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University of Cincinnati Academic Health Center
Publish Date: 11/27/02
Media Contact: AHC Public Relations, (513) 558-4553
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Dietitian Surprised by Benefits of Low-Carbohydrate Diet Over Short Term

Cincinnati--Bonnie Brehm, PhD, assistant professor, University of Cincinnati College of Nursing, recently reported surprising results of a study that compared the Atkins (low-carbohydrate, high protein) diet to the more balanced American Heart Association's (AHA) low-fat diet, at the national American Dietetics Association conference. In this comparison study of 53 obese, but otherwise healthy women, ranging from 31 to 59 years old, half followed the low-fat diet recommended by the AHA while the other half followed the very-low-carbohydrate diet made popular by physician Robert Atkins. Not only did the Atkins dieters lose more weight--an average of 18-1/2 pounds during a six-month period-- their cholesterol levels improved similarly to the low-fat dieters' levels.

"Here I was--eating more butter, eggs, meats, cheese and real whipped cream than I had eaten for years and my good cholesterol levels went up while my bad cholesterol went down," one participant said. Brehm, a registered dietitian, was surprised to find that in the short term, a low-carbohydrate diet produced a greater loss of weight and body fat and an improvement in most participants' lipid profiles. "I am not recommending the Atkins diet, and clearly more research needs to be done," Brehm said. Women on the low-carbohydrate diet were counseled to avoid foods rich in carbohydrates such as bread, fruit, grains, starchy vegetables and any dairy products other than cheese, cream or butter.

Consuming fewer carbohydrates causes ketosis, a physiological state in which blood sugar levels drop so low that fat stores are broken down and converted by the liver into ketone bodies which are then filtered out by the kidneys and excreted in the urine. Participants on the Atkins diet were given ketone strips to test their urine daily. Blood tests that were taken at three months confirmed the ketosis. Daily food records showed that those on the Atkins diet consumed an average of 41 grams of carbohydrates per day while those on the AHA diet took in about 169 grams.

The Atkins diet seemed harder to stick to in the long term, Brehm said. During the first three months, both groups met once a week with a registered dietitian and both ate approximately the same amount of calories. During the fourth through sixth months, both groups were told to adhere to their respective diets. The low-fat group maintained their nutrient intake during this period while the Atkins group started to add back carbohydrates.

The Atkins dieters complained they could no longer deprive themselves of fruit, fruit juice, breads or pasta, and even a small amount of fruit could kick them out of ketosis. By the end of the six-month study, both groups showed a weight loss, but the Atkins group lost twice as much on the same amount of calories as the AHA group. The UC study results are similar to studies done by Duke University.

"There is still a lot of evidence to show that diets rich in fiber, fruit and vegetables are associated with lower rates of disease and no one really knows how the Atkins diet may affect a person's health over a longer period of time," Brehm said. The bottom line is: more research is necessary. Obesity is linked to increased risk of heart disease, cancer and diabetes, and is increasing in Americans. "The goal is to find a diet that takes the weight off and keeps it off, without adverse affects," Brehm said. Other UC College of Medicine co-investigators involved with this study, which was funded by the American Heart Association, included David D'Alessio, MD, associate professor/endocrinologist and Randy Seeley, PhD, associate professor/researcher, Center for Obesity Research, Department of Psychiatry.

Note: Results of this UC study recently appeared on MSNBC, the CNN Network, and the Washington Post. It will also be published in the January issue of Redbook magazine. For more information about this study or other related studies, e-mail

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