A recent study funded by the Atkins Foundation attempts to compare the Atkins low-carbohydrate eating plan against two other diets. Although none of the study participants lost much weight over two years, the research is being trumpeted by some as a victory for Atkins, because the low-carb group lost slightly more weight and posted better cholesterol numbers than the low-fat dieters.
But were the participants really following the Atkins diet?
In the book “Dr. Atkins’ New Diet Revolution,” dieters are advised that they can eat “liberal amounts” of eggs, meat and fish, including beef, pork, chicken, turkey, duck, wild game, shellfish, veal and lamb. They are also instructed to eat “liberal amounts” of fats and oils, including butter, olive oil and mayonnaise.
But according to the report in The New England Journal of Medicine, the low-carb dieters in the study “were counseled to choose vegetarian sources of fat and protein.” Although saturated fat was not specifically restricted, the dieters were told that “moderation” was recommended.
The instructions are surprising, given that the Atkins diet is often celebrated as a carnivore’s dream. Indeed, part of the surge in the popularity of pork rinds in the 1990’s was a result of Dr. Atkins’s endorsement.
“A vegetarian Atkins?” said Dr. Dean Ornish, a proponent of low-fat eating and critic of the recent study. “Most people associate an Atkins diet with bacon, butter and brie, not a plant-based diet.”
Dr. Arthur Agatston, creator of the low-carb South Beach diet, which does advise limiting saturated fat and eating plant-based foods, agreed. “This was not the traditional Atkins diet,” Dr. Agatston said.
Although Dr. Atkins was famous for encouraging dieters to eat bacon, eggs and lobster dripping with butter, Atkins researchers now say there is far more to the eating plan.
“Despite the common belief that the Atkins Nutritional Approach is about steak, eggs and bacon primarily, we encourage individuals on our Web site and in our literature to consume healthy protein choices consisting of fish, poultry, meats, soy, eggs and egg whites along with dairy products,” said Colette Heimowitz, vice president of nutrition communication and education at Atkins Nutritionals. “In addition, consumption of olive oil, nuts, seeds along with other plant-based food choices provide additional healthy fat intake for well-balanced meal selections.”
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In this study, the “Atkins” group reduced their % energy intake from carbs by about 10%, and increased % energy intake from fat by ~10%, and in particular from saturated fat by 3%.
So, the answer to “Did Low-Carb Dieters Really Follow the Atkins Plan?” must be “Yes”.
Unless I’m missing something?
Here’s an interesting point: the “Atkins diet” group was not instructed to reduce their overall caloric intake. They were just instructed to limit specifically their carb intake. However, at the 24 month mark they had reduced their daily carb intake by 130 grams. They had also REDUCED their daily protein intake by ~7 grams, and REDUCED their daily fat intake by ~2 grams.
Interesting evidence for the idea that reducing carbs reduces hunger pangs - because these people were not instructed to eat less protein or fat, but they did.
And the Med diet was significant in that participants ate significantly more dietary fiber on this plan.
In any case - I pretty much completely disagree with the Well’s analysis in these two posts, but appreciate the publicity and link to a really interesting study. Here’s the detail food intake for those interested:
http://content.nejm.org/content/vol359/issue3/images/large/04t2.jpeg
— TCFROM TPP — Yes they followed a low-carb diet, but was at the Atkins plan? The Atkins diet historically has not urged moderate saturated fat consumption or vegetarian sources of fat and protein. This is a man whose claim to fame was eat as much bacon, pork rinds and butter-laden lobster as you want — skip the fruit salad and bran muffins.
Already Hippocrates claimed that eating fatty foods was the best way to lose weight because thus you were nourished by eating least.
— SusannaI wish I had a nickel for everyone who comments on the Atkin’s diet as if they were an expert, and hasn’t read the book. That would probaly include most doctors, nutritionists, scientists, the media, etc. Dr. Atkin’s did say that you can eat butter, cream, fatty meat, etc. and still lose weight and improve your lipid profile, and you can. He did not say you had to eat those things. His emphasis was on low-carb eating without counting calories. If you want to eat low fat protein, vegetable protein (as long as it’s low-carb), vegetable oils, you can. It won’t necessarily make you healthier, but you can. I believe he emphasized that you can eat rich foods because conventional wisdom at that time said you had to eat low fat to be healthy. That myth has continued. He wanted people to know that you don’t have to deprive yourself of everything that tastes good to lose weight and be healthy. He has been crucified over the years by people who don’t know what he’s about-they just keep repeating what they read here and hear in the news. Don’t make comments unless you’ve read the book. They are constantly teaching kids in school today about primary resources. Maybe the adults should go back to school
Atkin’s is not just about lobster dripping with butter and filet mignon. If you like to eat that you can. If you don’t, there are many other alternatives. If I remember right, he said you can do the diet as a vegetarian-it’s harder, but you can.
Also, I might be mistaken, but I believe the Atkin’s Foundation split from Atkin’s Nutritionals awhile ago. I’m not sure which group funded the study.
— ReadtheBookHere is some interesting reading about one person’s investigation of how diet guru Dr. Atkins died. I don’t know if Physicians Committee for Responsible Medicine is ‘a vegan group’ as this author, Laura Dolson, states, but the rest of the article seems to be fairly responsible journalism. Dr. Dean Ornish comes off looking like a partisan fanatic here as well for something he wrote in Newsweek in 2007 re Dr. Atkins’ death that Newsweek later had to retract.
To me, all of this just shows how nutty America is about dieting and weight-loss. Can we put the whole nation on a shrink’s couch, or would people then complain that we spend too much time on couches as it is? (-;
http://lowcarbdiets.about.com/od/atkinsdiet/a/dratkinsdeath.htm
— Rob L; N Myrtle Beach SCI’m disappointed in this article. It does not state that the Atkins Research Foundation only partially funded the study, had no input in designing the diet, and only helped pay for it because they were asked to, by the researchers. The study was conducted in Isreal, not the US, by the Ben-Gurion University of the Negev at the S. Daniel Abraham International Center for Health and Nutrition. Iris Shai is the study’s lead author and a registered dietitian at Ben-Gurion University of the Negev. This article also failed to point out that the study called the low carb diet “Atkins-like”. It was not the actual Atkins diet as it is written. So to use this study to bash the Atkins Diet specifically seems to me, anyway, rather unfair and a blatant misuse of the facts.
FROM TPP — The Atkins people contributed more than a half million dollars for this study.
— Stacy“Vegetarian-based” does not equal “plant-based.”
I think this comes from confusing the term “vegetarian” with “vegan.” The butter and brie Dr. Ornish speaks of are perfectly permissible vegetarian choices, as are eggs.
A vegan believes, sometimes for health but many times on moral grounds, that the by-product of any animal is to be avoided.
A vegetarian avoids meat, either for health or moral reasons, but believes it is acceptable to eat animal by-products such as eggs, butter, and cheese. I’m on Atkins, and I’m vegetarian - and it’s working.
— Alex O’NealHonestly I think there are two types of people who can lose weight based on their diets…those who’ll lost by eating less fat and those who’ll lose by eating less carbs.
I cut out fast food and dropped 30lbs.
— MitchP‘low-carb dieters in the study “were counseled to choose vegetarian sources of fat and protein’
This is not the Atkins diet. In fact, these recommendations can sabotage a low carbohydrate weight loss program.
“Vegetable sources” of protein suggests soy, which can promote weight gain by impairing thyroid function in iodine deficient people; with public health recommendations to cut iodized salt iodine deficiency is now common. Long chain fatty acids in commercial oils (soy, canola, corn, etc.) store quickly as fat; most promote an unhealthy imbalance of omega 6 fatty acids as well, leading to systemic inflammation. These modifications make the diet both fattening and unhealthy.
Moreover these recommendations are not compatible with how our bodies adapted to our environments millions of years ago. Caveman did not eat tofu and braise skinless chicken breasts in canola oil. In recent times Native Americans selected the fattiest elk for their food stores, and the “fatted calf” was prized in the Middle East for thousands of years. The Aboriginals ate virtually no carbohydrates for millennia, as did the Inuit and First Nations people of Canada without a hitch, without a speck of tofu or soy oil, and no diabetes in sight. In and of themselves animal fats are safe.
While, for reasons I will not go into here, I do not favor a strict Atkins diet, I do not think the researchers gave Atkins a chance.
— Dr. CWe can’t let good results for an Atkins based diet go, can we.
The study authors did not use the Med. diet book either, they used Willet’s book (footnote 21) which was a tirade against the Food Pyramid and was based on the premise that fat did not matter only carbs did.
Once again the results are in and they are not what the mainstream wants to hear.
— RichThere is a huge difference between what Atkins wrote about in his first book and how it was marketed to the masses.
It may be true that Atkins never told anyone to base their eating patterns on pork rinds and bacon.
But it was the publics perception that Atkins was a diet where you could chow down on bacon, steak, lobster and pork rinds and still lose fat at a ridiculously rapid rate that made it the best selling diet book of all time.
I would be surprised if 10% of the general public didn’t think of Atkins as the bacon and cheese diet.
And fair or not, perception is reality.
— DRHey, ReadtheBook, it’s Atkins not “Atkin’s”.
— SallyThis is just more proof that a low carbohydrate diet is superior. The subjects in this group lost the most weight and had the most improved lipid profile even though they didn’t count calories. Did they follow the Atkins Diet? Who cares. They followed a low carbohydrate diet and it was superior to the other experimental groups. What will dieticians and endocrinologists recommend to their overweight patients with metabolic syndrome? Why they will be told to eat all the carbohydrates that they want as long as they eschew fatty foods. Evidence just doesn’t matter. And what will we continue to find on lists of healthy foods? Why things like pomegranate juice because what could possibly be wrong with that?
One side note about the study. It was conducted in Isreal, at the S. Daniel Abraham International Center for Health and Nutrition which is part of Ben Gurion University of the Negev. So who is S. Danny Abraham? He is an American billionaire who is in esteemed company as a memeber of the Forbes 400 list of wealthiest Americans. How did he make his billions? He was the inventor of Slim Fast.
— WigWagThe problem with the low fat diet is that it was NOT low fat. 30% fat is NOT low fat - 7-10% is low fat. That’s the problem - plus it should have been compared to a “LOW fat plant based diet” - not the crummy 30% “low fat” diet that the AHA recommends - which has 300 mg of cholesterol per day and foods that promote heart disease. If one follows a low fat plant based diet then one not only will drop weight and cholesterol - but also help prevent cancer and other diseases.
— LALAFROM TPP — Agree. this study used a moderate fat diet and the group reduced their fat intake from 31% to 30%. And we wonder why they didn’t get much result?
Alex - thanks for writing > “A vegetarian avoids meat, either for health or moral reasons, but believes it is acceptable to eat animal by-products such as eggs, butter, and cheese. I’m on Atkins, and I’m vegetarian - and it’s working.”
A person who consumes ANY animal products should not be called a vegetarian in my opinion - I don’t know how that ever got started. Sudo-vegetarian or omnivore is more like it. Dairy is liquid meat and still comes from an animal and eggs are an animal product too. I wish people would use the CORRECT terms to avoid confusion - like, “He is a lacto-ovo vegetarian” etc…. not just vegetarian.
I am vegan but not solely for animal rights - but because of reading The China Study - best research book out there on nutrition.
— LALAWhether or not this diet was the familiar caricature of the Atkins Diet, the fact remains that lo-carb participants ate significantly increased amounts of dietary cholesterol, saturated fat, and total fat — while eating less fiber — on a calory unrestricted diet over TWO YEARS. The result: they LOST 10 pounds, 1.5 waist inches and significantly IMPROVED their lipid risk profiles.
This result absolutely flies in the face of everything Dr. Ornish, Ms. Parker-Pose, et al. have been telling us for years about what happens when you change your diet in that way. That, to me seems to be the real story and it is completely unsurprising that it’s being downplayed and spun the way it is in this column.
— Ted KampI just read Dr. Atkins book last week and went on a low-carb diet (about 20% carbs - 80% fat and protein) after I read it. I’ve also read read the main book by Dr. Dean Ornish. Since I’ve been on this low-carb diet over the last 5 days I feel awesome. Plus, I’m a diabetic and my glucose was getting so unstable that I was told I may have to go on insulin by my doctor and I was constantly hungry. Over the last 5 days since I’ve been on this low-carb diet (about 100-125 carbs/day) my hunger seems to have gone away and my glucose has dropped by 50%. Will I be this enthusiastic about a low-carb diet 6 months from now? I don’t know. But, I feel 15 years younger and I actually have energy and a clear head with no mental fog at 5PM which is amazing. The energy level I feel is amazing.
I had very big doubts about going on a low-carb diet but I have been very surprised. I’m not doing Atkins actual plan though because his carb count initially (20 carbs/day) is even too low for me but just doing a low-carb diet has been amazing. This reminds me of the food I used to eat growing up - bacon and eggs for breakfast, steak and salad for dinner, etc with lots of water and a little fruit. I don’t think I’ll get bored of it. I do think the Dean Ornish diet has a lot of merits but I found it too unsatisfying. I think Dr. Atkins goes overboard on his recommendations about eating so much meat because one has to worry about all the steroids these animals have pumped into them but nonetheless my initial reaction to a low-carb diet is very positive.
— TomI still say a lot of one thing is unhealthy. Moderation in all things. If you go overboard in one area, whether it’s all carbs or protein, then something else is suffering, that might get you in the long run. The study might not show it in what they are monitoring it. That’s the issue that I have with the Atkins Diet.
Ultimately, I still say that a balanced diet, and watching caloric intake is the best way to live. There are no short cuts, or all you can eat diets that will allow you to lose weight. But people will always fall for the latest fad.
Exercise and a balanced diet.
— JamesLet us not forget that it has yet to be proven in humans (and may never be) that any one of these diets works by simply changing fat/protein/carb contents.
It is likely that these diets work by reducing the number of calories taken in. They may work by increasing satiety, decreasing hunger, or some other mechanism.
Dietary reporting is notoriously error-prone, and dieters cheat without always admitting it. These are not trivial considerations, and can make huge differences in study outcomes and interpretation of results.
It might be worth paying obese volunteer subjects lots of money to be confined to a facility for three months, and to split them into Atkins, Mediterranean, and low fat groups. Each group would get the same number of calories (perhaps 1500 per day), and have a monitor verify that they ate everything given them. Exercise would be mandatory, but limited to perhaps a uniformly slow 20 minute walk per day, so that everyone was capable of completing it. Only then could we determine if there is a real weight loss difference that’s not based merely on calorie intake.
— jackWe just DESPERATELY wish they’d bring their vitamins back to market. As a pair that had been taking them for more than a decade (from back in their “nutrionist’s formulatory” days) it’s been impossible to find a formula even close with the required megadoses for low carbohydrate diets.
— Leslie BellSome comments in this post and in yesterday’s related one bear emphasis:
1) The low-carb diet was not calorie restricted and yet the group that followed it still lost weight. This is a big deal. Because of this point alone, low carb diets deserve closer scrutiny.
2) Low fat plans are notoriously difficult to follow, which is a major reason why these diets fail.
3) My theory as to why the low carb group was “counseled to choose vegetarian sources of fat and protein?” Because we are still anchored to a conventional wisdom on fats (especially saturated fats) that may very well be flawed. Incidentally, the “Atkins Diet” existed long before it was named after someone.
— PangaeaI personally shed 80lbs on the Atkins diet (with moderate exercise) and got down to 6% body fat in just over 3 months. My HDL was high, LDL was low, and I ate to my heart’s content a good variety of meats, vegetables, dairy, and berries and had never felt better. I kept the weight off for nearly 4 years until I started the McFastfood diet and adopted a sedentary lifestyle (and profession).
I have yet to have any skeptics produce a single credible study that proves that Atkins has any bad long term side effects. Even the AMA has published reports stating as much. Atkins himself cautioned his readers of the dangers of his plan, which are that if you don’t consume enough good carbs (non starchy vegetables; Atkins is low carb not ‘no carb’) or if you go off and on the diet too much it will be bad for your health.
Yet for some reason, health professional insist on being detractors. In my first year of college, our lifetime fitness instructor said she was glad he died and joked about his death. I dropped that class the next day. Do Cheetos and Doritos have so much of a spell over the medical community that they refuse to acknowledge that whatever alleged danger the Atkins lifestyle poses, it is less of a danger than being morbidly obese?
— johnSorry Sally, post #11, you are so right. That was an unfortunate mistake on my part.
— ReadtheBookThis study just replicates the stanford study from a few years ago.
The major point is that the low carb people were not on a calorie controlled diet. They were allowed unrestricted calories, as long as the calories were not from carbohydrates. Yet they still lost weight.
Incidentally, no one can maintain a diet with under 10% fat for two years. You just become depressed and hungry all the time. That is why during the stanford study people the ‘ornish’ diet did not work and was the worst diet to follow.
— brianWell,relative energy from fat was only reduced from 31% to 30% - but because total caloric intake dropped, actual fat intake dropped by about 20 grams a day.
That’s quite meaningful, and so total fat intake was statistically different in this group as compared to the low-carb group.
Because of the absolute reduction in fat intake, we should expect to see at least some of the purported benefits of a lower-fat diet, I think.
Can anyone point to any stand-alone studies that show that a very low fat diet results in lower rates of cancer or other diseases?
Ornish points to one study in his recent article, but that only looks at patients that also doubled the amount of exercise they were getting.
Curious - why all the defense of low fat diets, at the expense of the low carb diets? Low carb diets, whatever you call them, seem to work fine for a lot of people, have good outcomes, and at least for some people are easier to maintain. Low fat diets seem to be a little more difficult to maintain, and people tend to replace the fat with sugars, which is bad for you, almost everyone would agree.
— TCI went on the Atkins 18 months. I followed the regimen from the old book and kept the carbs at less than 20. No bread, potatoes, pasta, etc. After a couple of months, didn’t miss the bread, no yearning and actually began reducing my intake of meats as food became less important and a meal, less of an event. I rarely was hungry. I lost 27 pounds in 4 to 5 months, from 204 to 177, my highest bmi.
— Webb SherrillI left the diet but watched my weight and consumption and have kept it off. Still eat very little bread, pasta, etc.
I think the report is accurate as any can be. My cholesterol didn’t rise nor my blood pressure. At this lower weight I feel terrific.
Sorry that it took so long to learn that this diet was not what many doctors claimed it was - probably bad for your health. It seems that the media cherishes the controversy, then sides with the logical side - eat lots of carbs because they are good for you and have few calories, but leave you hungry. Glad to see that there is research and solid evidence that the low carb diet is better. Maybe it will reduce the obesity problems that are of such concern.