Tuesday, June 30, 2009

Do slimming diets work?

Atkins, South Beach, and Zone-trade-marked high-protein, high-fat slimming diets, received a crushing blow recently.

A major study, published in the February, 2009 edition of The New England Journal of Medicine (NEJM), concluded that the calorie count, rather than the composition, determines the success or failure of a weight loss diet.

This study erases the support given to eat-all-you-want Atkins type diets by smaller studies. It also vindicates nutritionists like Dr. Ornish who have been saying all along that balanced, predominantly complex-carb, low-calorie diets are effective.

The NEJM study recruited 811 overweight adults, “randomized” them in to four groups, and studied them over two years. The calories derived from fat, protein, and carbohydrates in the four groups were 20, 15, and 65 percent; 40, 15, and 45 percent; 40, 15 and 45 percent; and 40, 25, and 35 percent. Most weight loss occurs 6-12 months after beginning any diet. In the real world, most people put on weight steadily thereafter. The study period of two years measures long-term success.

Weight loss was similar in all four groups. More important, the study subjects reported similar levels of hunger, satiety and satisfaction with their diets.

This eliminates one of the chief advantages claimed by high-protein advocates that they feel less hunger compared with high-carb dieters.

If all diets are equally effective for slimming, why shouldn’t an Atkins devotee stick to his old diet after cutting down some calories? The NEJM study does not answer this question because it was not the focus of research, but other studies have covered this ground in detail and depth. Although an Atkins-type diet may lower weight as effectively as the Mediterranean Diet, the latter has important health benefits beyond just weight loss.

The Mediterranean Diet of olive oil, fresh fruit, herbs, complex, carbs, fatty fish, red wine, and nuts is rich in antioxidants, dietary fibre, omega-3 fatty acids and monosaturated fats that promote cardiovascular health, lower cancer risk and favourably affect blood cholesterol profile.

Atkins-type diets, which are rich in red meat and saturated fat, increase the risk of heart disease, stroke and cancer. They are constipating, and promote the formation of kidney stones.

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