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... Not yet, but his dietary ideas are two steps closer to acceptance.
about.com <HEART DISEASE/CARDIOLOGY>
~ By DrRich
Dateline: 05/26/03

Two studies appearing in this week's New England Journal of Medicine have offered additional evidence that the sort of low-carbohydrate diet popularized by Dr. Robert Atkins may be more effective at producing weight loss, and may produce more beneficial metabolic changes, than the low-fat and calorie restricted diets favored by most doctors and their professional organizations.

In the first study, 64 subjects with marked obesity and a history of severe overeating - most of whom had either diabetes or metabolic syndrome - were randomized to a low-carbohydrate diet or to a low-fat, calorie-restricted diet. While neither group had impressive weight loss, those on the low-carb diet lost significantly more weight than those on the low-fat diet. Further, the low-carb diet produced lower triglyceride levels and a greater improvement in insulin sensitivity.

In the second study, 63 obese patients received either the Atkins diet or a conventional low-calorie diet. Those on the Atkins diet lost significantly more weight at the 6 month follow-up period, but by one year the difference in weight loss between the two groups were similar. In this study, however, patients on the Atkins diet had significant improvements in their HDL cholesterol and triglyceride levels throughout the entire duration of the study. Lead investigators for both studies expressed surprise at the success of the carbohydrate-restricting diets - not so much in their achieving weight loss (which was not spectacular in either study), but instead in the metabolic and lipid improvements achieved with the low-carbohydrate diet. That a failure to restrict fat intake could result in anything other than a marked worsening in lipid levels remains a surprise to much of the medical community.

Lest Atkins proponents get carried away by the positive results, two editorials accompanying these articles appeared in the same issue of the Journal. Both demanded caution in interpreting these results. To really know whether the low-carbohydrate diets are successful, the editorialists concluded, much larger, better-conducted studies will have to be done showing not just an improvement in blood tests, but also an improvement in the things that really matter - like the incidence of heart attack, stroke, and death.

What do these studies mean?

These studies were part of the strategy that DrRich refers to as the "Atkins quick kill" gambit. This is the strategy whereby a few, small, rapidly conducted studies (launched primarily to shut up the low-carb faddists) would quickly demonstrate that low-carbohydrate diets don't work, and that they're dangerous. Now that these studies are being completed, it is plain that they are not yielding the expected results. Indeed, based on the two studies published this week, it is safe to say that the "quick kill" strategy has now officially failed.

So: we're at the point where the larger, more expensive, much more time-consuming studies called for by the New England Journal editorialists will have to be planned and funded. Now that their opening gambit has failed, denigrators of the Atkins-style diet will have little choice but to agree to such studies, since the "latest" information on low-carb diets is disturbingly positive, and thus cannot be allowed to stand.

In the meantime, those who favor low-carbohydrate diets will have to wait at least 5 - 7 years for these studies to yield meaningful results, and can expect little or no further "official" endorsement from the medical establishment in the meantime. This, of course, is standard operating procedure for changing any longstanding and embedded policy for which vested interests are doing quite nicely, thank you, whether the policy in question involves health care, government, or religion. So there's no need for the followers of Atkins to feel particularly persecuted. It's not personal; only business.

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"You are the music while the music lasts."