Here is the original Mayo Clinic Journal article:
http://www.mayo.edu/proceedings/2003/nov/7811a1.pdf


Here is the reporter's take of the study:
http://my.webmd.com/content/Article/...m?pagenumber=1

Low-Carb, High-Fat Diet Drops Weight

Atkins-Like Plan Won't Hurt Cholesterol Levels, but Critics Aren't Impressed

By Sid Kirchheimer
WebMD Medical News
Reviewed By Michael Smith, MD
on Tuesday, November 11, 2003

Nov. 11, 2003 -- Is it really possible to lose weight on a no-starch,
high-fat diet, similar to Atkins, without hurting cholesterol levels?
Apparently so, even for people with heart disease, according to the latest
study on the topic.

The new study details the effects of a no-starch, high-fat diet on 23
patients at risk for diabetes. All were overweight, were taking
cholesterol-lowering statin drugs, and had been diagnosed with heart
disease. The high-saturated fat and no-starch diet was developed eight years
ago by endocrinologist James Hays, MD, in an effort to help his diabetic
patients.

On average, those following his low-carb, high-fat diet lost 5% of their
body weight after only six weeks. For example, a 200-pound person would have
lost 10 pounds.

Importantly, the high-fat diet did not have harmful effects on cholesterol
levels. In fact, the participants saw a lowering of the blood fat called
triglycerides. "Bad" LDL and "good" HDL cholesterol levels didn't change,
but the size of the HDL and LDL molecules increased.

Larger LDL molecules are less likely to form artery-clogging plaques. Larger
HDL molecules stay around in the body longer to clean up more plaque.

"We also saw a significant drop in glucose and insulin levels," Hays tells
WebMD. Higher blood sugar (glucose) and insulin levels indicate the early
signs of diabetes.

Lots of Fat Allowed

Under Hays' plan, half of the daily 1,800 calories come from saturated fats
-- mostly red meats and cheese. "We're not talking about protein, egg
whites, and turkey and white-meat chicken," he says. "We're talking about
fat."

Just days ago, another study at the American Heart Association's annual
meeting compared the low-carb, high-fat Atkins diet to three other popular
diets -- the very low-fat Ornish plan, the high-protein, moderate-carb Zone
diet, and the low-fat, moderate-carb Weight Watchers plan. When devotedly
followed, all produced similar weight loss and reductions in heart disease
risk.

Hays tells WebMD that he believes the heart-healthy benefits of his
Atkins-like eating plan are because of its high intake of saturated fats --
considered by most experts to cause heart disease.

"Cholesterol leaves our body through bile, and high-fat foods cause bile
secretion," he says. "Although I would caution that this is genetically
determined, I think that most people are able to excrete huge amounts of
cholesterol they're consuming with this bile secretion." Still, he advises
that anyone starting any type of high-fat diet keep close tabs on their
cholesterol and triglyceride levels.

Under Hay's low-carb, high-fat diet, milk and starches such as pasta and
baked goods are forbidden and only certain fruits and vegetables can be
eaten. And unlike Atkins, which allows for increased but still low amounts
of carbohydrates the longer participants remain on the plan, Hays' plan
remains constant.

A typical dinner on the Hays plan: "A half-pound of red meat or chicken dark
meat (after cooking), with 1/2 cup of vegetables, 1/2 cup of salad, and a
half piece of fruit. There's lots of oil but no vinegar or other
condiments," he says. Acceptable vegetables include broccoli, cauliflower,
and others that grow above ground; allowed fruits (which must be eaten last
at every meal to keep glucose levels low) include apples, oranges, peaches,
and pears, as long as they are not processed.

"It's very vigorous to eliminate starches completely, but those who do seem
to do very well," Hays says. "We followed two other groups of patients who
weren't taking statin medications for six months and a year, and they lost
15% and 20% of their body weight respectively and had no adverse effects on
their [blood fats]. I've had some patients lose up to 40% of their weight on
this plan."

But Is It Healthy?

Not all are convinced a high-fat diet is the best strategy for the long
term.

"The main reason people lost weight on this diet is because they're
consuming fewer calories than they're used to," says Jen Keller, RD, staff
nutritionist for the Physicians Committee for Responsible Medicine, a
nonprofit organization that promotes preventive medicine and a vegetarian
diet.

"It doesn't matter how you lose weight -- you can starve yourself, you can
eat eggs all day, however you do it, if you're eating fewer calories that
you're used to, your blood fats will improve in the short-term," she tells
WebMD. "But a lot of times, when the weight loss plateaus, the benefits in
cholesterol are erased and you're no better off than when you started, and
sometimes worse."

Her group has been a longtime and vocal critic of low-fiber, high-fat diets
such as Atkins, and she is concerned that such eating plans raise the risk
of colon cancer, kidney disease, and other health problems.

"A new study comes out every day talking about what's the best way to lose
weight. If you look at the world's population, the healthiest and thinnest
people are people who follow a plant-based diet," she says. "As they start
to eat more fats, they gain weight and develop health problems."

In an accompanying editorial, Mayo Clinic cardiologist Gerald Gau, MD, urges
doctors to keep an open mind about these high-fat diets. "But I am concerned
about the long-term cardiovascular risk," he writes. "We should continue to
examine the risk-benefit profile of caloric-restricted, more rational diets
such as the Mediterranean diet, which recently was associated with a
striking decrease in cardiovascular risk."
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SOURCES: Hays, J. Mayo Clinic Proceedings, November 2003; vol 78: pp
1331-1336. Gau, G. Mayo Clinic Proceedings, November 2003; vol 78: pp
1329-1330. American Heart Association Scientific Sessions 2003, Orlando,
Fla., Nov. 9-12, 2003. James Hays, MD, endocrinologist, Christiana Care
Health Services, Cardiology Research, Newark, Del. Jen Keller, RD, staff
nutritionist and nutrition projects coordinator, Physicians Committee for
Responsible Medicine (PCRM), Washington, D.C.
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