Thursday, October 04, 2007

Dr. Ornish: "When You Go On An Atkins-Type Diet, You Lose Weight. But You Mortgage Your Health."

This is another in my series of posts on low-carb diets. I've been reducing the amount and changing the type of carbohydrate I eat, which by default changes the amount of fat and protein I eat. I'm wondering what the long-term effect of this pattern of eating is.

Jimmy Moore on his Livin' La Vida Low-Carb™ Blog, posted the following YouTube of a 2002 Charlie Rose program this week.

Guest Host:Guests:

The video is about an hour long. If I was pressed to characterize the three guests' endorsements of diet after watching just this video, I'd say:
  • Dr. Ornish endorses a very-low-fat diet, with reduced refined carbohydrates.
  • Dr. Howard endorses moderation, neither Ornish-style low-fat nor low-carb, with reduced refined carbohydrates.
  • Mr. Taubes avoided making an endorsement, but stressed the need for more evaluation of a low-carb diet.
I thought each of them made a case for their respective endorsements/objectives.

I was impressed most by Dr. Ornish's presentation. I haven't in the past been impressed by Dr. Ornish's low-fat (10% of calories) diet. I think it's difficult to stick with and the foods people eat to replace fat end up being highly-refined, albeit low-fat, foods which none of the panel members, nor anyone else that I've read, seems to think are good for health.

Here's what Dr. Ornish said that struck me. (This conversation starts at about 41 minutes into the video. It has to do with a diet's ability to reduce heart disease. I'm paraphrasing, but you can check my near-quotes in the video.)

Dr. Oz:
I think the panel will agree that if you're heavy you have a higher incidence of heart disease. (Everyone nodded.)

Is it also true that if you follow a diet, no matter what diet, that reduces your weight, you're better off than if you do a diet that does not reduce your weight.
Dr. Ornish:
Absolutely not. When you go on a high-fat, high-protein Atkins type diet ... you lose weight, there's no question about it, but you mortgage your health.

We're not just talking about risk factors, we're talking about disease. And when we measure the underlying disease, using state-of-the-art measures, even in people whose triglycerides went up a little or whose HDLs went down ... their LDLs went down by 40% ... they still showed [heart disease] reversal.

Markers for inflammation [C-reactive protein, fibrinogen, Lp(a)] also improve when we make these changes in diet that I recommend. In a recent randomized clinical trial [comparing Ornish, Atkins, AHA diets] these markers of inflammation were by far the lowest when people were put on a diet of the type I recommend [low-fat] and they actually got worse in people, every one of them, in people who went on an Atkins-type diet. We found 2.5 times fewer cardiac events as well in this trial.

The question is not, can you lose weight on a high-fat diet, clearly you can. That's why Dr. Atkins is selling so many books. The issue to me is, are people mortgaging their health by doing that, and the data that we do have, as imperfect that they may be, indicate that they are.

I think Dr. Ornish has a compelling argument, especially since heart disease is essentially a disease of inflammation. I'm wondering what Dr. Davis' take on this would be.

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