Abstract
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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Biography
M. Miller is an associate professor of Medicine, Epidemiology, and Preventive Medicine at the University of Maryland School of Medicine, Baltimore
Biography
V. Beach is a study coordinator and C. Mangano is a research echocardiographer, University of Maryland Medical Center, Baltimore
Biography
C. Dobmeier is a registered dietitian and D. Novacic is a medical resident, University of Maryland Hospital, Baltimore
Biography
J. Rhyne is a research assistant, University of Maryland and Baltimore VA Medical Center, Baltimore
Biography
R. A Vogel is professor of medicine, University of Maryland School of Medicine, Baltimore
Biography
J. D. Sorkin is chief, Biostatistics and Informatics, University of Maryland School of Medicine Division of Gerontology and Baltimore VA Medical Center, Baltimore
Article info
Publication history
Accepted:
September 25,
2008
Identification
Copyright
© 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.
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- 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.
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- Preview
