Fad diets are clearly not all they are cracked up to be. Most are simply made up of theories that seldom get put to the test other than with the anecdotal evidence of users who swear by them. When put to the test of time, however, they fail those who use them and when carefully scrutinized by scientists and researchers they collapse under the weight of the evidence.
Low-Carb diets are the prototype for this. They've been around for well over 100 years in one form or another, with the most popular version being marketed by Dr. Atkins over the last 40 years. People do lose weight, but not for the reasons put forth by those who champion such plans. The weight loss comes partly from eating fewer calories and partly because in this day and age, eliminating carbohydrates means eliminating calorie dense, highly processed foods (most of which contain high fructose corn syrup (HFCS)).
I can't imagine why anyone would follow a diet -- any diet -- that takes entire food groups away from you. There's no reason to give up great foods like pasta, potatoes, beans and corn to lose weight or to be healthier. Giving up these foods is one of the main reasons that the Atkins diet is not a diet that can be sustained for the long term. Further, such diets seldom prepare people for eating real food: when they go off the diet they usually gain the weight back, and then some.
There's been concern for years about the long term health risks of such diets. We've seen that those eating higher protein diets that are also high in saturated fat were more likely to develop heart disease than those whose higher protein diet came from vegetable protein sources. Interestingly, those women eating a strict low-carbohydrate diet weighed more than those eating a more normal diet.(1) Their Body Mass Index was higher in all categories. We also know that extremely-low-carbohydrate diets also seem to affect one's cognitive abilities.(2)
Recently a group of researchers affiliated with Harvard University looked at whether low carbohydrate diets such as the Atkins diet had any effect on a person's risk of developing Type 2 diabetes.(3) They made use of information gathered through the Health Professionals Follow-Up Study, which included over 40,000 men who did not have Type 1 or Type 2 diabetes, heart disease or cancer at the start of the study, which began in 1986. Every other year the participants responded to a health and lifestyle survey, along with a food frequency questionnaire which allowed the researchers to assess the subjects' usual diets.
After 20 years of follow-up (ending in late 2006), the researchers looked at the participants' dietary information and identified those persons whose diets would be considered "low-carbohydrate diets." Those persons' diets were then further broken out into three different varieties of low-carbohydrate diets based on a "low-carbohydrate diet score" that ranged from zero (higher carbs, lower protein and fats) to 30 (lower carbs, higher proteins and fats):
Low-carbohydrate, high total protein and high total fat
Low-carbohydrate, high animal protein and high animal fat
Low-carbohydrate, high vegetable protein and high vegetable fat
The researchers then compared the diets of those who developed Type 2 diabetes with those who did not. They found that those following diets high in animal protein that included red and processed meats and a high percentage of animal fat (as opposed to fats from vegetable sources) were almost 75 percent more likely to develop Type 2 diabetes than those who followed a more moderate diet. The risk was highest in those men who were also obese.
There was a little bit of good news in this study. Those who ate a diet that was low in carbohydrates but high in vegetable proteins and fats were not found to have a higher risk of Type 2 diabetes. That combination appeared to be protective for those men under the age of 65, but that effect was lost in those who were older. That group also weighed less than their low-carb/high animal protein counterparts. Not a lot less, mind you, with the difference only being a body mass index of 25.5 (high vegetable protein and fat group) versus 26.3 (high animal protein and fat group).
The one thing to understand about this study is that it is not interventional research. The participants weren't necessarily on the Atkins diet and we don't know how many might have been attempting to lose weight during the study. The data reported were simply drawn from what the participants were eating during the study. We don't know if some of them lost or gained weight or were on and off of diets. The results simply show that consuming less animal protein and fat is a better, healthier choice.
One interesting observation that the researchers don't comment on is that the lower the low-carbohydrate diet score (i.e., those eating the most carbohydrates), the lower the risk of diabetes. This applies to both groups, whether they ate a high animal protein and fat or a high vegetable protein and fat diet. Moderate carbohydrate consumption with most of the protein and fats coming from vegetable sources appears to be the best choice.
As an aside, the study also reported that a fair number of the physicians smoked. Fourteen percent of those whose diets were most like the prototypical Atkins style diet, consuming low-carbs with high intake of animal protein and fat, also smoked.
Research about diet has come a long way in the last 20 years. It's clear that the dialogue should not be about macronutrients. The challenge is as follows: For researchers there's certainly a reason to focus on the composition of food to understand what works best. But for day to day life the focus should be on food. It's clear that eliminating whole groups of foods doesn't work and does more harm than good.
We already know that the Mediterranean Diet is the best diet for those who have Type 2 diabetes4 and that following such a diet reduces your risk of developing heart disease as well as diabetes. There's no need to give up carbohydrates in order to reduce your risk of diabetes when you can eat real, delicious food and still reduce your risk of diabetes.
1. NEJM 2006: 355: 1991 - 2002
2. Appetite 52 (2009) 96-103
3. Am J Clin Nutr 2011;93:844-50
4. Ann Intern Med. 2009;151:306-314
Follow Tim Harlan, M.D. on Twitter: www.twitter.com/DrGourmet
David Katz, M.D.: The Paleo Diet: Can We Really Eat Like Our Ancestors Did?
Mary Ann Esposito: May Is Mediterranean Diet Month
American Diabetes Association Home Page - American Diabetes ...
WebMD Diabetes Center: Types, Causes, Symptoms, Tests, and Treatments
Sun Pharma to Market Merck's Diabetes Drugs in India
http://www.archevore.com/get-started/
Then do a stude and see what happened.
http://www.medicalnewstoday.com/articles/5822.php
Repeating this lie does not make it true.
"Was Atkins Overweight?
" A report from Atkins Nutritionals states that he played tennis competitively and that his weight was frequently checked, and in the years before his death was below 195, and six feet tall. And a medical report at the time of his admission to the hospital, which was later made public by his widow, states that he was 195 lbs on admission to the hospital. "
"Atkins' Death
"On April 8, 2003, at age 72, Dr. Atkins slipped on the ice while walking to work, hitting his head and causing bleeding around his brain. He lost consciousness on the way to the hospital, where he spent two weeks in intensive care. His body deteriorated rapidly and he suffered massive organ failure. During this time, his body apparently retained an enormous amount of fluid, and his weight at death was recorded at 258 pounds. His death certificate states that the cause of death was "blunt impact injury of head with epidural hematoma".
http://lowcarbdiets.about.com/od/atkinsdiet/a/dratkinsdeath.htm
I always found it odd that Nathan Pritkin's requested his autopsy be public and the results were published in the NEJM. Pritkin suffering from leukemia committed suicide at 69 years old, but had the coronary arteries of a teenager according to the pathologist who peformed the autopsy. The autopsy results were stunning. Pritkin was diagnosed with coronary artery disease at 41 and designed his plant based diet to reverse his disease.. Too bad Atkins could have done the same and delivered the last laugh to the medical community that shunned him, makes you wonder.
Mostly I'm low carb for the health benefits now. I have been able to get off blood pressure meds, statins, and am no longer pre-diabetic. I still have weight to lose, but the lab numbers are fantastic and I'm healthier than ever. I now want to go for a long walk, instead of thinking of it as a chore.
But still, as I said, I never recommend Atkins or low carb because it is a way of life that you can not return from. For me, this is the way I will eat for the rest of my life. Because I have so dramatically increased my fat intake, I make sure that most of that fat comes from healthy sources like coconut oil and meat that is hormone, antibiotic, nitrate, and nitrate free -- hopefully grass fed. I also buy as much organic and natural products as I can afford. I have to do most of my own cooking, can't eat fast food and definitely nothing processed. So its not easy, its take a commitment, and is not for those who want a quick and easy fix. It helps if your family is on board.
And stay away from unscientific observational studies.
The "low" carbohydrate diets were not low, there were moderate ranging from 37% to 43% carbohydrates (let's call it 40%). A true low-carb diet is one that is less than 20% carbohydrate and generates ketosis. That's an Atkins diet.
Furthermore the protein was from 19% to 22% and the fat was 36% to 39%. These numbers are pretty close to the Zone diet. The Zone diet doesn't recommend red meat or processed meats, but does recommend low-fat chicken and fish. So if you take out the words "vegetable protein" and substitute "low-fat protein primarily from chicken and fish" then the Zone diet should reduce the likelihood of diabetes especially in those less than 65 years old compared to the standard diet recommended by Harvard.
The Zone diet is simply the evolution of the Mediterranean diet being you eat more colorful carbohydrates and less white ones and cut out most of the saturated fats and omega-6 fats. Or another way of stating this is that the Mediterranean diet is the kindergarten version of the Zone diet.
The New England Journal of Medicine article is a prime example of over-interpreting data which allows blog writer a field day for pushing their own agendas.
By the way, I've no use for these Atkins apologists who recoil at the thought of frying steak in butter. The only reason I can think of not to fry steak in butter, or at least ghee, is its cost. Coconut oil is better. Quit going along with the party line that saturated fat kills people. If it killed you, your body wouldn't produce it and make cell membranes out of it. If you're going to toe *that* party line, go back to a low-fat diet and leave the rest of us to fight our own battle, thanks in advance.
and yes, I've had my labs checked. They're probably better than yours.
Number two, your body handles macronutrients on a use-it-or-lose-it basis. For example, if you eat a lot of starch, your amylase production gets dialed up. If you eat a lot of fat, your lipase production gets dialed up. You have to be able to deal with these foods and move them through the system. Likewise, if you don't habitually eat a lot of carbohydrate, and then all of a sudden you start eating a lot, your body has not had time to adjust to those carbs and you will get high blood sugar readings. Good doctors are aware of this phenomenon, which is why they advise patients about to undergo a glucose tolerance test to eat at least 150g of carbohydrate a day for several days prior. This also explains why American Indians have been hit so hard by the diabetes epidemic. They are not genetically flawed; everyone has an equal chance of developing the disease depending on how they eat and live. Rather, they come from an ancestral background of simply not getting a lot of dietary carbohydrate, rather like any group of people that does not have a strong grain-agricultural history.
And you actually make the correct point about the carbs that the Native groups in climates that could support agriculture consumed along with the meats from the animals they hunted. The corn and beans they grew were not then highly processed for consumption. (I don't have the time right now to do the research, but I am also curious when the Pima started growing those crops because I believe that in the grand scheme of evolution, it was fairly recently).
In other words, this study is useless and just one more anti-animal-protein tirade. This study, like studies of cholesterol lowering drugs (Statins) and many other drugs designed to prevent or treat heart disease, tells us absolutely NOTHING, and is a waste of Huffpost's space. The headline, as usual, is very misleading.