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Most Pounds Off with Lowest Carbs

Women on the Atkins diet lost more weight during 1 year than did women on other diets.

Which diet plan is best at promoting sustained weight loss remains a controversial issue. In the A TO Z (Atkins, Traditional, Ornish, Zone) Weight Loss Study, investigators randomized 311 women (age range, 25–50) to one of four diets: Atkins (very low carbohydrate); Zone (low carbohydrate); Traditional (lifestyle, exercise, attitudes, relationships, nutrition [LEARN]; low fat, high carbohydrate); and Ornish (very high carbohydrate). Women in each group received the corresponding diet book and attended eight weekly nutrition classes led by a registered dietician. Dietary intake, physical activity, and anthropometric and metabolic measures were assessed at baseline and at 2, 6, and 12 months.

One-year retention was >75% for all diets. Women lost a mean of 4.7 kg on Atkins, 2.6 kg on Ornish, 2.2 kg on LEARN, and 1.6 kg on Zone, with a significant difference between the Atkins and Zone diets. Between-group differences in body fat percentage and waist-hip ratio did not reach significance at 1 year, although the Atkins group had the greatest decreases. HDL cholesterol and triglyceride levels improved significantly in the Atkins group compared with other groups. Although 1-year mean systolic and diastolic blood pressures decreased in all groups, the Atkins group decreased significantly compared with the other groups (Atkins mean decrease, 7.6/4.4 mm Hg).

Comment: Concerns that the relatively high fat levels in the Atkins diet might deleteriously affect lipid profiles were not substantiated by these results: Women in the Atkins group showed no adverse effects on lipid variables. Interestingly, the decrease in blood pressure seen in these women is comparable to that attained with the low-sodium Dietary Approaches to Stop Hypertension (DASH) diet. Although the weight loss was greatest in the Atkins group, it was still less than 5 kg for the year. However, considering that many women gain weight each year, a 2% to 5% weight loss is an accomplishment that may come with important long-term health benefits.

— Wendy S. Biggs, MD

Published in Journal Watch Women's Health April 12, 2007

Citation(s):

Gardner CD et al. Comparison of the Atkins, Zone, Ornish, and LEARN Diets for change in weight and related risk factors among overweight premenopausal women: The A to Z Weight Loss Study: A randomized trial. JAMA 2007 Mar 7; 297:969-77.

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