What is Atkins diet and Does the Atkins Diet Work?

Controversial diet expert Robert Atkins may no longer be alive, but the tug-of-war over his belief that the road to weight loss is paved with bacon cheeseburgers still continues.

Now, two new studies could help settle the dispute over the effectiveness of the so-called Atkins diet, which advocates a low-carbohydrate, high-fat diet.

The Atkins diet, popular with dieters but controversial with its doctors, remains a big question mark in the quest for reliable weight loss. Many experts remain critical of the diet, but have little evidence to back up their criticisms.

That is, until today, with the results of the first two studies specifically examining the low-carbohydrate, high-fat diet. The new study, published in the New England Journal of Medicine, compares the weight loss of severely overweight individuals following the Atkins diet with that of individuals following a conventional low-fat, low-calorie diet plan.

The results. While participants on the Atkins diet lost significantly more weight than those on the conventional diet, there was no difference in weight between the two groups after one year. The researchers also reported no differences in side effects during the one-year study.

Although the authors point out that further study is needed, they noted an increase in high-density lipoprotein (HDL) cholesterol, or "good" cholesterol, and a decrease in serum triglycerides among participants in the Atkins group. These results are positive because low HDL and high triglyceride levels increase the risk of heart disease.

Although diet participants may be pleased with the initial results of the Atkins plan, the success could be short-lived, as the scales immediately tip back to baseline. According to the study authors, this is partly evidence that it's not that easy for most people to stick with the diet long-term.

"Any approach to calorie restriction that is not compatible with daily lifestyle is difficult to sustain over the long term," states an accompanying editorial to the studies, written by Robert O. Bonow, M.D., of Northwestern University Feinberg School of Medicine in Chicago, Ill. and Robert H. Eckel, M.D., of the University of Colorado Health Sciences University in Denver, Colo.

Patrick McBride, M.D., chief of the Division of Preventive Cardiology at the University of Wisconsin, argues, "The low-carbohydrate, high-protein Atkins diet is not a diet that is nutritionally adequate or palatable over an extended period of time because it essentially excludes important food groups such as fruits, vegetables and complex grains."

Diet experts remain divided

About 45 percent of women and 30 percent of men in the U.S. are actively trying to lose weight at any given time. Unfortunately, these studies do not answer the million-dollar question: what is the best way to keep the weight off?

Diet experts remain divided. While many believe that long-term diet success is most valuable, others believe that weight loss is always beneficial, even if it's followed by an inevitable pound gain.

And there are growing signs that some of the country's leading medical institutions are not only increasing research on low-carbohydrate diets, but also beginning to offer them to their patients.

Harvard University, for example, is currently completing a study comparing an extremely low-carbohydrate diet with the American Heart Association's low-fat diet. And at the Joslin Diabetes Center in Boston, obesity expert Dr. Terry Maratos-Flier recommends a "modified Atkins diet" that focuses on fish and chicken instead of beef and pork.

Although the study found that people on low-carb, high-protein diets regained weight after a year, "the low-carb group still weighed about five pounds less than the conventional diet group, suggesting that some people in this group were better able to maintain their weight," Maratos-Flier said.

And other experts seem to agree. "These two randomized controlled trials add to the recently accumulating evidence that low-carbohydrate diets may be an important weight-control option for many obese or severely obese patients," says Howard Eisenson, M.D., director of the Duke University Diet and Fitness Center.

The Duke Center has been using low-fat diets since 1969. But, Eisenson says, "what we've done for so long doesn't produce enough lasting improvement for enough of our patients to be satisfied." Believing that "it's time to open up to the potential benefits of a low-carbohydrate diet," Eisenson plans to offer a new carbohydrate diet to Duke patients this summer.

Losing weight is more than just a diet

On the other hand, critics like James W. Anderson, M.D., professor of medicine and clinical nutrition at the University of Kentucky, argue, "The high-fat diet promotes weight loss but reinforces unhealthy but popular diets."

These unhealthy eating habits, experts say, could cause potential health problems if maintained beyond a year. Research has shown that high levels of saturated fat, such as those consumed by many Atkins dieters, can have negative health effects.

Anderson, who advises his patients against the Atkins diet, adds, "Using the Atkins guidelines long-term increases cholesterol by 28 percent, while a low-fat diet lowers cholesterol by 20 percent."

Ultimately, Bonow and Eckel add, "The recipe for effective weight loss is a combination of motivation, physical activity and calorie restriction. Until more evidence is available, physicians should continue to recommend a healthy lifestyle that includes regular physical activity and a balanced diet."