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Waist Not!

September 4, 2008 By:
Michelle Mostovy-Eisenberg, JE Feature
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Andrew Langer
Contrary to popular notions, lots of steak in the diet might not be so bad for the heart after all, according to the results of a new study published in a recent issue of The New England Journal of Medicine.

The two-year, Israeli-conducted diet comparison carried out by researchers at Ben-Gurion University of the Negev and the Nuclear Research Center in Dimona examined the effectiveness of three widely used weight-loss plans: low-fat, restricted calorie; Mediterranean, restricted-calorie; and low-carbohydrate with no caloric intake restrictions. The study concluded that, after looking at the cholesterol and lipid levels among the 322 moderately obese participants, the Mediterranean and low-carb diets are just as safe and effective compared to the low-fat diet -- the standard plan most commonly prescribed by medical professionals for healthy weight-loss and maintenance regimens.

It also showed that the dieters on the low-carb plan (essentially, the plan popularly known as the Atkins diet) lost the most weight, and did not have dangerous changes in the blood cholesterol one could assume would occur -- a reasonable expectation considering the fat intake of a diet with a focus on meats, such as steak and veal.

"All the diets were beneficial in terms of health parameters," noted one of the study's authors, Iris Shai, researcher in nutrition and chronic diseases at the department of epidemiology's S. Daniel Abraham International Center for Health and Nutrition at Ben-Gurion University.

"However, low-carb and Mediterranean were much more favorable for parameters related to blood lipid and sugar control."

The study also answered questions regarding the long-term effects that an Atkins diet of high fat and high protein could have on blood cholesterol and triglycerides.

"As we concluded in the paper, we found that alternative dietary strategies (Mediterranean and low-carb) as compared to low-fat [diets] are effective for weight-loss and appear to be just as safe," noted the researcher.

She emphasized that the study participants also included a moderate level of physical activity in their diet regimen, as "physical activity plays a significant [role] in weight loss and especially in weight maintenance."

Shai added that while vegetarians can adhere to all diet strategies, "it would be more difficult with the low-carb diet if the vegetarian sources of protein are soy, legumes [and] nuts, which are rich in carbs, unless they also consume eggs, cheese and tuna."

Study a 'Validation'

In the initial days after the study's publication, some controversy arose over the connection between a sponsor of the study with the word "Atkins" in its name and the researchers.

Shai commented that the Dr. Robert C. and Veronica Atkins Foundation "had no say in the design, performance or conclusions of this study," and that the foundation was just one of three supporters that provided funding.

Abby Bloch, executive director of the Atkins Foundation, explained that the foundation is unaffiliated with, and operates independently of, Atkins Nutritionals, the weight-loss plan; rather, it's a board of directors-governed organization based in Jenkintown under the auspices of the National Philanthropic Trust, an independent public charity, although it was originally started under the guidance of Dr. Atkins.

As for the study results specifically, Bloch, a registered dietician who holds a doctorate in clinical nutrition, said that portion-control diets are hard for many people to follow, as "they leave you hungry."

The Israel study "is a validation" -- not "a vindication," as Bloch said she was inaccurately quoted as saying to other media outlets -- "of what Dr. Atkins saw in his practice," and it's "only the latest in a long chain of studies that have shown that low-carb is effective for the long-term."

Although multiple media outlets, weight-loss programs and dieters themselves hailed the recent findings of the Israeli-conducted diet study, a closer look at the results is needed to fully grasp the aspects of the results. At least one local doctor isn't so quick to jump on the Atkins bandwagon.

"I would hate to change what's logical, based on one study," said Gilbert Grossman, M.D., of Cardiology Consultants of Philadelphia, P.C. "Different diets work for different people. Crash ones just don't work well. Being practical in terms of caloric intake and increasing exercise -- that the masses can do."

Erica Feldon, 31, who works as a publicist for a major publishing house, has been on and off the South Beach diet for the past two years in an effort to maintain her weight. The Manhattan resident, who grew up in Springfield in northern New Jersey, said that South Beach worked for her because she was able to eat as much as she wanted on the plan -- no calorie limit -- as long as it wasn't carbs.

Her blood work, done about a year after she started the diet, showed that her cholesterol levels were fine compared to a year earlier, despite eating more fats and protein.

Atkins did work for Andrew Langer, 37, of Centreville, located on Maryland's Eastern Shore. In just five months back in 2004, the president of the Institute for Liberty, a small-business and entrepreneurship advocacy nonprofit, went from 265 pounds down to 204 -- and, so far, he's "kept it all off through an ongoing low-carb diet."

"It was a liberating experience," said Langer of his dramatic weight-loss through Atkins, which was accomplished in combination with workouts three days a week at the gym. He noted that besides the weight, his daily acid reflux is gone, and his cholesterol levels -- both good and bad -- "were right where they needed to be."

However, doctors still advocate the best and most healthy way to lose weight -- and to keep it off -- is to take in fewer calories than you expend through exercise.

"Everyone wants the quick fix, like Atkins," said Grossman, but they just "need to control what they're eating."

Grossman recommends eating a balanced, lower-calorie diet with lots of fresh fruit and vegetables, fish, poultry and the occasional meat, combined with exercise -- even a half-hour of walking per day, seven days a week, can help with cholesterol, ward off diabetes and improve heart function.

He also stressed that studies show that it's not exercise or diet alone, but a combination of both that is best for getting long-term results.

Fad diets, as he called Atkins and similar diet plans, offer a quick start, but Americans have to learn how to eat properly, in a more general sense. He attributes a lot of weight gain to a diet high in bread consumption: a bagel for breakfast (the average bagel, even without a topping, can range from 450 to 500 calories, he pointed out), a sandwich for lunch, and a slice of bread or roll with dinner.

When eating out, he advises ordering a salad and sharing a main course with a dining partner, as restaurants "serve larger portions -- much too large" for one person to consume in one sitting.

Be conscious of salad dressings, he adds -- that Caesar salad might sound healthy, but the dressing is made of mayonnaise and eggs, which equals fat.

Walk It Off?

Grossman also emphasized the importance of not exercising -- not even brisk walking -- for at least one hour after eating, as the body needs to digest the food properly.

Shai said that while her study's "results might be a turning point," she doesn't "think that one single study, although well-designed, should change the rules."

She advised waiting to assess forthcoming results from diet studies conducted in the United States that should "confirm our conclusions."

In the meantime, she suggested that doctors consider the low-carb option when the patient has failed with a traditional diet, and when the patient needs to reduce triglyceride levels or increase HDL-C (the good cholesterol).

The bottom line, noted Shai, is that "one diet doesn't fit all."


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