THE SPECTRUM
Dean Ornish M.D.
The Never-Ending Diet Wars
A new study reports that the Atkins diet can be just as healthy as a low-fat diet. But don't start buying bacon yet. This research has some serious flaws.
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.
I'm also very skeptical of the quality of data in this study. For example, the investigators reported that those on the "low-fat" diet consumed 200 fewer calories per day—or 10,000 fewer calories per year—than those on the Mediterranean diet, yet people lost more weight on the Mediterranean diet. That's physiologically impossible.
In addition, in the "Atkins diet" that was tested, "the participants were counseled to choose vegetarian sources of fat and protein and to avoid trans fat." A vegetarian Atkins diet? Most people associate an Atkins diet with bacon, butter and brie, not a plant-based diet like the one I recommend.
Then there's the question of what constitutes a "low-fat" diet. The one used in the NEJM study was not very low in fat. It was based on the American Heart Association (AHA) guidelines, which I have long criticized as not being enough of a change in diet to show much benefit. In earlier studies, as in this one, the AHA diet did not cause much of a reduction in either blood cholesterol levels, weight or blood sugar, so it's not surprising that the new NEJM study reported that the Atkins and Mediterranean diets were more successful at reducing these levels. In the Womens Health Initiative study, the AHA diet didn't do much to prevent heart disease, colon cancer or breast cancer, either.
My colleagues and I at the nonprofit Preventive Medicine Research Institute and the University of California, San Francisco, have studied for more than three decades the effects of diets much lower in fat (10 percent) than the one used in NEJM study as well as lower in refined carbohydrates and higher in fruits, vegetables, whole grains, legumes and soy products.
We reported in a randomized, controlled clinical trial published in the Journal of the American Medical Association a 24-pound weight loss after one year and 13-pound average weight loss after five years in a group of men and women, much more than the 9.7 to 10.3 pounds lost in the new NEJM study. These findings were replicated in larger demonstration projects as well.
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Member Comments
Posted By: KWalt @ 07/22/2008 4:13:40 PM
Comment: Ornish's comments are interesting, but a bit arrogant.
According to him, virtually every human society in the past 50,000 years has been eating WRONG. They have been killing themselves, and didn't realize it. Or they were too stupid to realize they were eating deadly. It's wonderful the Ornish has come to earth to save us all.
The Laplanders eat caribou and caribou milk. Ornish says they're killing themselves.
The Swiss Lake Dwellers ate fish. Ornish calls animal protein a no-no. They were just stupid.
The Yanomamo of the Amazon eat game, river fish. Ornish says this is unhealthy.
The American Plains Indians relied on buffalo meat. Ornish would claim they were foolish.
Okinawans eat port and cook in lard. Forbidden by Ornish.
The Japanese eat prodigious quantities of seafood and shellfish, rich in cholesterol. Ornish says this is stupid and the Japanese are wrong.
The Andorrans include milk and cheese in their diets. Ornish would claim they are harming themselves.
Native Americans of the American Northwest thrived on salmon and game. According to Ornish, they were eating wrong.
The Clovis societies in North America fashioned spearpoints to hunt game. But they were ill-advised, according to Ornish. Better to hunt broccoli, or wait for it to be invented.
The Chinese cook in oil. Tsk, Tsk, according to Ornish.
Bedouin drink camel's milk. They are foolish according to Ornish.
Pacific Islanders lived on coconut and fish for eons. Which is a bad thing, because of the animal protein and the saturated fat, says Ornish. Perhaps they should wise up.
Australian aborigine ate kangaroo, and the fattiest parts thereof. A mistake, says Ornish. They should have eaten plants.
The Pygmy of Africa hunted game. They were compromising their health, but didn't know it.
I'd like to know of ANY society anywhere that was traditionally vegan/eggwhite/fat-free as Ornish contends is the correct human diet.
Posted By: OnlyCureJGK @ 07/21/2008 8:52:09 PM
Comment: Homosexuals should not be aloud to spend time with children and corrupt there minds. Homosexuality is just as wrong as Murder they are both depraved sick crimes against what is natural.
Both these crimes fly in the face of what is normal decient human behavior.
Anyone that supports homosexual activity is a contributor to it.
Homosexuality is wrong.
Its is not diversity it is perverisity
They should be given the mental help they need.
It is not about left or right wing politics its about right and wrong.
Homosexuality is wrong and always will be just because you say its not does not mean its true.
Posted By: DodgerFan @ 07/21/2008 4:57:20 PM
Comment: It seems that the author of the article is at least partially responsible for the "never-ending diet wars" by his apparent refusal to acknowledge the growing body of scientific evidence that the low-carb approach does provide significant weight loss and other benefits. However, the low-carb fanatics also fuel the controversy by their "my way or the highway" approach to diet recommendations. They seem regard any suggestion that there might be acceptable alternatives almost as a personal insult. The excellent results obtained by the Okinawans, Cretans, and vegetarians seem to suggest that low-carb is not the only way to achieve a positive outcome. Perhaps we should leave the "if you're not with us, you're against us" attitude to the soldiers and politicians. Those of you who are bewildered and confused by this trivial bickering should probably speak to your doctor and work out a plan with his/her professional advice and assistance.