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High fat atkins diet confounds experts { May 22 2003 }

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May 22, 2003

High-fat Atkins diet confounds experts
By Nigel Hawkes, Health Editor

DR ROBERT ATKINS, the much derided diet guru who told his followers to fill up with fat, may have been right.
Two studies in the ultra-respectable New England Journal of Medicine show that overweight people following his controversial diet lose more weight than those on a conventional low-calorie diet, and emerge at the end with higher levels of the good form of cholesterol.

The results will surprise many dieticians, who have claimed for at least two decades that eating fat is the cause of the Western world’s increasing girth. They will also worry that the results may encourage people to take up a diet very low in fruit and vegetables, and in fibre, offending against two more dietary shibboleths.

Neither study investigated potential long-term effects, which could include kidney damage and bone loss through lack of calcium.

Many of the world’s most glamorous stars have claimed that the Atkins diet is their secret to staying slim. Less than three months after giving birth, Catherine Zeta-Jones had shed 50lb, which she credited to her “high-fat” diet.

Other stars claim to have kept their famous figures thanks in no small part to Dr Atkins. The pop singers Jennifer Lopez and Geri Halliwell both follow the diet, as do the actresses Julia Roberts, Minnie Driver and Jennifer Aniston as well as her husband, Brad Pitt.

One of the new studies, led by researchers from the Weight and Eating Disorders Programme at the University of Pennsylvania School of Medicine, studied 63 obese men and women. They were all in their mid-40s, and weighed an average of 97kg (15st 6lb).

Half were given a copy of Dr Atkins’s New Diet Revolution and asked to follow it. The other half were prescribed a low-calorie diet (1,200-1,500 calories a day for women, 1,500-1,800 for men) made up of 60 per cent carbohydrates, 25 per cent fat, and 15 per cent protein.

The Atkins diet prescribes meat, fish, eggs, cheese, butter, oil and a few salad leaves. For the first fortnight followers must eat only 20g of carbohydrate a day (a single banana is 22g), cutting out bread, pasta, most vegetables, rice, potatoes, biscuits, sugar, milk and yogurt.

After two weeks carbohydrate intakes double, but remain very low. It also recommds taking a series of nutrional supplements.

Over the first three months of the University of Pennsylvania study Dr Atkins advice was the most effective by a big margin — an average of 14.7lb lost, against 5.8lb.

Over six months, Atkins’s followers lost 15.2lb against 6.9lb, but over a year the gap had narrowed significantly. The Atkins group had lost 9.5lb, reversing some of their earlier gains, while the other group had also gone backwards, losing 5.4lb.

The second study involved 132 men and women who were severely obese, averaging over 20 stone. Half were put on a low carbohydrate diet (30g a day) with no limit on fats, and half on a low-fat diet, calorie- restricted and with no more than 30 per cent of energy from fat.

Over six months the lowcarbohydrate group lost 13lb, compared with 4lb in the low-fat group. Both trials showed that the low-carbohydrate diets improved the profile of blood lipids — cholesterol and trigyclerides that can contribute to clogged arteries.

Even more remarkably, the second trial included some participants with diabetes, whose control of insulin improved much more on the low-carbohydrate diets than it did on the low-fat version.

Frederick Samaha, of the Philadelphia Veterans Administration Medical Centre, who led the second study, said: “The metabolic effects were fairly impressive.”

He said that results underscored the paradox that the more people follow “healthy eating” guidelines and cut fat, the more obese the population becomes. “People have gotten the message loud and clear, they are restricting their fat,” Dr Samaha added.

“But they are still overeating. And when they overeat carbohydrates, they remain overweight and perhaps even exacerbate the development of diabetes, unfavourable lipids and heart disease. There were some aspects of what Dr Atkins was saying that were not being taken seriously, and perhaps should have been.”

Gary Foster, who led the other study, said: “Widely recommended low-carbohydrate approaches may be premature, but our initial finding suggests that such diets may not have the adverse effects that were anticipated.”

Sara Stanner, senior nutrition scientist at the British Nutrition Foundation, said: “A lot of people get quite unpleasant side-effects from the Atkins diet, and the fact that it is low in fibre has implications for cancer and heart disease.”

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