The other story

  • Health
  • Sunday, 12 Jan 2003

RAJEN. M, on the other hand, feels that Dr Robert Akins is on to something which could provide a breakthrough on how foods can help support cardiovascular health.  

A RECENT cover story in the Sunday New York Times Magazine featured the low-carbohydrate diet made famous by Robert C. Atkins, M.D., the author of the best selling book, Dr Atkins’ Diet Revolution

Over the course of 30 years, Dr Atkins, a board certified cardiologist, has not wavered from his controversial dietary ideas. In a nutshell, Dr Atkins advises us to eat as much meat and other high protein (soy, cheese and yoghurt) as we care to, while avoiding starches and refined carbohydrates such as breads, pasta, rice and sugars. He nevertheless, increasingly recommends the regular and sustained intake of wholesome fruits and vegetables. This plan has won many millions of readers, but has drawn numerous, often viscous attacks from doctors and nutritionists. 

However, the book by Dr Atkins has been in the New York Times bestsellers list for more than 20 years. That tells a lot. A diet that does not work or may even be dangerous as claimed by many critics, cannot fool that many people for that long.  

The American Heart Association (AHA) has long condemned the Atkins diet as an unhealthy regimen for the cardiovascular system and overall health in general. So it must have been thoroughly galling to many in the AHA “low-fat” camp when the Duke University study results were announced on 18th September, as part of the 75th annual AHA meeting.  

Dr Robert Atkins...His book has sold over 15 million copies in the United States.

Step 1 stumbles 

The Duke University study was conducted by Dr Eric Westman of Duke University, an internist at Duke’s diet and fitness centre. He decided to study the Atkins approach because of concerns over so many patients and friends taking it up on their own. 

In the study, 120 overweight subjects were put on two diets: one half of the group followed the American Heart Association’s Step 1, low-fat diet, and the other half followed the Atkins diet, in which 60% of their daily calories came from fat, while carbohydrates were reduced to less than 20 grams per day.  

The Atkins subjects lost, on average, 14kg each over six weeks, while the AHA group lost an average of 9kg each. That alone would be major news. But the real news comes from the blood cholesterol and triglyceride levels.  

The levels of LDL cholesterol (commonly called “bad cholesterol”) for the two groups showed almost no statistical change. And while the numbers break even, I would guarantee that many low-fat nutritionists fully expected the Atkins diet to raise the LDL. Meanwhile, the Atkins group showed an 11% increase in HDL cholesterol (the “good” cholesterol). The AHA group recorded no rise in their HDL levels! 

Finally, and more importantly, the AHA group had a 22% drop in triglycerides, while the Atkins group experienced a drop of almost 50% – more than double the AHA dieters on the recommended Step 1 diet! 

On to Pennsylvania! 

The anti-Atkins folks are up in arms – but certainly not backing down. In the San Francisco Chronicle, Gail Woodward-Lopez, the associate director of the Centre for Weight and Health at the University of California, Berkeley, compared the Atkins diet to a disease, saying, “Hepatitis C is effective at helping people lose weight too.” And Judith Levine, an AHA registered dietitian curtly dismissed the results, claiming, simply, “It’s such a scam.”  

I can’t help but think that their comments would have skewed much kinder and gentler if the results had shown the AHA diet to be superior. After all, that’s how it was supposed to turn out, right?  

The critics are emphasising that the Duke study was funded by the Robert C. Atkins Foundation – as if that automatically makes the results corrupt. What they don’t mention is that three other studies presented at medical conferences throughout last year have all shown results similar to the Duke statistics. And their call for further studies has already been answered. Currently underway is a one-year study at the University of Pennsylvania being directed by Dr Gary Foster of the University of Pennsylvania, which will test the Atkins diet on 360 patients. 

In light of how things have been going for Atkins in the last few months, if you had to place a bet on the Pennsylvania study, which side would you lay your money on? Obviously this issue is far from settled – at least for the AHA. This is no longer just a weigh-loss question, but also a possible breakthrough on how certain foods may enhance our cardiovascular health. 

In the meantime, the heart association’s president, Dr Robert Bonow of Northwestern University, said the organisation would reconsider the Atkins diet as more research results become available.  

“Having our top academic centres look at this is wonderful,” he said. “We are still dealing with small numbers of patients. We just need more data.” Dr Sidney Smith, the heart association’s research director, said it was a surprise that the Atkins diet did not raise LDL cholesterol. “One small study like this flies in the face of so much evidence. We can’t change dietary recommendations on the spot,” he said. As always – I will keep an eye on my sources and let you know about the Pennsylvania study results as soon as it becomes available. 

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