• Dietary analysis each time they complete questionnaires
• Access to a nutritionist to ask questions online
• Monthly newsletters on controlled carbohydrate topics and other health-related topics
• Controlled carbohydrate recipes

 
Dr. CJ Segal-Isaacson, assistant clinical professor of epidemiology and population health at Albert Einstein College of Medicine, has been a nutritionist in the field of weight control and eating disorders for more than two decades. Seeing the need for alternative weight control approaches, she began conducting research on controlled carbohydrate dieters three years ago. Over 6,000 people who had used controlled carbohydrate diets participated in her Low Carbohydrate Weight Loss Diet Study, the pilot study for CCARBS. The results of this study were presented at the most recent American Dietetic Association’s conference in October 2002.
 
BBC DIET TRIALS LEND FURTHER SUPPORT TO THE GROWING BODY OF U.S. EVIDENCE THAT ATKINS IS EFFECTIVE AND SAFE WHILE LOWERING CARDIOVASCULAR RISK FACTORS
 
In conjunction with The British Heart Foundation (BHF), the BBC begins airing a year long, 14-part series entitled, “Diet Trials” on March 16, 2003 on BBC One. With over 300 participants, “Diet Trials” examines the UK’s most popular diets (Atkins, Weight Watchers, Slim Fast and Rosemary Conley’s Eat Yourself Slim Diet and Fitness Plan) through a free-living, scientific and independent study led by the University of Surrey. After a six-month test period, Atkins was shown to be a safe and effective weight-loss plan and it lowered various cardiovascular risk factors like triglycerides while raising heart-healthy HDL or “good” cholesterol.
 
REDUCTION IN EPILEPTIC SEIZURES FOUND WITH HIGH-FAT, LOW-CARBOHYDRATE DIET
 
A group of British researchers recently reported that a high-fat, low-carbohydrate diet can drastically cut seizures in children with severe epilepsy and could reduce the need for medication.
 
Researchers at Great Ormond Street Hospital in London, led by Dr. Helen Cross, put 14 children on a high-fat, low-carbohydrate diet. After three months, the reduction in seizures was 50% in seven of the children. Four children had a reduction of 75 percent. The researchers found that the effect of the diet varies, but it appears to work in a significant proportion of children.
 
Dr. Cross plans to recruit 120 children for the study, which will be the largest of its kind in Britain. (Publication pending).
 
RECENT STUDIES
 
INDEPENDENT STUDY SHOWS STARTLING IMPROVEMENTS TREATING METABOLIC SYNDROME WITH THE ATKINS NUTRITIONAL APPROACHTM
 
At the Nutrition Week 2003 national meetings this past January, Dr. Joseph T. Hickey, a board-certified internist at Heritage Medical Center, Hilton Head, S.C., presented preliminary results on 122 patients with metabolic syndrome who had been treated over a period of up to 18 months with a carbohydrate-restricted diet. The study subjects were instructed to follow the Induction and then the Ongoing Weight Loss or Maintenance program as described in the current edition of Dr. Atkins’ New Diet Revolution. The goal of the study was not weight loss, but to lower risk factors associated with metabolic syndrome.
 
Metabolic syndrome occurs frequently in a large segment of the adult population in industrialized countries. It is produced by genetic, hormonal and lifestyle factors such as obesity, physical inactivity and certain nutrient excesses. This syndrome includes insulin and lipid (cholesterol) problems that usually lead to hardening of the arteries, hypertension, obesity, noninsulin-dependent diabetes, all aspects of cardiovascular disease and other disorders and diseases. Of perhaps greatest concern, metabolic syndrome increases the risk of heart disease four to six times over the average rate.
 
The best way to identify the metabolic syndrome is with lipoprotein subclass analysis, performed at Liposcience in Raleigh, N.C. In his study, Dr. Hickey identified 122 patients with pronounced metabolic syndrome and counseled them on carbohydrate restriction. Compliance was measured by urinary ketones. He measured their lipoprotein subclasses over a six to 18 month period. The results showed that carbohydrate restriction according to Atkins protocols significantly lowered all of the risk factors that are related to heart disease in the metabolic syndrome, namely small dense LDL (bad cholesterol), which was reduced by an average of 82 percent, and large protective HDL (good cholesterol), which increased by an average of 30 percent.
 
During the first month of the study, subjects were maintained at 20 grams or less of carbohydrates per day and then were individualized up to 30 to 50 grams per day for the next 17 months. Overall, the average was 30 grams per day. The study was privately funded by Dr. Hickey. (Publication pending).
 
WEIGHT-LOSS ADVANTAGE OF HIGH-PROTEIN FOODS CONFIRMED BY UNIVERSITY OF ILLINOIS STUDY
 
Researchers from the University of Illinois at Urbana-Champaign, Ill., recently studied the amino acid leucine, found in high-protein animal foods (beef, chicken, fish, milk products and eggs), and discovered it may play a major role in losing fat and maintaining muscle.
 
Published in the February issue of the Journal of Nutrition, Donald Layman, PhD, compared a high-protein, leucine-rich diet with a high-carbohydrate diet on 24 middle-aged women who averaged about 182 pounds. All the women consumed about 1,700 calories per day, but the protein-rich group took in approximately 30 percent of their calories from protein, 41 percent from carbohydrates, and 29 percent from fat sources. They averaged about 125 grams of protein daily, with a goal of 0.73 grams for each pound of body weight.
 
The women ate about 10 ounces of meat daily over the 10-week study—including one beef serving—as well as three servings of low-fat milk or cheese and at least five servings of vegetables. Meanwhile, the high-carbohydrate group ate only half as much protein, getting 16 percent of their total calories in protein, 58 percent from carbohydrates, and 26 percent from fat. They averaged 0.36 grams of protein per pound of body weight.
 
While weight loss was about 16 pounds for all the women, those in the high-protein group lost more body fat and retained more lean muscle than those in the high-carbohydrate group. Dr. Layman also found that several months after the study was concluded, the high-protein group continued to lose weight while the high-carbohydrate group did not.
 
The study also showed that women in the high-protein group were less hungry between meals and also experienced more stable blood glucose levels and reduced insulin response following meals than the high-carb group. Both groups had reductions in total blood cholesterol, but the high-protein group also had decreased triglyceride levels.
 
Reference: Layman, D, Boileau, R, Erickson, D, et al., "A Reduced Ratio of Dietary Carbohydrate to Protein Improves Body Composition and Blood Lipid Profiles During Weight Loss in Adult Women," Journal of Nutrition, 133(2), 2003, pages 411-417.
 
DEMAND FOR REVISED FOOD GUIDE PYRAMID AND DIETARY GUIDELINES CONTINUES WITH BACKING OF HARVARD RESEARCHERS
 
In a study, published in the December 2002 issue of the American Journal of Clinical Nutrition, Harvard University and American Cancer Society (ACS) researchers are calling for revisions to the decade-old USDA Food Guide Pyramid and the Dietary Guidelines for Americans, last revised and published in 2000. The researchers argue changes in both nutritional education tools could reduce the risk of chronic diseases in Americans. The general concern revolves around the lack of distinction between good fats and bad fats, as well as a lack of distinction between types of protein in both the Pyramid and the Guidelines.
 
The study analyzed the diets of over 150,000 men and women participating in the Health Professionals Follow-up Study and the Nurses Health Study over 15 years. Those subjects who followed an alternative diet to the one advocated by the Food Guide Pyramid, specifically a diet that distinguished between good and bad fats and carbohydrates, had a lower overall risk of chronic disease (40 percent for men and 30 percent for women).
 
The current Pyramid, according to the researchers, over-emphasizes carbohydrates and combines different types of fats and proteins into the same groups. Study authors recommend the pyramid base of starches and grains be replaced with exercise and then healthy fats such as olive oil, followed by whole grains. Breads and refined starches should be minimized at the top of the pyramid. Other recommendations include daily consumption of four servings of fruit, 15 grams of cereal fiber, one serving of nuts and soy protein and a multivitamin supplement.
 
Reference: McCullough, M.L., Feskanich, D., Stampfer, M.J. et al. “Diet quality and major chronic disease risk in men and women: moving toward improved dietary guidance”. American Journal of Clinical Nutrition, 76(6), 2002, pages 1261-1271.
 
DANISH RESEARCHERS DISPROVE BONE-LOSS CRITICISM AIMED AT HIGH-PROTEIN FOLLOWERS
 
A study recently published in Obesity Research, out of the Department of Human Nutrition, The Royal Veterinary and Agricultural University, examined the long-term effect of dietary protein on bone mineralization. Sixty-five overweight or obese subjects were enrolled in a six-month dietary-intervention study comparing high-protein (107.8 grams/day) or low-protein (70.4 grams/day) intake with equal fat intake in both groups. The total weight loss after six months was greater in the high-protein group (8.9 kilograms) than in the low-protein group (5.1 kilograms). In fact, bone mineral loss, after being adjusted for differences in fat loss, was greater in the low-protein group than in the high-protein group. While body fat loss was the major determinant of bone mineral content loss, the study found no adverse effects of six months of high-protein intake on bone mineral content.
 
Reference: Skov, A.R., Haulrik, N., Toubro, S., et al., "Effect of Protein Intake on Bone Mineralization during Weight Loss: A 6-Month Trial," 10(6), 2002, Obesity Research, pages 432-438.
 
CANADIAN EXPERTS DEMONSTRATE BENEFICIAL HEALTH AND HEART EFFECTS OF A LOW-CARBOHYDRATE DIET ON WOMEN
 
The Canadian Journal of Physiology and Pharmacology recently published a study out of the University of Guelph that examined the effects of a very-low-carbohydrate diet on weight loss and health in overweight women. Twenty women completed the eight-week trial that significantly reduced their daily carbohydrate intake (from 232 grams to 71 grams) and calories (from 1996 to 1366 calories/day), while protein and fat remained the same. The average weight loss was 11 pounds and body mass index decreased with a loss of 3.4 percent body fat. Systolic blood pressure significantly decreased by an average of nine mmHg and diastolic blood pressure also went down by seven mmHg. Also, total cholesterol decreased, which was accounted for by a decrease in low-density lipoprotein cholesterol (LDL or “bad” cholesterol) with no change in high-density lipoprotein cholesterol (HDL or “good” cholesterol). Total triglycerides were also greatly reduced, as was the ratio of triglyceride/HDL. Also, there were no significant changes in fasting blood sugar, fasting insulin, glucose tolerance, free or total insulin-like growth factor.
 
The researchers concluded that calorie reduction aside, carbohydrate restriction to 70 grams or less with concomitant energy restriction, without changes in protein or fat consumption, promotes weight loss, improvements in body composition, blood pressure and blood lipids without compromising glucose tolerance in moderately overweight women.
 
Reference: Meckling, Kelly A.; Gauthier, Melanie; Grubb, Rebecca; Sanford, Jennifer, “Effects of a hypocaloric, low-carbohydrate diet on weight loss, blood lipids, blood pressure, glucose tolerance, and body composition in free-living overweight women”, Canadian Journal of Physiology and Pharmacology, Vol. 80 Issue 11, November 2002, pgs. 1095-1105.
 
COMPREHENSIVE REVIEW SHOWS LITTLE SUPPORT FOR POPULAR CRITICISMS OF LOW CARBOHYDRATE DIETS
 
In the November 2002 issue of the Cleveland Clinic Journal of Medicine, researchers examined approximately 50 scientific studies featuring very-low-carbohydrate diets (less than 50 grams of carbohydrate per day). Based on the hypothesis that there is a lack of scientific evidence for the criticisms against such diets, the researchers, Jeff S. Volek, PhD, RD, of the University of Connecticut, and Eric C. Westman, MD, MHS of Duke University, were surprised to find a significant amount of scientific data showing positive metabolic responses to very-low-carbohydrate diets.
 
The key points of their findings are the following:
 
 

• Much of the criticism is based on a misunderstanding of Atkins protocols. Many critics attribute issues associated with protein-sparing fasts to controlled carbohydrate diets.
• In most of the studies, people lose more weight on very-low-carbohydrate diets than on standard weight-loss diets.
• Mechanisms of weight loss on very-low-carbohydrate diets may go beyond water loss, and include appetite suppression and increasing the metabolic rate.
• Weight loss is usually associated with reductions in lean body mass, but individuals following a very-low-carbohydrate diet tend to lose less lean body mass compared with individuals following a low-fat diet.
• Very-low-carbohydrate diets have favorable effects on cardiovascular disease risk factors.