Diets are short-term solutions to weight loss

You can trim down quickly on the Atkins diet and others, but the best way to lose weight and keep it off is to make lifestyle changes.

By DR. DAVID LIPSCHITZ, Special to the Times
Published May 15, 2007

How best to lose weight and keep it off is a national obsession. Of the many weight loss programs available, the Atkins diet is the most controversial.

Dr. Robert Atkins thought that the best way to lose weight is to become a true carnivore: Eat steak, bacon and as much fat as you want, but at all costs, avoid carbohydrates. No rolls, pasta or potatoes. Even fruit is limited.

And the diet does work. Pounds melt off and surprisingly, despite the fat intake allowed, total and "bad" or LDL cholesterol falls, metabolism improves and risk of diabetes decreases. It seems too good to be true.

Those who oppose the Atkins diet raise serious questions about the long-term effects of a high-fat diet that may increase the risk of breast, colon and prostate cancers, heart attacks, strokes and even Alzheimer's disease.

But the diet's proponents argue that limiting carbohydrates significantly reduces total calorie intake, improves the ability of insulin to function and lowers blood pressure.

The antithesis of the Atkins diet is one developed by Dr. Dean Ornish, whose vegetarian diet is rich in fruits, vegetables and complex carbohydrates. Fat intake is kept at a minimum.

In combination with lifestyle changes, rigorous study indicates that this weight loss program promotes a longer life and decreases risk of heart attacks in healthy people and in those with severe coronary artery disease.

Between Ornish and Atkins is the Zone diet, based on the principle that excess insulin, a hormone that controls blood sugar, leads to increased appetite and preferential formation of fat at the expense of muscle.

To assure that insulin levels are in the ideal "zone," every meal must be balanced and the proportion of total calories as carbohydrates, fat and protein is strictly controlled.

Staying on the Zone diet and preparing your own meals is most difficult. Realistically, the only way to participate in it is to purchase prepared meals.

To determine which diet is best, the National Institutes of Health funded a study that compared the effectiveness of the three approaches to weight loss in more than 300 overweight, premenopausal, women.

The researchers also compared these diets with one that most clinical nutritionists thought to be ideal. Called LEARN (Lifestyle, Exercise, Attitudes, Relationships and Nutrition), it consists of a diet low in fat, high in carbohydrates and based on national guidelines for nutrient intake.

A key component is intensive counseling to assure adequate exercise and stress reduction. It emphasizes lifestyle changes.

The results of this study, recently published in the prestigious Journal of the American Medical Association, are unambiguous: Weight loss occurred most rapidly in the women on the Atkins diet.

After one year, those on the Atkins diet had lost, on average, five pounds more than the other diets. Blood pressure was lower, as was the cholesterol level.

However, the study tells us nothing about the long-term effects of a high-fat, low-carbohydrate diet. We do know that it is virtually impossible to stay on this diet indefinitely. Eventually you will be eating too much fat and too much carbohydrate - a prescription for disaster.

Quick fixes, even over one year, are never the solution. Only through total lifestyle changes will a healthier and happier life be guaranteed. Diets are only temporary fixes to weight problems.

Gerontologist David Lipschitz holds both a medical degree and a Ph.D. and is the author of "Breaking the Rules of Aging." Write to him at askdrdavid@msn.com His Web site is www.drdavidhealth.com.