Yet another low fat vs low carb study...

Discussion in 'Food and nutrition' started by September, Feb 19, 2004.

  1. September

    September Guest

    Jury's still out on Atkins vs. low-fat

    02/17/04, LESLIE COLE, The Oregonian

    http://www.oregonlive.com/foodday/o...63973318780.xml

    Results from a preliminary study at Oregon Health & Science University offer mixed news for
    disciples of the Atkins diet:

    If you're counting carbs, you're likely to lose weight without feeling deprived. But some people,
    especially those prone to heart disease, might be putting themselves at risk.

    The study, which compared low-carb and low-fat weight-loss regimens, tracked 25 dieters for 18
    weeks, then followed up a year later. The results will be used to help launch a larger three- to
    five-year study of potential health risks under the popular diet, says Diane Stadler, research
    assistant professor and bionutritionist at OHSU's General Clinical Research Center. Stadler
    presented the results in late January at two public lectures arranged by the university's Center
    for Women's Health.

    Researchers wanted to test several Atkins claims: that calorie for calorie, people lose more weight
    and more fat on the diet than on other weight-loss regimens, and that it confers a "metabolic
    advantage," preserving lean muscle tissue as the weight comes off. They also wanted to track blood
    lipid levels, a key indicator of cardiovascular health.

    The study compared two groups of dieters ages 25 to 55, averaging 230 pounds. One group followed a
    low-carb plan modeled on the induction phase of the Atkins diet. The other was put on the low-fat,
    high-complex-carbohydrate DASH diet (Dietary Approaches to Stop Hypertension), recommended by many
    physicians for lowering blood pressure and cutting heart-disease risk without medication.

    Patients in the study ate prepared meals for six weeks, then were asked to follow the same diet at
    home for another 12 weeks.

    Here's how the two plans stacked up:

    Both groups lost about the same amount of weight when consuming the same number of calories,
    regardless of what they ate. Average weight loss for the Atkins group was 13.5 pounds for first six
    weeks, while DASH dieters dropped 11.5 pounds on average (no significant difference statistically).
    Not everyone lost as much as they expected, though. Stadler says some dropped only 3 or 4 pounds on
    the Atkins plan, indicating that different people respond differently to the diet.

    Low-carb and low-fat dieters lost the same amount of lean muscle tissue. "The Atkins diet," Stadler
    says, "doesn't preserve it any more than other diets."

    DASH dieters, whose cholesterol levels improved as weight came off, scored better on heart-disease
    risk factors. Cholesterol concentrations for the Atkins group stayed about the same for most
    participants, and actually worsened in some individuals, which is a concern for people with a family
    history of heart disease, Stadler says. "You almost expect cholesterol to be reduced when you see
    that kind of weight loss. We didn't see that."

    Blood pressure, which started out at normal rates for both groups, didn't change significantly for
    participants. "But a longer-term, larger study is required to really tease out the effects of this
    diet," Stadler says.

    For painless weight loss, the carb counters came out ahead. Atkins dieters were offered more food
    than they needed and asked to eat until satisfied. With no prompting, they ate just 67 percent of
    the estimated calories needed to maintain their weight, results Stadler called "impressive."

    The DASH group was asked to consume the same number of calories sticking with low-fat foods. And
    averaging 2,100 calories a day, everyone in both groups still lost weight. That's good news for
    anyone who equates weight loss with starvation. "It's possible to lose weight without depriving
    yourself," Stadler says.

    Bigger questions for women on the Atkins diet -- such as does it decrease bone density, and does the
    high-protein diet lead to kidney damage -- require tracking patients for years. Stadler also wants
    to know if low-carb dieters can stay slim over the long haul.

    "The real question is, not just can you make somebody lose weight, but what is the success of that
    individual keeping that weight off?" Stadler asks. "History tells us that the success is very low."

    In the meantime, here's her advice for dieters:

    Low-carb

    Tell your doctor before starting an Atkins-type diet, get a blood test, and schedule regular
    checkups while on the diet.

    Work with a registered dietitian to tweak food choices so they're in line with doctors'
    recommendations for heart health. For instance, substitute egg beaters for whole eggs, and emphasize
    lean meats and low-fat dairy products.

    Take a vitamin and mineral supplement to help prevent cramps, constipation and other possible side
    effects of low-carb plans.

    For everyone

    Focus on portion size.

    Use low-sodium products whenever possible.

    Eat more dried fruits (packed with potassium and magnesium, high in fiber), and dark green leafy
    vegetables, foods known to protect against heart disease.

    Increase nuts and legumes to two to three servings a day. That alone, Stadler says, is "really a
    huge step in working toward a heart-healthy diet."

    "Benefits and Hazards of Ketogenic Low Carbohydrate Diets for Weight Loss—Atkins Njeri Karanja,
    Principal Investigator Mikel Aickin, Co-Investigator

    Funding source: National Center for Complementary and Alternative Medicine, through a subcontract
    with Oregon Health & Science University Study period: May 2001 – March 2003

    Research issue: Low-carbohydrate, high-fat, high-protein diets promoted by books, the Internet, and
    other media are among the most enduring weight-loss diets in the US and Europe. Without an evidence-
    based understanding of the consequences of these diets, health care providers cannot accurately
    evaluate these diets to advise patients who wish to use them. Study: The goal of this pilot project
    was to establish a methodology for studying these diets in a clinical trial setting. Participants
    with body mass index (BMI) between 27 and 39.9 Kg/m2 were assigned to either a low-carbohydrate
    diet similar to the one marketed by Dr. Robert Atkins or to an energy-matched, high carbohydrate,
    low-fat diet similar to the combination diet used in the Dietary Approaches to Stop Hypertension
    (DASH) study. Participants received all foods and beverages from Oregon Health & Science University
    during the six-week controlled feeding phase. Follow-up consisted of following these same diets at
    home for an additional six weeks. Measures of interest included markers of oxidative damage,
    cardiovascular disease risk (lipids, blood pressure insulin, glucose), bone health, energy
    expenditure, substrate utilization, and body composition. This study provided us with tools to
    evaluate how low-carbohydrate weight-loss diets affect adherence, body weight and body composition,
    energy metabolism, and several markers of chronic diseases that may be affected by the altered
    nutrient intake. "
     
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  2. Mark D.

    Mark D. Guest

    "September" <[email protected]> wrote in message
    news:[email protected]
    >
    > The study compared two groups of dieters ages 25 to 55, averaging 230 pounds. One group followed a
    > low-carb plan modeled on the induction phase of the Atkins diet.

    > Patients in the study ate prepared meals for six weeks, then were asked to follow the same diet at
    > home for another 12 weeks.

    Disturbing. The 'induction phase' is the most extreme part of Atkins, and is meant to be followed
    for just *2 weeks*, if I remember correctly. Yet these participants were kept on it for *18 weeks in
    all*!! In short, the researchers chose a *pseudo-Atkins* regimen - and of a kind which might even be
    likely to *maximise* any dangerous or worrying aspects the diet has. Spot the 'groupthink', people?
    Spot the way a 'good' researcher serves the prevailing orthodoxy by subtly, gently massaging the
    experimental situation in the direction of producing *just the sort of results that the 'orthodoxy'
    expects*...?

    > Here's how the two plans stacked up:
    >
    > Both groups lost about the same amount of weight when consuming the same number of calories,
    > regardless of what they ate. Average weight loss for the Atkins group was 13.5 pounds for first
    > six weeks, while DASH dieters dropped 11.5 pounds on average (no significant difference
    > statistically).

    Really? I'd say something over *17%* was possessed of a certain significance. Especially since if it
    was *the other way around* we'd *never hear the end* of all those "DASH better than Atkins for weight-
    loss" stories...

    > DASH dieters, whose cholesterol levels improved as weight came off, scored better on heart-disease
    > risk factors. Cholesterol concentrations for the Atkins group stayed about the same for most
    > participants, and actually worsened in some individuals, which is a concern for people with a
    > family history of heart disease, Stadler says. "You almost expect cholesterol to be reduced when
    > you see that kind of weight loss. We didn't see that."

    If these measurements were just of 'total cholesterol' rather than separate assessments for HDL and
    LDL, then they don't tell you anything worth knowing. Of course, every serious investigator of
    nutrition 'groupthink' knows that falling back on measures of 'total cholesterol' is *one way* a
    researcher can avoid inconvenient findings...

    >
    > The DASH group was asked to consume the same number of calories sticking with low-fat foods. And
    > averaging 2,100 calories a day, everyone in both groups still lost weight. That's good news for
    > anyone who equates weight loss with starvation. "It's possible to lose weight without depriving
    > yourself," Stadler says.

    Unfortunately, whether 2100 calories actually *feels like* 'depriving yourself' can depend to a
    significant extent upon just what foods are being consumed: protein is appetite-suppressing; fat and
    carbs - especially refined carbs - may be just the opposite. Thus there's no-one in the world who
    can eat *just one* potato chip - and then *stop*...

    >
    > Bigger questions for women on the Atkins diet -- such as does it decrease bone density, and does
    > the high-protein diet lead to kidney damage -- require tracking patients for years. Stadler also
    > wants to know if low-carb dieters can stay slim over the long haul.

    Incredible. Atkins has been going for *how many* decades...? And yet *still* there's this pretence
    that we 'won't know' these things until we've found people we can 'track for years': that there's
    *no-one around* yet who can be studied to produce even a *ball-park* figure for 'bone-density' and
    'kidney damage' and 'whether they can stay slim over the long haul'!! See how 'groupthink' means
    that people *just won't admit* that some of these 'big unknowns' are actually less completely
    'unknown' than their self-censored world-view requires...

    You know, I'm starting to feel a real sense of *disgust* about how this issue is being handled.
    Science it ain't.

    M.
     
  3. Mirek Fidler

    Mirek Fidler Guest

    > > The study compared two groups of dieters ages 25 to 55, averaging
    230
    > > pounds. One group followed a low-carb plan modeled on the induction phase of the Atkins diet.
    >
    > > Patients in the study ate prepared meals for six weeks, then were asked to follow the same diet
    > > at home for another 12 weeks.
    >
    > Disturbing. The 'induction phase' is the most extreme part of Atkins,
    and is
    > meant to be followed for just *2 weeks*, if I remember correctly. Yet
    these
    > participants were kept on it for *18 weeks in all*!! In short, the

    AFAIK, Atkins says you can be on induction for up to 6 month.

    Anyway, "common sense" in ADSLC says that going over 2 weeks has a little sense.

    > > Both groups lost about the same amount of weight when consuming the same number of calories,
    > > regardless of what they ate. Average weight loss for the Atkins group was 13.5 pounds for first
    > > six weeks, while DASH dieters dropped 11.5 pounds on average (no significant
    difference
    > > statistically).
    >
    > Really? I'd say something over *17%* was possessed of a certain significance.

    With all respect, I think that it was just two pounds of glycogen with water...

    > You know, I'm starting to feel a real sense of *disgust* about how
    this
    > issue is being handled. Science it ain't.

    Come on. Learn to live with fact that not everything Atkins ever said about LC is true... :)

    Anyway, I think that half year results, with OWL carb levels and further weight loss might be
    more interesting.

    Mirek
     
  4. Mark D.

    Mark D. Guest

    "Mirek Fidler" <[email protected]> wrote in message
    news:[email protected]
    >
    > Come on. Learn to live with fact that not everything Atkins ever said about LC is true... :)

    I'm not interested in 'what Atkins said'. I'm interested in *good science*.

    M.
     
  5. Tcomeau

    Tcomeau Guest

    [email protected] (September) wrote in message news:<[email protected]>...
    > Jury's still out on Atkins vs. low-fat
    >
    > 02/17/04, LESLIE COLE, The Oregonian
    >
    > http://www.oregonlive.com/foodday/o...63973318780.xml
    >
    > Results from a preliminary study at Oregon Health & Science University offer mixed news for
    > disciples of the Atkins diet:

    The jury is still out on a *preliminary* study that garners headlines without being peer-reviewed
    and published.

    Once it gets peer reviewed and published we will be able to see who these researchers are and what
    their connections are to industry dollars, we'll be able to judge the quality of their work and then
    we be able to judge whether it is bona-fide science or just some other junk study.

    Until then, it's isn't worth the paper it is written on.

    TC
     
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