(The Associated Press) -- A month after Dr. Robert C. Atkins' death, his much-ridiculed diet has received its most powerful scientific support yet: Two studies in one of medicine's most distinguished journals show it really does help people lose weight faster without raising their cholesterol.

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May 22, 2003

By Alice Chang, M.D.
Harvard Medical School

How does this article relate to me?

Even though the Atkins diet made it to the New England Journal of Medicine, you will still hear many physicians advising against this form of weight loss. No matter what the numbers show in these studies, the Atkins diet still goes against better studies showing that low-fat diets, fruits, vegetables and whole grains help lower the risk for diabetes and heart disease.

What is helpful about the two studies just released is that they are better quality studies over a longer period of time than those done before. Over a year, there were no significant detrimental effects on cholesterol numbers in the studies. However, only one study used the high fat, low fruit and vegetable recommendations of the Atkins diet, and that study did not include people with diabetes or high cholesterol. Neither study looked at enough people over a long enough period of time to measure the effects of the Atkins diet on health, whether there is a higher or lower risk for heart disease or diabetes.

The short-term effects of this diet cannot be denied — the difference is about 10 pounds in the first six months. People will tell you that they don’t feel hungry due to the high protein and fat content in the diet. But as with many forms of dieting, it's hard to maintain drastic changes to your lifestyle. As one friend commented about the Atkins diet, "I’d rather die than live without carbohydrates." After a year, most people regained the weight, largely because they could no longer keep to the diet.

So all in all, although some of the numbers look good, I still would not promote this diet to my patients. While there may be benefits to a low carbohydrate diet (essentially a lower calorie diet), you should also limit the amount of fat in a diet that also includes fruits, vegetables and whole grains.

What changes do I need to make?

If you want to try the Atkins diet, talk to your health-care provider first. You may be at higher risk for complications from this diet if you have heart disease, diabetes, high cholesterol, a history of kidney stones, liver or kidney disease.

For a longer-lasting effect on your health, make the gradual changes in both your diet and physical activity that have been proven to maintain long-term weight loss. Reduce the saturated fat in your diet in favor of plant-based oils with unsaturated fat. Increase the fruits, vegetables and whole grains in your diet. Lower the amount of total calories in your diet. The healthy eating food pyramid includes the benefits of fruits, vegetables and whole grains, a reduction in carbohydrates from breads and pasta while avoiding the saturated fats and high protein content of the Atkins diet.

Avoid the following two pitfalls:

• Don't be misled by advertising. — Many low-fat products are actually high in calories — read the labels.
• Choose a realistic physical activity — One that you can do at least three to five times a week is best. Adding a weight regimen is often helpful.

What can I expect in the future?

Further research is needed to look at the long-term effects on health from the Atkins diet. The cholesterol levels seen in these studies are reassuring but do not prove that the Atkins diet is safe. Further study is needed to understand how this diet affects metabolism and cholesterol changes and most importantly, the development of atherosclerosis, a major concern of many physicians about the Atkins diet.

Related Areas:

Nutrition
Cholesterol