DURHAM, N.C. -- People who followed a low-carbohydrate, high-protein diet lost more weight than people on a low-fat, low-cholesterol, low-calorie diet during a six-month comparison study at Duke University Medical Center. However, the researchers caution that people with medical conditions such as diabetes and high blood pressure should not start the diet without close medical supervision.

"This diet can be quite powerful," said lead researcher Will Yancy, M.D., an assistant professor of medicine at Duke University Medical Center and a research associate at the Veterans Affairs Medical Center in Durham, N.C. "We found that the low-carb diet was more effective for weight loss," Yancy added. "The weight loss surprised me, to be honest with you. We also found cholesterol levels seemed to improve more on a low-carb diet compared to a low-fat diet."

The study is the first randomized, controlled trial of an Atkins-style diet approach, which includes vitamin and nutritional supplements. Along with losing an average of 26 pounds, dieters assigned to the low-carbohydrate plan lost more body fat, and lowered their triglyceride levels and raised their HDL, or good cholesterol, more than the low-fat dieters. The low-fat dieters lost an average of 14 pounds. Though the low-fat diet group lowered their total cholesterol more than the low-carb dieters, the latter group nearly halved their triglycerides and their HDL jumped five points. The low-carbohydrate group reported more adverse physical effects, such as constipation and headaches, but fewer people dropped out of the low-carbohydrate diet than the low-fat diet.

The results appear in the May 18, 2004, issue of the Annals of Internal Medicine. The research was funded by an unrestricted grant from the Robert C. Atkins Foundation. The study authors have no financial interest in Atkins Nutritionals, Inc.

The study builds on earlier results by the Duke University Medical Center researchers showing a low-carbohydrate diet can lead to weight loss -- the first study of the low carbohydrate diet since 1980. Yancy and co-investigator Eric Westman, M.D., are currently testing whether a low-carbohydrate diet can help diabetics control their blood sugar levels.

Despite the considerable weight loss experienced by the low-carbohydrate dieters, Yancy does not recommend an Atkins-style plan for patients attempting to lose weight for the first time.

"Over six months the diet appears relatively safe, but we need to study the safety for longer durations," Yancy said. He also cautioned that the diet could present certain health risks, such as elevations in LDL cholesterol levels, bone loss, or kidney stones. This and other recent studies of the low-carbohydrate diet have not demonstrated that these health risks occur over short durations, but they might occur in people on the diet for long-term. It is especially important that people on diuretic or diabetes medications be monitored by a doctor because the low-carbohydrate diet affects hydration and blood sugar levels, Yancy said.

The 120 study participants were randomly assigned to either the low-carbohydrate, high-protein diet or the low-fat, low-cholesterol, low-calorie diet. All were between 18 and 65 years old and in generally good health, with a body mass index (BMI) between 30 and 60, indicating obesity, and a total cholesterol level of more than 200 mg/dL. None had tried dieting or weight loss pills in the previous six months.

The low-carbohydrate group was permitted daily unlimited amounts of animal foods (meat, fowl, fish and shellfish); unlimited eggs; 4 oz. of hard cheese; two cups of salad vegetables such as lettuce, spinach or celery; and one cup of low-carbohydrate vegetables such as broccoli, cauliflower or squash. They also received daily nutritional supplements recommended by Atkins -- a multivitamin, essential oils, a diet formulation and chromium picolinate. There were no restrictions on total calories, but carbohydrates were kept below 20 grams per day at the start of the diet.

The low-fat, low-cholesterol, low-calorie group followed a diet consisting of less than 30 percent of daily caloric intake from fat; less than 10 percent of calories from saturated fat; and less than 300 milligrams of cholesterol daily. They were also advised to cut back on calories. The recommended daily calorie level was 500 to 1,000 calories less than the participant's maintenance diet -- the calories needed to maintain current weight.

Study participants were encouraged to exercise 30 minutes at least three times per week, but no formal exercise program was provided. Both sets of dieters had group meetings at an outpatient research clinic regularly for six months. Others members of the Duke research team were Maren Olsen, Ph.D.; John Guyton, M.D.; Ronna Bakst, R.D.; and Eric Westman, M.D., who was co-principal investigator for the study. The researchers maintained exclusive control of all data and analyses.

Source: Duke University

I'm so pleased that there is a growing body of peer-reviewed research confirming what many of us have discovered for ourselves.

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Hi all,

Thanks for this opportunity. I've been coming to the site for many months now. This is first time ive posted.
My story as of today is 164 lb weight loss from 6 foot 2 388lbs to 224lbs. I'm basically at my goal or maybe just a few more lbs would be nice. Needless to say Im enjoying life now and having been on many low fat diets which I would eventually fail, I truly feel this is the solution to my weight problem.
This thing we call low carb was basically my last desparate attempt to do it on my own before resorting to the gastric bypass surgery. I never in my life dreamed that this diet would work. In fact I figured it to be impossible and basic "BS" that you could eat hamburgers & cheese and cream and still lose weight.
I'm so glad I finally tried low carbing. I see others who currently suffer like I did and are unaware that this solution really does work. I just want to grab them by the arms and tell them to do this and you too will succeed. I think there are a lot of people like me who refuse to try because they think it wont work and they dont want to fail again. Its tuff to convince someone who has been told all their life that calories and fat matter most that this style of eating will lead to weight loss. I myself started the process with the mindset that it would not work. But I was truly desparate and had nothing to lose--other than the 164 lbs that is.
HERE'S WHY IM WRITING:
I've been on this diet for some thirteen months. My concerns are about the longterm effects. I continue to keep my carbs VERY LOW on a per day basis. If I exceed 25 Carbs or more I gain weight. Hence I find myself some days not eating veggies or the cheese or the other foods which have carb in them. I truly do not find it difficult to only eat foods with little or no carbohydrate in them. This wasnt the case in the beginning. However I will say those darn pizza hut commercials with them pulling the slices off the pie still get to me. Am I hurting myself if I dont eat the veggies or the cheese everyday? I religiously take the atkins basic 3 vitamin three times @ day and also the Atkins essential oils two times a day. But I noticed in this article we are responding to that they mentioned a chromium type vitamin. Is this something I should be taking?
I eat tremendous quantities of food each day. But so long as it is of the low carb variety I either stay the same or continue to lose. I exercise vigorously nearly everyday--jogging 4.5 to 5 miles. So I personally disagree with the theories of how low carb dieting adversely affects your energy levels. I love eating chicken and hamburger and other meats each day. I also eat lots of sunflower seeds and acceptable sweets. This consists of either jello mixed with real cream in a whip type dessert-- which is truly delicious or some of the sugar free low carb hard candies they now have available. I find these at Walmart. I am more than happy to continue with this menu.
I guess Im just asking for advice from those of you who have been on the diet much longer than me. If I stay in the induction type eating PERMANENTLY will I suffer health consequences as a result? I realize none of you have a crystal ball but your COMMENTS would be appreciated.

Also I read a little at this site about kidney stones and how low carbing creates them. The truth of the matter is I did have a kidney stone some 16 months ago well BEFORE I started low carbing. I HAVE NOT HAD ANY ADDITIONAL PROBLEMS WITH KIDNEY STONES SINCE I'VE BEEN LOW CARBING. I also forgot to mention how I got off high blood pressure medication and dropped my cholestorol some 40 points. Its been so long since that happened for me I nearly forgot. I was off the blood pressure medicine approximately 60 days after I began my low carb diet.

Thanks very much for this forum.

nickyboy, first off, congratulations! that's wonderful how well you've done. you should post your pix up in the photo gallery...

on the eating stuff. i would be less concerned about not eating cheese, which isn't essential, thank skipping the veggies, which are. you may want to consider checking with your doc about finding the right balance for you now. i'm sure your body has undergone tremendous changes with that huge amount of weight loss, and personally, i think professional support may be in order.

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If you're referring to my post, I didn't say that low-carbing causes kidney stones. It's a matter of some disagreement among pro and anti low-carb doctors. Andrea has some good articles in her database that would seem to refute the argument. However, if you're already prone to kidney stones, going low-carb won't make you LESS prone.

About the safety of staying on induction for a long time... There may be some controversy about this too. I think Doc Atkins would have said that it was safe but unnecessary. Maybe somebody can find an appropriate quote.

Sooner or later, your body adjusts to whatever level of carb intake you're at. That magical first rush of weight loss that people experience during the early days of induction will eventually slow down. Staying at too low a level of carbs just makes your life more difficult without necessarily providing significantly better results.

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