The Diet Wars: Low-Fat vs Low-Carb

A new study comparing the Atkins diet, a Mediterranean diet and a low-fat diet published on July 17 inThe New England Journal of Medicine (NEJM), is likely to inspire headlines saying that the Atkins diet is better for your waistline and your health than a low-fat diet.

However, as a lead investigator on numerous peer-reviewed studies of low-fat diets, and the author of several books about the benefits of healthy low-fat lifestyles, I believe this study is extremely flawed. Here's why:

The NEJM study, which was funded in part by the Atkins Foundation, reported that participants who ate a low-carb (Atkins) or Mediterranean diet (restricted calorie, moderate fat intake) for two years lost more weight, and saw more of an improvement in their glucose and cholesterol levels, than those who were on a low-fat, restricted calorie diet. However, participants in the study who were on the "low-fat" diet decreased their total fat intake from 31.4 percent to 30.0 percent, hardly at all.

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Comments

[Pacific231]

Interesting discussion.

As for me, I am interested in books with sound advice on healthy adult eating in general; not for the specific purpose to lose weight but for best possible health and minimizing the aging process. If you can recommend such a book(s), please Reply with the title and author. Thanks...

[jamesinraro]

Obesity per se is not the problem. The real issue is the health and mortality consequences which follow from obesity. In November Harvard Medical School studied obese mice. The team of researchers gave one group biotivia transmax resveratrol extract, a commercial version of a compound found in red wine, and the other a placebo. The group receiving transmax resveratrol lived 31% longer and did not contract the normal diseases of aging such as diabetes, tumors, and cardiac diseases. Their endurance and energy levels also improved dramatically. Resveratrol is clearly no substitute for a good diet, exercise and a healthy lifestyle but it may augment all of these and extend the potential for ultimate life span. We need to first concentrate of the prevention of the disease of obesity and treat the excess weight as a separate issue. This approach will result in a reduction of suffering and huge health care cost savings.

[trinity]

It's called moderation and regular physical activity...aka a lifestyle change, not just a 4 month stint on Atkins. What is especially making people fat is America's obsession with quick and easy highly processed prepackaged food (chucked full of preservatives who knows what else?)

I always bring up this fact with my anti-carb friends who think pasta and bread are evil, I think of my father's Italian family...They lived on pasta and sauce, tomatoes(as well as other vegetables), garlic, olive oil, with Italian bread and meats on the side. There is no diabetes in that part of my family, no heart disease, nor problems with cholesterol. My grandmother is 98, her sister is 100, and her other siblings are also in their 90s. Guess bread and pasta aren't so bad.

[10000Lakes]

The way most of you talk (probably mostly men, seeking to justify their 1 lb. Angus burger) you would think that we are closely related to the Mountain Lion, and not the Mountain Gorilla. We are PRIMATES. Eat like one. That means almost totally raw fruit and vegetables, with a very small percentage of meat if you have to. Like once a week or less. Better to use beans or tofu.

If you're someone who just wants to justify your high meat-eating ways, why bother? Just do it. And pay for the heart surgery out of your own pocket too. Aitkins is so lame. Trick your body to burn fat through ketosis?! And people think that's smart? Wow.

The best book by far on the human diet is 'Eat To Live', by Joel Fuhrman.

[DPonyourset]

HI im a 40 year old man with 11% body fat. The secret is eat a protein, simple carb, and complex carb with every meal. Eat 6 times a day small portions. This gets your metabolism up. Then EXERCISE!! Stay away from processed foods and never never eat high fructose corn syrup!

[LollieDotCom]

Low fat is not healthy. Low carb is not healthy. Balance is healthy. And who is saying this? A 55 year old woman with a family history of extreme morbid obesity who has learned how to lose weight (finally) without feeling like I'm starving. Oprah's Dr.s Oz and Roizen have the only great answer I've ever seen to our obesogenic society. I only half-assed it the first year because I was sick of a life time of giving myself heart and soul to a new plan and then finding I couldn't stick with it.

Well, two years into the good doctor's "you on a diet" and I am feeling great, 47 pounds lighter and best of all, on the one day a week I eat regular food, I can't help but notice that even though it's nice to eat something different, I still like my "you on a diet" food BETTER. And with that said, can one correctly even call it a diet?

The most important thing I got from them, If you're eating processed foods that have had a great deal of nutrition taken out, then a sprinkling of vitamins added back in to make the label look good.... you're going to be hungry no matter how much you eat, even if your stomach hurts. If you want to stop the food cravings you must cut out high fructose cornsyrup and low nutrition foods.

Wii fit and my 7 speed beach cruiser bike keep exercise fun.

[wm1066]

Very good points Lollie.
I think getting rid of the cornsyrup additives is key in losing pounds.

[iluvsam]

Sugar is evil, and I fully believe is what is causing all of the health and weight problems in the U.S. I went through a period where I couldn't lose any weight no matter what I did. I also found myself sluggish, waterlogged and bloated, and LITERALLY falling asleep everywhere. Absolutely zero energy to the point of where I thought I blew out my thyroid. It really put me in a panic, because I knew something was wrong. So, I cut out all refined sugar and salt and only eat lean meats and veggies (lots and lots and lots of green veggies), and those fruits that are higher in fiber then others (more apples, less bananas). The change in diet completely changed my life. I lost the unwanted weight, have boundless energy, and feel unbelievable. I haven't felt bloated or sluggish since (almost 2 years now). I really don't understand why doctors don't get this. After all the research I've done, it seems to be pretty fundamental. I mean come on people, our ancestors in caves didn't have pasta, cake, and chocolate. They ate meats, veggies, nuts and berries. Is it surprising that our bodies can't handle the sugar?

[Philippa]

Too much sugar does not promote good health, absolutely. But the fact is, our brain and the rest of our nervous system depends on sugar, specifically glucose to function optimally. Blood glucose allow our cells to nourish themselves. If our blood glucose is below normal, we may become dizzy and weak, while high blood glucose causes fatigue. Our body constantly regulates our blood glucose level (homeostasis) because fluctuation- high or low- can be fatal. We can't live without glucose in our body. The key is choosing the right food sources of sugar like whole grains, legumes, vegetables, and fruits. Yes, vegetables and fruits contain sugar. Fruits contain fructose which is the sweetest of all sugars. So, if you're eating lots and lots of fruits, you are ingesting lots and lots of fructose. Sugar is evil? Nope, ingesting the wrong type and too much of it is.

[Kungfublood]

Want to loose weight? Practice Kung Fu, and as to food if it runs away don't eat it.

[recruitgal]

LOL - Not sure I'm cut out for Kung Fu, but a good philosophy on the food front...

[jamesinraro]

Obesity is not the problem. The real issue is the effect obesity has on one's health and mortality. In November Harvard Medical School studied obese mice. The team of researchers gave one group biotivia transmax resveratrol extract, a lab grade version of a compound found in red wine, and the other a placebo. The group receiving transmax resveratrol lived 31% longer and did not contract the normal diseases of aging such as diabetes, tumors, and cardiac diseases.

If we can prevent the adverse health consequences such as diabetes, cancers, heart disease and strokes we can deal with the weight issue separately. This study has huge implications for treatment of obesity in humans and for lowering the human, social and health care cost of Diabetes. We need to look at more innovative approaches to this problem as the tired old remedies simply waste time and money.

[rma2108]

Asia is a country??

[xxnounxx]

There is nothing more healthier than a mediteranian diet,full of fresh vegetables,and a combination or carb& protein,and olive oil.
everything in moderation is good,all extremes are bad for you.

but i do agree the best diet to loose weight qiqly is atkins diet..but the min you stop it,your back to square one if not fatter

[mphalen]

That is not true. It takes a while for your body to return to its pre-Atkins state. Unless you totally gorge yourself with carbs after you stop the diet, you generally don't start gaining the weight back for a month or two.

[allonfla]

The trick is that you should NOT go back to the way you ate before. This is true for any diet you follow. If you decide to follow a high fiber diet for a couple of months - lose the weight and then go back to crappy eating - you will gain back the weight. Does that the mean the diet did not work? No it means that you did not understand that eating healthy is a lifestyle change that you have to maintain at least 80% of the time, along with exercise. You can't just lose the weight and expect it to stay off without work.

[latinopride]

I'm a little curious about the Mediterranean diet. Which country has the healthier cuisine France, Italy, or Spain? And if starches are unhealthy, wouldn't the Italian cuisine be a dangerous health option since it's heavy on the pasta?

[NoSillyName]

Pasta is eaten in small amounts, not the platesfull Americans think of as "dinner", The Mediterraneans generally eat several small courses during a meal. That's what makes them more healthy than those who gorge. They tend to walk more, buy fresh food from markets daily, and basically have healthier lifestyles than in the U.S. Generally speaking.

[mphalen]

They also have banned high fructose corn syrup, that we here in the US allow our food manufacturers to put in our food instead of sugar, because sometimes profits trumps healthy food.

[Diogenis]

Answer: Greece has the healthier cuisine. The sad part is...Fast Food Chains like McDonald's etc. have invaded the world, and obesity is a world wide pandemic.

Pan Metron Ariston=Everything in moderation. A Greek philosophy that will always be ageless.

Diets are fads..and ultimately do not work.

Diet should mean what one eats routinely, not something one does when they gain weight, the go on diets and run to the gym. And to fall for the trap of taking "pills" etc. too reduce weight..is absurd and dangerous.

Life requires a discipline of the body, the mind, and spirit to maintain a balance. And we see world wide that the masses are too much in a "hurry" to maintain a discipline.

You are what ...you eat.

[axt113]

Here's how to diet:

Replace all of your animal based food items with plant based alternatives, take all processed foods out of your diet, eat whole grains whenver possible, fill your plate with a lot of dark green veggies, snack on healthier alternatives like dried fruits, nuts, seeds and veggies in between meals. Replace sugary drinks with water, sugar free veg or fruit juices, or with low calorie beverages

[jinjinpinti]

Which requires you to work three jobs to afford that food, destroys your muscle mass and can lead to diabetes and carbohydrate metabolism problems for the percentage of the populace who are genetically unable to tolerate a high carb diet. Read Barry Sears, "The Zone," and the truth shall set you free. How IS your eicosinoid balance anyhow?

[DavidMG]

That is a competely inaccurate statement. The approach to eating found in "American Wholefoods Cuisine" for example, is meatless and uses only unprocessed ingredients - it is the cheapest, easiest, healthiest, most environmental and interesting cuisine you will find anywhere. Your search is ended.

[anfractuous]

Dr. Ornish, every time I've seen you, you look cadaverous. Perhaps you should find a better spokesperson for your diet - thriving though you may be.

[raskolnikov72]

Weight loss and related bio marker measurements (triglycerides, blood pressure, cholesterol) are all important, but do not give the whole picture -- these guys they tested the things they wanted to emphasize. Consumption of a lot of meat is beginning to be seen as a leading cause of cancer:

See: The China Study: http://www.amazon.com/China-Study-Comprehensive-Nutrition-Implications/dp/1932100385

See: Surviving Prostate Cancer
http://www.amazon.com/Patrick-Walshs-Surviving-Prostate-Cancer/dp/0446696897/ref=pd_bbs_sr_1?ie=UTF8&s=books&qid=1216425352&sr=1-1

Watch the doctor of the book above discuss the importance of Vitamin D in the diet and its potential influence on prostate cancer (its a brief mention, but startling) ...

http://www.charlierose.com/shows/2008/03/31/1/a-conversation-with-dr-patrick-walsh
All in all, you may need to 'go Atkins' to begin your weight loss, but as people live longer, the ravages of your body having to break down 250lbs of meat a year (what the average American eats) will take its toll. We were not designed for a 6-8 oz portion of meat 2-4 times a day. Plain and simple.

Other biomarkers including vitamin levels are not part of de rigeur testing - a shame. The drug lobby in this country has all but squashed common sense as 'preventative maintenance' as a means of maintaing your health.

I'm willing to bet that vitamin levels in the Atkins folks are substantially different than in others) ...

[NoSillyName]

"Atkins For Life" is NOT all about meat & fat. Many people confuse the brief "induction" phase for the whole eating plan. Maybe you aren't one of the "many", but this seems a good place to mention the facts.

[rbspickles]

This is soooooo true! The Adkins diet not only promotes HEALTHY PROTIENS but also demands high amounts of leafy green vegetables. I love this way of eating. Once you get past having to have lots of starches at each meal, I eat less, sleep better, have much more energy and I've lost 45 lbs. I've been on it for 3 years now and have great muscle tone, memory and energy that lasts all day. Also, I don't get cravings for anything, I just get hungry when I need to refuel. I've been a on low fat diet, gained 25 lbs. I think it's more about your own personal metabolism as to which diet will work for you.

[mphalen]

Cancer cells feed on carbs, that is why there is an obesity link to cancer.

[jinjinpinti]

That is so uninformed. Read Barry Sear, The Zone," and you will finally understand the bliss of a perfect, hormonally tuned meal.

[sophieozz]

I just finished The China Study by T. Colin Campbell, PhD, and wholeheartedly recommend it. The research is solid. After following a plant-based diet and giving up foods that I have an intolerance to, I am better than ever.