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2007-9-2 10:08:15

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Dean Ornish, one of the few giants in nutrition science who dare count on a healthy diet to prevent and treat heart disease and other chronic diseases and founder of the Ornish diet, published an commentary March 6 on Newsweek.com to dispute the claim by Stanford researchers that the Atkins diet beats the Ornish diet when it comes to weight loss.


This Ornish is not an ordinary M.D. who counts on prescription drugs and medical instruments to make a living.   He actually formulated a dietary regimen that helps people cure heart disease.   Many people may think heart disease is cureless. But he has proved that his Ornish diet and lifestyle program, which is now covered by some health insurance plans, can stop or reverse the progression of coronary artery blockage in 99% of patients.


News media reported that a Stanford University study showed pre-menopausal women on Atkins lost on average 10 pounds after one year compared to four to six pounds in those on other diet plans.   Even better, the Atkins diet followers experienced an increase in the level of good cholesterol, indicating Atkins is good for the heart according to the common nutritionists' belief.   The study was published in the current issue of JAMA.


Ornish found that the conclusion made by the authors that “Women assigned to follow the Atkins diet, which had the lowest carbohydrate intake, lost more weight and experienced more favorable overall metabolic effects at 12 months than those assigned to follow the Zone, Ornish, or LEARN diets” is false.


He said that the authors actually say in the context of their report that there was no significant difference in weight loss between the Atkins and Ornish or LEARN diets after one year.   He cited the study to say that Atkins followers lost more weight only when it was compared to the Zone diet.


Ornish said that the current study was flawed because first most participants could not follow Ornish diet, which requires that dietary fat be limited to 10% of the total calories.   Instead, those on the Ornish diet in the study reduced their fat intake only to 30% from 35% in a typical American diet after one year.


The second reason to say that the study was flawed is that when people strictly followed an Ornish diet, the dieters experienced drastic improvements. Ornish said a randomized controlled trial published earlier in JAMA already demonstrated that the study subjects lost 25 pounds after one year and better yet, half of the lost weight did not come back even after fiver years.   That trial also showed that the Ornish diet reduced LDL cholesterol, the bad cholesterol by 40% without resorting to any drug, which was not seen in those on the Atkins diet in the current study.


Early studies also found, according to Ornish, that some patients had coronary heart disease reversed only one month after they used the Ornish diet and more people experienced the same effect after one year and five years.   How well people adhere to the Ornish diet determines how much of the benefit they can gain from the diet.   Those who adhered well to the diet were 2.5 times less likely to have cardiac events such as heart attack and 99% patients stopped or reversed their heart disease.


The Ornish diet is better than the Atkins diet when it comes to the protection against heart disease.    Many trials on the Ornish diet directly measured the effect of the artery blockage, not cholesterols.   Ornish said just because something raises the level of good cholesterol does not mean it is healthy. He said that good cholesterol is raised to clear saturated fat and cholesterol from a diet. That explains why the new study found that those on the Atkins experienced a slight increase in good cholesterol because they have too much saturated fat and cdietary cholesterol to deal with.   Unfortunately, these people did not experience any decrease in bad cholesterol while studies have demonstrated that the Ornish diet reduces the bad cholesterol in patients.


Previous studies have shown the Ornish diet and lifestyle program could also reverse progression of prostate cancer and diabetes while the Atkins diet has been proved to worsen heart disease, Ornish said.


It has been proved for a long time that the Atkins diet can help weight loss, say in a time frame of six months.   But the lost weight may come back soon. The current study acknowledged that after one year, the average weight loss was smaller than that at six months.


All nutritionists have or should have concerns over the Atkins diet.   High fat diet is in no way a healthy diet.    The high fat and often low carbohydrate diet contain little of certain essential vitamins and minerals, which can lead to nutrition deficiencies easily.    And many other adverse effects associated with this diet have been reported.   It is easy to follow the Atkins diet.   But there is likely a consequence the followers need to face.

  

For the full commentary, visit  Why I Disagree With this Study





The following is an article detailing the problems associated with low carbohydrate diets including Atkin's diet.  Republished from http://www.atkinsdietalert.org/advisory.html with permission.



Health Advisory



Health Risks of Low-Carbohydrate Diets
Recent media reports have publicized the short-term weight loss that sometimes occurs with the use of low-carbohydrate weight-loss diets. Some of these reports have distorted medical facts and have ignored the potential risks of such diets. Past experience with the fen-phen drug combination and other weight-loss regimens has shown that some people may disregard even serious long-term health risks in hopes of short-term weight loss.

The American Heart Association,1,2 American Dietetic Association,3 and the American Kidney Fund4 have all published statements warning about the various dangers associated with low-carbohydrate, high-protein diets.

We would like to notify you of (1) the potential risks from the long-term use of low-carbohydrate, high-protein diets, (2) currently circulating misunderstandings and deceptive statements made in support of such diets, and (3) the establishment of a registry for individuals who feel they may have been harmed as a result of following a low-carbohydrate, high-protein diet.

What is a Low-Carbohydrate Diet?
The theory behind low-carbohydrate diets is that if dieters avoid foods containing carbohydrate—that is, starches or sugars—they will shed pounds. Such diets eliminate or dramatically restrict the intake of fruit, fruit juice, starchy vegetables, beans, bread, rice, cereals, pasta and other grain products, and all other foods containing carbohydrate, leaving a limited diet of foods that contain primarily fat and protein: meat, cheese, nonstarchy vegetables, and very little else. As the diet proceeds, the carbohydrate restriction relaxes somewhat, but fatty, high-protein foods continue to dominate the dieter’s plate.

Despite anecdotal accounts of seemingly dramatic weight loss, the effect of low-carbohydrate diets on body weight is similar to that of other weight-reduction diets. In research studies at the University of Pennsylvania and at the Philadelphia Veterans Affairs Medical Center, the average participant lost weight during the first six months on a low-carbohydrate diet, but regained some of this weight during the next six months so that the net weight loss after one year (15.8 pounds in the University of Pennsylvania study and 11.2 pounds in the VA study) was not significantly different from that seen with other diets used for comparison.5,6 This degree of weight loss is not greater than that which occurs with programs using low-fat, vegetarian diets. In Dean Ornish’s program for reversing heart disease, for example, a combination of a low-fat, vegetarian diet and exercise led to an average weight loss of 22 pounds in the first year, along with dramatic reductions in cholesterol levels and reversal of existing heart disease.7 Five years later, much of that benefit had been retained.8 Studies of whether weight loss from low-carbohydrate diets is maintained for more than one year have not been performed.

In a one-year clinical trial reported in JAMA in 2005, researchers randomly assigned 160 overweight individuals to one of four popular diets. Participants assigned to the Atkins diet lost 2.1 kilograms, while Weight Watchers dieters lost 3.0 kilograms, Zone dieters lost 3.2 kilograms, and dieters following the Ornish program lost 3.3 kilograms.9

A review of 107 research studies on various low-carbohydrate, high-protein weight-loss diets concluded that weight loss on these diets is not due to any special effect of restricting carbohydrate; rather, weight loss depended on the extent to which the dieters’ caloric intake fell and how long they continued with their regimens.10 Other reports have also found calorie reduction to be the most important factor in weight loss, with no special weight-loss advantage from the restriction of carbohydrates.11,12

A review on the safety of low-carbohydrate diets notes that Atkins-type diets are at a greater risk for being nutritionally inadequate and raise the issue of potential long-term health effects.13

Some low-carbohydrate diet books, such as those promoting the Atkins diet, describe how a diet devoid of carbohydrate forces the body to turn to other fuels for energy. That means getting energy from fats and protein in the diet or from body fat. When fats in the diet or in body fat are used for energy, they produce compounds called ketones, and low-carbohydrate dieters sometimes check for the presence of ketones in their urine as a sign that they have managed to eliminate carbohydrate. It turns out, however, that, in controlled trials, the degree of ketosis does not appear to influence weight-loss speed.12



Nutritional Concerns
Low-carbohydrate diets typically include quantities of cholesterol, fat, saturated fat, and protein that exceed the recommended safe limits set by the National Academy of Sciences, and are often low in fiber and other important dietary constituents.11 The Nutrition Committee of the Council on Nutrition, Physical Activity, and Metabolism of the American Heart Association states, “High-protein diets are not recommended because they restrict healthful foods that provide essential nutrients and do not provide the variety of foods needed to adequately meet nutritional needs. Individuals who follow these diets are therefore at risk for compromised vitamin and mineral intake, as well as potential cardiac, renal, bone, and liver abnormalities overall.” 1

A nutrient analysis is presented below for the sample menus for the three stages of the Atkins diet as described in Dr. Atkins' New Diet Revolution (M. Evans & Co., 1999), pp. 257-259, using Nutritionist V., Version 2.0, for Windows 98 (First DataBank, Inc., Hearst Corporation, San Bruno, CA). The menus analyzed were as follows: