ARTICLE: Yet another study has shown that the Atkins diet works

The burning question

October 23, 2003

*Yet another study has shown that the Atkins diet works. But even the
scientist in charge is baffled about why the low-carb regime reduces fat
more effectively than conventional low-calorie, low-fat eating plans,
Robert Matthews reports.*

An academic nutritionist at the University of Cincinnati, Dr Bonnie
Brehm, is at the cutting edge of research into the biggest question to
hit her field in decades: does the Atkins diet work?

Most nutritionists faced with the torrent of anecdotal evidence for its
effectiveness have simply parroted the mantra that more research is
needed, while muttering darkly about possible long-term health effects.

Brehm and her colleagues, in contrast, have spent the past few years
actually doing the research and will unveil their findings at the
American Dietetic Association's annual meeting next week.

They have been studying the effectiveness of the Atkins diet in trials
involving people classed as clinically obese, implying a weight of more
than 92 kilograms (14 stone) in a person 175 centimetres (5 foot, 9
inches) tall. The latest results are in - and they appear to vindicate
the late Dr Robert Atkins, whose diet books have sold 15 million copies
over 30 years.

According to Brehm, those following Atkins's low-carbohydrate diet for
four months achieved twice the weight loss of those on a conventional
calorie-controlled, low-fat diet. Furthermore, the team found no
evidence of harmful effects from following the diet - at least during
the study.

These results are in line with those found in similar small studies now
starting to emerge. As well as backing the claims made for the Atkins
diet, these latest results seem to further undermine standard
nutritional advice about the need to focus on cutting fat and calories.

They are something of an embarrassment to Brehm, whose research is
funded by the American Heart Association, which has long advocated
calorie-controlled, low-fat diets.

As a scientist, Brehm puts unearthing the truth above pleasing her
paymasters - but it is this that causes most concern. She is having
problems explaining her findings - and in the increasingly vociferous
debate over the Atkins diet, that may well land her in trouble at next
week's meeting.

The scientific world is becoming increasingly polarised over the diet,
with researchers such as Brehm being given a tough time over their
apparent support for what some scientists regard as the nutritional
equivalent of crystal therapy. At the heart of the controversy is the
science behind the Atkins diet - first published 30 years ago - and
whether it is really anything more than a collection of buzzwords.

Conventional wisdom dictates that calories are the key to weight loss,
and so those who lose weight must simply be consuming fewer calories
than they burn up. Yet, according to Brehm, the obese people who lost
weight on the Atkins diet ate and burned up essentially the same number
of calories as those on the standard diet. What was very different was
the proportion of body fat shed by each group, which mirrored their
percentage weight loss. On the face of it, this backs the central claim
of the Atkins diet: that a low-carb diet turns the body into a
fat-burning machine.

To trigger this effect, Atkins dieters are instructed to begin by
eliminating all carbohydrates from their diet, forcing their bodies to
get energy by burning up fat reserves instead. The result is supposed to
be weight loss, plus the production of compounds known as ketones; the
higher the level of "ketosis", the more fat is being burnt.

That's the theory. Yet studies of the patients in Brehm's trial failed
to reveal a connection between ketosis and fat loss. "We didn't see any
correlation - all of our expectations were confounded," she says. "I'm
hoping someone in the audience might have some answers."

Brehm is confident that there is a reasonable, if not simple,
explanation for her findings: "In the end, the energy in has got to
match the energy out."

Even more baffling is why there are still such enormous gaps in
knowledge about how humans respond to diet. The past 20 years have seen
obesity reach record levels in the developed world. This has led
scientists to concede that the standard advice on nutrition and healthy
eating has been an abject failure - yet the Atkins diet is still
dismissed as a "fad" by the British Dietetic Association, with leading
nutritionists insisting that there is insufficient scientific evidence
to give it more credence. This lack of evidence has not deterred many in
the medical profession from condemning the diet out of hand. Last week a
poll of British doctors revealed that one in four would advise their
patients to stay fat rather than try the Atkins diet - despite the
proven life-threatening effects of obesity.

Such attitudes might suggest that the scientific world is in the grip of
cognitive dissonance over the Atkins Diet, preferring to ignore whatever
evidence it does not like. Professor Eric Westman, a clinical trials
expert at Duke University in North Carolina, and author of a study of
the evidence for and against the diet, says, "It is making people
re-examine dogma - and it's not always appreciated."

According to his review, which is due to appear in Current
Atherosclerosis Reports, studies show that the Atkins diet does produce
weight loss over six months, and without obvious health effects.
Contrary to the claims of many nutritionists, there is even evidence
that it may be healthier than the standard diet: despite its promotion
of fat and eggs, studies suggest that the diet may boost levels of the
healthy forms of cholesterol.

Westman thinks that this unexpected effect may explain a long-standing
mystery surrounding heart disease. In the late 1980s, researchers began
investigating the unusually low rates of heart attacks and stroke among
Eskimo communities in Greenland. Until now, the explanation was thought
to lie in their diet of oily fish. Yet attempts to reduce heart disease
using supplements of fish oil extracts proved disappointing. Westman
says the studies of the Atkins diet point to another explanation: that
the lo-carb diet forced on the Inuit by their environment gives them
higher levels of healthy forms of cholesterol, which are proven to lower
heart disease risk.

Despite this, Westman cautions anyone with a medical condition against
rushing onto a low-carb diet. "The problem is that it works too well,"
he explains. "The diet can cause insulin levels to drop by 50 per cent
in one day, so diabetics could find themselves over-medicated. It's the
same for those with high blood pressure."

Even so, Westman believes that the results are impressive enough to
warrant an intensive research effort on the Atkins diet: "We're in a
period when we will learn a lot."

It is not a prospect that thrills the entire nutritional science
community. Westman has been vilified for conducting research with
financial support from the Atkins Foundation - despite the fact that
some vocal critics of the diet, such as Dr Susan Jebb, the head of
nutrition at the UK Medical Research Council, have, in turn, received
funding from bodies such as the Flour Advisory Bureau.

Brehm has also run into resistance even over her research funded by the
American Heart Association.

"We had a tough time getting our results published - it took 18 months
altogether," she says. "The big journals really couldn't handle it. But
we're not endorsing the diet: it's just our results."

What both sides do agree on is the paucity of scientific evidence on the
long-term benefits and health effects of the Atkins diet. With the
world-wide obesity problem now claiming an estimated 2 million adult
lives a year, Brehm believes that the time has come to commit serious
resources to studies of low-carb diets.

As she says: "We need much more doing - and doing quickly." This is a
sentiment endorsed by Professor Tom Sanders, the director of the
Nutrition, Food and Health Research Centre at King's College, London -
and a sceptic regarding the Atkins diet.

"The evidence is that it's the calorie intake that counts," Sanders
says. "But in the end, diets don't work because people don't follow
them. We need large-scale, randomised and controlled trials of
treatments of obesity running for one to two years."

Those already embarked on such research suspect that it will take a
great deal to overcome the visceral response the mere mention of Atkins
provokes among academics. Says Brehm: "A lot of people just want to hold
on to what they learned in college."

The Telegraph, London
--
Jim
231/194?/197
Atkins since 22 May '03
Gym since 1 sept '03

Why is this such a controversy? Whether or not there truly exists a
"Metabolic Advantage" as Dr. Atkins used the term, there is another very
simple explanation.

For some people, if not all people, it MUST be true that:

Consuming 1,000 Kcal of Fructose is NOT metabolically equivalent to
consuming 1,000 Kcal of Bacon grease.


Why not???? I'll tell you why:

1. Not all foods have EXACTLY the same absorption in the gut. Most of the
fructose calories will be used by the body, while a greater percentage of
the bacon grease calories will end up in the toilet.

2. The energy USED by the body in metabolizing & processing is not EXACTLY
the same for all foods. Again, my hypothesis is that sugary/starchy foods
are much more easily processed by the body.

Even a 1% difference in NET ABSORBED CALORIES (between a low-carb and a
high-carb diet of equivalent GROSS calories) would be significant. I would
bet it's much greater than 1%.

If I'm wrong, then Atkins' "Metabolic Advantage" seems to be the only
logical explanation for these results.

"cheesegator" wrote in message
...
Why is this such a controversy? Whether or not there truly exists a
"Metabolic Advantage" as Dr. Atkins used the term, there is another
very
simple explanation.

For some people, if not all people, it MUST be true that:

Consuming 1,000 Kcal of Fructose is NOT metabolically equivalent to
consuming 1,000 Kcal of Bacon grease.


Why not???? I'll tell you why:

1. Not all foods have EXACTLY the same absorption in the gut. Most
of the
fructose calories will be used by the body, while a greater
percentage of
the bacon grease calories will end up in the toilet.

2. The energy USED by the body in metabolizing & processing is not
EXACTLY
the same for all foods. Again, my hypothesis is that sugary/starchy
foods
are much more easily processed by the body.

Well, yeah. Consider that we introduce rice cereal as the first solid
food in a baby's diet. Why? Because it is easily digestible. Then
fruit. Protien is last on the list. Now think about the implications
in that.


Even a 1% difference in NET ABSORBED CALORIES (between a low-carb
and a
high-carb diet of equivalent GROSS calories) would be significant.
I would
bet it's much greater than 1%.

I doubt it is so high, myself, for 'average' folks, and I have heard
that sort of differential factoring is accounted for in the
calculations of caloric loads of different foods (for average folks).
Of course, for us overweight people, we have visual evidence that our
bodies react differently to food than 'average' folks.

revek




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revek wrote ...
"cheesegator" wrote ...
For some people, if not all people, it MUST be true that:

Consuming 1,000 Kcal of Fructose is NOT metabolically equivalent to
consuming 1,000 Kcal of Bacon grease.

Why not???? I'll tell you why:

1. Not all foods have EXACTLY the same absorption in the gut. Most
of the
fructose calories will be used by the body, while a greater
percentage of
the bacon grease calories will end up in the toilet.

2. The energy USED by the body in metabolizing & processing is not
EXACTLY
the same for all foods. Again, my hypothesis is that sugary/starchy
foods
are much more easily processed by the body.

I doubt it is so high, myself, for 'average' folks, and I have heard
that sort of differential factoring is accounted for in the
calculations of caloric loads of different foods (for average folks).
Of course, for us overweight people, we have visual evidence that our
bodies react differently to food than 'average' folks.

It's all about the insulin ... carbs stimulate insulin, protein/fats don't,
or at least *very* little.

I'm no scientist so bear with me here, but the insulin spike you get with
the fructose (or any carbs, to a greater or lesser degree) means your body
is going to store any excess calories as fat. Too many such insulin spikes
can leave a person insulin resistant, which means the body is producing more
and more of the fat-storing insulin because it's not registering ... and if
it continues you end up with type 2 diabetes if you're not careful.

Hence the idiocy of the high-carb diet so commonly prescribed for diabetics.

I'm sure there are others here who can explain it all soooo much better than
I can! This is essentially what I can recall from reading DANDR.

When my GP told me I was insulin resistant, she said my body is extremely
efficient at gaining and retaining weight.

bloody brilliant ...

)

Rachel
(New Zealand)

On 2003-10-26, Supergoof wrote:

Hence the idiocy of the high-carb diet so commonly prescribed for diabetics.

What diet is that?

I recently visited my father and my step-mom, who has diabetes. The
first thing I noticed is the similarities between her diabetes diet
and my Atkins diets. They were virtually identical. We shared recipe
notes and eating tips on everything from meats to sugar free foods. I
loved her Russel Stover nut clusters and she loved my Carb Safe white
chocolate. I got cooking tips on how to cook up killer carnitas and
homemade chile sauce. She loved my Johnsonville Beer'n Brats. In
fact if she ingests too many carbs (sound familiar?) she has to
immediately get on the treadmill to compensate. The only difference
between diests I could see was, if she cheated, it kicked her ass. I
hope I never have to suffer that. It's why I'm on this diet now.

nb

On Tue, 28 Oct 2003 19:14:57 GMT, notbob wrote:

On 2003-10-26, Supergoof wrote:

Hence the idiocy of the high-carb diet so commonly prescribed for
diabetics.

What diet is that?

I recently visited my father and my step-mom, who has diabetes. The
first thing I noticed is the similarities between her diabetes diet
and my Atkins diets. They were virtually identical. We shared recipe
notes and eating tips on everything from meats to sugar free foods. I
loved her Russel Stover nut clusters and she loved my Carb Safe white
chocolate. I got cooking tips on how to cook up killer carnitas and
homemade chile sauce. She loved my Johnsonville Beer'n Brats. In
fact if she ingests too many carbs (sound familiar?) she has to
immediately get on the treadmill to compensate. The only difference
between diests I could see was, if she cheated, it kicked her ass. I
hope I never have to suffer that. It's why I'm on this diet now.

nb


Here are some quotes from the American Diabetes Association (see:
http://care.diabetesjournals.org/cgi...25/suppl_1/s50). Note
the second and third paragraphs(!).

Foods containing carbohydrate from whole grains, fruits, vegetables, and
low-fat milk should be included in a healthy diet.

As sucrose does not increase glycemia to a greater extent than isocaloric
amounts of starch, sucrose and sucrose-containing foods do not need to be
restricted by people with diabetes; however, they should be substituted for
other carbohydrate sources or, if added, covered with insulin or other
glucose-lowering medication.

Carbohydrate and monounsaturated fat together should provide 60–70% of
energy intake. However, the metabolic profile and need for weight loss
should be considered when determining the monounsaturated fat content of
the diet.

Sucrose and sucrose-containing foods should be eaten in the context of a
healthy diet.

Less than 10% of energy intake should be derived from saturated fats. Some
individuals (i.e., persons with LDL cholesterol 100 mg/dl) may benefit from
lowering saturated fat intake to 7% of energy intake.

Dietary cholesterol intake should be 300 mg/day. Some individuals (i.e.,
persons with LDL cholesterol 100 mg/dl) may benefit from lowering dietary
cholesterol to 200 mg/ day.

--
Bob M in CT
Remove 'x.' to reply

cheesegator wrote:
:: Why is this such a controversy? Whether or not there truly exists a
:: "Metabolic Advantage" as Dr. Atkins used the term, there is another
:: very simple explanation.
::
:: For some people, if not all people, it MUST be true that:
::
:: Consuming 1,000 Kcal of Fructose is NOT metabolically equivalent to
:: consuming 1,000 Kcal of Bacon grease.
::
::
:: Why not???? I'll tell you why:
::
:: 1. Not all foods have EXACTLY the same absorption in the gut. Most
:: of the fructose calories will be used by the body, while a greater
:: percentage of the bacon grease calories will end up in the toilet.

Do you have a cite for this? I'm not saying it isn't true, but I've never
read anything convincing on this. I do know, however, that when I eat lots
of fat -- stuff floats

::
:: 2. The energy USED by the body in metabolizing & processing is not
:: EXACTLY the same for all foods. Again, my hypothesis is that
:: sugary/starchy foods are much more easily processed by the body.
::
:: Even a 1% difference in NET ABSORBED CALORIES (between a low-carb
:: and a high-carb diet of equivalent GROSS calories) would be
:: significant. I would bet it's much greater than 1%.
::
:: If I'm wrong, then Atkins' "Metabolic Advantage" seems to be the only
:: logical explanation for these results.

I like your notions better than the metabolic advantage. I just don't know
if they are true.

On Thu, 23 Oct 2003 10:47:10 -0400, Roger Zoul
wrote:

cheesegator wrote:
:: Why is this such a controversy? Whether or not there truly exists a
:: "Metabolic Advantage" as Dr. Atkins used the term, there is another
:: very simple explanation.
::
:: For some people, if not all people, it MUST be true that:
::
:: Consuming 1,000 Kcal of Fructose is NOT metabolically equivalent to
:: consuming 1,000 Kcal of Bacon grease.
::
::
:: Why not???? I'll tell you why:
::
:: 1. Not all foods have EXACTLY the same absorption in the gut. Most
:: of the fructose calories will be used by the body, while a greater
:: percentage of the bacon grease calories will end up in the toilet.

Do you have a cite for this? I'm not saying it isn't true, but I've
never
read anything convincing on this. I do know, however, that when I eat
lots
of fat -- stuff floats

::
:: 2. The energy USED by the body in metabolizing & processing is not
:: EXACTLY the same for all foods. Again, my hypothesis is that
:: sugary/starchy foods are much more easily processed by the body.
::
:: Even a 1% difference in NET ABSORBED CALORIES (between a low-carb
:: and a high-carb diet of equivalent GROSS calories) would be
:: significant. I would bet it's much greater than 1%.
::
:: If I'm wrong, then Atkins' "Metabolic Advantage" seems to be the only
:: logical explanation for these results.

I like your notions better than the metabolic advantage. I just don't
know
if they are true.




Has anyone even studied this? The problem, as I see it, is that no one
wants to undertake an analysis of what's happening. Who would pay for it?
The beef industry? They don't care -- people eat beef regardless.
Certainly none of the corn, wheat, rice, etc. people are going to pay.
This is where I think the government should step in. Evidence is mounting
that their "food pyramid" is pure crap. Undertake studies to see if it is.
They're requiring schools to limit fat to 30% by calories per day, yet I
eat way more than that and feel great. No one wants to undertake this
research, so the Government, who's making up rules based on who knows what,
should do something.

--
Bob M in CT
Remove 'x.' to reply

On 2003-10-23, Bob M wrote:

Has anyone even studied this? The problem, as I see it, is that no one
wants to undertake an analysis of what's happening. Who would pay for it?
The beef industry? They don't care -- people eat beef regardless.

Not true. The beef industry has been taking it in the shorts for
years. Look at all the turkey/chickne hotdogs, lunchmeat, chili,
breasts, etc. It's one of the reasons beef is at an all-time high,
price-wise. That and the ban on Canadian beef. But, it would seem
the beef and corn industry would benefit from a beneficial study. Maybe
they are studying it. The milk industry ...cheese!... would also
benefit.

On the other side of the coin, the starch industry is quaking in their
boots. Potato growers are already starting to feel the pinch in the
form of a noticeable reduction in french fry sales. Rice is
safe. Eleventy jillion asians will see to that. Wheat? Well, bread
will be around forever, but I think all the crap snacks will be hard
hit.

nb

Please see the last couple paragraphs of this news item.
http://www.news.harvard.edu/gazette/...3-lowcarb.html

Although the hypotheses I stated are my own, the intuitive logic is
compelling--as the above-reference researcher illustrates. To me, this is
by far the most obvious reason why LCers may consume more calories (than
LFers) and yet lose more weight. It may not ultimately prove to be true,
but isn't this the logical place to begin the research?

The converse to my simple hypothesis would be:
"All foods (i.e. no exceptions, ever, anywhere, under any circumstances) are
metabolized in EXACTLY the same way, or at least have EXACTLY the same net
metabolic effect on EVERY SINGLE HUMAN BEING".

Not particularly likely, IMHO.


"Roger Zoul" wrote in message
...
cheesegator wrote:
:: Why is this such a controversy? Whether or not there truly exists a
:: "Metabolic Advantage" as Dr. Atkins used the term, there is another
:: very simple explanation.
::
:: For some people, if not all people, it MUST be true that:
::
:: Consuming 1,000 Kcal of Fructose is NOT metabolically equivalent to
:: consuming 1,000 Kcal of Bacon grease.
::
::
:: Why not???? I'll tell you why:
::
:: 1. Not all foods have EXACTLY the same absorption in the gut. Most
:: of the fructose calories will be used by the body, while a greater
:: percentage of the bacon grease calories will end up in the toilet.

Do you have a cite for this? I'm not saying it isn't true, but I've never
read anything convincing on this. I do know, however, that when I eat
lots
of fat -- stuff floats

::
:: 2. The energy USED by the body in metabolizing & processing is not
:: EXACTLY the same for all foods. Again, my hypothesis is that
:: sugary/starchy foods are much more easily processed by the body.
::
:: Even a 1% difference in NET ABSORBED CALORIES (between a low-carb
:: and a high-carb diet of equivalent GROSS calories) would be
:: significant. I would bet it's much greater than 1%.
::
:: If I'm wrong, then Atkins' "Metabolic Advantage" seems to be the only
:: logical explanation for these results.

I like your notions better than the metabolic advantage. I just don't
know
if they are true.