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Old Sun, Feb-16-03, 08:08
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Plan: Atkins/PP/BFL
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I found at least 23 refrences in the media to this story, here's from Canada.com/AP

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New research on Atkins diet challenges 30 years of nutritional dogma

DANIEL Q. HANEY
Canadian Press

Thursday, February 13, 2003

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

The dietary elite are not ready to change their collective mind, but a half-dozen or so new studies have taken an objective look at the presumed evils of Atkins, and the results have been little short of astonishing: people on the Atkins diet lose more weight than those on the standard low-fat, high-carbohydrate diets - even though they appear to consume more calories - and do so without seeming to drive up their risk of heart disease.

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

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

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

The American Medical Association set that tone a year after the book, Dr. Atkins' Diet Revolution, came out in 1972, dismissing it as "potentially dangerous."

On the Atkins diet, up to two-thirds of calories may come from fat - more than double the usual recommendation - which violates the established belief that carbohydrates are the foundation of a good diet.

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

None of the studies - some done in an effort to prove Atkins wrong - has been published yet, but summaries presented at medical conferences "show pretty convincingly that people will lose more weight on an Atkins diet, and their cardiovascular risk factors, if anything, get better," says Dr. Kevin O'Brien, a University of Washington cardiologist involved with one of the studies.

The studies say nothing about how much people lose when they stay on Atkins more than a few months, whether they keep the weight off for good and whether their cholesterol rebounds when they stop losing weight.

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

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

His Atkins study was intended to "show it doesn't work," yet after three months, the overweight men and women had lost an average of 8.6 kilograms, 4.5 more than people on the standard high-carb approach.

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

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

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

Despite these data, the Atkins diet still gives many health professionals the willies. It encourages people to eat bacon, butter, prime rib and lots of other things loaded with saturated fat. And it lectures against such mainstay carbohydrates as grains, pasta and starchy vegetables, especially in the diet's first cold-turkey stage.

"There are many principles in the Atkins diet that go against what we know," says Dr. Robert Eckel of the University of Colorado, senior author of the American Heart Association's policy on high-protein diets. "It keeps people away from staples of the diet that we know are associated with less heart disease."

Research has shown that people have the best chance of avoiding heart disease, high blood pressure and cancer if they eat a varied diet with plenty of fruits, vegetables and grains.

"It's scary if people leave out these very important food groups and just depend on high-fat, high-protein foods," says Wahida Karmally, nutrition director at Columbia University's clinical research centre.

Furthermore, people on the Atkins plan may get a quarter of their daily calories from saturated fat, which research has shown clogs the arteries and leads to heart attacks.

Mainstream scientists wave off the Atkins camp's answer to this - that saturated fat is harmlessly burned off unless it is eaten with large amounts of carbohydrates.

Traditionalists explain the cholesterol improvement seen in the Atkins dieters by saying slimming down improves cholesterol levels, but add the benefits are probably overshadowed any damage done by all the unhealthy fat that people ate.

Why people lose more weight on the diet is also not clear, although some researchers say they buy one of Atkins' arguments: people stick with it because fat and protein satisfy the appetite. Eating lots of carbohydrates raises insulin levels, lowers blood sugar, and eventually makes people ravenous.

Skeptics say another of Atkins' ideas - that people lose more weight on his plan even if they actually eat more calories - violates the laws of thermodynamics.

Some of the new studies, however, suggest Atkins may be right, with Atkins dieters losing more weight than those on low-fat diets despite eating more calories.

"Surprised? Definitely," says Bonnie Brehm, a registered dietitian. "We really don't know what the answer is."

And the Atkins weight loss was not simply dehydration, as critics often contend, since dieters in one study also lost twice as much body fat.

Despite these results, many of the researchers who did the studies are reluctant to recommend the Atkins diet for now, saying they know too little about its long-term effects. A large new study just under way could settle those doubts.

This federally sponsored project will randomly put 360 overweight men and women on the Atkins plan or the U.S. Department of Agriculture's standard high-carb, low-fat diet, then watch them in painstaking detail for at least two years.

Despite the professions' unease at the findings so far, some of the researchers involved expect that if the Atkins approach proves safe and effective in larger, longer studies, established opinions will eventually change.

"It's difficult to swallow," says O'Brien, "but the data are the data, even if they go against 30 years of dogma."

Copyright 2003 The Canadian Press

Canada.com
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