamin D 400 IU, which would correct nearly all of these, as discussed at my Week 2 Recap.] 

I am starting to miss my sweet carbohydrates, like Reese’s Peanut Butter cups, apple pie, and ice cream.  My birthday is coming up.  What . . . No cake?  It’s time to think about a “cheat day,” perhaps once a month.  The Advanced Mediterranean Diet has one every two weeks.

-Steve

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My Ketogenic Mediterranean Diet: Day 23

CB104470Weight: 161 lb

Transgressions: none

Exercise: 60 minutes shovelling horse poo and picking up rocks from a new corral

Comments

I followed Dr. Atkins New Diet Revolution for 10 weeks in 2003.  When my daughter was 3-years-old, I realized that my exercise habit—six hours a week either at a gym or running—had been interfering with my family time and helping out around the house.  So I quit exercising for 3–4 years and, therefore, gained some weight.  In 2003, my Atkins starting weight was 178 lb, waist 37 inches.  Goal weight was 162-165.  I lost 11 pounds on Atkins.  Towards the end I was bored and increasingly noncompliant.  Here are my 2003 verbatim notes summarizing my experience with Atkins:

Lost 10 lbs [4.55 kg] over first 5 weeks, ½ of that in the first 2 weeks.  I have not exercised nearly as much as he recommended.  Have not suffered much hunger or sense of deprivation.  No wt change in last 6 weeks, coinciding with poor exercise compliance (may or may not be related).  Note that I really don’t have much wt to lose at this point, just a cosmetic amount.  At some point, even if fully compliant with Atkins, wouldn’t wt loss stop in everyone?  I have no idea how may calories I am eating now.  With wt stable, will assume it is around 2000-2400 cal/day.  Ten years ago when I was exercising religiously, my wt-maintaining intake was 2400 cal.  Probably closer to 2000 now in view of aging and sedentariness.  Over the last 6 weeks of stable wt, however, I was mostly compliant with his induction-phase food prescription.  To lose wt now I probably need to exercise more and count actual calories.  Even took his recommended Essential Oils supplement (2/day) and Basic 3 vitamin supplement (2 instead of 3/day).  He has convinced me I am a carbaholic.  Sugars and refined carbs are empty calories that don’t provide much except energy, which in excessive amounts is stored as fat.  But I cannot yet abandon the dogma that saturated fats (e.g., red meat) can be harmful to circulation over the long run.  And his carb restriction would keep me from eating adequate beneficial vegetables.  If I want to eat sweets and refined carbs, I will have to exercise more and/or give up fats, vegetables, or proteins.  Atkins makes a lot of sense for obese people who love carbs and overeat them.  I also like the rapid results of induction phase.  I admire the simplicity of the induction phase.  Thereafter, the “Ongoing Weight Loss” and “Lifetime Maintenance” phases do require counting carbs.  The latter phase, for me, would allow 40-60 gm/day, unless I were a vigorous exerciser (then 90+ gm).  A serving of apple pie has 58 gm.

Now it’s six years later and I’m much more willing to reconsider that dogma that saturated fats cause impaired circulation (atherosclerosis).  But I still think that fruits, vegetables, whole grains, and legumes are healthy for many people.

-Steve

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Atkins Diet Beats Low-Fat Diet Over Three Months in Overweight Diabetic Black Women

MPj04384250000[1]A recent study compared effects of a low-carb versus low-fat diet in overweight diabetics (mostly blacks).  After one year, the only major difference they found was  lower HDL cholesterol in the low-carb eaters.  The low-carb diet was more effective measured at three months into the study.  Study participants were overwhelmingly black women, so the findings may not apply to you.

Background

The authors note at the outset that:

Optimal weight loss strategies in patients with type 2 diabetes continue to be debated, and the best dietary strategy to achieve both weight loss and glycemic control . . . is unclear.

They also note that in short-term randomized studies, low-carb diets help improve glucose control in type 2 diabetics.

Methodology

Participants (105) were randomized to either:

  • a low-fat diet in the fashion of the Diabetes Prevention Program, with a fat gram goal of 25% of energy needs, or . . .
  • the Atkins diet, including the 2-week induction phase and gradually increasing carb grams weekly, etc.

The adult partipants were black (64%), Hispanic (16%), white (15%), or other.  Women were 80% of the group.  Average age 54.  Average weight 215 pounds (98 kg).  Average BMI 36.  Most of them were taking metformin, half were taking a sulfonylurea, 30% were on insulin.  Thiazolidinedione drugs were discontinued since they cause weight gain as a side effect.  Short-acting insulins were changed to glargine (Lantus) to help avoid hypoglycemia.  For the low-carb group initially, insulin dosages  were reduce by half and sulfonylureas were stopped (again, to minimize hypoglycemia).  For the low-fat group, insulin was reduced by 25% and sulfonylurea by 50%.  Metformin was not adjusted.  Subjects were instructed to keep daily food diaries.  Goal rate of weight loss was one pound per week.   

Results

The drop-out rate by the end of 12 months was the same in both groups – 20%.  The low-carbers lost weight faster (3.7 lb/month) in the first three months, but by month twelve each group had the same 3.4% reduction of weight (6.8 lb or 3 kg).  As measured at 3 months, low-carbers were down 11.4 lb (5.2 kg) and low-fat dieters were down 7 lb (3.2 kg).  Maximum weight loss was at 3 months, then they started gaining it back.  At 12 months, low-carb subjects using insulin were on 10 less units, while low-fat dieters were using 4 more units (not statistically significant).  Hemoglobin A1c measured at 3 months was down 0.64 in the low-carb group and down0.26 in the low-fat.  By 12 months, HgbA1c’s were back up to baseline levels for both groups.  Blood lipids were the same for both groups at 12 months except HDL was about 12% higher in the low-carb dieters.

At baseline, subjects derived 43% of calories from carbohydrates, 36% from fats, 23% from proteins.  At three months, the low-carb group ate 24% of calories as carbohydrates (estimated at 77 grams of carb daily) and 49% from fat.  The low-fat group at 3 months derived 53% of calories from carbohydrate (199 grams/day) and 25% from fat. Diet compliance deteriorated as time passed thereafter. 

Study Author Conclusions

After one year, the low-carb and low-fat groups had similar weight reductions.  The low-carb dieters raised their HDL cholesterol levels significantly [which may protect against heart disease].

My Comments

Lasting weight loss is difficult!  Down only 6.8 pounds for a year of  effort. 

These study participants needed to lose a lot more than 6.8 pounds.  They needed to lose 50.  Both groups were woefully noncompliant with diet recommendations by the end of the study year.  They were eating more carbs or other calories than they were assigned.  But their results weren’t much different than other groups studied for an entire year. 

How do we keep people fired up about maintaining their weight-loss efforts?  The solution to that problem will win someone a Nobel Prize.

The Atkins diet was superior – for weight loss and glycemic control – when measured at three months, when compliance by both groups was still probably fairly good.

Results of this study may apply only to black women.  There weren’t enough men and other ethnic groups to make meaningful comparisons.    

Steve Parker, M.D.        

Reference:  Davis, Nichola, et al.  Comparative study of the effects of a 1-year dietary intervention of a low-carbohydrate diet versus a low-fat diet on weight and glycemic control in type 2 diabetes.  Diabetes Care, 32 (2009): 1,147-1,152.

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