HOLD THE LARD!: The Atkins Diet still doesn't work

Issue settled. The Atkins Diet—the famous high-fat, low-carb regime that lets dieters load up on pork rinds and Scrapple as long as they avoid potatoes and Wheaties—works. The American Heart Association has been wrong all along, as has essentially the entirely American medical establishment. Not only is gorging on fat the key to becoming thin, it's heart-healthy to boot. So say the headlines:

The public responded predictably to the pro-Atkins results of an Atkins-funded study last month. Sales of Dr. Robert Atkins' diet book skyrocketed over 900 percent on Amazon.com the day the news broke. Dr. Atkins' New Diet Revolution has now sold over 10 million copies; according to one Atkins stooge, more than 20 million people have signed on for the diet. Celebrities ranging from callipygian lovelies Jennifer Lopez and Minnie Driver to formerly porky Spice Girl Geri Halliwell to one-man body mass rollercoaster Matthew Perry have reportedly taken the Atkins plan straight to the scales.

There are two issues here. One is the effect of the Atkins diet on weight loss. The other is its effect on cholesterol and triglycerides, a group of fatty compounds that circulate in the bloodstream and are stored in the fat tissue.

In the study in question, Dr. Eric Westman of the Duke University Medical Center looked at both. He followed two groups of 60 dieters each, one on a high carbohydrate diet and one on the high-fat, low-carbohydrate Atkins diet. He reported that the Atkins group lost twice as much weight during the six-month study period as did the high-carb group. But this is both unsurprising and meaningless.

Gary Foster of the University of Pennsylvania co-authored a study conducted in virtually the same manner as Westman's. Foster, whose work will soon appear in a major medical journal, provides a simple explanation for the Atkins weight loss. The regimen "gives people a framework to eat fewer calories, since most of the choices in this culture are carbohydrate driven," he says. "Over time people eat fewer calories."

Randy Seeley of the University of Cincinnati co-authored yet another "sister study" with similar results. His explanation is the same as Foster's. Ultimately, Atkins is nothing more than a low-calorie diet in disguise.

In any event, the main issue with any diet—be it Atkins, popcorn, or jelly bean—isn't whether people can lose weight in the short-term but rather whether they can stick to the regimen and keep the pounds off not for just half a year but essentially forever. Yet completely lost in the media mania was that among the 60 Atkins dieters in the Westman group analyzed for weight loss, the dropout rate was 43 percent.

Thus almost half the Atkins cohort couldn't stay with the steak and bacon routine for even six months. By comparison, only 25 percent of the high-carb eaters dropped out.

Moreover, it's generally accepted that drop-out rates anywhere near this level completely invalidate a study because you don't know how all those drop-outs would have affected the result. Maybe those Atkins dieters were quitting not only because of carbohydrate cravings but also because they weren't losing weight or losing it fast enough to satisfy them.

Why would Westman's interpretation be so different from those of Foster and Seeley? It may help to know not only that this particular study was paid for by the Atkins Center, but that it's part of a long-term funding arrangement.

Analyses such as one published in the New England Journal of Medicine (NEJM) in May 2000 have shown that funding sources do in fact influence study results and the interpretations (or "spin" if you will) of those results. "When the boundaries between industry and academic medicine become as blurred as they are now, the business goals of industry influence the mission of medical schools in multiple ways," declared an accompanying NEJM editorial.

Westman's interpretation, based on his handful of subjects observed over a mere six months, also directly contradicts three decades of randomized controlled studies published in peer-reviewed journals. A review of over 200 of these published last year in a major medical journal concluded bluntly: "The BMIs [a surrogate measure of weight] were significantly lower for men and women on the high carbohydrate diet; the highest BMIs were noted for those on a low carbohydrate diet."

But what about the blood findings? Wasn't it a real shocker that Atkins dieters consuming heavy amounts of fat saw their HDL ("good cholesterol") levels increase by 11 percent while harmful triglycerides fell 49 percent? (LDL or "bad cholesterol" levels remained the same.)

"Often just losing weight alone will cause improvement in triglyceride and cholesterol levels," the president of the American Heart Association Dr. Robert Bonow told me. Since the Atkins dieters did lose more weight than those on the high-carb diet, it only stands to reason that by comparison their blood levels would also improve more.

Says Seeley, Westman's "weight loss data look just like ours and my argument is that the weight loss accounts for the beneficial effects."

Westman told me that he doesn't believe this to be the case, because another study, in the July 2002 Journal of Nutrition, claims to have found a similar improvement on an Atkins-type diet regardless of weight loss. But the same researchers, using the same group of dieters, published another study at the same time reporting that the Atkins dieters lost an average of 7.5 pounds over a six-week period. So again, blood fat levels merely fell with body fat levels.

Ultimately this fat-fest over a single study shows nothing more than the media's amazing ability to pick out and flaunt a will o' the wisp—even to the point that one American network repeatedly used on-the-air interviews from a representative of the Atkins Institute to interpret a study paid for by the Atkins Institute!

Why? Our increasingly obese population is desperate for some magical formula to avoid the physiological law that body fat is determined by calories in and calories out. The media tried to fill the need, but ultimately failed the public. "It just makes people confused and frustrated," an exasperated Seeley said. Yes, and fatter by the day.

My brother, an M.D., used the Adkins diet years ago to win a weight-loss bet with his wife. After he won (the diet worked) he blimped out again within a couple of years. the only diet that works long term is the "Hungry All The Time And Get Used To It" diet. Unless someone comes up with a magic pill without the side effects of speed.

"There are about 3000 calories per pound of body fat. Supposing that you are consuming 2300 calories per day to maintain your present weight, if you drop down to 2000 calories per day by cutting equally your fat, protein and carbs, you will loose one pound every 10 days. I guarantee it and there is no more healthy way to diet."

It is not so simple. If you eat 3000 calories of just carbs, any excess will be stored as fat. If you eat 3000 calories of just fat, your body will flush most (all?) of the fat it does not use for energy. Part of the reason Atkins works so well is because it forces your body to go into ketosis. Ketosis makes it so your body burns fat for energy instead of carbs.

I am not expert on the subject by any means but I have gathered this much from my own research. Whoever told you that all calories are equal do not know what they are talking about.

This is a good diet for people without risk factors for heart disease, high cholesterol, bowel cancer, etc, or for people who eat low-cal proteins like chicken and fish. You have to factor that in. For example, being a vegetarian, I tried Atkins and was eating all high-fat foods, like avocadoes, nuts, olives, tofu and cheese. My dad died of colon cancer and I am borderline in the cholesterol department. Although avocados, olives and nuts are high in the good cholesterol, overall, this was still a bad diet for me. And I also gained weight, as I could not be full without eating more than the prescribed amounts, i.e. 1/4 cup of nuts.

All this is to say that weight is not the only consideration -- your family history is very important.

spoken like a true radical materialist... except for one small fact. human metabolism is EXTREMELY COMPLICATED and does not fall into the same simple straight-forward algorithm found on a junior physics thermodynamics final.

am a programmer too and a physicist to boot, and have been fighting my weight for 40 years to boot and say that Atkins has captured a better paradigm of what is happening inside our stomachs and guts and glands vis a vis nutrition than these bozos at the AHA and their Archer-Daniels-Midland sponsored "nutrition charts"

The only way I could lose weight by eating fat would be to take big bites out of my stomach, arms, and thighs.

In all seriousness, I did try Atkins once, and all that fat literally made me sick to my stomach. Hence, I cut back on what I ate and lost weight. Who knew I could get sick of steak?

IMO and personal experience, the author is dead on correct: Atkins is nothing more than a calorie-reduction diet.

Is this really the right assumption to make? It looks like Fumento is stacking the deck to produce the answer he wants. If a diet helps people to achieve their weight loss ends without harming their general health it is a success -- period. It may not be an optimal lifelong sustainable regimen, but it's not intended to be. Fumento's stupid, biased assumption weakens his whole article.

Ah, there is the rub: your assumption is that the "human body" has a fixed rate of calorie consumption, which is far from the truth. even when external activity *appears* to remain the same, the metabolism can vary WILDLY...

most likely the internal energy consumption is being changed by the various hormones and glands which control the metabolism based on a large number of factors: this is why some people can eat awesome amounts of food and not gain any weight, others eat just a bit and gain weight -- without some deus-ex-machina like "exercise" to explain it. this is a very very common phenomena.

" Oh, yes it is, it's just that simple. What I said in the paragraph that you are referring to is absolutely true. It's guaranteed by the second law of thermodynamics. If you run a 300 calorie per day deficit, you or anyone on this planet will loose at least one pound every 10 days, I don't care what you eat. This establishes a lower limit on the amount of weight that one can expect from a given calorie deficit. If you don't believe so, please tell me how it could be otherwise. I don't think that you even understand how your comments stand in relation to my statement. It seem that you are trying to say that if one were to eat some screwed up skewed diet, they could better this by loosing even more. I don't doubt it. You are probably correct, but who cares. Everything that I said is still correct. If you have the will power to stick to a good healthy diet, you'll get where you want to go just as quickly and in better health. "

I think I am talking above your head. No point in talking about this any further. By the way it is 3500 calories per pound, not 3000. You can't even get this little fact right so I don't know how you expect anybody to believe the rest of what you are saying.

" If you had half a brain, you could see that the numbers have nothing to do with the argument."

Well, I don't feel like having a flame war. I stand by everything I said. If you have some links to back up you simplistic logic, please post them.

I know from personal experience that the Atkins diet works tremendously well at reducing your weight. There are costs - you lose a lot of great tasting food, like pasta, pizza and such. And there are potential health risks, although the anti-Atkns-diet people haven't been able to publish lists of autopsy reports of people that the Atkins diet has killed. NB it's not for athletes. For athletes carbs are good things.

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