From the New York Times

Pass the Butter, Please

Dr. Robert Atkins, the diet guru who died last month from head injuries suffered in a fall, would have enjoyed reading last week's issue of The New England Journal of Medicine. It carried two independent studies that enhanced the credibility of his controversial low carbohydrate, high fat, high protein approach to weight loss. Though the Atkins diet has been reviled by the medical establishment for decades as a bit wacky and even potentially dangerous, the two new studies and a third published last month suggest that the diet actually works better than standard low-fat diets in the short term, without any detectable signs of harm. It was a startling reminder of how little the experts know, in this obesity-plagued nation, about the best way to lose weight and keep it off.

For the past several decades, the prevailing dietary dogma has been that a fat-laden diet is bad for you, driving up weight and clogging the arteries with substances that can endanger the heart. Going against the grain, Dr. Atkins said the real culprit was carbohydrates. It was just fine to eat all the steak, eggs and butter that we yearned for as long as we cut down on the carbs. Unfortunately, there was scant scientific evidence to support his claims.

Now, however, three controlled clinical trials in small numbers of patients have validated the Atkins approach, at least when pursued for six months. One study of 63 moderately obese subjects put half on a conventional low-fat diet and half on the Atkins plan. The Atkins dieters lost more weight than the comparison group and, surprisingly, had healthier blood-fat levels — fewer dangerous triglycerides and more "good cholesterol."

The only trouble is, neither diet worked all that well given the group's excessive weight, averaging 216 pounds at the start. Those on the Atkins diet lost an average of 15 pounds by the end of six months and those on the conventional diet lost 7 pounds. By the end of a year, however, each group had gained some of the weight back, with the Atkins group leading the way. Worse yet, people dropped out of both diets in droves. The sad truth is, no matter what diet people go on, they have a hard time sticking to it. It's enough to drive us back to the Drinking Man's Diet.

http://www.nytimes.com/2003/05/25/o....html?tntemail0