From Medscape Diabetes & Endocrinology

Low-Carbohydrate, High-Protein Diets Physicians are often asked about the safety and efficacy of low-carbohydrate, high-protein diets. Unfortunately, very few controlled studies have evaluated these popular regimens. These diets, which are often high in fat, raise concerns about their effects on lipid levels. One such diet, the Atkins Diet, restricts carbohydrates and encourages unlimited consumption of protein and fat. Preliminary results were presented from a 3-center (University of Pennsylvania, University of Colorado, Washington University) randomized controlled trial comparing the Atkins Diet with a conventional low-fat, high-carbohydrate plan that restricted daily caloric intake to 1200-1500 kcal for women and 1500-1800 kcal for men.[10] The study included 63 obese (BMI 33.8 ± 3.4 kg/m2) males and females who were randomized to 1 of the 2 diets. Subjects received an initial session with a dietitian to explain the assigned diet program. At 12 weeks, the researchers found that the Atkins group had a lower rate of attrition (12%) compared with that of the conventional program (30%). In addition, subjects in the Atkins group lost significantly more weight (8.5 ± 3.7%) compared with the conventional group (3.7 ± 4.0%). In terms of serum lipids, the Atkins group demonstrated slight increases in total cholesterol (TC; 2.2 ± 16.6%) and low-density lipoprotein (LDL) cholesterol (6.6 ± 20.7%), whereas the conventional group showed significant decreases in these measures (TC -8.2 ± 11.5%; LDL -11.1 ± 19.4%). High-density lipoprotein (HDL) cholesterol significantly increased in the Atkins group (11.5 ± 20.6%) but did not change in the conventional group, whereas triglycerides showed a significant decrease for the Atkins group (-21.7 ± 27.9%) and no change in the conventional group. At 26 weeks, these changes persisted in both groups even though the sample size was smaller. The researchers concluded that the Atkins Diet produced favorable effects on weight, HDL, triglycerides, and retention compared with a conventional low-fat, low-calorie program, whereas the conventional plan was associated with more favorable effects on TC and LDL cholesterol.