Conscious Choice: Solving the Diet Dilemma

March 2004

Solving the Diet Dilemma

An Atkins Rebuttal

by Mark Hyman, MD & Mark Liponis, MD

Who should we believe? For decades we’ve been told that a low-fat diet is the key to weight loss and health. Yet now, some 32 million Americans — that’s one in every nine of us — are on designer diets rich in fat, such as the popular Atkins or South Beach plans. The confusion is enough to make one want to rush out for a box of Krispy Kremes.

And why not? Most of us are basically walking doughnuts anyway. Obesity rates have tripled since the 1960s. More than two thirds of the adult population and one third of children are overweight. Obesity is overtaking smoking as the number one cause of preventable deaths in this country, accounting for heart disease, strokes, cancer, dementia and diabetes. That Krispy Kreme might as well serve as a poster child for today’s "waist land."

How did this happen? It’s no mystery, really. The Super-Size era combined with steadily dropping levels of physical activity. And the U.S. Department of Agriculture’s made matters worse with its ill-conceived (and scientifically unfounded) Food Pyramid, which advised we eat 6 to 11 servings of bread, cereal, rice and pasta per day. The processed food industry then created some 15,000 low-fat products — many of which turned out to be high in sugar. And we became a society where the average person consumes half a pound of sugar per person per day, mostly in the form of a super sugar called high-fructose corn syrup.

And so along came Dr. Atkins. His high-protein, high-fat diet promised to let us forget about calories and still lose weight. Atkins claims a low-carb diet is the key to weight loss and good health. The best selling diet plan also promises you can "lose weight eating the same number of calories on which you used to gain weight." Atkins followers are advised to eliminate all carbohydrates, including some fruits and vegetables, and instead they are allowed to eat protein and fat without limitation, including foods high in saturated fat.

Atkins’ rationale is that by avoiding carbs, insulin levels are lower, which could help with weight loss by a few plausible mechanisms. Insulin is one of the hormones our body makes to regulate our blood sugar level. High levels of insulin have been linked to weight gain, as well as high cholesterol and a number of health problems from heart disease to dementia to diabetes. Theoretically this might mean that Atkins could live up to its claims of improving both weight and health.

But does Atkins really work, and is it safe? Despite the fact that millions of Americans are on the Atkins’ diet, there is scarce little research on its safety and long-term effectiveness. Short-term studies have been promising, but there have been few studies lasting more than six months.

A one-year study comparing Atkins to three popular diets was recently reported by the American Heart Association. Atkins squared off against Weight Watchers, the Zone and Dean Ornish’s diet to see which worked the best and what effects the diets had on cholesterol and cardiovascular risk factors.

The Atkins diet is a low-carbohydrate, high-fat, high-protein diet. Dean Ornish’s diet is a vegetarian-based, low-fat, high-fiber diet. Weight Watcher’s is a low fat, moderate calorie diet that works on the point system. Finally, the Zone diet promotes proportions of 40 percent carbs, 30 percent protein and 30 percent fat at each meal.

First, the good news: All participants lost weight. The bad news was that the weight loss at the end of one year was small — only about 3 percent, or about 6 pounds for a 200-pound person. Weight loss was partly blunted by the fact that about half of the participants in both the Atkins and Ornish diets dropped out before one year, and about on third of those on the Weight Watchers and Zone plans dropped out. For those who stuck with their diet for the full yearweight loss ranged from about 4 percent for the Atkins group, to about 6 percent for the Ornish group. Pretty tepid results for a year of dieting!

Probably the best news is that all four groups experienced a significant reduction in cardiovascular risk factors. This meant a drop in LDL ("bad") cholesterol, a rise in HDL ("good") cholesterol, and a reduction in insulin levels.

However, Atkins dieters actually had the least drop in insulin levels (only 7.7 percent, compared with 19.9 percent on Ornish). Likewise, cholesterol levels were most improved on the Ornish diet compared with Atkins. Of the four diets, Atkins fared the worst, with the least weight lost, the lowest cardiovascular risk reduction, and the highest drop out rates.

And there’s much more than fat to consider. Years of conventional nutritional wisdom and substantial research has linked saturated fat in the diet with cardiovascular disease and some forms of cancer, such as prostate and colon cancer. High protein diets may increase the risk of bone loss and kidney problems.

At Canyon Ranch, we have 25 years of experience in teaching healthy weight and nutrition. Two simple truths have not changed. First, significant weight loss is a long-term process that requires a lifelong commitment and a permanent change in eating behavior. And second, regular exercise and an increase in daily physical activity is an essential component of a long-term weight and health maintenance program.

Americans need to lose weight, but we also need a healthy diet that we can adhere to for life. A healthy diet and an active, healthy lifestyle can prevent 70 percent of the all premature deaths due to diseases that affect us later in life.

Mark Hyman and Mark Liponis are co-medical directors of Canyon Ranch, a leading health resort, as well as co-authors of the bestselling Ultraprevention: The 6-Week Plan That Will Make You Healthy For Life (Scribner, $25).

Ultra Eating

Ultraprevention co-authors Mark Hyman and Mark Liponis have developed a system of health care based on science and common sense for managing your overall health and ideal weight. What, when and how much you eat is the key:

Start the day with protein for breakfast such as eggs, nut butters and unsweetened yogurt with nuts.

Avoid eating carbs alone. Include protein and fat along with carbs at every meal or snack. Mixing carbs with protein and fat slows down the rate of sugar absorption. The exact combination isn’t as critical as choosing from foods that have a high nutrient-to-calorie ratio.

Eat every 3-4 hours (3 meals, 2 snacks). Smaller amounts eaten more frequently keep your blood sugar and insulin levels normal. Two things raise your blood sugar — foods that turn immediately to sugar when you eat them and large quantities of any food except very low-glycemic-index vegetables.

Eliminate the White Menace - white flour, white sugar and white fat. Strictly avoid hydrogenated fat (margarine, shortening, all processed and refined oils and fried foods). It blocks insulin metabolism and can cause weight gain. Likewise, whole grains high in dietary fiber should replace refined grains. For example, choose brown rice over white rice or whole-wheat bread instead of white bread.

Eat the GOOD fats daily. These are the special fats in foods such as fish, omega-enriched eggs, nuts, avocados, sea vegetables, flaxseeds and olive and canola oils.

Increase your daily intake of soluble fiber, which slows sugar absorption. Include beans, a high-fiber protein, in your daily diet. Try things like bean dip, refried beans with olive oil, hummus and beans in soups and salads.

Increase your intake of brightly colored fruits & vegetables to 8 to 10 servings a day. These foods are rich in antioxidants and healthful phytonutrients.

This column is for information only and no part of its content should be construed as medical advice, diagnosis, recommendation or endorsement.

Recommend this page to a friend

Top Ten pages recommended to friends: