https://jamanetwork.com/journals/jama/fullarticle/200094
Comparison of the Atkins, Ornish, Weight Watchers, and Zone Diets for Weight Loss and Heart Disease Risk Reduction A Randomized Trial
Michael L. Dansinger, MD; Joi Augustin Gleason, MS, RD; John L. Griffith, PhD; et al
We conducted a 1-year randomized trial of the dietary component of the Atkins, Zone, Weight Watchers, and Ornish plans, aiming to determine their realistic clinical effectiveness and sustainability for weight loss and cardiac risk factor reduction.
Our results support a growing body of research suggesting that carbohydrate restriction and saturated fat restriction have different effects on cardiovascular risk profiles. Low carbohydrate diets consistently increase HDL cholesterol,17,20 and low–saturated fat diets consistently decrease LDL cholesterol levels.34 Low carbohydrate diets have typically been more effective for short-term reduction of serum triglycerides, glucose, and/or insulin.
These findings may suggest to some clinicians that the degree to which a patient exhibits features of the metabolic syndrome might guide the degree of carbohydrate restriction to recommend. In the long run, however, sustained adherence to a diet rather than diet type was the key predictor of weight loss and cardiac risk factor reduction in our study.
In conclusion, poor sustainability and adherence rates resulted in modest weight loss and cardiac risk factor reductions for each diet group as a whole. Cardiac risk factor reductions were associated with weight loss regardless of diet type, underscoring the concept that adherence level rather than diet type was the key determinant of clinical benefits. Cardiovascular outcomes studies would be appropriate to further investigate the potential health effects of these diets. More research is also needed to identify practical techniques to increase dietary adherence, including techniques to match individuals with the diets best suited to their food preferences, lifestyle, and medical conditions.
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