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Atkins or bust?

News - Health Articles

Published: June 9, 2009

Low-carbohydrate diets like the popular Atkins plan can lead to rapid weight loss but tend to rely heavily on animal protein, and studies suggest they may do little to lower LDL, or low-density lipoprotein, the “bad” type of cholesterol linked to heart disease. Enter what researchers are calling the “eco-Atkins” diet, a high-protein, low-carbohydrate and entirely vegan diet.

A small, four-week randomized controlled clinical trial that tested the new regimen found that overweight adults who consumed a high-protein, entirely vegan diet were able to lose about the same amount of weight as a comparison group of dieters on a high-carbohydrate, low-fat vegetarian dairy diet. But while those on the high-carbohydrate dairy diet experienced drops of 12 percent in their LDL cholesterol, those on the high protein vegan diet saw cholesterol reductions of 20 percent.

“We felt this was quite remarkable,” said the study’s lead author, Dr. David J. A. Jenkins, a professor of medicine and nutritional sciences at the University of Toronto and St. Michael’s Hospital. “The early statins reduced cholesterol by 30 percent,” he added, referring to the first generation of cholesterol-lowering statin drugs.

Results of the study were published in this week’s issue of The Archives of Internal Medicine.

“The idea preyed on me for a long time: Heavens, if the Atkins Diet looks good, and it’s got so much saturated fat and cholesterol in it, suppose we took that out and put vegetarian protein sources in, which themselves may lower cholesterol,” Dr. Jenkins said. “We know that nuts lower cholesterol and prevent heart disease, and soy is eaten in the Far East, where they don’t get much heart disease. So we put these foods together as protein and fat sources.”

The 50 participants in the study, all of whom were overweight men and women with high cholesterol, were randomly assigned to either the low-carbohydrate high-vegetable protein diet or a high-carbohydrate vegetarian diet including eggs and dairy for four weeks. All of the food was provided by the study.

Those in the “eco-Atkins” arm got their protein from vegan sources like soy, gluten or seitan, nuts and cereals as well as fruits, vegetables and vegetable oil. The comparison group ate a more traditional high-carbohydrate but vegetarian diet that included dairy and eggs and was closely modeled on the DASH diet, an eating plan designed to lower hypertension.

The low-carbohydrate diet eliminated bread, baked goods, potatoes and rice but did not reduce carbohydrates as much as the Atkins diet does. Some 26 percent of the calories in the eco-Atkins plan were from carbohydrates, compared with 10 percent to 25 percent on the Atkins Diet, while 31 percent of calories on the eco-Atkins plan came from protein and 43 percent from fat. The high-carbohydrate diet included roughly 58 percent of calories as carbohydrates, 16 percent as protein and 25 percent as fat, using low-fat and skim milk dairy products and egg whites or other egg substitutes.

Another popular diet, the South Beach Diet, which some have dubbed a “modified low-carb” plan, has people getting up to 28 percent of their calories from carbohydrates.

Twenty-two participants in each group completed the four-week study, with an average weight loss of 4 kilograms, or just under 9 pounds in each group.

In both groups, participants lost weight because they were on a reduced-calorie diet, providing 60 percent of daily caloric needs, Dr. Jenkins said, not because of the composition of the diet.

An editorial accompanying the article said larger long-term studies of the diet are needed to determine the safety and sustainability of the regimen.

“This is another option for people who are trying to lose weight and do it in a prudent manner,” said editorial writer Dr. Katherine R. Tuttle, who is the medical and scientific director of the Providence Medical Research Center at Sacred Heart Medical Center in Spokane, Wash. “It suggests that a high-protein diet, especially one that is more vegetarian-based than meat-based, appears to have some favorable effects.”

Earlier this year, a large study that compared different kinds of diets — including low-fat and low-carbohydrate plans — found that the method didn’t matter as long as people cut calories. That study also found that after two years, most people had regained at least some of the weight they had lost.

Dr. Tuttle said that while different weight loss plans offer people different “tricks” and strategies, ultimately, “It really comes down to calories in and calories out.
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