Although popular diets focus on weight loss and their favorable biochemical and physiological effects, fewer investigations have evaluated the biological impact of these diets during weight maintenance. To study this issue, three popular diets—Atkins, South Beach, and Ornish—were tested in a randomized and counterbalanced crossover study between January and December 2006. Participants completed each of the three 4-week isocaloric dietary intervention phases followed by a 4-week washout period. They were weighed weekly and caloric adjustments made if weight change exceeded 1 kg. At the completion of each dietary phase, 3-day food records were analyzed, fasting blood sampled, and brachial artery reactivity testing performed. Eighteen adults completed all three isocaloric dietary phases. During the South Beach and Ornish maintenance phase, there were significant reductions in low-density lipoprotein cholesterol (11.8%; P=0.01, 16.6%; P=0.0006, respectively) compared to prediet baseline. In addition, in contrast to the Atkins maintenance phase, significant reductions in low-density lipoprotein cholesterol and apolipoprotein B levels were observed after the South Beach (P=0.003, P=0.05; repeated measures analyses of variance) and Ornish maintenance phases (P=0.0004, P=0.006, repeated measures analyses of variance). Brachial artery testing revealed an inverse correlation between flow-mediated vasodilatation and intake of saturated fat (r=−0.33; P=0.016). These data suggest that during weight maintenance, less favorable biological effects are observed during a simulated, high-fat Atkins diet when compared to the South Beach and Ornish diet. The findings support additional study in subjects with visceral obesity and the metabolic syndrome, in whom an increased risk of coronary disease at baseline may be accentuated with chronic consumption of a diet that exhibits unfavorable effects on lipids and endothelial function.
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M. Miller is an associate professor of Medicine, Epidemiology, and Preventive Medicine at the University of Maryland School of Medicine, Baltimore
V. Beach is a study coordinator and C. Mangano is a research echocardiographer, University of Maryland Medical Center, Baltimore
C. Dobmeier is a registered dietitian and D. Novacic is a medical resident, University of Maryland Hospital, Baltimore
J. Rhyne is a research assistant, University of Maryland and Baltimore VA Medical Center, Baltimore
R. A Vogel is professor of medicine, University of Maryland School of Medicine, Baltimore
J. D. Sorkin is chief, Biostatistics and Informatics, University of Maryland School of Medicine Division of Gerontology and Baltimore VA Medical Center, Baltimore
Accepted: September 25, 2008
© 2009 American Dietetic Association. Published by Elsevier Inc. All rights reserved.
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- Authors' ResponseJournal of the American Dietetic AssociationVol. 109Issue 9
- PreviewFeinman raises the suggestion that saturated fat intake had little effect on flow-mediated dilation because individuals who consumed lower amounts of saturated fat were “most as likely” to show a reduction in flow mediated vasodilation (FMD) compared to when higher saturated fat was consumed. These conclusions are based upon subdividing the groups by FMD (positive or negative response) and stratifying saturated fat intake by using an artificial cut-point. However, this interpretation is misguided for the following reasons.
- Saturated Fat and Vascular ComplianceJournal of the American Dietetic AssociationVol. 109Issue 9
- PreviewThe recent paper by Miller and colleagues (1) reported “an inverse correlation between flow-mediated vasodilatation and intake of saturated fat (r=0.33; P<0.016). These data suggest that during weight maintenance, less favorable biological effects are observed during a simulated, high-fat Atkins diet when compared to the South Beach and Ornish diet.” An analysis of their data, however, shows the opposite: consistent with the poor correlation coefficient, saturated fat intake had little effect on flow-mediated dilatation.