Atkins wins … sort of

Nutrition Action Healthletter, May, 2007

An Atkins diet (low-carb, highprotein) may work better than some others, but it probably won't make you slender.

Researchers assigned roughly 300 overweight premenopausal women (they averaged 187 pounds) to one of four diets:

* Atkins: no more than 20 grams of carbs a day for the first 2 to 3 months and 50 grams a day later.

* Learn: limited calories, 30 percent of calories from fat, more exercise.

* Ornish: only 10 percent of calories from fat.

* Zone: limited calories, 40 percent of calories from carbs, 30 percent of calories from protein, 30 percent of calories from fat.

Despite those goals, by the end of one year the participants were eating fairly similar diets. Among the differences that remained: carbs were lower (138 grams a day) in the Atkins dieters than in the others (180 to 200 grams a day). And fat was higher (44 percent of calories) in the Atkins dieters than in the others (30 to 35 percent of calories).

The results: After one year, the Atkins dieters had lost more weight (10 pounds) than those who followed LEARN (6 pounds), Ornish (5 pounds), or Zone (4 pounds). And all four groups had regained some of the weight they lost after the first six months they were on their diets.

Triglycerides and blood pressure dropped the most in the Atkins dieters, in part because they lost the most weight. HDL ("good") cholesterol went up the most in the Atkins dieters and the least in the Ornish dieters. LDL ("bad") cholesterol didn't change significantly in any group.

What to dot If you want to lose weight, consider the South Beach Diet, a lower-carb regimen that includes good fats and good carbs. (It wasn't tested in this study.) An Atkins diet may not raise LDL cholesterol while you're losing weight, but it may clog arteries after you stop losing weight, especially in men or postmenopausal women.

JAMA 297: 969, 2007.