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Critics of Atkins Diet Having Second Thoughts

March 23, 2003|Daniel Q. Haney | Associated Press Writer

Is it just possible that Dr. Robert C. Atkins was right? That his high-fat, low-carb plan, ridiculed for 30 years as dangerous nonsense, actually is a good, safe way to lose weight?

The dietary elite are not ready to change their collective mind, but half a dozen or so new studies have taken an objective look at the presumed evils of Atkins. The results have been little short of astonishing:

* During a few months on the Atkins diet, people lose about twice as much as on the standard low-fat, high-carbohydrate approach recommended by most health organizations.

* They do so without seeming to drive up their risk of heart disease. Their cholesterol, triglycerides, blood pressure and ominous bloodstream inflammation generally improve, perhaps even more than on the standard diet.

* They appear to lose more weight even while actually consuming more calories than people on a so-called healthy diet.

All the experiments were short and small. None by itself would make a big stir. But together, they undermine much of what mainstream medicine long assumed about the Atkins diet.

"Some scientists are dismayed by the data and a little incredulous about it," said Gary Foster, who runs the University of Pennsylvania's weight-loss program. "But the consistency of the results is compelling in a way that makes us think we should investigate this further."

Until now, the opinion of the medical world has been essentially unanimous: Any diet that emphasizes meat, eggs and cheese and discourages bread, rice and fruit is nutritional folly.

The American Medical Assn. set that tone a year after the book, "Dr. Atkins' Diet Revolution," came out in 1972. Its sarcastically worded critique dismissed the diet as "potentially dangerous." It called the diet's scientific underpinning "naive" and "biochemically incorrect." And it scolded book publishers for promoting "bizarre concepts of nutrition and dieting."

On the Atkins diet, up to two-thirds of calories may come from fat -- more than double the usual recommendation -- and that violates everything medical professionals believe about healthy eating. Carbohydrates are the foundation of a good diet, most say. Eating calorie-dense fat makes people fat, and eating saturated fat is what kills them.

Despite this, Atkins' books have sold 15 million copies, uncounted millions have tried the diet, and practically everybody has heard of someone who dropped a ton of weight on the Atkins plan.

Finally, several research teams around the country have put Atkins to the test, driven largely by weariness at having nothing solid to tell patients and, in some cases, a desire to prove Atkins wrong. One study was sponsored by the American Heart Assn., an Atkins skeptic.

None has been published yet, but summaries have been given at medical conferences.

"They all show pretty convincingly that people will lose more weight on an Atkins diet, and their cardiovascular risk factors, if anything, get better," said Dr. Kevin O'Brien, a University of Washington cardiologist involved with one of the studies.

This is not the end of the story. The studies say nothing about how much people lose when they stay on Atkins more than a few months, whether they keep the weight off for good, and whether their cholesterol rebounds when they stop losing weight.

Nevertheless, three decades of dietary gospel are in doubt, and those questioning it include some of the most prominent names in obesity research. For instance, one of the new studies was conducted by Foster with Drs. Samuel Klein and James Hill, the current and past presidents of the North American Assn. for the Study of Obesity, the premier professional group.

"I'm part of the obesity establishment," said Foster, who has published more than 50 scientific papers on the subject. "I've spent my life researching ways to treat obesity, and 100% of them have been low-fat and high-carb. Now I'm beginning to think it isn't as it has appeared."

His Atkins study was intended to "show it doesn't work," but after three months, the overweight men and women had lost an average of 19 pounds, 10 more than people on the standard high-carb approach.

The big surprise was cholesterol. Atkins dieters' overall profile changed for the better. Although bad cholesterol went up 7 points, good cholesterol rose almost 12. (Changes in the high-carb dieters were less dramatic. Their bad cholesterol went down slightly while their good cholesterol remained unchanged.)

The largest difference was in triglycerides. The Atkins dieters' dropped 22 points. The low-carb dieters' didn't budge.

"It was unexpected, to put it mildly," Foster said. "It made us think maybe there is something to this."

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