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thanks to Josee (gracia_30) for sending the original article. I've posted the CANADIAN version and link here - Doreen
High-Fat Atkins Diet Shows Small Cholesterol Benefit
By Neil Osterweil
But Don't Opt for Bacon Over Broccoli Just Yet
With Additional Reporting by Monica Matys
WebMD Canada Medical News
Reviewed by Jacqueline Brooks, MD
March 23, 2001 -- You can't have your cake and eat it, too, but depending on which best-selling diet guru you choose to believe, you can have your cheeseburger -- or your fruits and vegetables. Robert C. Atkins, MD, a proponent of high-fat, low-carbohydrate diets, squared off against Dean Ornish, MD, an advocate of low-fat, high-fibre, low-meat diets, this week at a meeting of the American College of Cardiology in Orlando, Fla.
The two physicians, whose views on what constitutes a heart-healthy diet could not be more different, argue passionately about the relative merits of their opposing approaches.
Atkins contends that heart attacks are a monster created by our modern diet and lifestyle, and that this monster is part triglycerides -- a category of harmful blood fat -- and part insulin -- the hormone that controls how the body uses blood sugar.
He claims that people lose weight on his high-fat, low-carbohydrate diet because it sends the body along an "alternate metabolic pathway," causing it to stop burning the blood sugar glucose as a fuel and forcing it to burn fat stores instead.
Ornish, however, says that a diet heavy in animal proteins can be hazardous to your health. He points to China, where the consumption of meat, and incidence of heart disease, has soared in recent years. "In Asian countries where they're starting to live like us, they're starting to die like us."
Ornish's philosophy is "Eat more, weigh less." In his diet, fat represents a maximum of 10% of total calories -- and beans, fruits, vegetables, and whole grains make up the rest. Ornish also recommends exercise, stress management, dietary fish-oil supplements, and support groups, and he decries the use of simple sugars and discourages alcohol consumption.
And because fat has nine calories per gram, vs. four per gram for carbohydrates, "you can eat the same amount of food and get fewer calories," Ornish tells WebMD.
So who's right?
"We need to fall somewhere between Atkins and Ornish," says Susie Langley, MS, RD, a nutrition consultant in Toronto. "It's choosing from all the food groups [in Canada's Food Guide to Healthy Eating] and choosing in moderation.
"It doesn't make sense to follow a high-fat, low-carbohydrate diet because it will be higher in saturated fat and cholesterol, and that flies in the face of all the guidelines for heart health," she tells WebMD. "Furthermore, the Atkins diet promotes a state of ketosis, which is incomplete metabolism of fats that allows the body to burn more fat. But it's not a normal, healthy state to be in."
Langley says she puts more stock in Ornish's approach because it focuses on lifestyle change as well as diet. "But I do not agree with the 10% fat approach because I still think we probably don't get enough protective fat-soluble vitamins and essential fatty acids. His approach is for people who have known heart disease, and he's now promoting it to the population at large, which bothers me."
Canadian guidelines recommend 30% or less of total calories from fat, with an emphasis on more mono- and polyunsaturated fat, and less saturated fat.
Langley says the Ornish diet also skimps on protein, which can result in a lack of iron, zinc, and essential fatty acids -- all important for health.
Although Ornish is quick to dismiss Atkins' claims, a study presented by Y. Wady Aude, MD, and colleagues at Mount Sinai Medical Center in Miami Beach hints of a small benefit to a high-fat diet. For three months, 45 adults ate either a high-fat, low-carbohydrate diet or a more conventional "heart healthy" diet of the American Heart Association (AHA). While the AHA diet was more effective at reducing overall levels of LDL, a "bad" cholesterol, only the high-fat diet caused a significant reduction in the very small, dense LDL particles. This form of the cholesterol is thought to be particularly harmful to arteries that nourish the heart.
Ornish contends that Atkins and his supporters can't prove that the Atkins diet actually stops or reverses heart disease, but only that it reverses risk factors for heart disease.
"People who make the diet and lifestyle changes I recommend tend to get better, and people who follow the high-fat, low-carbohydrate diets tend to get worse," says Ornish.
He's supported by a different study presented by Australian researchers, who used a special imaging technique to look at levels of calcium deposits -- a measure of atherosclerosis build-up -- in the coronary arteries of elderly Seventh Day Adventists, all of whom were vegetarians. When the results were compared with patients the same age who ate typical diets, the authors found that the vegetarians had much healthier arteries.
Langley says, "One size doesn't fit all when it comes to a diet. All factors need to be considered by your doctor or registered dietitian." These include genetic and medical history, eating style, and activity and stress levels.
© 2001 WebMD Canada Inc. All rights reserved.
http://health.msn.ca/content/article/3207.3290
... WebMD, the great bastion of lowFAT, highCARB eating, who won't even RESPOND to letters of contradiction.
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