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Another round in the ongoing “Diet Wars” goes to Atkins and the Low Carb diet.

By Nurse Mark

It seems the “Diet Wars” might just never end.

There are the veggie eaters who are disgusted by the cavemen meat eaters,
the whole food and raw food crowds,
the low fat folks,
the high carb and the low carb camps,
the protein lovers and the protein haters,
the juicers and the squeezers,
the junk foodies and super-size me’s, and,
there’s even a bunch that is working valiantly to figure out how they can get all the sustenance they need from sunlight, fresh air, and pure thoughts – who call themselves Breathairians.

Just like so many opposing viewpoints in today’s world – political, religious, tribal, ethnic, and so on – the chances of these different dietary believers ever acknowledging the worth of any diet but their own are slim-to-none.

Still, medical researchers continue to take up the cause and try to figure out if there might really be one dietary regimen that is better than all others – I guess it is just human nature to want to classify things as “Good, Better, and Best” or “winner” and “loser.”

In a study in  called  “Comparison of the Atkins, Zone, Ornish, and LEARN diets for change in weight and related risk factors among overweight premenopausal women: the A TO Z Weight Loss Study: a randomized trial.” done by Stanford University Medical School and published in JAMA in 2007 the researchers looked at 4 popular and relatively “mainstream” diets:

• The Atkins diet, a very low carbohydrate but liberal fat and protein diet plan,
• The Zone diet that advocates a “40:30:30” ratio of calories obtained from carbohydrates, proteins, and fats, respectively,
• The Ornish diet that excludes cholesterol and saturated fat, including all animal products (except egg whites and nonfat dairy products), nuts, seeds, avocados, chocolate, olives, and coconuts and eliminates all oils, and
• The LEARN (Lifestyle, Exercise, Attitudes, Relationships, and Nutrition) diet that recommends 55% to 60% energy be obtained from carbohydrate and that less than 10% energy come from from saturated fat.

Three high carbohydrate, low fat diets, put up against one low carbohydrate, high fat diet.

Just over 300 overweight/obese, nondiabetic, premenopausal women were divided into 4 groups and each group was directed to follow one of the four diet plans for a full year.

The main thing that the researchers wanted to see was weight loss – but they also looked at what they called “secondary outcomes” which included lipid profile (aka “cholesterol levels”), percentage of body fat, waist-hip ratio, fasting insulin and glucose levels, and blood pressure.

So, what did they find? (I thought you would never ask…)

Weight loss for each of the diets at the end of 12 months was:

• Zone diet – about 3.5 pounds (1.6 kg)
• Ornish diet – about 4.8 pounds (2.2 kg)
• LEARN diet – about 5.7 pounds (2.6 kg)

And finally; (drum roll please…!)

• Atkins dieters lost about 10.3 pounds (4.7 kg) with weight losses within that group ranging from as “little” as 6.8 pounds to as much as 13.8 pounds!

And, those “secondary outcomes” that they thought they might check while they were at it?

The researchers were forced to admit that “At 12 months, secondary outcomes for the Atkins group were comparable with or more favorable than the other diet groups.”

And finally, the researchers rather grudgingly conclude that “a low-carbohydrate, high-protein, high-fat diet may be considered a feasible alternative recommendation for weight loss.”

Folks, this is what Dr. Myatt has been telling us for years now. Check out her Super Fast Diet – which actually builds and improves on the success of the Atkins plan with over two decades of Dr. Myatt’s clinical experience and patient successes.

References:

http://www.ncbi.nlm.nih.gov/pubmed/17341711

Why Do We Go To All The Trouble And Effort To “Diet”?

Part 2 In A Series By Nurse Mark

In our first “Diet” article we saw that:

• Everyone is on a “diet” of some sort
• Some “diets” are followed for moral reasons, others for medical reasons.
• The food intake of our “diet” provides us with energy – measured as “calories”
• Of the three food types that we consume for energy, only two are “essential” to life (pop quiz: which two?)

And now we’ll look at some common physical conditions and how those conditions affect our dietary needs. Next, we’ll look at some of the more trendy or popular diets with some thoughts on their strengths, weaknesses, and even dangers. We’ll also look at vitamins, minerals, and micronutrients to see how and where they fit into the dietary picture. Finally, we’ll look at how to put all this knowledge together and look at Nutrition Facts Boxes on foods so that we can make better dietary decisions.

Some of the physical or medical conditions that cause people to alter, modify, manage, or otherwise control their food intake include:

• Obesity
• Cardiovascular disease – including hypercholesterolemia (high cholesterol) and hypertension (high blood pressure)
• Food allergies, sensitivities, and intolerance
• People with inherited metabolic disorders, such as PKU and Homocystinuria or with kidney or liver disease may be prescribed a low protein diet.
• Neurological disorders such as epilepsy, ALS, bipolar disorder, depression, autism, and more often respond dramatically to dietary changes.
• Diabetes
• Cancer
• Weight gain may be desired for any number of reasons from increased athletic performance to recovery from illness to pregnancy.

Let’s look at these a little more closely, and at some of the dietary strategies that are proposed for each.

Obesity and overweight are the first condition that most people think of when they hear the word “diet.”  In it’s most basic terms, overweight and obesity is a result of consuming more energy (food) than the body requires. The excess is stored as fat, an evolutionary adaptation that allowed early man to survive lean times. In today’s context however things are not so simple.

We have access to foods that are far more calorie-dense than our distant ancestors could dream of – in the form of sugars and other concentrated carbohydrates. Because these foods tend to have less nutritive value than some other, healthier choices, many obese and overweight persons are actually malnourished – lacking in fats, proteins, and micronutrients such as vitamins and minerals. They get enough calories to make them fat but not enough nutrients to make them healthy or satiated.

Here is an essential truth: All “reducing diets” are calorie restriction diets – the differences between the multitude of diets available is in which of the calorie-containing macronutrients are restricted.

Most (if not all) of the diet plans that win approval of the conventional medical establishment favor some restriction of all three macronutrients – fats, proteins and carbohydrates – usually with special attention given to reducing fats and animal-based proteins while increasing the intake of fruits, vegetables, and “good” carbohydrates such as whole grains and fibers. Not surprisingly, these diets tend to be hardest to adhere to since they rely on deprivation – meal servings must be smaller and thus less satisfying. Ornish is one popular example of this type of diet.

Others diets reduce caloric intake by restricting carbohydrates while allowing nearly unlimited proteins and fats. While they do not initially seem to be diets of deprivation many people find that they crave carbohydrates such as breads and starches and sweets and complain that the diets are “boring” and “monotonous” because of that. While the nearly unlimited allowances of fats and animal protein make diets like the Atkins diet satisfying and nutritionally complete the restriction of sweets and carbohydrates can lead to dissatisfaction and surprisingly, excessive protein intake can result in weight (fat) gain through gluconeogenesis – effectively undermining the dieters efforts.

A variety of other weight loss diets all promote themselves as being the best and range from mixed macronutrient diets relying on portion control such as The South Beach Diet to radical fasts and semi fasting diets that rely on near complete food deprivation such as grapefruit or cabbage soup or water fast schemes. There are also diet plans that rely on “gimmicks” such as the HCG diet which uses injections of small doses of HCG (Human Chorionic Gonadotropin) as an adjunct to a very low calorie deprivation diet plan, or the various commercial diets that rely on special prepackaged foods or “meal replacements.”

All potential weight-loss diets must be evaluated on their nutritional completeness, for any diet that lacks in essential nutrients has the potential to cause significant malnutrition and ill health and can lead to rebound weight gain.

Cardiovascular disease, including high blood pressure and high cholesterol, is another condition for which conventional medical wisdom will prescribe diets – usually low-fat, low-salt, low protein, and high in “low glycemic index” carbohydrates, along with the usual mantra of “more fresh fruit and vegetables.” Unfortunately these conventional recommendations usually do little more than make the dieter miserable, and often make the medical condition worse.

While diets like the Pritikin and Ornish have some success if very carefully adhered to there is evidence that a Very Low Carbohydrate diet that allows adequate fat and protein can be highly effective and easier to stick with. Cholesterol control is paradoxically easier to achieve on a diet of adequate fats and protein and restricted carbohydrates than by attempts to limit dietary cholesterol – since the liver is quite effective at creating this vital substance de novo (from new, or by itself). Blood pressure control becomes much easier when carbohydrates are limited – salt limitation is effective in only a small percentage of patients and carbohydrates cause as much or more water retention than salt.

Diabetes and “Metabolic Syndrome” diets as prescribed by conventional medical and dietetic practitioners tend to look very much like conventional weight loss and conventional cardiovascular diets – that is, the standard recommendation as promoted by the A.D.A. (American Diabetes Association) and others is usually low-fat, low-salt, low animal protein, and high in “low glycemic index” carbohydrates, along with the usual “more fresh fruit and vegetables.”

Because these diets tend to be carbohydrate based, dieters have difficulty actually reversing the condition and the best that can be hoped for is usually “stabilization” of blood sugar levels at some arbitrary (and achievable) level so as to allow for safe administration of hypoglycemic drugs or even insulin – based on frequent blood sugar level testing.

Though still actively discouraged by most conventional dieticians and medical practitioners, the Very Low Carbohydrate (VLCD) diet is well-proven to reverse type II diabetes safely and quickly and is beginning to find some support among practitioners who are willing to look outside of the standard A.D.A. dietary protocols.

Cancer is a word that terrifies most people, and for every diagnosis of cancer there are dozens of well-meaning family, friends, neighbors, co-workers, and casual acquaintances who all seem to have a theory about the best diet for the disease, and are insistent that the sufferer should “give it a try.”

Most conventional medical practitioners on the other hand are loathe to concede that diet could play much, if any role in cancer. Other than the standard mantra of “eat more fresh fruit and vegetables” the usual conventional dietary recommendations center around preventing any weight loss during the course of the disease. To this end, high carbohydrate foods and supplements such as Ensure drinks are usually recommended.

There is also a massive amount of conflicting and often confusing diet advice for cancer on the internet and patients can become overwhelmed, flitting from one promising dietary protocol to another in their search for the curative answer. Much of this advice is based on legend, “common sense” armchair theory, or testimonial rather than science and most of it is wrong – even harmful.

Even cancer diet advice that is based on science and clinical trial must be evaluated carefully since cancer is not one single disease and the best diet for one cancer may not be appropriate for another.

Long-dismissed by conventional dietary wisdom as “dangerous,” a ketogenic diet is beginning to find acceptance among more open-minded cancer treatment practitioners. Treatment successes with a Ketogenic diet are often nothing short of spectacular, and medical researchers are beginning to take notice of this dietary strategy that targets a metabolic weakness of most cancer cells.

Dr. Myatt has been using the Ketogenic diet successfully in her practice for many years and considers it to be an indispensable tool in the treatment of cancer. She has written and teaches on the use of it for many conditions including cancer – more information can be found here: Dietary Ketosis In The Treatment of Solid Tissue Malignancy

Food allergies, sensitivities, and intolerance are the subject of almost as many special dietary strategies as is cancer, and results that are just as varied.

Some conditions, like celiac disease are straight-forward: A diet which avoids the protein gluten which is found in barley, rye and wheat is the accepted treatment. For someone with celiac-like symptoms, confirmatory testing can be performed quickly and easily at home with a Celiac / Gluten-Gliaden Sensitivity Panel .

Other complaints are less cut-and-dried and without extensive testing to determine the true cause of a food-caused gastrointestinal upset sufferers can spend years, even decades in pursuit of an offending food. What seems to cause an allergic reaction at one meal may or may not be the true culprit, and many people deprive themselves of important nutrition by eliminating one food after another from their diet. For these people food allergy and sensitivity testing can save untold misery. Performed at home, a Food Intolerance Profile can provide valuable answers quickly and easily.

It is also worth remembering that not all “allergies” and “intolerances” are permanent. With careful management intestinal complaints that are sometimes incorrectly attributed to “allergies” can be made to go away and never return.

Neurological disorders such as epilepsy, ALS, bipolar disorder, depression, autism can all be addressed with diet. Some of the diets, such as the Ketogenic diet for childhood epilepsy have a long and successful history of use (prior to falling into disfavor with the introduction of “anti-seizure” drugs) while other diets claim success by reducing sugars and simple carbohydrates, eliminating food preservatives, colorings, and other synthetic additives, or avoiding stimulants such as caffeine.

While diet is not well accepted as being a factor in ADD/ADHD by conventional medicine there are legions of mothers of hyperactive children who will disagree and who have excellent results with variations of low carbohydrate diets. Others have found that food allergies play a significant role in abnormal behaviors. In children the Food Intolerance Profile can help isolate food allergies that may be causing behavioral problems.

While depression is acknowledged by conventional medicine to be a result of certain forms of malnutrition, is rarely addressed through diet by conventional practitioners who rely instead on drug treatments. Bipolar disorder, anxiety disorders, alcoholism, and a variety of other neurological and psychiatric disorders have been successfully addressed with diet, especially low-carbohydrate diets rich in essential fatty acids which serve as precursors to vital neurotransmitters.

Pregnancy and weight gain are also reasons for manipulating diet – with athletes and body-builders seeking to improve endurance and build muscle mass, and women in pregnancy following the old adage that they are “eating for two.” Recovery from illness or injury often involves weight restoration as well.

Conventional dietary advice for all these circumstances is usually to follow a diet rich in carbohydrates. This usually does have the effect of rapidly adding weight, but the weight gain is usually that of fluid and fat mass rather than healthy lean muscle. Remember, the body requires protein to build muscle – not carbohydrates. Carbohydrates are useful as a source of energy but contribute nothing more than that. Essential fatty acids and essential amino acids are required in abundance if any tissue building is to be done.

The stated requirements for increased dietary intake during pregnancy vary from source to source – each “expert” having a slightly different opinion. An overall energy increase of from 200 to 300 Kcal is usually recommended, but mostly during the last trimester of pregnancy.

Proteins (essential amino acids) must be available in abundance to provide for the formation of a healthy placenta and fetus and to prevent sacrifice of maternal protein (muscle mass) to the developing fetus.

Essential fatty acids play a vital role in many functions both maternal and fetal. Omega-3 fatty acids increase blood flow to reproductive organs and help regulate reproductive hormones. Consumption is also known to help prevent premature delivery and low birth weight. Other essential fatty acids play a role in brain and nervous system development.

In addition to increased intakes of the essential macronutrients (fats and proteins) micronutrients must be adequate or fetal development and health will suffer. Folate is one of the better known of the micronutrients since a deficiency can lead to neural tube defects and other serious problems.

Inflammation reduction is often given as a reason for following special diet regimens. An anti inflammation diet usually restricts refined carbohydrates – foods that elevate insulin and glucose levels, and raise levels of pro-inflammatory cytokines (chemical messengers). Also restricted are Omega 6 fatty acids which are inflammatory. Omega 3 and Omega 9 fatty acids as found in fish oil and olive oil are anti inflammatory and are encouraged. Fresh fruits and vegetables are encouraged for their inflammation-reducing antioxidants and organically raised meats and eggs are encouraged as protein sources. Trans fats are highly inflammatory and are prohibited in this diet. Anti inflammatory herbs and spices such as oregano, rosemary, ginger, turmeric and green tea contain bioflavonoids and polyphenols which reduce inflammation and limit the production of free radicals. Also, remember that any food that causes an allergic or intolerance reaction will be causing inflammation too – so Food Intolerance Profile testing for allergens is very helpful.

In Summary…

• Everyone is on a “diet” of some sort (since diet means “way of life”)
• Some “diets” are followed for moral reasons, others for medical reasons.
• The food intake of our “diet” provides us with energy – measured as “calories”
• Of the three food types that we consume for energy, only two are “essential” to life (proteins and fats)
• Almost every medical condition will respond to changes in dietary intake – many responding dramatically
• Conventional doctors and dieticians tend to favor diets low in fats and animal proteins and higher in “good” carbohydrates, even though proof for this is scant and conflicting
• A growing number of practitioners are recognizing that traditional dietary advice may be flawed and that diets that feature lowered carbohydrate intake and increased protein and fats are safe and highly effective for many conditions
• While fats and proteins are essential nutrients, carbohydrates are not – and they contribute to inflammation
• Food allergies are common, but not necessarily life-long

Next, we’ll look at some of the more trendy or popular diets with some thoughts on their strengths, weaknesses, and even dangers. We’ll also look at vitamins, minerals, and micronutrients to see how and where they fit into the dietary picture. Finally, we’ll look at how to put all this knowledge together and look at Nutrition Facts Boxes on foods so that we can make better dietary decisions.

References

1. Zhao Z, Lange DJ , Voustianiouk A, et al. A ketogenic diet as a potential novel therapeutic intervention in amyotrophic lateral sclerosis.BMC Neuroscience 2006, 7:29. (PMID 16584562).
2. Ketogenic diet to be tested in adults with ALS Medicalpost.com, May 2, 2006
3. Application of a ketogenic diet in children with autistic behavior: pilot study J Child Neurol. 2003 Feb;18(2):113-8, PMID: 12693778
4. Ketogenic diet in bipolar illness PMID: 12047499
5. The ketogenic diet may have mood-stabilizing properties PMID: 11918434
6. A low-carbohydrate, ketogenic diet to treat type 2 diabetes Nutrition & Metabolism, 1 December 2005
7. Can a High-Fat Diet Beat Cancer? Time magazine, Sep. 17, 2007
8. Calorie-restricted diet can fight against cancer? Published in the October 4, 2007 Edition of The Heights
9. Williamson CS (2006). “Nutrition in pregnancy”. British Nutrition Foundation 31: 28–59.
10. Leite JO, DeOgburn R, Ratliff J, Su R, Smyth JA, Volek JS, McGrane MM, Dardik A, Fernandez ML. Low-carbohydrate diets reduce lipid accumulation and arterial inflammation in guinea pigs fed a high-cholesterol diet. Atherosclerosis. 2010 Apr;209(2):442-8. Epub 2009 Oct 12