Tuesday, April 10, 2007

There is Something Perverse About the Atkins Diet...

I've been crazy busy the last few weeks, but absolutely had to stop what I was doing to write about an article today - The Atkins Paradox: What Diet Studies Don't Reveal - by Christopher Wanjek, the "Bad Medicine" columnist over at LiveScience.com.

My headline above was taken directly from the column, "So why not go with Atkins if you can loose weight and eat bacon? The reason, most doctors say, is because there is something perverse about the Atkins diet."

I haven't laughed so hard in, well, a few days. And, what followed was even funnier...Consider the breakfast of a gentleman on the Atkins diet whom I encounter each morning on a commuter train eating an entire block of baloney right out of the package with one hand and washing it down with a diet Coke in his other hand. Between the salt, fat and artificial additives in the lunchmeat and soda, this simply can't be healthy.

Good golly Miss Molly!

I don't know about you, but when I read these stories about someone "on the Atkins diet" - or any carbohydrate restricted approach - doing it completely wrong, well all I can do is laugh. I'm not laughing because the poor fellow eating the bologna and diet coke breakfast is going about Atkins wrong, but because this columnist really, truly believes this guy is a good example to show how "perverse" the Atkins diet is.

For anyone who has not read Dr. Atkins' New Diet Revolution, he was pretty clear to avoid, or at least limit, processed meats - "Processed meats such as ham, bacon, pepperoni, salami, hot dogs, and other luncheon meats - and some fish - may be cured with added sugars and will contribute carbs. Try to avoid meat and fish products cured with nitrates, which are known carcinogens." (page 124, paperback, 1992, 1999, 2002 edition)

In fact, he specifically recommended "Always aim for unprocessed natural foods and select the freshest produce you can find. If possible, purchase organic meats and dairy products." (page 130, paperback, 1992, 1999, 2002 edition)

Not exactly a ringing endorsement of bologna for breakfast each day, huh? Then again, let's not let inconvenient facts get in the way of an article promoting low-fat diets are supreme!

And this presentation of bologna & diet coke for breakfast for an Atkins dieter really isn't the biggest problem with this article.

No, the biggest problem really is the deceptive assessment of the study published in JAMA that I previously wrote about. This is how Mr. Wanjek portrayed the results:

The Atkins and Ornish data have overlapping confidence intervals. This is a measure of statistical strength given sample size and other factors. The study implies that, with 95-percent confidence, the true weight loss could be as low as 6.8 pounds for the Atkins group and as high as 8.2 pounds for the Ornish group.

In fact, the Ornish dieters were closing the gap at 12 months as the Atkins dieters were gaining weight. This supports earlier studies suggesting that a low-fat lifestyle is better at keeping off weight in the long run.

Closing the gap? Who is he kidding? Here is the graph of each group at each measurement interval:

Note that I've highlighted the Ornish group. I've done that because the contention that they "were closing the gap" and losing weight at 12-months is utter and complete hogwash. As a group, they were gaining weight since the two-month point in the study!

Then the suggestion that the overlapping confidence interval was masking some secret weight loss potential for the Ornish group - more utter and complete hogwash.

What Wanjek didn't say is important and it's that the range of weight loss in those following Ornish and Atkins. Here is the data:

Atkins 4.7kg [95% CI, -6.3 to -3.1kg]

Ornish 2.2kg [95% CI, -3.6 to -0.8kg]

Oh, there was an over-lap all right, but no matter how you slice it, those trying to follow the Atkins diet lost as little as 6.8-pounds (3.1kg) and as much as 13.9-pounds (6.3kg), with an average weight loss of 10.3-pounds for the group. Compare that to those trying to follow the Ornish diet - weight loss was a little as1.8-pounds (0.8kg) and as much as 7.9-pounds (3.6kg) with an average weight loss of 4.8-pounds for the group.

Put another way - the least weight loss in the Atkins group was about the best in the Ornish group. Have a look for yourself:

We're supposed to be convinced that those following Ornish were doing as well as those following (or trying to) Atkins? Oh yeah, that graphic above shows just how close the two dietary approaches were...not.
Pass the nitrite-free bacon and double cream brie, thank you very much.


  1. I have to agree with you, if I am in need of a good laugh all I have to do is read another article about how good low fat is for you. NOT. What saddens me is the number of people who have likely died in the past 20 to 30 years following the low fat diets as prescribed on there Dr's advice and taking statins. It just isn't right that they can't see the forest for the trees.

  2. Anonymous5:06 PM

    Thanks for the travel tip -- I'm always looking for new things to carry on trains and planes, nuts are fun, but I get tired of them.. I never thought of bologna straight from the package. Mmmm, let's go one better. How about mortadella! -- it's got those added white meat bits to boot! That should give our stressed low fat friends on the train heart attacks and open up some seats.

    In reality, I don't think bologna for breakfast is as detrimental as it sounds. Putting the nitrate issue aside, compare bologna eating to the ubiquitous blueberry muffin for a moment. Muffins are basically cake - and I don't remember anybody's mother reminding us to eat our cake for breakfast. Yet starting from about the l980's, suddenly cake breakfast became normal.

    You're the best read on the web. Regina, please skip over your other responsibilities

  3. Hey Regina, great post as always! I read this article by Mr. Wanjek today and was so amused that I was compelled to write him a rather lengthy email. We shall see if he responds. You can find my email here.

    Keep up the great work
    Scott Kustes
    Modern Forager

  4. Anonymous2:44 PM

    I am actually amazed that while the media is still bashing the Akins Diet, physicians are starting to become aware of its benefits.

    While within a year I have felt insane with how to eat that meets everyones approval , lately instead of my physician saying, "Eat the Atkins way." It is simply, "Eat more protein...Fat isn't as bad as you think." Perhaps someone has finally sat down to read the studies and realized they can no longer ignore a diet that limits twinkies and encourages fresh produce?

  5. I guess it's just as well that I've been busier than a one-armed-paper-hanger lately, and haven't been able to make the rounds of all the anti-atkins/pro-low-fat nonsense out there, it tends to just get me upset that people are so willfully ignorant.

    I suppose I could consider them to be un-willfully ignorant if the proper information wasn't right there in front of them, in the form of DANDR describing what he really recommends eating (I wonder if the guy eating a block of bologna was losing weight? Probably was, probably was... I supect jealousy, in that the author couldn't bring himself to eat like that! LOL), and the actual study data showing that low carb clearly beats out low fat, but this guy is obviously going beyond even being willfully ignorant - talk about putting "spin" on the facts!

    Ornish closing the weight loss gap by 12 months?! What a laugh! Not even close!

  6. Great job in sorting through the statistical mumbo jumbo.

    I wonder how the author KNOWS the baloney-eating man was on Atkins. Did he ask, or did he just ASSUME that only someone on Atkins would do that? Maybe he was on a baloney diet.