This proves Atkins is best diet, say scientists

[anita45]

Just found this article on the UK Times website:

http://www.timesonline.co.uk/tol/news/uk/health/article1466880.ece

This proves Atkins is best diet, say scientists
John Elliott

A SCIENTIFIC study into the controversial Atkins diet suggests that it can be one of the most effective ways for women to lose weight.

At the end of 12 months, overweight subjects on the Atkins regime had lost twice as much weight on average as women on three competing diets. Atkins minimises carbohydrates, such as bread and sugar, in favour of meat and other proteins.

However, amid increasing concern that its devotees miss out on vital nutrients, it has recently been supplanted by new regimes such as the GI diet, which consists of foods that release glucose slowly and evenly into the bloodstream.

This week, however, the study will say Atkins produced more weight loss with no signs of undesirable side-effects.

“So many people have been asking questions about diets for years. We think it’s time to give them some answers,” said Christopher Gardner, professor of medicine at Stanford University’s disease prevention research centre in California, who led the study.

“We have an epidemic of obesity that’s still on the rise, and the ideas of our best and brightest people haven’t been able to change that.”

In the study, 311 pre-meno-pausal, overweight women were asked to follow one of four regimes: the Atkins, Zone, Learn or Ornish diet. Each involve a different level of carbohydrate intake. The Atkins diet recommends the lowest level, the Zone diet a little more.

The Learn (Lifestyle, Exercise, Attitudes, Relationships and Nutrition) diet follows the American government’s recommendations for a diet low in fat and high in carbohydrates.

The Ornish diet is very high in carbohydrates and extremely low in fat.

After a year, the 77 women in the Atkins group lost an average 10lb — about twice as much as those on the Learn and Ornish diets. Women on the Zone lost an average of 3.5lb.

Women in the Atkins group also achieved larger reductions in body mass index, triglycerides and blood pressure — all signs of improved health.

Susan Jebb, head of nutrition and health research at the Medical Research Council, said the reason for Atkins’s success was that people found a diet that allowed high intakes of meat and fat easier to follow than other more spartan regimes.

In Britain, the Atkins diet reached its peak popularity around 2003 when a survey indicated that 3m people were on it. It was endorsed by celebrities such as Jennifer Aniston. Its popularity has since waned.

Has Atkins worked for you or are other diets better?

Have your say

[fatnewmom]

The amounts of weight loss over a year's time are really low (10 pounds or less). Do you think they meant "per month"?

Anyway, it's good to see supporting studies.

[Samuel]

I believe that there is a cause for the current obesity epidemic and that there will be no permanent cure for obesity untill that cause is discovered. However, I agree that Atkins diet is the only diet which can stabilize your weight with minimum suffering until that cure is found.

[PS Diva]

The amounts of weight loss over a year's time are really low (10 pounds or less). Do you think they meant "per month"? I imagine it was folks who didn't have a lot to lose.

[Rachel1]

People who are not significantly overweight will lose much more slowly, as do older people (particularly women). The article doesn't tell us the average age or weight of the participants.

Speaking for myself: I started Atkins about five years ago. At my age then (45ish, perimenopausal), most women gain weight. I've lost 35 pounds over the years, which doesn't seem like much averaged out, but considering I would have gained otherwise, it's more than it seems! My health has also improved over the time span many women's health deteriorates, so I am certainly not complaining.

Rachel

[SadLady]

I think that older women lose more slowly is a myth. I am 62 years old and basically inactive and with a lot of health problems and in a year I lost 70 lbs. I did not lose any more because I hit a plateau and got depressed.

[kebaldwin]

However, amid increasing concern that its devotees miss out on vital nutrients, it has recently been supplanted by new regimes

They must be talking about another Atkins diet. The Dr Robert C. Atkins that I read all about said that you had a high quality multi-vitamin plus plenty of fish oil to get proper nutrition. i.e. that was part of the Atkins diet. And then he wrote a whole book on Vita Nutrients that told one how to fix most health problems.

http://www.amazon.com/Dr-Atkins-Vita-Nutrient-Solution-Natures/dp/0684844885/ref=ed_oe_p/103-9272191-0372668?ie=UTF8&qid=1173046627&sr=8-1

In fact when his diet went up against other diets -- not only did the participants lose more weight and more fat -- their blood tests were much better also.

[brobin]

The amounts of weight loss over a year's time are really low (10 pounds or less). Do you think they meant "per month"?

Anyway, it's good to see supporting studies.


Remember, that is an average, and after a year. Some people might have failed on the diet, others might have had less to lose.

Not many people on any diet actually stick to the "lifestyle". Ten pounds after a year for people who were probably 10 to 30 pounds over weight to begin with, is awesome.

[Lisa N]

They must be talking about another Atkins diet.

I was thinking the same thing. The Atkins diet that I'm familiar with encourages the eating of more vegetables than most people ate before they even thought of Atkins (5 or 6 servings a day and that's at induction levels!).
Fruits? Yup, even during induction. Of course, they aren't the type of things that most people (even dieticians, it seems) think of as fruits, but tomatoes, peppers, cucumbers, olives and avocados are all botanical fruits and are permitted during induction. :idea:

Good to see low carb getting some positive press, though. :D

[fatnewmom]

Fruits? Yup, even during induction. Of course, they aren't the type of things that most people (even dieticians, it seems) think of as fruits, but tomatoes, peppers, cucumbers, olives and avocados are all botanical fruits and are permitted during induction. :idea:

:D

Great point!

[diemde]

Here's a link to the abstract: http://nutrition.stanford.edu/pdfs/AZ_abstract.pdf

And Stanford's press release http://nutrition.stanford.edu/pdfs/AZ_press.pdf
STANFORD, Calif. — The case for low-carbohydrate diets is gaining weight. Researchers at the Stanford University School of Medicine have completed the largest and longest-ever comparison of four popular diets, and the lowest-carbohydrate Atkins diet came out on top.

Of the more than 300 women in the study, those randomly assigned to follow the Atkins diet for a year not only lost more weight than the other participants, but also experienced the most benefits in terms of cholesterol and blood pressure.

“Many health professionals, including us, have either dismissed the value of very-low-carbohydrate diets for weight loss or been very skeptical of them,” said lead researcher Christopher Gardner, PhD, assistant professor of medicine at the Stanford Prevention Research Center. “But it seems to be a viable alternative for dieters.”

The results will be published in the March 7 issue of the Journal of the American Medical Association.

The 311 pre-menopausal, non-diabetic, overweight women in the study were randomly assigned to follow either the Atkins, Zone, LEARN or Ornish diet. Researchers chose the four diets to represent the full spectrum of low- to high-carbohydrate diets.

The Atkins diet, popularized by the 2001 republication of Dr. Atkins’ New Diet Revolution, represents the lowest carbohydrate diet. The Zone diet, also low-carbohydrate, focuses on a 40:30:30 ratio of carbohydrates to protein to fat, a balance said to minimize fat storage and hunger. The LEARN (Lifestyle, Exercise, Attitudes, Relationships and Nutrition) diet follows national guidelines reflected in the U.S. Department of Agriculture’s food pyramid—low in fat and high in carbohydrates. The Ornish diet, based on bestseller Eat More, Weigh Less by Dean Ornish, is very high in carbohydrates and extremely low in fat.

Study participants in all four groups attended weekly diet classes for the first eight weeks of the study and each received a book outlining the specific diet to which they were assigned. For the remaining 10 months of the study, the women’s weight and metabolism were regularly checked, and random phone calls monitored what they were eating.

One of the strengths of the $2 million study was that this setup mimicked real-world conditions, Gardner said. Women in the study had to prepare or buy all their own meals, and not everyone followed the diets exactly as the books laid out, just as in real life.

At the end of a year, the 77 women assigned to the Atkins group had lost an average of 10.4 pounds. Those assigned to LEARN lost 5.7 pounds, the Ornish followers lost 4.8 pounds and women on the Zone lost 3.5 pounds, on average. In all four groups, however, some participants lost up to 30 pounds.

After 12 months, women following the Atkins diet, relative to at least one of the other groups, had larger decreases in body mass index, triglycerides and blood pressure; their high-density lipoprotein, the good kind of cholesterol, increased more than the women on the other diets.

Gardner has several ideas for why the Atkins diet had the overall best results. The first is the simplicity of the diet. “It’s a very simple message,” he said. “Get rid of all refined carbohydrates to lose weight.” This message directly targets a major concern with the American diet right now—the increasing consumption of refined sugars in many forms, such as high-fructose corn syrup.

Beyond pinpointing this high sugar intake, the Atkins diet does the best at encouraging people to drink more water, said Gardner. And when people replace sweetened beverages with water, they don’t generally eat more food; they simply consume fewer calories over the course of the day.

The third theory Gardner offered as to why the Atkins diet was more successful is that it is not just a low-carbohydrate diet, but also a higher protein diet. “Protein is more satiating than carbohydrates or fats, which may have helped those in the Atkins group to eat less without feeling hungry,” he said.

Although the Atkins group led in terms of the average number of pounds lost, this group also gained back more weight in the second half of the study than those in the three other groups. Gardner also noted that the women in the Atkins group had lost an average of almost 13 pounds after six months, but ended the one-year period with a final overall average loss of 10 pounds.

Though critics of low-carbohydrate diets say that such diets can lead to health problems, none of the factors measured in this study was worse for the Atkins group. Gardner cautions, however, that there are potential long-term health problems that could not have been identified in a 12-month study. Also, several basic vitamins and minerals can be difficult to get in adequate amounts from a very-low-carbohydrate diet.

In the long run, Gardner hopes to use the large data set generated in this study to investigate why different diets might work better for different people. “We’re trying to see if we can learn more about the factors that predict success and failure with weight loss,” he said.

Regardless of what new insights are revealed, Gardner said the message he hopes people take from the study is the importance of eliminating from their diet, as much as possible, refined carbohydrates such as white bread and soda.

Gardner’s co-authors were Alexandre Kiazand, MD, postdoctoral scholar; Sofiya Alhassan, PhD, postdoctoral scholar; Soowon Kim, PhD, data analyst; Randall Stafford, MD, PhD, associate professor of medicine; Raymond Balise, PhD, statistical programmer; Helena Kraemer, PhD, professor of biostatistics; and Abby King, PhD, professor of health research and policy and of medicine. The work was supported by the National Institutes of Health, and a grant from the Community Foundation of Southeastern Michigan.

[fatnewmom]

It will be published in JAMA, fabulous!

[.muse.]

http://www.millan.net/minimations/smileys/cheerleader.gifhttp://www.millan.net/minimations/smileys/cheerleader2.gifhttp://www.millan.net/minimations/smileys/cheerleader3.gifIN YOUR FACE! NYAH NYAH! http://www.millan.net/minimations/smileys/cheerleader.gifhttp://www.millan.net/minimations/smileys/cheerleader2.gifhttp://www.millan.net/minimations/smileys/cheerleader3.gif

Man, it feels good to be validated, especially by such an esteemed school as Stanford. I cannot tell you how many friggin' people I have had tell me that I was going to die of a heart attack, or that all the weight would come back, or that it was terrible for my cholesterol or triglycerides, or any of that. Even my specialist when I was pregnant told me after I quit breast feeding to not do Atkins, that it was "dangerous".

Gnehehehe!~#$$%~#$!~#$%!~#

[LC FP]

It probably also helps that it wasn't supported by the Atkins Foundation.

Also, several basic vitamins and minerals can be difficult to get in adequate amounts from a very-low-carbohydrate diet.
I wonder what they are?


One of the strengths of the $2 million study was that this setup mimicked real-world conditions, Gardner said. Women in the study had to prepare or buy all their own meals, and not everyone followed the diets exactly as the books laid out, just as in real life.
I hate real life. I'd like to see them cram all that low fat food into the poor Ornish group for a whole year and see if they live... :)

[Dodger]

The problem that I have with studies like this is the randomization of the diets. People are randomly assigned to one of the diets. This tends to cause poor compliance. Many people have heard so much about the harmful effects of eating fat that, if assigned to Atkins, they try to eat low-carb and low-fat. This ends up being too few calories and leads to binges and going off the plan. It would be even worse for those randomly assigned to Ornish. You really have to be a fanatic to keep on that plan.

I would much rather have the people choose which plan they want to go on. Of course this would make it difficult to fill out some of the groups.

[Dodger]

Here is the abstract (http://jama.ama-assn.org/cgi/content/abstract/297/9/969)from the Journal.

Comparison of the Atkins, Zone, Ornish, and LEARN Diets for Change in Weight and Related Risk Factors Among Overweight Premenopausal Women
The A TO Z Weight Loss Study: A Randomized Trial

Christopher D. Gardner, PhD; Alexandre Kiazand, MD; Sofiya Alhassan, PhD; Soowon Kim, PhD; Randall S. Stafford, MD, PhD; Raymond R. Balise, PhD; Helena C. Kraemer, PhD; Abby C. King, PhD


JAMA. 2007;297:969-977.

Context Popular diets, particularly those low in carbohydrates, have challenged current recommendations advising a low-fat, high-carbohydrate diet for weight loss. Potential benefits and risks have not been tested adequately.

Objective To compare 4 weight-loss diets representing a spectrum of low to high carbohydrate intake for effects on weight loss and related metabolic variables.

Design, Setting, and Participants Twelve-month randomized trial conducted in the United States from February 2003 to October 2005 among 311 free-living, overweight/obese (body mass index, 27-40) nondiabetic, premenopausal women.

Intervention Participants were randomly assigned to follow the Atkins (n = 77), Zone (n = 79), LEARN (n = 79), or Ornish (n = 76) diets and received weekly instruction for 2 months, then an additional 10-month follow-up.

Main Outcome Measures Weight loss at 12 months was the primary outcome. Secondary outcomes included lipid profile (low-density lipoprotein, high-density lipoprotein, and non–high-density lipoprotein cholesterol, and triglyceride levels), percentage of body fat, waist-hip ratio, fasting insulin and glucose levels, and blood pressure. Outcomes were assessed at months 0, 2, 6, and 12. The Tukey studentized range test was used to adjust for multiple testing.

Results Weight loss was greater for women in the Atkins diet group compared with the other diet groups at 12 months, and mean 12-month weight loss was significantly different between the Atkins and Zone diets (P<.05). Mean 12-month weight loss was as follows: Atkins, –4.7 kg (95% confidence interval [CI], –6.3 to –3.1 kg), Zone, –1.6 kg (95% CI, –2.8 to –0.4 kg), LEARN, –2.6 kg (–3.8 to –1.3 kg), and Ornish, –2.2 kg (–3.6 to –0.8 kg). Weight loss was not statistically different among the Zone, LEARN, and Ornish groups. At 12 months, secondary outcomes for the Atkins group were comparable with or more favorable than the other diet groups.

Conclusions In this study, premenopausal overweight and obese women assigned to follow the Atkins diet, which had the lowest carbohydrate intake, lost more weight and experienced more favorable overall metabolic effects at 12 months than women assigned to follow the Zone, Ornish, or LEARN diets. While questions remain about long-term effects and mechanisms, a low-carbohydrate, high-protein, high-fat diet may be considered a feasible alternative recommendation for weight loss.

Trial Registration clinicaltrials.gov Identifier: NCT00079573 (http://www.clinicaltrials.gov/ct/show/NCT00079573)


Author Affiliations: Stanford Prevention Research Center and the Department of Medicine, Stanford University Medical School, Stanford, Calif.

[pbowers]

i put the article here (http://www.box.net/public/ornz4ogfss) .

[Samuel]

Study tips scale in favor of Atkins diet

Reuters (http://www.topix.net/redir/loc=off-hosted-page/http=3A=2F=2Ftoday.reuters.com)

March 06, 2007



http://205.217.158.209/pics/pullquote_open.gifMany health professionals, including us, have either dismissed the value of very-low-carbohydrate diets for weight loss or been very skeptical of them


By Michael Conlon

CHICAGO (Reuters) - A study of four popular diets found that women put on the one with the least carbohydrates -- the Atkins (http://www.topix.net/food/atkins) plan -- lost at least twice as much weight as those on the others, researchers said on Tuesday.

"Many health professionals, including us, have either dismissed the value of very-low-carbohydrate diets for weight loss or been very skeptical of them," said Christopher Gardner, assistant professor of medicine at the Stanford Prevention Research Center in California, lead author of the study.

"But it seems to be a viable alternative for dieters," he added, for whom the basic message is cutting down as much as possible on refined carbohydrates such as white bread and soda.

The research was described as the largest and longest comparison yet done on the four diets.

They were Atkins, the lowest in carbohydrates for the four; the Zone diet (http://www.topix.net/food/dieting), also low in carbohydrates and based on a 40:30:30 ratio of carbohydrates to protein to fat; the Lifestyle, Exercise, Attitudes, Relationships and Nutrition (http://www.topix.net/food/nutrition) (LEARN) diet which follows U.S. government guidelines for low fat but higher carbohydrates; and the Ornish diet, which is very high in carbohydrates but very low in fat.

The study randomly assigned a group of 311 overweight, post-menopausal, non-diabetic women one of the four diets. All attended weekly diet classes for eight weeks and were given books to follow. Their weight and metabolism were then checked for the following 10 months.

CHOLESTEROL AND BLOOD PRESSURE

Women assigned to the Atkins group lost an average of 10.4 pounds (4.7 kg) compared to 5.7 pounds (2.5 kg) for LEARN, 4.8 pounds (2.1 kg) for Ornish and 3.5 pounds (1.6 kg) for Zone, the study said.

The women on the Atkins diet also had the most improvements in terms of cholesterol and blood pressure, added the study published in this week's Journal of the American Medical Association.

The authors said some have worried that diets low in carbohydrates but high in total and saturated fat would cause cholesterol problems and increase the risk of heart disease.

"These concerns have not been substantiated in recent weight-loss diet trials," including the new research, the authors said.

Barry Sears, who developed the Zone diet, criticized the study as "bad science," saying details show the participants did not really follow the diet rules.

"The execution basically was fairly pathetic at best so the conclusions are jaded," he said in an interview. The way people followed the Atkins diet in the study, he said, is actually closer to the Zone's principles.

Study author Gardner, however, said one of the strengths of the $2 million project was that it mimicked real-world conditions, with participants preparing or buying all their own meals and not everyone following the diets exactly.

Gardner said the Atkins diet has "a very simple message. Get rid of all refined carbohydrates to lose weight," thus targeting the increasing consumption of refined sugars, such as high-fructose corn syrup.

He also said the Atkins diet is best at encouraging people to drink more water, and when people replace sweetened drinks with water, they do not generally eat more

[elpasopop]

I believe that there is a cause for the current obesity epidemic and that there will be no permanent cure for obesity untill that cause is discovered. However, I agree that Atkins diet is the only diet which can stabilize your weight with minimum suffering until that cure is found.

Unfortunately, in contradistinction to what some in Atkins-land espouse, the cause of obesity is eating more calories than you burn. Period, end of story. Now, the reasons for eating more calories than we burn are multicausal, but we can probably start with affluence, sedentary lifestyles, fast food in poor neighborhoods, loss of PE in schools, poor dietary choices made by working adults, advertising, and addicition/emotional disorders, to name a few. Fix those problems and the Nobel is yours. Shoot, the world is yours.

The "permanent cure" is to eat less calories than one needs to maintain current body weight. Which, during the past 60 days of working the Atkins program, I have been able to achieve. It's the best metabolic advantage one can have.

Glad this article is coming out, it is another tool in the toolbox for physicians.

[Samuel]

http://www.nbc30.com/news/11185197/detail.html

Study: Atkins Doesn't Raise BP, Cholesterol
Some Worry About Fat, Cholesterol In Low-Carb Diet
POSTED: 3:58 pm EST March 6, 2007


The Atkins diet is a very popular way to lose weight. But the idea of cutting carbohydrates and eating more protein and fat worries some doctors, who fear it could lead to increased cholesterol and blood pressure.

A new study in the Journal of the American Medical Association shows that not only was Atkins the most successful of four diets at weight loss, but that it did not increase blood pressure or cholesterol.

Christine Dillion said the diet worked for her.


"I was on the Atkins diet for about nine months and lost between 10 and 15 pounds but, much more importantly, lost two dress sizes, which is huge," she said.

Her results were typical in the study by Christopher Gardner, of Stanford University, that compared Atkins to the Zone, Learn and Ornish diets in about 300 women.

"By the end of the year, on average within the Atkins group, the average woman lost 10 pounds compared to the other three groups, where the average loss was closer to 5 pounds," he said.

Gardner said the simplicity of the diet may be the key to its success.

"Cutting out those simple refined carbohydrates -- the white bread, the white rice, the high fructose corn syrup, the soda pop," he said.

People on Atkins replaced soda with water, and Gardner said that played a big role in weight loss. A heart disease specialist who helped the study, Dr. Randall Stafford, agreed.

"This study will change my practices. In the future, I'm going to be more supportive of patients who come in already on an Atkins diet, and I'm certainly going to suggest this as a possible, reasonable approach to weight loss," he said.

The study's authors stressed that if people are going to go on the Atkins diet, they should follow the actual diet, which includes all kinds of healthy proteins, not just those that are high in fat and cholesterol.

[elpasopop]

The problem that I have with studies like this is the randomization of the diets. People are randomly assigned to one of the diets. This tends to cause poor compliance. Many people have heard so much about the harmful effects of eating fat that, if assigned to Atkins, they try to eat low-carb and low-fat. This ends up being too few calories and leads to binges and going off the plan. It would be even worse for those randomly assigned to Ornish. You really have to be a fanatic to keep on that plan.

I would much rather have the people choose which plan they want to go on. Of course this would make it difficult to fill out some of the groups.

Problem is, without randomization you can't use analytical methods (in this case epidemiological analyses) to draw inferences. In order to convince the scientific establishment of anything, we must use their language and processes to compare our apples to their apples. We know anecdotally that Atkins works, but that and a dollar will get you a non-Starbucks coffee at a scientific symposium of dietitians and bariatric docs.

[CarolynC]

An article linked on the front page of today's USA Today online also says that Atkins beats other diet plans in a study. See:

http://www.usatoday.com/news/health/2007-03-06-atkins-diet_N.htm

[Samuel]

Unfortunately, in contradistinction to what some in Atkins-land espouse, the cause of obesity is eating more calories than you burn. Period, end of story.
Sorry, although I agree that eating more calories than you burn is the direct cause, but we can't end the story here.

The human body contains a self regulation mechanism which - if functioning properly - knows how to maintain a constant weight. You cannot eat unless your body allows you to. Even if you could force yourself to eat and keep doing that for a long time, your body have other means to stabilize your weight. It can raise your metabolic rate, it pass food without complete digestion and it can even make you thraw-up if necessary.

[pbowers]

it didn't take long. the spin doctors have already started spinning and whinning and outright lying. ornish, of course, has the most spinning to do, because he's also defending the animals that the atkins people call breakfast lunch and dinner. sears and brownell (http://www.msnbc.msn.com/id/17484912/) are already on damage control as well.


Ornish: Why I Disagree With New Diet Study
A new comparison of four diets—including mine—is misleading and riddled with problems.
By Dean Ornish, M.D.
Special to Newsweek
Updated: 7:29 p.m. ET March 6, 2007

March 6, 2007 - A study came out today in the Journal of the American Medical Association (JAMA) claiming that you can lose more weight on an Atkins diet than an Ornish, Zone, or LEARN (Lifestyle, Exercise, Attitudes, Relationships and Nutrition) diet and—ta dah!—(drum roll, maestro), it’s even better for your heart! I imagine that a lot of people are going to be saying, “You mean I’ve been eating fruits and vegetables for all these years for nothing when I could have been eating bacon and eggs? What was I thinking!”

The authors concluded, “Women assigned to follow the Atkins diet, which had the lowest carbohydrate intake, lost more weight and experienced more favorable overall metabolic effects at 12 months than those assigned to follow the Zone, Ornish, or LEARN diets.” This is simply not true. If you read the study carefully, you will find that the authors found that there was no significant difference in weight loss between the Atkins and Ornish or LEARN diets after one year! (There was significantly more weight loss on the Atkins diet after one year only when compared with the Zone diet.) This directly contradicts the primary conclusion of their study.

As a result, many people may go on a diet that harms them based on inaccurate information. Other studies also found that people who lost weight on an Atkins diet after six months gained it back after one year.

This new JAMA study is seriously flawed and its conclusions misleading for other reasons. Here’s why:
# Most study participants weren’t following an Ornish diet, which is 10 percent fat. They reduced their fat intake from an average of 35 percent to only 30 percent after one year. If they’re not following the dietary recommendations, it’s not surprising that they didn’t show as much improvement. By analogy, two-thirds of people prescribed Lipitor aren’t taking it only four months later. Lipitor is a very effective way to lower cholesterol levels, but only if you take it. It would have been helpful if the authors had reported findings on the subset of people who actually followed the different diets to see what happened to them.

# When people adhere to an Ornish diet, they have striking improvements. In a randomized controlled trial, also published in JAMA, study participants who were asked to follow an Ornish diet showed a 25 pound weight loss after one year and kept off half that weight five years later. Also, they had a 40 percent average decrease in LDL-cholesterol without cholesterol-lowering drugs, and their apolipoprotein profiles improved. In a series of randomized controlled trials, patients showed some reversal of coronary heart disease after only one month, even more after one year, and even more after five years using state-of-the-art measures such as quantitative coronary arteriography and cardiac PET scans, also published in JAMA.

There was a direct correlation between how well people adhered to the diet and how much blockage there was in their coronary arteries. There were 2.5 times fewer cardiac events such as heart attacks, and 99 percent of these patients stopped or reversed the progression of their heart disease. These are actual measures of heart disease, not just risk factors such as changes in cholesterol levels. So, for the study that came out today in JAMA to say that the Atkins diet is just as good for your heart as an Ornish diet makes me a little crazy, since they didn’t measure heart disease, only risk factors.

Last year, my colleagues and I at the nonprofit Preventive Medicine Research Institute and the University of California, San Francisco published the first randomized controlled trial showing that our diet and lifestyle program could stop or reverse the progression of prostate cancer. We also found this diet may reverse the progression of diabetes, high blood pressure, and other chronic diseases.

# In contrast, studies show that heart disease worsens on the Atkins diet. This is consistent with published autopsy results on Dr. Atkins revealing that he had serious heart disease when he died. It’s important to lose weight in a way that enhances health rather than ones that may harm it. These are summarized more extensively in a review article that I wrote, “Was Dr. Atkins Right?” that was published in the Journal of the American Dietetic Association.

# LDL (“bad” cholesterol) rose on the Atkins diet but came down on the Ornish diet in this new JAMA study.

# HDL (“good cholesterol”) rose slightly on the Atkins diet but did not change after one year on the Ornish diet. However, not everything that raises HDL is good, which is summarized in a recent NEWSWEEK column, “The Garbage Trucks in Your Blood.” Your body makes HDL to get rid of excessive saturated fat and cholesterol in your diet. If you eat a stick of butter, your HDL will go up, but that doesn’t mean that butter is good for your heart. Pfizer recently had to stop a large trial of torcetrapib when it was found that this drug raised HDL but also increased the risk of heart attacks and strokes.

# This study did not test the effectiveness of different diets. It only tested how well people adhered to different diets simply by reading a book and having a few sessions with a dietitian. It’s easier for people to follow an Atkins diet of bacon and brie than an Ornish diet that includes fruits, vegetables, whole grains, legumes, soy products, and fish, so it’s not surprising that people adhered better to an Atkins diet. However, we need to distinguish what is healthful from what is easy. I’d love to be able to tell you that bacon and brie are good for your heart, but they’re not. Enjoy them in moderation, if you wish, but don’t kid yourself that these are health foods. Also, the diet is only one component of my lifestyle program. It’s hard to adhere to a new way of eating unless you also practice stress management techniques and have psychosocial support, since many people overeat when they are under stress or feeling lonely and depressed.

# Given sufficient support, many people are able to follow our program of diet and lifestyle changes. Beginning in 1993, my colleagues and I at the nonprofit Preventive Medicine Research Institute began training hospitals in our diet and lifestyle program at hospitals throughout the country. Not just in San Francisco, Boston, and New York, but also in Columbia, SC, where they told me, “gravy is a beverage,” as well as 10 hospitals in West Virginia, which is No. 1 in the country in the incidence of heart disease. We now have data from more than 3,000 patients who have gone through our program in three demonstration projects, including one with Medicare. We have consistently found bigger changes in diet and lifestyle, better clinical outcomes, and larger cost savings than have ever before been documented.

# Medicare recently agreed to cover our program for reversing heart disease. Two years ago, we presented data from the first 2,000 patients to the Medicare Coverage Advisory Commission in an all-day hearing. These patients lost almost 20 pounds during the first year, their blood pressure decreased from 150/86 to 129/76, and their fasting blood sugar decreased from 150 to 125 mg/dl.

Having spent the past 30 years of my life conducting research showing what a powerful difference changes in diet and lifestyle can make, I’m concerned that this study may cause some people to forego eating a healthy diet in favor of one that may be harmful to them. I’m tired of these diet wars. It’s not low fat vs. low carb. It’s both. An optimal diet is low in total fat and low in refined carbohydrates, emphasizing whole foods such as fruits, vegetables, and whole grains.

http://www.msnbc.msn.com/id/17490143/site/newsweek/page/2/

[Samuel]

Actually, this means good news to us. The concerns of Ornish and Sears mean that the new study can cause a change in how Atkins diet is evaluated by the medical community.

[Demi]

This study has also now been reported by New Scientist:

Atkins diet marginally better than rivals (http://www.newscientist.com/article/dn11321-atkins-diet-marginally-better-than-rivals.html)


The Times Online site has changed the front page link to the original story to read: Atkins is a girl's best friend (http://www.timesonline.co.uk/tol/news/) ... if one phrase is guaranteed to revive the Atkins diet in the UK, then that's definitely it! (Sorry guys!)

[Demi]

Have also just come across these:

Atkins Fares Best in Study Of Four Weight-Loss Regimens (http://www.washingtonpost.com/wp-dyn/content/article/2007/03/06/AR2007030601166.html) - Washington Post

Atkins Beats Other Diet Plans in Study (http://www.washingtonpost.com/wp-dyn/content/article/2007/03/06/AR2007030601058.html) - Associated Press (Published in Washington Post)

Eat To Live: Atkins diet back on top (http://www.sciencedaily.com/upi/index.php?feed=Science&article=UPI-1-20070305-12185900-bc-eat2live-diets.xml) - Science News Daily


I know that these articles are all much of a muchness, but IMO it's good to see the Atkins (low carb) message being given positive publicity in this way.

[Nico78]

This is the link

http://www.newscientist.com/article.ns?id=dn11321&feedId=online-news_rss20

It says that Atkins is marginally better than rivals diets.... but I really don't understand all the reasoning they did just to say that in the end we are eating low-calories and that's still the reason we are losing weight.

[kebaldwin]

Unfortunately, in contradistinction to what some in Atkins-land espouse, the cause of obesity is eating more calories than you burn. Period, end of story.

You are incorrect. Millions of Atkins dieters have proved that incorrect. I hope that you soon start listening.

[kneebrace]

Unfortunately, in contradistinction to what some in Atkins-land espouse, the cause of obesity is eating more calories than you burn. Period, end of story.

Actually it's only the beginning of the story elpasopop. Firstly because a low carb dietary approach will also cause a human body to burn more calories per calorie consumed. And secondly, and IMHO far more importantly, the hormonal environment engendered by low carb will lead to many of the 'excess to energy demands' calories consumed being merely excreted. I wish more bench scientists would start analyzing the energy content of human urine under different macronutrient ratios. It seems a pretty obvious place to start looking for the explanation of why 'eating more calories than you burn' is a hopelessly simplistic and inadequate explanation of obesity.... or the lack of it ;)

[kebaldwin]

I appreciate your insight as to what is happening - because I don't know how it works -- I know only that it does work.

You don't even have to look at exactly what happens inside your body. Just take several over weight people put them on the Atkins diet - and see what happens. They lose weight and their health improves (by no longer needing prescription drugs, having more energy, health problems are gone, concentration is much improved, eyesight is better, by looking at their blood tests, etc).

[1000times]

Have also just come across these:
Atkins Fares Best in Study Of Four Weight-Loss Regimens (http://www.washingtonpost.com/wp-dyn/content/article/2007/03/06/AR2007030601166.html) - Washington Post
Atkins Beats Other Diet Plans in Study (http://www.washingtonpost.com/wp-dyn/content/article/2007/03/06/AR2007030601058.html) - Associated Press (Published in Washington Post)
Eat To Live: Atkins diet back on top (http://www.sciencedaily.com/upi/index.php?feed=Science&article=UPI-1-20070305-12185900-bc-eat2live-diets.xml) - Science News Daily

I'm waiting for GamePro magazine to headline their version thusly:
ATKINZ PWNS 0RNISH D!ET!!!111

[diemde]

Well, regardless of how it works, the good news here is that the researchers and reporters are paying attention! Even the rebuttals will help to stir things up a bit. I think sometimes the researchers are staring into their test tubes for too long and need to come up for air and look at the real world. While they are off studying, trying to find that magic pill, people are dying from obesity related illnesses. We need to get the word out on the street to use lower carb diets, regardless of which specific plan. I think this announcement will help do that.

[pbowers]

The authors concluded, “Women assigned to follow the Atkins diet, which had the lowest carbohydrate intake, lost more weight and experienced more favorable overall metabolic effects at 12 months than those assigned to follow the Zone, Ornish, or LEARN diets.” This is simply not true. If you read the study carefully, you will find that the authors found that there was no significant difference in weight loss between the Atkins and Ornish or LEARN diets after one year! (There was significantly more weight loss on the Atkins diet after one year only when compared with the Zone diet.) This directly contradicts the primary conclusion of their study.i guess the lack of fat is impairing dean's ability to read and comprehend. the authors' conclusions are accurate; the women on atkins lost more weight and had better biomarkers after 12 months. the weight loss, after 12 months, was not statistically significant (notice how dean omits the word 'statistically'). the women lost twice as much weight as the ornish people - despite eating a diet composed of 34% carbs after 1 year.
http://farm1.static.flickr.com/174/413598941_422aad43e9.jpg

also, note that dean claims the conclusions of the authors are false, but he only disputes the weight loss, not the metabolic factors.

[pbowers]

In contrast, studies show that heart disease worsens on the Atkins diet. This is consistent with published autopsy results on Dr. Atkins revealing that he had serious heart disease when he died. It’s important to lose weight in a way that enhances health rather than ones that may harm it. These are summarized more extensively in a review article that I wrote, “Was Dr. Atkins Right?” that was published in the Journal of the American Dietetic Association.which studies were these, dean? perhaps one that you conducted? atkins had severe heart disease? really? care to expound? you had your boys steal the autopsy report, but no such information was found. atkins suffered from myocarditis, a viral infection of the heart, which can cause weakening of the heart muscle and heart failure. i'm not sure dean would know the difference.

If you eat a stick of butter, your HDL will go up, but that doesn’t mean that butter is good for your heart.does it mean its bad for you? some evidence please. it's revealing that people like dean are now trying to dispute the benefits of low-carbing as opposed to telling us how bad it is for us. i guess this is how paradigms begin to change.

[elpasopop]

You are incorrect. Millions of Atkins dieters have proved that incorrect. I hope that you soon start listening.

I'm an Atkins believer, as I have lost 50+ pounds on the plan. Your claim is unsupported by the facts and unsubstantiated in any literature. The reason anyone loses weight on atkins is because they consume fewer calories than they burn. We may burn it by a variety of mechanisms, but we still burn more than we eat, hence weight loss. The burden of proof is on you to prove your claim; there is 200 years of medical research to back up my claim.

[elpasopop]

Sorry, although I agree that eating more calories than you burn is the direct cause, but we can't end the story here.

The human body contains a self regulation mechanism which - if functioning properly - knows how to maintain a constant weight. You cannot eat unless your body allows you to. Even if you could force yourself to eat and keep doing that for a long time, your body have other means to stabilize your weight. It can raise your metabolic rate, it pass food without complete digestion and it can even make you thraw-up if necessary.

You are mentioning set point theory. Our bodies tend to stabilize towards a specific weight. IF WE ARE NORMAL. I, however, have quite an abnormal food intake pattern. I can eat when my body tells me no. I have no such mechanism...hence morbid obesity exists for me and countless others. There are hundreds of ways to burn weight and our bodies adapt and adjust depending on the types of foods we eat...nobody disputes that. But we can't burn calories that aren't there to burn -- out of thin air -- so what we eat gets burned and the rest, if there is a deficit, comes from our bodies.

[pbowers]

The reason anyone loses weight on atkins is because they consume fewer calories than they burn.this is obvious. however, what's in question is whether one's metabolism can be modified to burn more calories simply by changing the composition of one's diet. it appears that energy expenditure goes up on lc diets without increases in physical activity. this would constitute a metabolic advantage over other types of diets and would come in addition to the reduced intake of calories that typically occurs when one reduces carb intake.

[1000times]

Unfortunately, in contradistinction to what some in Atkins-land espouse, the cause of obesity is eating more calories than you burn. Period, end of story.

Begone, blasphemer! To Hell with you, heretic -- and take your unholy "biochemistry" with you!

:devil: :lol:

[camkuhns]

And still another link to support Atkins.
www.eurekalert.org/pub_releases/2007-03/sumc-sds030107.php

[1000times]

And still another link to support Atkins.
www.eurekalert.org/pub_releases/2007-03/sumc-sds030107.php
That's the same story. It doesn't count as additional evidence.

[PS Diva]

the cause of obesity is eating more calories than you burn. Period, end of story.Certainly the medical establishment has believed this for years. Don't you think, with what you have learned about low carb that that is a bit of over simplification?

[Whoa182]

Little video report on it here

http://wjz.com/seenon/local_story_066074912.html

[KarenJ]

HDL (“good cholesterol”) rose slightly on the Atkins diet but did not change after one year on the Ornish diet. However, not everything that raises HDL is good, which is summarized in a recent NEWSWEEK column, “The Garbage Trucks in Your Blood.” Your body makes HDL to get rid of excessive saturated fat and cholesterol in your diet. If you eat a stick of butter, your HDL will go up, but that doesn’t mean that butter is good for your heart. Pfizer recently had to stop a large trial of torcetrapib when it was found that this drug raised HDL but also increased the risk of heart attacks and strokes.

That is the most insulting, ridiculous, illogical thing I've ever read. Gee, I better start getting my HDL down or I'm going to die of a heart attack. :rolleyes:
Is torcetrapib made from butter? Unbelievable how this guy twists words to suggest that "not everything that raises HDL is good".
The man obviously needs a steak.

Anecdotal at best, but I gained 30 pounds on a 1500 calorie/day diet.
I now maintain exactly the same weight (and have for 3 years) eating at least 2,000 calories/day. It has nothing to do with calories and everything to do with where those calories come from.
I believe in "energy in/energy out" when it comes to cars and gasoline, but not when it comes to Humans.

[mrjsmith]

I absolutely hate msnbc. Their health section is riddle with garbage. I've written several hate filled diatribes about articles they've posted in a blog (that I've since taken down, as I'm looking for a job and don't want to see too angry ;).

You know how they posted this story? By giving Dean Ornish a podium to yell back from.

"Why I Disagree With this Study"

http://www.msnbc.msn.com/id/17490143/site/newsweek/

Yeah, if you go to the Health section, you get the normal article...

http://www.msnbc.msn.com/id/17484912/

but Dean's response gets posted on the actual home page.

Loved this...

“It’s a lot easier to follow a diet that tells you to eat bacon and brie than to eat predominantly fruits and vegetables,” said Dr. Dean Ornish, creator of the Ornish diet.

Yeah. Right. If you can't follow the diet, it doesn't work.

Loved this...

“To me, it just screams out for the need to prevent obesity,” Brownell said.

Thanks. Glad we solved that. We can just pack it up and go home now. How crazy is that? As if preventing obesity had an obvious solution.

I liked the opener...

"beating the Zone, the Ornish diet and even U.S. guidelines"

Like the U.S. guidelines were somewhere in the bible and found in cave paintings. I was doing a little research into the Pyramid. If you get some time, check it out.

Where does the pyramid come from? The government, right? Yeah, but what agency?

http://www.mypyramid.gov/

Ah. The Department of Agriculture. Wouldn't it make more sense to have the Food and Drug Administration do that?

Check out the mission statement on the USDA's site (http://www.usda.gov):

"expanding markets for agricultural products and support international economic development, further developing alternative markets for agricultural products and activities, providing financing needed to help expand job opportunities and improve housing, utilities and infrastructure in rural America..."

Seems like they have a lot of stuff to do. Not sure why they'd be coming up with food guidelines, unless they were selling something. To be fair, meat is made on farms too, but I'm guessing grains would have to actually kill you before they'd suggest you eat less of them.

Rant over.

[JL53563]

this is obvious. however, what's in question is whether one's metabolism can be modified to burn more calories simply by changing the composition of one's diet. it appears that energy expenditure goes up on lc diets without increases in physical activity. this would constitute a metabolic advantage over other types of diets and would come in addition to the reduced intake of calories that typically occurs when one reduces carb intake.


Notice that the calorie intake was virtually the same in all 4 diets. Yet Atkins people last twice as much weight.

[1000times]

it appears that energy expenditure goes up on lc diets without increases in physical activity.
I don't understand how you're coming to this conclusion. Is this coming out of that chart that you provided? Or are you referring to a different study?

[tie_guy]

mrjsmith, that is a good point. Food guidlines probably should come from the FDA and not the USDA. Health information should come from the department that is in charge of safety not the department in charge of helping an industry.

Of course even if it came from the FDA, that doesn't mean that the FDA would do anything different. I have heard former FDA employees claim that they initially thought the FDA was formed to protect consumers from drug companies; in reality they say the FDA does the opposite. Gotta keep those statin sales going! So they may have some side effects we will only mention them quickly in our TV ads!

[Whoa182]

That is the most insulting, ridiculous, illogical thing I've ever read. Gee, I better start getting my HDL down or I'm going to die of a heart attack. :rolleyes:

you're taking way to personal. The logic in the statement you are responding to is a possibility and is not illogical at all. Whether or not its true... it can be that way and yes more research needs to be done. Nothing is final yet, and the picture of what is going on will continue to evolve as we get better science.

Anecdotal at best, but I gained 30 pounds on a 1500 calorie/day diet.

Hmmm

So what? Everyone has their own calorie needs for their own body. What might make someone else lose at 1500 might not work for you. it proves nothing. I doubt you gained 30lbs on 1500k/cal a day unless you are 4ft?

It has nothing to do with calories

That is illogical and false.

I believe in "energy in/energy out" when it comes to cars and gasoline, but not when it comes to Humans.

Sure humans are way more complex... but if you were in a calorie deficit you will lose weight if you are 'normal' and not suffering from some sort of metabolic disorder. Go search on pubmed and you'll see. Calorie restriction in obese or overweight will cause weight loss for the large majority. Only thing is, when people are left alone and not advised calorie intake is usually much higher than reported.

Im not saying atkins doesnt have an advantage over other diets, i'm saying that to say calories in unimportant is totally false.

[pbowers]

I don't understand how you're coming to this conclusion. Is this coming out of that chart that you provided? Or are you referring to a different study?well, it could come out of the data in the study being discussed, but I was speaking in general. there is quite of bit of research supporting the "metabolic advantage" of lc diets and logical biochemical explanations are available. you can find much of it on the nutrition and metabolism (http://www.nutritionandmetabolism.com/).

here's a good overview:

Background

It is commonly held that "a calorie is a calorie", i.e. that diets of equal caloric content will result in identical weight change independent of macronutrient composition, and appeal is frequently made to the laws of thermodynamics. We have previously shown that thermodynamics does not support such a view and that diets of different macronutrient content may be expected to induce different changes in body mass. Low carbohydrate diets in particular have claimed a "metabolic advantage" meaning more weight loss than in isocaloric diets of higher carbohydrate content. In this review, for pedagogic clarity, we reframe the theoretical discussion to directly link thermodynamic inefficiency to weight change. The problem in outline: Is metabolic advantage theoretically possible? If so, what biochemical mechanisms might plausibly explain it? Finally, what experimental evidence exists to determine whether it does or does not occur?

Results

Reduced thermodynamic efficiency will result in increased weight loss. The laws of thermodynamics are silent on the existence of variable thermodynamic efficiency in metabolic processes. Therefore such variability is permitted and can be related to differences in weight lost. The existence of variable efficiency and metabolic advantage is therefore an empiric question rather than a theoretical one, confirmed by many experimental isocaloric studies, pending a properly performed meta-analysis. Mechanisms are as yet unknown, but plausible mechanisms at the metabolic level are proposed.

Conclusions

Variable thermodynamic efficiency due to dietary manipulation is permitted by physical laws, is supported by much experimental data, and may be reasonably explained by plausible mechanisms.

Carbohydrate restriction as a general strategy for weight loss continues to gain in popularity and its utility and generally protective effect in lipid profile and glycemic control continues to be demonstrated, at least in an experimental setting [1-4]. The subject nonetheless remains controversial. Those critics who grant efficacy of low carbohydrate diets nonetheless contend that they act strictly by caloric restriction and there is no special effect of carbohydrate reduction. Beyond caloric restriction, several studies have shown increased weight loss on low carbohydrate diets compared to isocaloric low fat diets, the so-called metabolic advantage (see table 2). Although no clear experimental error has been demonstrated, critics continue to maintain that something must be wrong because the laws of thermodynamics would be violated [5], that "a calorie is a calorie" [6] We have previously shown [2,7] that this is not correct and it is our intention here to review the fundamental physics underlying the phenomenon of metabolic advantage. An outline may be described: Can metabolic advantage happen? If so, what mechanisms might account for such a phenomenon? Does it, in fact, occur?

Metabolic advantage: can it happen?

We have previously presented arguments that there is no violation of physical principles [2,7] and, ironically, that suggesting a change in body mass to be independent of macronutrient composition would itself be a violation of the second law of thermodynamics [7]. Here, we reframe these arguments in a more pedagogically direct way and we provide simple examples.

The misunderstanding that continues to be repeated in the expression "a calorie is a calorie" appears to be exclusive reference to the first law of thermodynamics. The difficulty with this theoretical approach is that it is only part of the relevant physics and its relationship to biologic systems. The first law says that in any transformation the total energy in the system can be accounted for by the heat added to the system, the work done by the system on its environment and the change in energy content of all the components of the system. It is important to understand, however, that the first law does not say what the relative distribution between these effects will be for any process. In fact, the first law does not even allow us to say whether the process will occur at all. To understand the progress of a physical change it is necessary to understand the second law which introduces an entity known as the entropy, S, a measure of disorder in all processes. In all real (irreversible) processes, entropy increases, usually written ΔS > 0. The most common marker of increasing entropy is heat, although it is by no means the only evidence for increased entropy.

In systems at constant temperature and pressure (i.e. biologic systems)), the first and second law are combined in the Gibbs Free Energy, ΔG, which represents the maximum useful work that can be performed by the process. The actual process however, in general derives less useful work than permitted by the theoretically available ΔG due to inefficiency in energy capture. A proper accounting of entropy and efficiency must be included if we are to understand energy utilization in biological and biochemical systems.

Biological systems and thermodynamics

It is also important in the discussion of biological systems to understand that they are open systems, i.e. they take in nutrients and oxygen and excrete carbon dioxide, water, urea and other waste products, as well as heat. The importance with respect to weight considerations is that mass and energy are conserved (the more general statement of the first law of thermodynamics), but they are not conserved entirely within the organism.

To illustrate the proper interpretation of the first law of thermodynamics consider a subject whose resting energy expenditure is met by the production of 95 moles of ATP. Since oxidation of a single mole of glucose provides 38 moles of ATP, 2.5 moles of glucose will be needed to meet this individual's resting energy requirements. It is important to note that the resultant carbon dioxide, water, and heat are not retained within the organism. The useful retained energy is in the 95 moles of ATP (Figure 1B). (Similar equations could be written for lipid or protein but we restrict our discussion to glucose for simplicity).

The illustration above can be compared to the oxidation of glucose in a calorimeter in which no useful energy is obtained and the total energy of oxidation is measured as the heat produced. This process is completely inefficient. A traditional (Atwater) value for glucose obtained in the calorimeter is approximately 4 kilocalories of energy per gram (Figure 1A). By contrast, the living organism above metabolizes and oxidizes glucose so that approximately forty percent of the energy of oxidation is retained as useful ATP (38 moles per mole of glucose)) whereas sixty percent is released as heat, the inefficiency in this mode of oxidation. The entropy (i.e. the second law of thermodynamics) shows up in this inefficiency. The calorimeter heat can no longer be interpreted in a simple way. The energy stored in useful ATP represents the efficiency of 40% (neglecting the difference in entropy between the structures of the products and reactants). This value approximates the efficiency for oxidation of carbohydrate as well as lipid, whereas proteins are generally oxidized at a lower value of approximately 30–35% (Figure 1B).

Summary of thermodynamics in living organism

1. The second law of thermodynamics dictates that there is an inevitable metabolic inefficiency in all biological and biochemical processes with heat and high entropy molecules (carbon dioxide, water, urea) as the most common products.

2. The first law of thermodynamics is satisfied in living (open) systems by properly accounting for the mass excreted and the heat radiated and exported in high entropy molecules.

Weight loss due to reduced caloric intake

The most common example of weight loss is reduction of caloric intake. At the risk of oversimplification, if our subject ingests fewer than 2.5 moles of glucose and produces, for example, only 90 moles of ATP from food, then homeostasis would require enlisting endogenous body stores for further oxidation. This oxidation would then provide the additional 5 moles of ATP required. Oxidation of body stores (lipid or lean body mass) will result in production of additional carbon dioxide, urea, water and heat. The excretion of these products will result in weight loss. (Figure 1C).

Weight loss due to increased metabolic inefficiency

The implication of the first and second laws of thermodynamics is that reduced efficiency has precisely the same result as reduced caloric intake. One conceptually simple means of reducing efficiency involves the process of uncoupling in mitochondria. ATP is produced in a variety of cellular locations. Glycolysis produces a net of two ATP's per molecule of glucose, in the cell cytoplasm. On the other hand, we recall that 36 additional molecules of ATP are produced from glucose as a result of the mitochondrial TCA cycle and electron transport. A critical part of the process involves the development of a hydrogen ion gradient across the mitochondrial membrane. This concentration gradient provides the energy that is converted into ATP as hydrogen ions pass down the gradient through the ATP synthase particle, entirely analogous to the energy in a high-pressure gas in a cylinder with a movable piston. (The expansion of the gas is like diffusion down a gradient: It does work against the piston). In the mitochondrion the energy of moving down the gradient is captured in ATP, the medium of exchange for the performance of work within cells. This capture of energy, referred to as coupling the energy to the formation of ATP, is the essential process permitting work to be done by living systems.

There are known endogenous and pharmacologic agents, which result in uncoupling the formation of ATP from the dissipation of the gradient. Uncouplers such as 2, 4-dinitrophenol bypass ATP synthase and cause hydrogen ion gradient dissipation without ATP formation that can result in organ dysfunction causing death. More modest degrees of uncoupling may be caused by the class of endogenous compounds we know as uncoupling proteins (UCP's). Three different isoforms, UCP1, UCP2 and UCP3 have been identified thus far in mammalian tissues. While the overall and relative physiologic importance of these proteins remains incompletely understood in human tissues, UCP1 has been shown in mice [8] to result in modest degrees of uncoupling in brown fat. Elevation of fatty acid concentration has been associated with induction of UCP3 and even with pathologic reductions of myocardial efficiency in rat heart [9]. For purposes of illustration, then, we may consider that there may be physiologic triggers that result in oxidative uncoupling, reducing the overall efficiency of glucose metabolism. For example if efficiency is reduced from 40% to 35%, the result will be the production of only 34 moles of ATP instead of the usual 38. While this represents a mechanism better demonstrated in rats than humans, our subject would require more glucose to make 95 moles of ATP. Now 2.9 moles of glucose would be required to produce 95 moles ATP. Our subject would either eat more and stay at the same weight (Figure 1D) or would eat 2.5 moles of glucose, the same amount as previously, but would produce less ATP. By eating only 2.5 moles of glucose our subject's metabolism would enlist oxidation of body stores to make up the additional ATP needed for homeostasis. This would result in weight loss exactly as it did for reduced caloric intake. (Figure 1D).

The essence of the second law of thermodynamics is that it guarantees inefficiency in all metabolic processes. However, variation of efficiency is not excluded. In fact, the laws of thermodynamics are silent on the existence of variable efficiency. If efficiency can vary (as in the example of oxidative uncoupling) then "a calorie is a calorie" is no longer a true statement. The role of uncoupling proteins in humans, as indicated, is as yet incompletely defined [10]. However, thermodynamic principles permit variable efficiency, and its existence must be determined empirically.

Metabolic advantage: how could it happen?

It is possible that metabolic efficiency may be decreased by oxidative uncoupling as described above. Polymorphisms connecting uncoupling proteins with obesity or propensity to gain weight have been identified in humans [11,12] although these are not firmly established and the effect of dietary intervention is unknown. Other mechanisms are better understood and are described below.

Substrate cycling and protein turnover

Substrate or "futile" cycles refer to the dynamic process that must accompany the thermodynamic steady state [13]. In particular, increased cycling of metabolic intermediates utilizes ATP and generates heat. The simplest examples are the numerous kinase-phosphatase pairs that regulate metabolism. In addition, although not generally considered in the category of substrate cycling, inefficiency results from the repeated breakdown and re-synthesis of proteins, lipids, and carbohydrates in cycles that use ATP for no apparent net gain. Such mechanisms, however, far from futile, allow for precision in the regulation of metabolism and constitute one of the uses of ATP. Protein turnover, in particular, provides for error correction or removal of "old" or damaged proteins. The effect of metabolic path on the energetics of oxidation is illustrated in Table 1 which summarizes the analysis from our earlier paper [2]. In this example, a mole of glucose directly oxidized to CO2 and water generates 38 moles of ATP with an overall efficiency of about 38.5%. On the other hand, if glucose is first incorporated into glycogen, followed by hydrolysis of the glucose and subsequent oxidation, 2 moles of ATP are lost per mole in this cycle with overall efficiency reduced to 35%. Similarly an amino acid from an "average" protein, when directly oxidized to CO2, produces ATP with an efficiency of about 33%. If the amino acid is first incorporated into a protein and later hydrolyzed and oxidized, four ATP's per molecule are used for synthesis of the peptide bond. This reduces the efficiency to 27%. Smaller degrees of inefficiency are seen for lipid cycles (Table 1) but multiple cycles may have a cumulative effect. It is estimated, for example, that half of depot fatty acids in triacylglycerol have been through at least one cycle [14]. It should be apparent that variation in efficiency is not a thermodynamic issue but an empiric question to be determined by the requirements of metabolism.

Thyrotoxicosis

Thyroid hormone decreases efficiency possibly by mechanisms involving both uncoupling and cycling described above: oxidative uncoupling as well as increased futile cycling of intermediates [15]. It is observed in thyrotoxic mice that UCP1 decreases efficiency in brown fat at the mitochondrial level [8]. In humans, the role of UCP1 in thyrotoxicosis is less certain due to the relative paucity of brown fat. On the other hand, activation of the adrenergic system via phosphoenolpyruvate carboxykinase ultimately increases "futile" metabolic cycling of intermediates ([15]). Thyrotoxicosis is well known to result in weight loss, often with increased food intake and increased generation of heat, indicative of metabolic inefficiency. The use of thyroid hormone has even been suggested therapeutically to induce weight loss in obese individuals, although its toxicity has limited this application. Inefficiency in metabolic processes with weight loss and increased heat generation, therefore, is known to occur on clinical grounds. Even without a complete understanding of the relative importance of different underlying cellular mechanisms in humans, the potential for biochemical processes to reduce their efficiency must be considered established as a feature of mammalian metabolism.

Protein induced protein turnover

There is abundant evidence that dietary protein stimulates protein breakdown and re-synthesis. In particular, branched chain amino acids, and especially leucine, are documented to act as nutritional signals acting via both the insulin and mTOR signaling pathways [16-18]. On the macroscopic level, the energetic cost of protein turnover is demonstrable as excess heat generated during a high protein meal. Thermogenesis (thermogenic effect of feeding; old name: specific dynamic action) has been defined as the extra heat generated during a meal due to digestion or metabolism. Johnston et al [19] compared the energy expended during 9 hour intravenous feedings of a high protein meal, vs. an isocaloric high carbohydrate meal; both contrasted with a 9 hour fast. The protein meal, with 70% of its caloric value due to protein, had significantly greater thermogenesis than the high carbohydrate meal (70% of calories from carbohydrate). These data have been reproduced in numerous studies [19-22]. The overall energy costs of protein turnover and synthesis have been estimated in various animal species, including man, and tabulated by Vernon Young ([23]), based on data from other investigators [24-26]. Despite the substantial experimental difficulties involved, the cost of protein synthesis clusters at around 4–5 kcal/gram in 8 species of birds, marsupials and mammals, including man. The high energetic cost is understandable in view of the multiple ATP-requiring processes involved. The cost of protein turnover can reduce efficiency from 33% to 27%, merely in the formation and hydrolysis of a single peptide bond (requiring 4 ATP's per bond formed: Table 1). In addition, protein processes that are ATP-dependent include formation of the ribosomal initiation complex, translation and folding of the protein, and protein degradation (both ubiquitin-dependent and -independent pathways) [23]. The energy costs of protein turnover could therefore account for a metabolic advantage in high protein diets, independent of carbohydrate content. This mechanism may also contribute to inefficiency in low carbohydrate diets, often high in protein.

Gluconeogenesis-stimulated protein turnover in carbohydrate restriction

The following hypothesis is suggested from classic studies of starvation done in chronically fasted obese individuals [27,28]. The brain's metabolism requires 100 grams of glucose per day. In the early phase of starvation, glycogen stores are rapidly reduced, so the requirement for glucose, is met by gluconeogenesis. Approximately 15–20 grams are available from glycerol production due to lipolysis, but fatty acid oxidation generally cannot be used to produce glucose. Therefore, protein breakdown must supply the rest of substrate for conversion to glucose in the early phases of starvation. By 6 weeks of starvation, ketone bodies plus glycerol can replace 85% of the brain's metabolic needs, the remainder still arising from gluconeogenesis due to protein. It should be mentioned that, since the fundamental role of ketones is to spare protein, it might be expected that the reliance on protein would actually decrease with time, perhaps relating to the anecdotal observation of "hitting the wall" on weight loss diets.

Very low carbohydrate diets, in their early phases, also must supply substantial glucose to the brain from gluconeogenesis. For example, the early phase of the popular Atkins or Protein Power diet restricts dieters to about 20–30 grams of carbohydrate per day, leaving 60–65 grams to be made up from protein-originated gluconeogenesis. One hundred grams of an "average" protein can supply about 57 grams of glucose so 110 grams protein would be needed to provide 60–65 grams glucose. Increased gluconeogenesis has been directly confirmed using tracer studies on day 11 of a very low carbohydrate diet (approx 8 grams/day) [29]. If indeed, 110 grams of endogenous protein is broken down for gluconeogenesis and re-synthesized, the energy cost, at 4–5 kcal/gram could amount to as much as 400–600 kcal/day. This is a sizable metabolic advantage. Of course, the source of protein for gluconeogenesis may be dietary rather than endogenous. Whereas endogenous protein breakdown is likely to evoke energetically costly re-synthesis in an organism in homeostasis, dietary protein may conserve energy. The source of protein for the observed gluconeogenesis [29] remains an open question, but there is no a priori reason to exclude endogenous rather than dietary sources. This is therefore a hypothesis that would need to be tested. The extent to which the protein for gluconeogenesis is supplied by endogenous protein would explain very high-energy costs. It should be noted, however, that even if limited to breakdown of dietary protein sources, there would be some energy cost associated with gluconeogenesis.

Metabolic advantage: does it happen?

Having established that there is no theoretical barrier to metabolic advantage and that there are plausible mechanisms that could account for such an effect, we must ask whether it can be demonstrated experimentally, that is, whether the proposed effects are of sufficient magnitude to be a practical feature of weight reduction strategies, in particular very low carbohydrate diets. If so there will be increased weight loss for the same caloric intake, or metabolic advantage. A recent animal model provides support for greater metabolic inefficiency in rats fed carbohydrate restricted diets compared with higher carbohydrate, leading to excess weight loss [30]. Human data in Table 2 illustrates 10 clinical trials of isocaloric diets with a lower versus higher carbohydrate arm in each trial [31-40]. It can be seen that the lower carbohydrate arm in 9 of 10 studies demonstrates increased weight reduction in comparison with the higher carbohydrate arm. Three of the studies show statistical significance (p < 0.05 or better). Even without statistical significance of individual studies, however, the likelihood that the lower carbohydrate arm would have an advantage in 9 of 10 studies is equivalent to the likelihood of 9 coin toss experiments having excess heads in comparison to excess tails. The 9th binomial coefficient shows this probability to be p < 0.01.

While the above suggests the possibility of metabolic advantage, it does not prove it, nor do we know the magnitude of the effect, or the factors that control it. The studies above were chosen from among those quoted by many of the authors who have disputed the existence of metabolic advantage. Nonetheless, a formal meta-analysis would be necessary to avoid the possibility of conscious or unconscious bias in their selection. Further, it would be necessary to establish evidence that energetically costly metabolic processes are more prevalent in low carbohydrate diets than in diets of higher carbohydrate content. Whereas the proposed mechanisms are plausible, they need to be proven.

Thermodynamics is not the limiting factor behind the concept of metabolic advantage. On the contrary, thermodynamics guarantees inefficiency in all metabolic processes and is silent on the possibility that inefficiency may be augmented in some instances. A familiar example of inefficiency is thyrotoxicosis, with attendant weight loss and heat generation despite unchanged or increased caloric consumption. The theoretical possibility of inefficiency and metabolic advantage due to macronutrient compositional change exists, but demonstration of the phenomenon can only be resolved experimentally. Isocaloric dietary studies with a low vs. a higher carbohydrate arm support the experimental possibility of metabolic advantage. A formal meta-analysis would be required to evaluate this more objectively. Further studies, including tracer methods, would be required to establish mechanisms. The presence of high quantities of dietary protein (often a feature of low carbohydrate diets) is known to stimulate protein turnover, an energetically costly process. However, it is unclear whether this is the only factor, or whether it is necessary for metabolic advantage to occur. In particular, obligate gluconeogenesis from endogenous sources may also contribute to induction of protein turnover.

http://www.nutritionandmetabolism.com/content/1/1/15

[kallyn]

So what? Everyone has their own calorie needs for their own body. What might make someone else lose at 1500 might not work for you. it proves nothing. I doubt you gained 30lbs on 1500k/cal a day unless you are 4ft?


You truncated the quote at the most important part. "Anecdotal at best, but I gained 30 pounds on a 1500 calorie/day diet.
I now maintain exactly the same weight (and have for 3 years) eating at least 2,000 calories/day."

[tie_guy]

You know that simple calorie in, calorie out thing doesn't even work for gasoline and cars!

Sure there is the first law of thermodynamics that says that energy cannot be created or destroyed (yes you can turn matter into energy ala E=MC^2 but unless you are in a nuclear reactor this isn't going to happen much.) People forget that there is a second law of thermodynamics!

That second law says that the general state of disorder in the universe tends to increase. In other words most energy would like to turn to heat and therefore not all energy is the same. It may not really make sense to add different forms of energy and expect to have an equation that makes sense.

What this all means is that a heat engine like the ones in cars can only become about 30% efficient or so (the maximum efficiency heat engine is called a carnot engine but that is another story.) Only a small amount of the energy in the gas can go into moving the car forward and the rest must be let out as heat. I don't care what you do. There is no super 500mph carb out there that the oil industry doesn't want us to know about. Cars are only so efficient and there is no reason to count the amount of chemical energy in gas and expect all of the energy to be converted into moving the car down the road -- most of the energy WILL BE turned into heat and there is nothing you can do about it.

Of course in cars that is a bad thing. In humans that can be a good thing (when it comes to loosing weight.) Humans may be much more complicated than cars but they still have to obey the same laws of physics. It simply doesn't make sense to say I ate so many calories therefore I have to do so much physical work to work it off. In reality it is much more complicated than that!

[kebaldwin]

Your claim is unsupported by the facts and unsubstantiated in any literature. The reason anyone loses weight on atkins is because they consume fewer calories than they burn. We may burn it by a variety of mechanisms, but we still burn more than we eat, hence weight loss. The burden of proof is on you to prove your claim; there is 200 years of medical research to back up my claim.

You are completely full of BS. I don't know what weak people you usually beat up, pick on, and lie to -- but it will not work here.

The facts are -- many Atkins people lose weight and improve their health by eating more calories - but simply change what they eat. The facts are - by simply changing your nutrition changes an awful lot about your health.

Are you trying to tell me that in the last 20 years -- as people moved away from whole, natural (unprocessed) foods -- that have to be cooked -- that our health has gotten better?

Other countries use to make fun of us. Now that they have adopted our eating of high glycemic foods out of a box, bag, or other wrapper -- what has happened to their health?

Are you trying to tell all of us that ate more and lost weight and improved weight -- did not really do it? Are you calling millions of us liars?

Low carb research goes back over 100 years.

Please start thinking.

[arc]

I'm not sure why those that claim that calories count even on low carb keep getting lumped in with the "a calorie is a calorie" crowd. What I see them saying, and I believe, is that calories do count on low carb - they just count differently. The article that pbowers posted above claims a significant metabolic cost to convert protein to the needed glucose. I believe that Jeff posted a while back that a ketone body was only 5 calories per gram verses 9 calories a gram for fat. These are just a couple of examples of the differences.

It makes counting calories while doing low carb difficult and probably unnecessary as we just don't know how they are going to be used. They could be getting wasted as the protein is being converted to glucose or they could be going to building muscle or to generate heat from the increased metabolism or a myriad of other purposes. It does lead to the idea that a stall is a sign that the energy intake is too high and one might want to cut back a bit.

[Samuel]

I believe in "energy in/energy out" when it comes to cars and gasoline, but not when it comes to Humans.
Here is the general formula:

Energy in = Energy out + Energy wasted

It does apply to humans just like it applies to cars. If you compare a mistuned car with black exhaust with a perfectly tuned car, you find that you don't get equal miles per gallon from the two. The reason is that the amounts of wasted energies of the two cars are not the same.

When we eat low carb food we waste more energy, especially when we are in the first year of the diet. This allows us to eat more while losing weight. However, I think this is not the only reason low carb diets work.

The human body is like a car which can automatically tune itself. It has a computer which contains in its memory how much a person's weight should be and it adjusts its tune up so that it maintains a constant weight. Whenever something goes wrong with that computer our weights become uncontrollable and this is what happened to most of us.

The reason low carb diets work to me is that whatever goes wrong with our weight control mechanism is in the carbohydrate metabolization section. So when we eat no carbs, our bodies become capable of regulating our weights again.

[Mutant]

You truncated the quote at the most important part. "Anecdotal at best, but I gained 30 pounds on a 1500 calorie/day diet.
I now maintain exactly the same weight (and have for 3 years) eating at least 2,000 calories/day."


I used to be generous and think the Whoa didn't understand what he posts. But after a bit of history and his 'errors' being so common and sometimes egregious, I've come to another conclusion.

Kind regards

[pbowers]

"It's a lot easier to follow a diet that tells you to eat bacon and brie than to eat predominantly fruits and vegetables," said Dr. Dean Ornish, creator of the Ornish diet.i dunno, but it sounds like dean is actually endorsing the atkins diet here. the question is, why would i eat only fruits and vegetables when i can eat bacon and brie?

[pbowers]

just another thought: imagine the frantic scrambling that's been going on at PCRM/PETA headquarters since word of this study came out. makes me feel all fuzzy inside.

[VLC.MD]

Unfortunately, in contradistinction to what some in Atkins-land espouse, the cause of obesity is eating more calories than you burn. Period, end of story. Now, the reasons for eating more calories than we burn are multicausal, but we can probably start with affluence, sedentary lifestyles, fast food in poor neighborhoods, loss of PE in schools, poor dietary choices made by working adults, advertising, and addicition/emotional disorders, to name a few. Fix those problems and the Nobel is yours. Shoot, the world is yours.


That's a powerful list. The stress pot that is modern American life is clearly killing people. It's sometimes hard to notice the most obvious problems because you think it's normal. I'm sure Freud would say our brains want to believe things are well as some sort of internal protection mechanism.

Glad this article is coming out, it is another tool in the toolbox for physicians.

Sanitizing water saves more lives than physician care. Don't look to the doctor's office to reduce American waistlines, I guarantee it'll fail (excluding gastric bypass surgery!).

[KarenJ]

you're taking way to personal. The logic in the statement you are responding to is a possibility and is not illogical at all.

Not personal. Consider the following Ornish statements:

1. "HDL (“good cholesterol”) rose slightly on the Atkins diet but did not change after one year on the Ornish diet. However, not everything that raises HDL is good"

Is that a true statement?

2. "If you eat a stick of butter, your HDL will go up, but that doesn’t mean that butter is good for your heart"

Why not? If HDL is actually heart-protective, and butter raises HDL, then that means that butter is good for your heart.

3. " Pfizer recently had to stop a large trial of torcetrapib when it was found that this drug raised HDL but also increased the risk of heart attacks and strokes."

What a tricksy, tricksy man! Is he insinuating that it was the raised HDL that increased the risk of heart attacks and strokes? Logically, that would negate all his other statements?
Edit: I could be underestimating his degree of cognitive decline due to his deficiency of meat & fat in the diet. Shucks, now I feel sorry for him. :cry:

Nothing he said was logical.
Everything he said was insulting (to anyone with half a brain), and for a doctor who should know better, his statements are ridiculous.

Next,
So what? Everyone has their own calorie needs for their own body. What might make someone else lose at 1500 might not work for you. it proves nothing. I doubt you gained 30lbs on 1500k/cal a day unless you are 4ft?

You truncated the quote at the most important part

Exactly. If not losing at 1500cal/day, how could I lose and/or maintain at 2000?

I am 5' tall, not 4', and moderately sedentary. I did indeed gain 30 (+) pounds over 10 years eating a diet that would make Ornish proud.

You know that simple calorie in, calorie out thing doesn't even work for gasoline and cars!
Thanks, Tie_Guy! I had forgotten about the second law of thermodynamics. :lol:

"The universe tends towards entropy"

[ysabella]

I'm waiting for GamePro magazine to headline their version thusly:
ATKINZ PWNS 0RNISH D!ET!!!111

Fark.com has: "Atkins diet performs best in longest-running, largest head to head comparison of popular diet plans. Suck it, vegans"

:D

[1000times]

You can always count on Fark. Maybe I should dust off my old login and pay a visit there.

Or not.

[KarenJ]

A good study relating to this topic can be found here. (http://www.ajcn.org/cgi/content/abstract/84/4/789)

Dr. Eades blogged about it HERE. (http://www.proteinpower.com/drmike/?p=294)

Dr. Mike's quote sums it up impeccably:

An interesting aspect of this study, to me, at least, was the fact that there was NO correlation with an increase or decrease of waist size with caloric intake. It wasn’t the number of calories consumed that caused the change, it was what those calories were made of. So, that makes this another one of the growing list of studies that throws a wrench into the works of the a-calorie-is-a-calorie set. As we all know, it’s not just the caloric content of the food we eat, it is also what those calories do to us metabolically.
To anyone who understands that calories have an effect beyond the amount of energy they provide, this study makes perfect sense. For those who can’t see beyond the energy content, this study is a real head scratcher.

At some point someone in academia is going to realize that the old calories in equals calories out model doesn’t work. I read a paper recently from a researcher at the University of California at San Francisco who is sniffing around the edges, but based on the conclusions he has drawn, the depth of his dumbth is of cavernous proportions. I’m saving his paper for a future post.

[Demi]

A great blog entry from Dr John Briffa in the UK:

Click here: Study confirms superior effectiveness of low-carb eating for weight loss (http://www.drbriffa.com/blog/2007/03/07/study-confirms-superior-effectiveness-of-low-carb-eating-for-weight-loss/)

However, there is another fundamental reason why low-carb diets may be the best for us: they mirror the diet we are designed for.

Through the process of evolution, we have become best suited to the foods which we had access to. For the vast majority of our time on this planet this meant a diet based on meat, fish, vegetable matter, fruit, nuts and seeds. Analysis of primitive hunter-gatherer diets allows us a window into our evolutionary diet. It turns out that compared to the primitive diet which we evolved on, the typical Western diet is significantly lower in protein and fat, while being much richer in carbohydrate.

Put another way, compared to the typical Western diet, the Atkins’ diet and other low-carb approaches are much more in keeping with the diet we, as a species, are best suited to from a genetic, metabolic, biochemical and physiological perspective. Let’s not be too surprised, then, that such as diet brings more benefits for health than higher-carb, lower-fat approaches traditionally touted as ‘healthy’.
Very nicely put :thup:

[LowCarbNic]

This has been splattered all over the news channels and my local news. LOL I love it. They are trying to say it doesnt work, even when the results show it does. On the morning shows, they had "expert nutritionists" saying neither low carb now high grains are ideal- and that you need the right balance..yadda yadda. She went on to say how Atkins dieters have Nasty breath and other Nasty things (I have no idea what they were referring to in that latter part). And that Atkins works for the first two times you do it, but then after that it doesnt work. (huh??)

To me- What works is what is simple. Now if only i could get that through my own thick head....hehe.... I always seem to want to over complicate my diet (ie: the sugar coated butter nuts i bought from target last nigh, knowing i am super addicted to them, but still insisted on buying just to proove that yes- i can eat 1/2 a jar at one sitting. EEK)

Anyhow- Atkins is NOT going ANYWHERE!!! (Especially if we have something to say about it).

[b_atkins]

http://ca.news.yahoo.com/s/capress/070306/health/health_health_best_diet

[elpasopop]

Certainly the medical establishment has believed this for years. Don't you think, with what you have learned about low carb that that is a bit of over simplification?

I know we humans don't want to believe simple stuff, but it is oh, so true. There is simply no evidence to the contrary. No doubt Atkins works better than other plans. Certainly burning fat for fuel leads to a loss of "unburned" fat in the urine and breath, which can count for a very small caloric "burn" (a few calories a day). But simply, there is no way to lose weight other than putting in less fuel than is used (or discarded sometimes) by the body. It really is that simple.

That said, I am not trying to be controversial. My wife and I have been doing Atkins for 60 days and we feel fabulous and have lost weight and inches. But a big reason is because a) we are not starving due to fluctuating blood glucose levels, and b) we simply cannot eat as many calories by eating fat and protein as we did eating carbs. We would have to eat most of the time. I can eat a 300 calorie piece of beef that fills me up, when it used to take 2 500 calorie donuts and half of a third to do the same. Calories count.

[elpasopop]

You are completely full of BS. I don't know what weak people you usually beat up, pick on, and lie to -- but it will not work here.

The facts are -- many Atkins people lose weight and improve their health by eating more calories - but simply change what they eat. The facts are - by simply changing your nutrition changes an awful lot about your health.

Are you trying to tell me that in the last 20 years -- as people moved away from whole, natural (unprocessed) foods -- that have to be cooked -- that our health has gotten better?

Other countries use to make fun of us. Now that they have adopted our eating of high glycemic foods out of a box, bag, or other wrapper -- what has happened to their health?

Are you trying to tell all of us that ate more and lost weight and improved weight -- did not really do it? Are you calling millions of us liars?

Low carb research goes back over 100 years.

Please start thinking.

Obviously personal attacks and hyperbole are your preferred method of tantruming. Thus I will stop engaging in a battle of intellect with an unarmed person, and have a reaonable discussion with others.

[Rachel1]

From Atkins DANDR, p. 143: "Although there is no need to count calories, they do matter. Gaining weight results in taking in more calories than you expend through exercise, thermogenesis (the body's own heat production), and other metabolic functions. Research has shown that on a controlled carbohydrate program, more calories are burned than in a low-fat/high-carb diet, so there is a certain metabolic advantage to the controlled carb approach."

There you have it from the horse's mouth. Elsewhere in DANDR, I believe Dr Atkins states (I paraphrase), "calories do count, but carbs count more."

Anecdotal evidence on this board suggests that on a LC approach, one can consume more calories without weight gain than on other approaches, but only to a certain extent. It is possible to gain weight on LC if one overeats. But in my experience, and as others suggest, it's a lot harder.

Rachel

[pbowers]

But simply, there is no way to lose weight other than putting in less fuel than is used (or discarded sometimes) by the body. yes, AND or BUT, changes in the macronutrient composition of your diet will change how much energy you expend regardless of physical activity levels.

[PS Diva]

originally posted by elpasopop
we simply cannot eat as many calories by eating fat and protein as we did eating carbs
That experience is true of many people on this board. But there are also many who are now eating more calories than they did previously and are still losing or maintaining instead of gaining!

[kneebrace]

Ok, lets make this a bit clearer, shall we?

Nobody here disagrees that there is some calorie intake level on a low carb dietary approach at which a particular individual will gain bodyfat. For most of the people here that calorie intake is so high that the natural hunger limiting effect of a low carb diet makes it quite difficult to achieve.

Many others on this board do still have to exercise some restraint with calorie intake, even in the context of a low carb diet, to prevent bodyfat gain and/or continue losing.

But that individual calorie intake break even point (bodyfat equilibrium) is always much higher with a low carb dietary approach than any other. Just how much higher varies between individuals.

I don't think anyone is really arguing that for bodyfat loss to occur more calories have to be expended or exreted than you consume.

The point is, with a low carb dietary approach you burn and excrete a lot more calories. So the calories consumed on a low carb diet might indeed be greater than before low carb and bodyfat loss still occurs.

[Enomarb]

Hi-
interesting thread, and I want to thank the posters for the links to the original article and the media coverage of the study.

Elpasopop- please modify your blanket statement, and instead state that in your opinion, FOR YOU, reduced caloric intake is the reason why you think Atkins is working FOR YOU. One of the problems with large controlled studies is that all individual differences are washed out- that is rarely addressed. I respectfully disagree with you, FOR ME- an N of 1.
For ME, caloric restriction has nothing to do with my weight loss and stabilization over the last 3.5 years. LC has corrected my insulin resistance. However, I would also respectfully submit that you and I are different.Which is okay- it 's one of the things that keeps life interesting!

[BTW- a study published in the last 3 years reported that people on LC lost more weight than Low Fat, despite eating an average of 300 calories a day more than the Low Fat group. (Can somone find it- it is in this forum.)]
E

[elpasopop]

From Dr. Atkins Diet Revolution, 1972, page 275:

"Q Don't calories play any role?
A There's no question - of course they do. A 1,500 calorie, ten gram diet will take more weight off-and more quickly--than a 2,000 calorie 10-gram diet. If you can cut down on your quantities, you are better off to do so -- but not when it gets to the point where you have to put up with discomfort or hunger. However, as a traditional overeater, you may have built up a mistaken impression of how much food it takes to satisfy you. On this diet there is a new level of satiety to become familiar with--try eating less and you'll find you are just as comfortable as when you ate more on a higher carboydrate diet. I'm not saying that "calories don't count.""

--page 275. This ought to end all debate really, along with Rachel's quotation from DANDR above.

Calories matter. You can't lose weight without burning more than you take in. That doesn't mean that calorie burn (including use and disposal via ketones) isn't a little different on Atkins, but it does mean that you have to account for the energy someplace.

[ReginaW]

[BTW- a study published in the last 3 years reported that people on LC lost more weight than Low Fat, despite eating an average of 300 calories a day more than the Low Fat group. (Can somone find it- it is in this forum.)]

I don't have the link handy, but the lead researcher (if anyone wants to PubMed for it) is Penelope Greene (GREENE P in PubMed) from Harvard.

[elpasopop]

Ok, lets make this a bit clearer, shall we?

Nobody here disagrees that there is some calorie intake level on a low carb dietary approach at which a particular individual will gain bodyfat. For most of the people here that calorie intake is so high that the natural hunger limiting effect of a low carb diet makes it quite difficult to achieve.

Many others on this board do still have to exercise some restraint with calorie intake, even in the context of a low carb diet, to prevent bodyfat gain and/or continue losing.

But that individual calorie intake break even point (bodyfat equilibrium) is always much higher with a low carb dietary approach than any other. Just how much higher varies between individuals.

I don't think anyone is really arguing that for bodyfat loss to occur more calories have to be expended or exreted than you consume.

The point is, with a low carb dietary approach you burn and excrete a lot more calories.

I can live with that description. :)

[elpasopop]

Hi-
interesting thread, and I want to thank the posters for the links to the original article and the media coverage of the study.

Elpasopop- please modify your blanket statement, and instead state that in your opinion, FOR YOU, reduced caloric intake is the reason why you think Atkins is working FOR YOU. One of the problems with large controlled studies is that all individual differences are washed out- that is rarely addressed. I respectfully disagree with you, FOR ME- an N of 1.
For ME, caloric restriction has nothing to do with my weight loss and stabilization over the last 3.5 years. LC has corrected my insulin resistance. However, I would also respectfully submit that you and I are different.Which is okay- it 's one of the things that keeps life interesting!

[BTW- a study published in the last 3 years reported that people on LC lost more weight than Low Fat, despite eating an average of 300 calories a day more than the Low Fat group. (Can somone find it- it is in this forum.)]
E

Hi Eno- What I am saying is that to burn excess stored fat -- lose weight in our vernacular -- one must eat fewer calories than one expends. It is universal and proven. Now, I am not saying that many people don't eat more food on Atkins...many eat more volume than before. But if they are losing bodyfat, the caloric intake is still less than what they were eating previously. Dr. Atkins says this in his books...calories do count. Millions of people lose weight on high carb diets each year...they just do so with hunger, lean muscle loss, and severe restriction of foods (none of which we have to do, thanks to ketosis!).

The example of the guy in the 1972 book that ate 3000-3500 calories a day and still lost 100 pounds is a good case study. This guy was 360 pounds or so and went on Atkins and ate 2 pounds of meat a day, etc. He lost about a pound a day (including water), was in ketosis, did everything right on a high calorie diet. But what happened is that he went from 5,000 calories a day on high carb, to 3,500 calories a day on low carb and more food, and lost weight. While many of us eat more food on Atkins, the food adds up to fewer calories than our previous high carb diets. I have kept a running food journal both before and after and I went from about 4,000-5,500 calories a day pre-Atkins to about 3,000 calories a day on Atkins, while eating more or less an equal amount of food as before. I am losing a lot of weight. As I approach goal, I will have to reduce my calories in order to maintain weight loss. Numerous maintenance threads on this site will confirm this phenomenon.

But of course, everyone's weight loss experience is different, almost to the point of being mystical! That doesn't mean the same metabolic and thermodynamic principles that govern everything else aren't working the same for each of us...nobody is special in that sense!

[Samuel]

Certainly burning fat for fuel leads to a loss of "unburned" fat in the urine and breath, which can count for a very small caloric "burn" (a few calories a day).
3 years ago, someone on this forum showed us calculations to prove that the amount of energy lost due to exiting ketones through the urine is too small, but I discovered that there has been an error in his calculations and proved it to him. I don't remember anything about this subject now.

Everyone can tell for sure that whenever someone has diarrhea, the food he eats produces minimum energy since it passes without significant amount of digestion. In general, the term "burning food" does not mean getting a specific amount of calories from the food. How hard or how efficient food is burnt must be stated and this can change from day to day or even from hour to hour.

[Abd]

Google News had a link just now to a response by Dr. Ornish to the study. Following it I ended up at:

http://www.msnbc.msn.com/id/17490143/site/newsweek/

The headline:
Why I Disagree With this Study
A new comparison of four diets—including mine—is misleading and riddled with problems.

The headline says a great deal about Dr. Ornish. He's functioning as an advocate, not as a scientist. First of all, scientists don't generally "disagree with studies." They often disagree with conclusions draw from studies. He doesn't like the conclusions that are rather obvious to draw, so he attacks the study. But he does not disagree with *all* of the study. For example, he cites the study as noting, as it does, that the difference in weight loss between the Ornish and Atkins groups was not statistically significant. Those who say that the study showed greater weight loss on Atkins than on Ornish are correct. It did. But Ornish is correct to note that the difference wasn't statistically significant.

But covered over in this confusion is the basic fact: low fat proponents have been claiming for years that low carb diets were ineffective and unsafe. Yet this has never been proven in any study, and indications from the studies that exist are that it may not be true. Including this study.

Is the study "riddled with problems". Well, that depends. If you think that the study showed that Atkins, followed according to recommendations, is better than Ornish, likewise followed according to recommendations, then, indeed, there is a problem, since the study was not designed to compare such groups.

Rather, the study strikes to a crucial point: what should public health authorities *recommend*? This study showed the effect of recommending (and educating) peope with regard to a particular diet. In that respect, recommending Atkins is shown by this study to be as good a recommendation as any of the other three, or better. And this is actually revolutionary. The conclusion of the study was not that Atkins is better than Ornish, so for Ornish to attack the study on the basis that it didn't prove that is entirely beside the point. The conclusion was that it was reasonable for physicians to recommend Atkins.

Here is a key paragraph from Ornish's rebuttal:
The authors concluded, “Women assigned to follow the Atkins diet, which had the lowest carbohydrate intake, lost more weight and experienced more favorable overall metabolic effects at 12 months than those assigned to follow the Zone, Ornish, or LEARN diets.” This is simply not true. If you read the study carefully, you will find that the authors found that there was no significant difference in weight loss between the Atkins and Ornish or LEARN diets after one year! (There was significantly more weight loss on the Atkins diet after one year only when compared with the Zone diet.) This directly contradicts the primary conclusion of their study.

Note that Ornish twists the meaning of what he quoted. He contrasts, not the weight loss shown, but *statistical significance," which isn't what the authors claimed. (They found statistical significance only between Atkins and the Zone.) But that Atkins dieters *did* show greater weight loss is still interesting, and it merely emphasizes that the hypothesis that Atkins is *worse* than Ornish in this respect becomes relatively unlikely to be true. What was the "primary conclusion of the study"?

In this study ... overweight ... women assigned to follow the Atkins diet, which had the lowest carbohydrate intake, lost more weight and experienced more favorable overall metabolic effects at 12 months than women assigned to follow the Zone, Ornish, or LEARN diets. While questions remain about the long-term effects and mechanisms, a low-carbohydrate, high-protein, high-fat may be considered a feasible alternative recommendation for weight loss."

That Ornish disagrees with this accurate and sober statement simply shows bad science. Taubes got fired up when he noticed the ubiquity of bad science among the low-fat advocates. This is just one more example.

The point is that conclusion the authors drew in the study is exactly appropriate, given what they were studying. They did not extend their results to claim, for example, that there were no possible harmful effects in areas not studied from, say, the high saturated fat content in a typical Atkins diet. They did not claim that participants actually followed the Ornish diet, another point that Ornish attacks. Ornish is defending his diet, not considering whether or not *recommending* the other diets is also reasonable.

What the public needs is better science, and better analysis of science, and too many diet advocates have become far more interested in being right, that is, in trying to prove that they were right, than in expanding our knowledge.

For years, the low-fat people have taken weak studies with conclusions that clearly did not follow from what was actually studied, and have reported them as proving their ideas. But if a study comes out that even can be taken as hinting that perhaps these ideas are limited or incomplete or maybe even mistaken, they attack it on far weaker grounds. They strain at a gnat and swallow a camel.

Absolutely, those of us who have come to generally trust the Atkins diet could be wrong. There could be some long-term effect that we don't know about. Avoiding carbs is, in some sense, unnatural. We know that carbs are not necessary to human nutrition (unlike what is commonly assumed by opponents of low-carb diet, as if carbs were a necessary nutrient), but quite clearly we are adapted to eat them and to find them tasty.

But, given the state of our knowledge and what we know happens when it is recommended that people follow low-carb diets, particularly Atkins, and particularly with caution being recommended about, for example, fiber and vitamins, about not taking the diet as meaning one should just eat eggs and butter and steak and forget about vegetables -- which is not what Atkins recommends! --, it is quite reasonable to recommend Atkins as a diet, and there seems little reason to strongly discourage people from doing so.

There is a population for whom Atkins works spectacularly. This won't show, necessarily, in general studies of the kind in question, for compliance reasons, among others. Perhaps there are people for whom it does *not* work, quite simply. All this is extremely difficult to study, but the fact is that the status quo is that if you went on Atkins, your doctor was quite likely to tell you that (1) it won't work and if you lose some weight, it is just water, (2) you may drop dead from a heart attack. Quite simply, these ideas, which have been repeated over and over again in consulting rooms and in the media, are wrong. And it's about time that they get tossed.

I still read, in articles critical of low carb diets, that these diets are "high in cholesterol," as if the idea that cholesterol in the diet was harmful was still a viable one. It was a mistake, the mistake has been known as suchh for a long time, but it still persists. It's bad enough that saturated fat is considered unhealthy, per se (rather than unnatural trans fats, the confounding factor that caused the early studies to conclude that saturated fat was harmful), but the cholesterol claim, I think, isn't even particularly controversial any more. It's been rejected. You can eat eggs.

Unless, of course, you are allergic to them. In the end, diet is an individual thing, one size does not fit all.

But Atkins fits a whole lot more people than the low fat crowd has been willing to admit.

[arc]

I wonder if the Ornish diet has ever come out ahead in a study that he didn't do himself? It seems like it always comes out at the tail end in these things. :lol