Reduced-Carbohydrate Diets: No Roll in Weight Management?

Editorials18 May 2004Reduced-Carbohydrate Diets: No Roll in Weight Management?Walter C. Willett, MD, DrPHWalter C. Willett, MD, DrPHFrom Harvard School of Public Health, Boston, MA 02115.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-140-10-200405180-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail For decades, nutritionists and dietitians have disparaged the very-low-carbohydrate Atkins diet because it is high in saturated fat and because its purported benefits had not been tested in formal studies. According to the conventional wisdom, a diet low in fat and high in starch reduces the risks for heart disease and cancer and promotes weight loss. However, these claims do not have solid evidence to support them. In large prospective studies, total fat intake does not predict cancer risk (1). In addition, dietary fat per se does not predict the risk for coronary heart disease in ecologic and prospective studies ...References1. Hunter DJ, Spiegelman D, Adami HO, Beeson L, van den Brandt PA, Folsom AR, et al . Cohort studies of fat intake and the risk of breast cancer—a pooled analysis. N Engl J Med. 1996;334:356-61. [PMID: 8538706] CrossrefMedlineGoogle Scholar2. U.S. National Research Council, Committee on Diet Health.. Diet and Health: Implications for Reducing Chronic Disease Risk. Washington, DC: National Academy Pr; 1989. Google Scholar3. Hu FB, Stampfer MJ, Manson JE, Rimm E, Colditz GA, Rosner BA, et al . Dietary fat intake and the risk of coronary heart disease in women. N Engl J Med. 1997;337:1491-9. [PMID: 9366580] CrossrefMedlineGoogle Scholar4. Institute of Medicine. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients). A Report of the Panel on Macronutrients, Subcommittees on Upper Reference Levels of Nutrients and Interpretation and Uses of Dietary Reference Intakes, and the Standing Committee on the Scientific Evaluation of Dietary Reference Intakes. Accessed at www.nap.edu/catalog/10490.html on 5 April 2004. Google Scholar5. Bray GA, Popkin BM. Dietary fat intake does affect obesity! Am J Clin Nutr. 1998;68:1157-73. [PMID: 9846842] CrossrefMedlineGoogle Scholar6. Willett WC. Dietary fat and obesity: an unconvincing relation [Editorial]. Am J Clin Nutr. 1998;68:1149-50. [PMID: 9846838] CrossrefMedlineGoogle Scholar7. Willett WC, Leibel RL. Dietary fat is not a major determinant of body fat. Am J Med. 2002;113 Suppl 9B 47S-59S. [PMID: 12566139] CrossrefMedlineGoogle Scholar8. Pirozzo S, Summerbell C, Cameron C, Glasziou P. Advice on low-fat diets for obesity. Cochrane Database Syst Rev. 2002;:CD003640. [PMID: 12076496] MedlineGoogle Scholar9. Brehm BJ, Seeley RJ, Daniels SR, D'Alessio DA. A randomized trial comparing a very low carbohydrate diet and a calorie-restricted low fat diet on body weight and cardiovascular risk factors in healthy women. J Clin Endocrinol Metab. 2003;88:1617-23. [PMID: 12679447] CrossrefMedlineGoogle Scholar10. Foster GD, Wyatt HR, Hill JO, McGuckin BG, Brill C, Mohammed BS, et al . A randomized trial of a low-carbohydrate diet for obesity. N Engl J Med. 2003;348:2082-90. [PMID: 12761365] CrossrefMedlineGoogle Scholar11. Yancy WS, Olsen MK, Guyton JR, Bakst RP, Westman EC. A low-carbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia. A randomized, controlled trial. Ann Intern Med. 2004;140:69-77. LinkGoogle Scholar12. Stern L, Iqbal N, Seshadri P, Chicano KL, Daily DA, McGrory J, et al . The effects of low-carbohydrate versus conventional weight loss diets in severely obese adults: one-year follow-up of a randomized trial. Ann Intern Med. 2004;140:778-85. LinkGoogle Scholar13. Samaha FF, Iqbal N, Seshadri P, Chicano KL, Daily DA, McGrory J, et al . A low-carbohydrate as compared with a low-fat diet in severe obesity. N Engl J Med. 2003;348:2074-81. [PMID: 12761364] CrossrefMedlineGoogle Scholar14. Ebbeling CB, Leidig MM, Sinclair KB, Hangen JP, Ludwig DS. A reduced-glycemic load diet in the treatment of adolescent obesity. Arch Pediatr Adolesc Med. 2003;157:773-9. [PMID: 12912783] CrossrefMedlineGoogle Scholar15. Hu FB, Willett WC. Optimal diets for prevention of coronary heart disease. JAMA. 2002;288:2569-78. [PMID: 12444864] CrossrefMedlineGoogle Scholar16. Atkins R. Atkins for Life. New York: St. Martin's Pr; 2003. Google Scholar17. Memisoglu A, Hu FB, Hankinson SE, Manson JE, De Vivo I, Willett WC, et al . Interaction between a peroxisome proliferator-activated receptor gamma gene polymorphism and dietary fat intake in relation to body mass. Hum Mol Genet. 2003;12:2923-9. [PMID: 14506127] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Harvard School of Public Health, Boston, MA 02115.Disclosures: Dr. Willett served as an unpaid consultant on a grant by the Atkins Foundation, which tests a low-carbohydrate diet.Corresponding Author: Walter C. Willett, MD, DrPH, Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoA Low-Carbohydrate, Ketogenic Diet versus a Low-Fat Diet To Treat Obesity and Hyperlipidemia William S. Yancy Jr. , Maren K. Olsen , John R. Guyton , Ronna P. Bakst , and Eric C. Westman The Effects of Low-Carbohydrate versus Conventional Weight Loss Diets in Severely Obese Adults: One-Year Follow-up of a Randomized Trial Linda Stern , Nayyar Iqbal , Prakash Seshadri , Kathryn L. Chicano , Denise A. Daily , Joyce McGrory , Monica Williams , Edward J. Gracely , and Frederick F. Samaha Metrics Cited ByIn vitro extraction of intra-corneal iron using reverse iontophoresis and vitamin CComparison of the effects of four commercially available weight-loss programmes on lipid-based cardiovascular risk factorsLiteraturThe influence of l-ascorbic acid on the antibacterial-toxic activity of aflatoxins on adsorbent layerLow-carbohydrate–high-protein diet and long-term survival in a general population cohortMethods for Nutrigenomics and Longevity Studies in DrosophilaDietSeparate effects of reduced carbohydrate intake and weight loss on atherogenic dyslipidemiaAcute prooxidant effects of vitamin C in EDTA chelation therapy and long-term antioxidant benefits of therapyNutritional Treatment in the Metabolic SyndromeMetabolic Effects of the Very-Low-Carbohydrate Diets: Misunderstood "Villains" of Human MetabolismGlycemic Index, Obesity, and Diabetes 18 May 2004Volume 140, Issue 10Page: 836-837KeywordsBloodCarbohydratesCholesterolDietFatsHigh density lipoproteinLow density lipoproteinOverweightRandomized trialsWeight loss ePublished: 18 May 2004 Issue Published: 18 May 2004 CopyrightCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...