2002;113:30-36. In another study, 70% of patients on an Atkins diet for 6 months were constipated, 65% had halitosis, 54% reported headaches, and 10% had hair loss (59). Analyses of all pairwise differences by the Tukey standardized range test (<.05) indicate that the Atkins diet group was significantly different than all other diet groups at 2 and 6 months and that the Atkins diet group was significantly different than the Zone diet group at 12 months. Whole-grain intake and the risk of type 2 diabetes: a prospective study in men. Many dietitians and other health professionals as well as people in the general public are often confused by the fact that many people are able to lose weight on these diets. In: Hennekens C, Manson J, eds. Ornish eventually received a bachelors degree in humanities (1975) from the University of Texas at Austin, graduating first in his class. The New York Times Sunday Magazine, July 7, 2002. 1993;328:1213-1219. They wrote: In any event, I wasnt wrong about this; in my oped I was clear that these benefits were seen in those under age 65. Lets check the facts: Headline: Why Almost Everything Dean Ornish Says about Nutrition Is Wrong, Subhead: When it comes to good eating habits, protein and fat are not your dietary enemies. 2003;138:460-467. In his lengthy reply to my article Dean Ornish says I distort his beliefs, cite questionable studies and dont have the clinical experience to assess nutritional evidence. N Engl J Med. Arteriosclerosis. To some, the fact that an Atkins diet does not significantly raise LDL-C is surprising given the amount of saturated fat and cholesterol in the diet. Regression of coronary atheromatosis in rhesus monkeys. Bill Clinton is one of the more public examples of this, having lost and kept off more than 20 pounds since following the whole foods, plant-based diet I recommended for him five years ago (including salmon once a week). Effects of diet and exercise in men and postmenopausal women with low levels of HDL cholesterol and high levels of LDL cholesterol. For someone trying to reverse heart disease, for example, the diet needs to be rather strict to accomplish this. For 37 years he has been touting the benefits of very low-fat, high-carbohydrate, vegetarian diets for preventing and reversing heart disease. But its not true. Fiber from whole grains, but not refined grains, was inversely associated with all-cause mortality in 11,040 postmenopausal women followed for 11 years (16). Atkins Nutritionals, Inc. In other words, when you change the type of food, you dont have to be as concerned about the amount of food. J Clin Invest. People have a spectrum of choices. That only supports my thesis, because I recommend that people eat less harmful fats and fewer refined carbohydrates. Stefanick ML, Mackey S, Sheehan M, Ellsworth N, Haskell WL, Wood PD. The Tukey studentized range test was used to adjust for multiple testing. This is especially incongruous when, as mentioned earlier, the only study to examine blood flow on the Atkins diet found that it actually worsened (35). Let us know if you have suggestions to improve this article (requires login). High-protein diets may cause loss of calcium and decreased levels of urinary citrate, leading to osteoporosis and kidney stones (52). Fung TT, Hu FB, Pereira MA, et al. If his diet worksand again, we dont know for sure that it doesis that because it reduces protein or fat or refined carbohydrates? These include a whole foods, plant-based diet low in refined carbohydrates, moderate exercise, stress management techniques and social support. Based on his experience caring for patients, Atkins thought that the things that were relegated to the narrow point of the food pyramidmeat, eggs, cream, and cheesewere the healthiest. The abstract clearly states, Respondents aged 5065 reporting high protein intake had a 75 percent increase in overall mortality and a fourfold increase in cancer death risk during the following 18 years. Some people are able to handle more simple carbohydrates and/or more cholesterol and saturated fat in their diet than others. The fact that processed meat is even worse for you than unprocessed meats does not change the fact that the risk of premature death from all causes is higher in those eating red meat than those who do not. This becomes a way of eating rather than a diet with rigid eat this and dont eat that guidelines. In this study, premenopausal overweight and obese women assigned to follow the Atkins diet, which had the lowest carbohydrate intake, lost more weight at 12 months than women assigned to follow the Zone diet, and had experienced comparable or more favorable metabolic effects than those assigned to the Zone, Ornish, or LEARN diets [corrected] While questions remain about long-term effects and mechanisms, a low-carbohydrate, high-protein, high-fat diet may be considered a feasible alternative recommendation for weight loss. New York: McGraw Hill; 2002. Create your free account or Sign in to continue. The primary drive was volume not calories (7). There has been a recent resurgence of interest in low-carbohydrate/high-fat diets such as the Atkins diet (1-3). An example of the half-truth of saying that anything that raises HDL-C is beneficial whereas anything that lowers it is harmful came at the November 11, 2003 annual scientific session of the American Heart Association. Ornish was a physician consultant to U.S. Pres. Its not just 48 patients. I am not against all forms of animal protein. Recent studies also seem to provide some evidence that high-protein diets may have beneficial effects on cardiovascular disease (CVD) risk factors such as high-density lipoprotein (HDL) and triglycerides. Ornish D. The case for low fat. WebDean Ornish, in full Dean Michael Ornish, (born July 16, 1953, Dallas, Texas, U.S.), American physician and author whose approach to treating heart disease through radical A diet high in whole grains was associated with a reduced risk of type 2 diabetes in 42,898 men followed for 12 years. The mechanism of the effects on HDL-C levels of changing from a high- to low-fat diet differs substantially from the mechanism explaining the differences in HDL-C levels between individuals who are eating a high-fat diet. Regulation of low-density lipoprotein receptors: Implications for pathogenesis and therapy of hypercholesterolemia and atherosclerosis. Explain the scientific basis of each author's position. Again, we dont know because his studies have not been designed in a way that can tell us anything about the effect of his diet alone. WebIn this video, we are comparing the new Atkins Protein Chips to the Quest Protein Chips. These include JAMA The Journal of the American Medical Association, The Lancet, Proceedings of the National Academy of Sciences, The Lancet Oncology, The New England Journal of Medicine, The American Journal of Cardiology and others. These are rich in fiber, which enhances satiety without adding significant calories. You can specify conditions of storing and accessing cookies in your browser, Compare and contrast Dr. ornish and Dr Atkins, which virus is responsible for chickenpox?. So theres little evidence to suggest that we need to avoid protein and fat. Reductions in total cholesterol, LDL-C, triglycerides, and total-to-HDL cholesterol ratios were significant only in patients who were following either a 10% fat diet or a 15% fat, calorie-controlled diet. WebMean 12-month weight loss was as follows: Atkins, -4.7 kg (95% confidence interval [CI], -6.3 to -3.1 kg), Zone, -1.6 kg (95% CI, -2.8 to -0.4 kg), LEARN, -2.6 kg (-3.8 to -1.3 kg), When people go on a high-protein diet, they may lose weight and lower triglycerides if, like most Americans, they had been eating a diet high in simple carbohydrates. Ornish D, Hart J. 1999;99:1278-1285. In addition to giving up smoking and fatty foods, the test subjects did yoga, meditated, and participated in a support group. The data suggest that reducing fat intake is one effective strategy for also reducing total energy consumption Given the increasing rates of obesity in the United States at an earlier age, dietary-fat reduction may be an effective part of an overall strategy to balance energy consumption with energy needs (8). Dietary cholesterol and saturated fats increase plasma LDL-C in part by down-regulating LDL receptors in the liver (28). Journal of the American Medical Association 104(2004):537. The case for a low-fat, highcarbohydrate diet. In: Seman FJ, ed. Continue reading with a Scientific American subscription. WebDr. Am J Physiol. Three recent studies suggested that an Atkins diet is superior to a low-fat diet with respect to short-term changes in weight, triglycerides, and HDL cholesterol (HDL-C) (18-20). Twelve-month randomized trial conducted in the United States from February 2003 to October 2005 among 311 free-living, overweight/obese (body mass index, 27-40) nondiabetic, premenopausal women. Sudden cardiac death of an adolescent during dieting. (Also: the heavy protein consumers in the study were consuming nearly 30 percent more protein than the average American does.) WebWas Dr. Atkins Right? An easier way to consume fewer calories is to eat less fat because fat (whether saturated, monosaturated, or unsaturated) has 9 kcal/g, whereas protein and carbohydrates have only 4 kcal/g. Both are written by doctors and have many successful followers but 1995;19:811-816. 1994;1:283-286. WebAtkins 40 is an easy low carb diet plan for those with less than 40 pounds to lose. Bazzano and her associates concluded that going on a low-carb diet is better than a low-fat one for those wishing to lose weight. Ketone bodies formed on a high-protein diet undergo urinary excretion with a cation to maintain electrical neutrality, resulting in the loss of cations such as calcium, magnesium, and potassium (55,56). On one side was Atkins, who had two strips of bacon and three eggs for breakfast. HDL returns cholesterol to the liver for metabolism, a pathway known as reverse cholesterol transport. Ludwig DS, Pereira MA, Kroenke CH, et al. The level of LDL-C is regulated by the LDL receptor, a cell surface glycoprotein that removes LDL from plasma by receptor-mediated endocytosis (27). In addition to fiber, complex carbohydrates and whole foods are rich in phytochemicals, bioflavonoids, carotenoids, retinols, sulforaphanes, isoflavones, and polyphenols and other substances that may reduce the risk of many chronic diseases. It found that individuals assigned to eat high-fat (41 percent calories from fat), Mediterranean-style diets for nearly five years were about 30 percent less likely to experience serious heart-related problems compared with individuals who were told to avoid fat. In simple terms, those with higher HDL-C levels have more garbage trucks (HDL) to get rid of the garbage (excessive fat and cholesterol). Taubes G. What if its all been a big fat lie? Am J Clin Nutr. He received an M.D. The recent multicenter PREDIMED trial also supports the notion that fat can be good rather than bad. Moyers article only adds to that confusion. And categorizing entire nutrient groups as good or bad is facile. Brown MS, Goldstein JL. New York: Random House; 1990. An Atkins diet often shows a greater reduction in triglycerides by comparison. At 12 months, secondary outcomes for the Atkins group were comparable with or more favorable than the other diet groups. There are so many other factors. Ornish represented the other viewpoint with his fruits, veggies, and sharp criticisms of Atkins. RAISING AND LOWERING HDLBENEFICIAL OR HARMFUL? Second, as I made clear in the oped as well as in my books and journal articles, the diet I recommend is low in refined carbohydrates and high in good carbs such as fruits, vegetables, whole grains, legumes and soy products in their natural, unrefined forms (which tend to have low glycemic loads). If they stop eating pasta, they are often avoiding sauces that are high in oil or cream (olive oil is 100% fat and only 1 tablespoon has 14 g fat). (1980) in internal medicine from Baylor College of Medicine in Houston. Mean apo A-II levels did not change. Stevens A, Robinson DP, Turpin J, et al. So even when we look at the data Ornish likes, we still dont see reason to blame Americas ill health on unprocessed red meat and saturated fats. J Cardiovasc Risk. Even better would be to reduce the intake of simple carbohydrates and most fats, which results in losing even more weight while enhancing health rather than potentially harming it. N Engl J Med. These associations were either abolished or attenuated if the proteins were plant derived.. In doing large-scale studies in which people complete dietary surveys, there is often so much noiseespecially in combining data in meta-analysesthat a type 2 error often occurs (that is, the noise obscures the ability to detect statistically significant differences). Because these foods are low in fiber, large quantities of calories can be consumed without feeling full. J Lipid Res. Risk assessment tool for estimating 10-year risk of developing hard CHD (myocardial infarction and coronary death). Ornish goes to argue that protein and saturated fat increase the risk of mortality and chronic disease. Stout RW. Dean Ornish, MD, is founder and president of the non-profit Preventive Medicine Research Institute and is Clinical Professor of Medicine at the Yet as I read this article, I cant help but to find amusement in Her article begins with a gross distortion of what I believe. He began the Lifestyle Heart Trial, a controlled study of the effects of a low-fat diet and stress-management regime on a small group of heart disease patients, implementing a unique approach to treating heart disease that he developed in the late 1970s while he was still a student. : How Simple Lifestyle Changes Can Reverse Most Chronic Diseases (2019; written with his wife, Anne Ornish). Atkins (In contrast, the recommendations of the American Heart Association allowed up to 30 percent of total calories from fat and 300 mg of cholesterol daily.) Companies such as McDonalds consulted him on the formulation of healthier foods, and he held lucrative positions on the advisory boards of PepsiCo and Safeway. These patients were eligible for revascularization and chose to make these comprehensive lifestyle changes instead. As you approach your weight loss goals, you start to In contrast, someone who increases the amount of fat and cholesterol in their diet (eg, an Atkins diet) may increase their HDL-C because their body is trying to get rid of the extra garbage (fat and cholesterol) by increasing the number of available garbage trucks (HDL). The decrease in the percentage of calories from fat during the period 1971 to 1991 is attributed to an increase in total calories consumed; absolute fat intake in grams actually increased. This is the premise of organizations such as America on the Move (63). WebComparison of the Atkins, Ornish, Weight Watchers, and Zone Diets for Weight Loss and Heart Disease Risk Reduction: a Randomized Trial The following information is available Seven Countries: A Multivariate Analysis of Death and Coronary Heart Disease. Armstrong ML, Warner ED, Connor WE. And Im not aware of any studies showing that walking and stress management techniques alone can reverse heart disease. Question 12 options: his core , muscle memory, his progression , specificity training, Kim is conditioning. If you know or suspect that you have a health problem, consult a health professional. Participants were randomly assigned to follow the Atkins (n = 77), Zone (n = 79), LEARN (n = 79), or Ornish (n = 76) diets and received weekly instruction for 2 months, then an additional 10-month follow-up. 1990;85:144-151. A critique of the diet guru's views on high-protein diets, followed by a response from Ornish and a reply from the author. Ornish believed that the stress-management aspect of his program, designed to combat social isolation as well as daily pressures, was as essential to his patients recovery as diet and physical activity. Saunders; 1998. Atkins R, Ornish D. Cardiology Crossfire. American College of Cardiology 50th Annual Scientific Sessions, Orlando, FL, March 20, 2001. Weight loss was not statistically different among the Zone, LEARN, and Ornish groups. The Atkins diet caused the most coronary artery blockages whereas a diet low in fat and high in unrefined carbohydrates caused the least amount of blockages. Esselstyn CB Jr. Updating a 12-year experience with arrest and reversal therapy for coronary heart disease (an overdue requiem for palliative cardiology). The Lifestyle Heart Trial. Other nonscientist, nonphysician writers have also been saying that Americans have been told to eat less fatWere eating less fat, were fatter than ever, so weve been given bad advice. In practice, someone trying to lose weight may begin by moderately reducing their intake of simple carbohydrates and fat and moderately increasing their level of exercise. This does not confer the same risk of atherosclerosis as in Americans with low HDL levels who are consuming a high-fat diet (41). The results of the trial, published in 1990, revealed that at least some effects of coronary atherosclerosis had been reversed in many patients. Dr. Atkins believed that cutting off carbohydrates and sugar will also do the same. 2001;73:1010-1018. Other high-protein diets such as the Zone and the South Beach diets are somewhat better but still emphasize consumption of meat, eggs, and butter. The information on this website is intended to supplement, not replace, the advice of a trained health professional. I feel passionately about doing this work because it helps transform peoples lives for the better. Hu JF, Zhao XH, Parpia B. Dietary intakes and urinary excretion of calcium and acids: A cross-sectional study of women in China. 1970;27:59-67. Although we always need more research, there is enough science now to guide us. Lancet. Available at: http://hin.nhlbi.nih.gov/atpiii/calculator.asp?usertype=prof . Fiber also slows the absorption of food, thereby preventing blood glucose from rising too rapidly and reducing insulin surges. But replacing animal protein with well-balanced plant proteins is beneficial, and this is in the mainstream of what most scientists who do nutrition research believe. On August 12, 2010, after 16 years of review, the Centers for Medicare & Medicaid Services began providing Medicare coverage for my intensive lifestyle program for reversing heart disease under a new benefit category, intensive cardiac rehabilitation. Many insurance companies are also providing coverage. Dietary fiber, weight gain, and cardiovascular disease risk factors in young adults. For the past 37 years my colleagues and I at the nonprofit Preventive Medicine Research Institute, in collaboration with leading scientists and medical institutions, have published a series of randomized controlled trials and demonstration projects showing that comprehensive lifestyle changes may slow, stop and often reverse the progression of many chronic diseases. Samaha FF, Iqbal N, Seshadri P. A low-carbohydrate diet as compared with a low-fat diet in severe obesity. HDL-C decreased 9% from 40.0 to 36.3 mg/dL after 1 year, yet these patients showed clear improvement in coronary atherosclerosis, myocardial perfusion, and cardiac events. Pereira MA, Jacobs DR Jr, Pins JJ, et al. But the real issue is what happens to actual measures of heart disease, not just risk factors, which I will describe further on. A frequently overlooked "waste product" of metabolism, uric acid actually threatens our health. In our debates, Dr Atkins often claimed that his diet can reverse coronary heart disease (CHD) but never published any peer-reviewed data to support this assertion, nor has anyone else, including advocates of similar diets such as the Zone and the South Beach diets (34). Ornish then moved to the Boston area for a clinical fellowship at Harvard Medical School and an internship and residency in internal medicine at Massachusetts General Hospital, which he completed in 1984. And although Ornish is right that I lack clinical experience, when analyzing evidence, distance can be useful. Could it be that our attempts to reduce fat have in fact been part of the problem? Over and over, Ive seen patients with coronary heart disease so severe that they cant walk across the street or work or play with their kids or make love or do much of anything without getting severe chest pain become pain-free after only a few weeks of making these diet and lifestyle changes. Body weight is inversely associated with dietary fiber and carbohydrates and positively associated with protein intake (11). Bill Clinton from 1993 to 2000 and served on the White House Commission on Complementary and Alternative Medicine Policy in 200102. You start by eating 40 grams of net carbs, 4 to 6-ounce servings of protein and 2 to 4 servings of fat per day. Effect of whole grains on insulin sensitivity in overweight hyperinsulinemic adults. Protein, too, doesnt look so evil when one considers the 2010 trial published in The New England Journal of Medicine that found individuals who had recently lost weight were more likely to keep it off if they ate more protein, along with the 2005 OmniHeart trial that reported individuals who substituted either protein or monounsaturated fat for some of their carbohydrates reduced their cardiovascular risk factors compared with individuals who did not. Anitschkow N. Experimental arteriosclerosis in animals. Total cholesterol decreased much more on the Ornish diet than on any of the other diets. Discover world-changing science. When people dutifully cut down on fat in the 1980s and 1990s, they replaced much of it with high-sugar and high-calorie processed foods (think: Snackwells). Harrisons Advances in Cardiology. Am J Med. Presented at the American Heart Association Scientific Sessions, Orlando, November 11, 2003. All consumption estimates are imperfect, of course, including the U.S. Department of Agriculture (USDA) data he cites. The purpose of this article is to find common ground among seemingly contradictory information about different diets, present an evidence-based rationale for optimal nutrition, and describe many of the half-truths and distortions of the Atkins diet and other similar diets. (Also: the heavy protein consumers in the study were consuming nearly 30 percent more protein than the average American does.) Fleming R, Boyd LB. Please refer to the appropriate style manual or other sources if you have any questions. Only patients following the Atkins diet showed a worsening of each CVD risk factor (LDL-C, triglycerides, total cholesterol, HDL-C, total-to-HDL cholesterol ratio, homocysteine, Lp(a), and fibrinogen), despite achieving statistically significant weight loss. Others expressed skepticism because his experimental methods did not attempt to account for the ways in which each component of his program affected the results. The effects of weight loss on the activity and expression of adipose-tissue lipoprotein lipase in very obese humans. The effect of high-protein diets on coronary blood flow. N Engl J Med. JAMA. She wrote about the reasons that autoimmune diseases overwhelmingly affect women in the September 2021 issue. Losing weight is important, but the history of medicine is replete with examples of weight-loss approaches that were harmful to health (eg, amphetamines, fen-phen). The decrease in HDL-C and apo A-I levels correlated with the decrease in apo A-I transport rate but not with the increase in apo A-I FCR.

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