Every so often, one of the journals will publish a study trying to compare a low-carbohydrate diet such as Atkins to a low-fat diet.
Last week's Annals of Internal Medicine had a comparison of patients following either diet for two years. Weight loss at two years was about the same, but on a few parameters, such as change in HDL, the low-carb diet was superior.
There are a few problems with the study. First off, low-fat was defined as 30% or fewer calories from fat. 30%? Really?! I would hardly call that low-fat. Also, there's nothing stating what people actually ate. When people in previous studies have been told to consume 30% fat, their fat intake actually hovers around 36%. That's definitely not low-fat.
If you look at Dean Ornish's studies on low-fat diets in patients with coronary disease, the fat content prescribed is 10%, and those patients had overall regression of their coronary disease and improvement in their lipids, even in the absence of statin medication. Perhaps 10% fat is challenging for most to obtain, but I think 30% is way too high to be called low-fat.
Look closely at the patient populations of the low-fat versus low-carb studies such as this one. They're overweight but remarkably healthy. They don't have diabetes and aren't on statin medications for cholesterol. Their blood pressure is under pristine control. And of course they don't have coronary artery disease. These are characteristics vastly different from the general American public, and a huge departure from the typical patient whom I see in my office.
Here's my problem with the concept of the Atkins low carbohydrate diet: We weren't designed to eat that way. Think back to our predecessors who dwelled in caves. They didn't eat huge quantities of meat. And admittedly, they weren't vegans either. They ate the little meat that they could hunt down, catch, and kill. There was no McDonald's drive thru or a supermarket meat counter to buy a prepared slab of meat.
I strongly believe that a plant-based diet is the best option for health. Plant-based diets reduce risk of coronary disease, lower blood pressure and cholesterol, help to manage and reduce the risk of diabetes, lower body mass, and reduce the risk of many cancers.