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Atkins and other low-carbohydrate diets: hoax or an effective tool for weight loss?
Lancet 2004 Sep 4-10; 364(9437):897-9Lct

Abstract

CONTEXT

The Atkins diet books have sold more than 45 million copies over 40 years, and in the obesity epidemic this diet and accompanying Atkins food products are popular. The diet claims to be effective at producing weight loss despite ad-libitum consumption of fatty meat, butter, and other high-fat dairy products, restricting only the intake of carbohydrates to under 30 g a day. Low-carbohydrate diets have been regarded as fad diets, but recent research questions this view.

STARTING POINT

A systematic review of low-carbohydrate diets found that the weight loss achieved is associated with the duration of the diet and restriction of energy intake, but not with restriction of carbohydrates. Two groups have reported longer-term randomised studies that compared instruction in the low-carbohydrate diet with a low-fat calorie-reduced diet in obese patients (N Engl J Med 2003; 348: 2082-90; Ann Intern Med 2004; 140: 778-85). Both trials showed better weight loss on the low-carbohydrate diet after 6 months, but no difference after 12 months. WHERE NEXT?: The apparent paradox that ad-libitum intake of high-fat foods produces weight loss might be due to severe restriction of carbohydrate depleting glycogen stores, leading to excretion of bound water, the ketogenic nature of the diet being appetite suppressing, the high protein-content being highly satiating and reducing spontaneous food intake, or limited food choices leading to decreased energy intake. Long-term studies are needed to measure changes in nutritional status and body composition during the low-carbohydrate diet, and to assess fasting and postprandial cardiovascular risk factors and adverse effects. Without that information, low-carbohydrate diets cannot be recommended.

Authors+Show Affiliations

Department of Human Nutrition, Centre of Advanced Food Research, RVA University, Copenhagen, 1958 Frederiksberg C, Denmark. ast@kvl.dkNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review
Systematic Review

Language

eng

PubMed ID

15351198

Citation

Astrup, Arne, et al. "Atkins and Other Low-carbohydrate Diets: Hoax or an Effective Tool for Weight Loss?" Lancet (London, England), vol. 364, no. 9437, 2004, pp. 897-9.
Astrup A, Meinert Larsen T, Harper A. Atkins and other low-carbohydrate diets: hoax or an effective tool for weight loss? Lancet. 2004;364(9437):897-9.
Astrup, A., Meinert Larsen, T., & Harper, A. (2004). Atkins and other low-carbohydrate diets: hoax or an effective tool for weight loss? Lancet (London, England), 364(9437), pp. 897-9.
Astrup A, Meinert Larsen T, Harper A. Atkins and Other Low-carbohydrate Diets: Hoax or an Effective Tool for Weight Loss. Lancet. 2004;364(9437):897-9. PubMed PMID: 15351198.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Atkins and other low-carbohydrate diets: hoax or an effective tool for weight loss? AU - Astrup,Arne, AU - Meinert Larsen,Thomas, AU - Harper,Angela, PY - 2004/9/8/pubmed PY - 2004/9/24/medline PY - 2004/9/8/entrez SP - 897 EP - 9 JF - Lancet (London, England) JO - Lancet VL - 364 IS - 9437 N2 - CONTEXT: The Atkins diet books have sold more than 45 million copies over 40 years, and in the obesity epidemic this diet and accompanying Atkins food products are popular. The diet claims to be effective at producing weight loss despite ad-libitum consumption of fatty meat, butter, and other high-fat dairy products, restricting only the intake of carbohydrates to under 30 g a day. Low-carbohydrate diets have been regarded as fad diets, but recent research questions this view. STARTING POINT: A systematic review of low-carbohydrate diets found that the weight loss achieved is associated with the duration of the diet and restriction of energy intake, but not with restriction of carbohydrates. Two groups have reported longer-term randomised studies that compared instruction in the low-carbohydrate diet with a low-fat calorie-reduced diet in obese patients (N Engl J Med 2003; 348: 2082-90; Ann Intern Med 2004; 140: 778-85). Both trials showed better weight loss on the low-carbohydrate diet after 6 months, but no difference after 12 months. WHERE NEXT?: The apparent paradox that ad-libitum intake of high-fat foods produces weight loss might be due to severe restriction of carbohydrate depleting glycogen stores, leading to excretion of bound water, the ketogenic nature of the diet being appetite suppressing, the high protein-content being highly satiating and reducing spontaneous food intake, or limited food choices leading to decreased energy intake. Long-term studies are needed to measure changes in nutritional status and body composition during the low-carbohydrate diet, and to assess fasting and postprandial cardiovascular risk factors and adverse effects. Without that information, low-carbohydrate diets cannot be recommended. SN - 1474-547X UR - https://www.unboundmedicine.com/medline/citation/15351198/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0140673604169869 DB - PRIME DP - Unbound Medicine ER -