Is Atkins the Healthiest Choice for Weight Loss?

March 6, 2007 — -- The beleaguered Atkins diet may get a breath of life from a new study that suggests the high-protein, low-carbohydrate diet regime leads to more effective weight loss with fewer negative health effects than three other weight loss strategies.

The study, which pits the Atkins diet against the Zone, Ornish and LEARN diets, appears in the current issue of the Journal of the American Medical Association (JAMA).

But the findings could be too little too late for the popular diet, which at one time changed the way Americans ate.

Proponents of Atkins say the study is only the latest piece of evidence testifying to the effectiveness of a diet that cuts carbs to a minimum.

"Clearly, this study shows that controlling carbohydrates is as or more effective than the low-fat, low-calorie approaches we've seen in the past," says Dr. Stuart Trager, author of "The All-New Atkins Advantage: 12 Weeks to a New Body, a New You, a New Life."

"The proof is now in the pudding," says Dr. Fred Pescatore, former medical director of the Atkins Center and best-selling author of "The Hamptons Diet," a guide on another low-carb regime.

"These findings are consistent with over a dozen papers in the past five years demonstrating the beneficial effects of carbohydrate restriction," says Dr. Eric Westman, associate professor of medicine and director of the Lifestyle Medicine Clinic at Duke University Medical Center. "I think low-carbohydrate diets should be first-line therapy for weight loss."

But will the new research be enough to save Atkins -- or even restore it to its former lead position in the pack of new diet regimes? Many diet experts say no.

"Health is not measured as the combination of several cardiac risk markers and weight over the course of a year," says Dr. David Katz, director of the Prevention Research Center at Yale University School of Medicine. "If it were, every patient getting chemotherapy would be 'healthy.'"

"Some heart indicators were better, but what about the mountains of evidence about high consumption of fruits and vegetables to promote overall health?" says Keith-Thomas Ayoob, associate professor at the Albert Einstein College of Medicine's department of pediatrics in Bronx, N.Y.

Safety Questions and Efficacy of Atkins

The JAMA study suggests that women on the Atkins diet not only lose more weight than those on the other diets studied, but that these women also maintain better cholesterol profiles and blood pressure levels.

But Dr. Dean Ornish, creator of the Ornish diet and president of the Preventive Medicine Research Institute in San Francisco, says the conclusions from these findings are misguided.

"This is simply not true," he says. "If you read the study carefully, you will find that the authors reported that there was no significant difference in weight loss between the Atkins and Ornish or LEARN diets after one year.

"This directly contradicts their primary conclusion."

Other experts say the fact that the study only features results for up to one year makes such conclusions premature at best.

"The weight loss with Atkins maxed out after six months and really started regaining then, and somewhat faster than with the other diets," Ayoob says. "It would be interesting to see if, by 18 months or so, everything evened out."

"The public may not realize that keeping weight off for one year is no indication of permanence," says Carla Wolper of the Obesity Research Center at St. Luke's Hospital in New York City.

"It may be that more than two years of weight stability are required before one can feel safe with weight loss achieved."

And some say the shortcomings of the research reach beyond simple weight loss. In particular, there's a belief that the study downplays the wide spectrum of factors that contribute to heart health.

"Numbers don't lie, but they don't tell the whole story -- by a mile," says Jackie Newgent, instructor at the Institute of Culinary Education in New York City. "There are more than just a couple numbers that determine your overall health. And as cholesterol numbers and blood pressure levels improve, it doesn't mean other heart-health indicators improve."

Since heart concerns have remained at the center of the debate over low-carb diets since their inception, the study may do little to silence critics with these concerns.

A Call for Common Sense

In recent years, the Atkins diet has also found itself surrounded by a lean, mean pack of other diet regimens, most with their own best-selling books.

Michael Roizen and Mehmet Oz's "You: On a Diet," one of the more recent wunderkinds of the growing diet genre, is now enjoying its 17th week on The New York Times best-seller list.

Other diets, low-carb and otherwise, likewise flood bookstore shelves -- a phenomenon that threatens to lead to diet-reader fatigue as the choices become ever more diverse and, in many cases, complex.

So, what's a dieter to do?

In short, losing weight and keeping it off may be more a function of adopting an overall healthier lifestyle -- and less about cutting whole classes of foods out of your diet.

"This is the message of this article -- focus on lifestyle and environmental factors and don't worry about the macronutrient composition of the diet, particularly if you can achieve the NHLBI guidelines of a 5 to 10 percent weight loss," says Dr. George Blackburn, chair in nutrition medicine at Harvard Medical School. "I think that was my message for the past 20 years."

"A healthy diet is the same as it ever was," Katz says. "Focus on health, and the long term, and your weight will take care of itself."

"It's not about demonizing whole food groups," Ayoob says. "It's about how much and how often, and learning to strike a balance between what we know we need, and what we don't want to live without."

And for diet book authors on both sides of the debate, an armistice in the "diet wars" would be a positive outcome by any measure.

"I'm tired of these diet wars," Ornish says. "It's not low-fat versus low-carb. It's both. An optimal diet is low in total fat and low in refined carbohydrates, emphasizing whole foods such as fruits, vegetables and whole grains."

"The future needs to be about getting away from this 'beauty pageant' mentality of what diet is best," Trager says. "It needs to be about incorporating the best practices of each approach to make lifestyle changes more achievable and improve adherence."