compare and contrast dr ornish and dr atkins

If anything, our attempts to eat less fat in recent decades have made things worse. Weight loss at 12 months was the primary outcome. If his diet worksand again, we dont know for sure that it doesis that because it reduces protein or fat or refined carbohydrates? Dr. Atkins believed that cutting off carbohydrates and sugar will also do the same. And it is worth noting that among people in the study over 65, heavy consumption of animal protein actually protected against cancer and mortality. First, I cited several large-scale studies from many different investigators, all of which showed that a diet high in red meat increases the risk of premature death from virtually all causes, even when adjusting for confounding variables. 1988;81:300-309. Here's a blog in which I addressed this issue: As Attilio Maseri, MD, an internationally known and respected cardiologist, wrote: My colleagues and I conducted a demonstration project of 333 patients from four academic medical centers and four community hospitals. If ones looks at the right data, he says, its clear that our countrys metabolic ills can be blamed on our increasing consumption of red meat and bad fatsboth of which, he says, are proved to be unhealthy. Im not cherry-picking data; Im looking at the preponderance of evidence from many studies by leading investigators such as those at Harvard School of Public Health. His dietary regimen was mostly an inverted version of the USDA pyramid that was high in fat and low in carbohydrates. But what about the claims Ornish makes about the success of his own dietdo they hold up to scrutiny? In doing large-scale studies in which people complete dietary surveys, there is often so much noiseespecially in combining data in meta-analysesthat a type 2 error often occurs (that is, the noise obscures the ability to detect statistically significant differences). Harrisons Advances in Cardiology. A paper was presented from Tufts University titled One Year Effectiveness of the Atkins, Ornish, Weight Watchers, and Zone Diets in Decreasing Body Weight and Heart Disease Risk. The researchers concluded All diets resulted in significant weight loss from baseline and all but the Ornish diet resulted in significant reductions in the Framingham risk score (45). Fiber from whole grains, but not refined grains, was inversely associated with all-cause mortality in 11,040 postmenopausal women followed for 11 years (16). Well, thats the pointwere not fat because were eating too little fat; were fat because were eating too much of everything. My colleagues and I have been training and certifying teams of health care professionals at leading hospitals, clinics and health systems in this lifestyle program for reversing heart disease. Am J Clin Nutr. Body weight is inversely associated with dietary fiber and carbohydrates and positively associated with protein intake (11). It found that individuals assigned to eat high-fat (41 percent calories from fat), Mediterranean-style diets for nearly five years were about 30 percent less likely to experience serious heart-related problems compared with individuals who were told to avoid fat. Clinical Trials in Cardiovascular Disease. Bill Clinton from 1993 to 2000 and served on the White House Commission on Complementary and Alternative Medicine Policy in 200102. RAISING AND LOWERING HDLBENEFICIAL OR HARMFUL? For example, the thenAmerican Dietetic Association published a position paper on plant-based diets in which they wrote, It is the position of the American Dietetic Association that appropriately planned vegetarian diets, including total vegetarian or vegan diets, are healthful, nutritionally adequate and may provide health benefits in the prevention and treatment of certain diseases.. She wrote about the reasons that autoimmune diseases overwhelmingly affect women in the September 2021 issue. WebWas Dr. Atkins Right? The Lifestyle Heart Trial. Am J Cardiol. 1970;27:59-67. Upon changing from high to low intake of saturated fat and cholesterol, the mean HDL-C decreased 29%, whereas apo A-I levels fell 23%. Ornish told Reuters, There has been a bit of a backlash against not only just low-fat eating, but healthy living in general. Ornish D. Dr. Dean Ornishs Program for Reversing Heart Disease. The Atkins diet has four phases: Phase 1: Induction A person consumes less than 20 grams (g) of carbs each day. You can hear some of their stories here. : How Simple Lifestyle Changes Can Reverse Most Chronic Diseases (2019; written with his wife, Anne Ornish). The effect of high-protein diets on coronary blood flow. First, shes again perpetuating the myth that when we cut out fat, we began eating foods that were worse for us. As the USDA data show, were eating more fat, not less. which types of nerves carries stimuli away from the brain?, In planning his fitness goals, Alonso wants to make sure that he improves his fitness without pushing himself too hard too fast. Zeman FJ, Hansen RJ. Samaha FF, Iqbal N, Seshadri P. A low-carbohydrate diet as compared with a low-fat diet in severe obesity. In locations such as Asia, where a low-fat diet has been the norm, HDL-C levels are low, yet the incidence of CVD is among the lowest in the world (43). This is the premise of organizations such as America on the Move (63). In: Seman FJ, ed. Second, as I made clear in the oped as well as in my books and journal articles, the diet I recommend is low in refined carbohydrates and high in good carbs such as fruits, vegetables, whole grains, legumes and soy products in their natural, unrefined forms (which tend to have low glycemic loads). Based on his experience caring for patients, Atkins thought that the things that were relegated to the narrow point of the food pyramidmeat, eggs, cream, and cheesewere the healthiest. JAMA. WHAT EVIDENCE SUPPORTS THAT HIGH-PROTEIN DIETS MAY BE HARMFUL? The March 2014 study in Cell Metabolism did distinguish between animal protein and plant-based proteins. 2002;5:110-118. A low-fat diet decreases high density lipoprotein (HDL) cholesterol levels by decreasing HDL apolipoprotein transport rates. Intensive lifestyle changes for reversal of coronary heart disease Five-year follow-up of the Lifestyle Heart Trial. Dr Atkins advocated substituting simple carbohydrates with high-fat, high-animal protein foods such as bacon, sausage, butter, steak, pork rinds, and brie. Brown MS, Goldstein JL. If you know or suspect that you have a health problem, consult a health professional. The two doctors had much in common: they both made millions from their best-selling books; Atkins graced the cover of Time while Ornish, Newsweek. In a study from Harvard School of Public Health they prospectively observed 37,698 men from the Health Professionals Follow-Up Study (19862008) and 83,644 women from the Nurses' Health Study (19802008) who were free of cardiovascular disease (CVD) and cancer at baseline. I am not against all forms of animal protein. You can eat fewer calories by consuming less food. They should not be used to make claims about cause and effect; doing so is considered by nutrition scientists to be inappropriate and misleading. The reason: People who eat a lot of animal protein often make other lifestyle choices that increase their disease risk, and although researchers try to make statistical adjustments to control for these confounding variables, as theyre called, its a very imperfect science. Ornish begins his piece with a misleading statistic. And it is worth noting that among people in the study over 65, heavy consumption of animal protein actually protected against cancer and mortality. Dansinger ML, Gleason JL, Griffith JL, Li W, Selker HP, Schaefer EJ. (This study was funded by the Atkins Center for Complementary Medicine.) The Tukey studentized range test was used to adjust for multiple testing. When you eat less fat, you consume fewer calories without having to eat less food, thereby increasing satiety without adding calories. 1999;84:339-341A8. Eating a stick of butter will raise HDL-C in those who are able to do so, but that does not mean that butter is good for the heart. A person is likely to lose more weight by reducing intake of both simple carbohydrates and fat than from simple carbohydrates alone. Diet was assessed by validated food frequency questionnaires and updated every four years. Available at: http://hin.nhlbi.nih.gov/atpiii/calculator.asp?usertype=prof . Bell EA, Rolls BJ. The Framingham risk score is calculated from age, sex, total cholesterol, HDL, smoking, and systolic blood pressure (46). Last month, an oped in The New York Times argued that high-protein and high-fat diets are to blame for Americas ever-growing waistline and incidence of chronic disease. As I mentioned above, we found significant improvements in virtually all risk factors in almost 3,000 patients who went through my lifestyle program in 24 hospitals and clinics in West Virginia, Nebraska, and Pennsylvania. Participants were randomly assigned to follow the Atkins (n = 77), Zone (n = 79), LEARN (n = 79), or Ornish (n = 76) diets and received weekly instruction for 2 months, then an additional 10-month follow-up. 1999;277:F813-F819. In addition, patients on an Atkins diet are counseled to take n-3 fatty acids in the form of fish oil (something else we agreed on), which is known to reduce triglycerides significantly. The rivalry between Atkins and Ornish was related to food intake. The effect of high-, moderate-, and low-fat diets on weight loss and cardiovascular disease risk factors. Ornish was raised in Dallas by his father, a dentist, and his mother, a childrens book author and filmmaker. We also published an analysis showing that improvements in dietary fat intake, exercise and stress management were individually, additively and interactively related to coronary risk. As all dietetics professionals know, there is no mystery in how to lose weight: burn more calories and/or eat fewer calories. In addition to fiber, complex carbohydrates and whole foods are rich in phytochemicals, bioflavonoids, carotenoids, retinols, sulforaphanes, isoflavones, and polyphenols and other substances that may reduce the risk of many chronic diseases. It found that individuals assigned to eat high-fat (41 percent calories from fat), Mediterranean-style diets for nearly five years were about 30 percent less likely to experience serious heart-related problems compared with individuals who were told to avoid fat. You can lose weight without feeling hungry or deprived. If they stop eating desserts, they consume less fat as well as less sugar. Ornish D, Brown SE, Scherwitz LW, et al. Kennedy ET, Bowman SA, Powell R. Dietary-fat intake in the U.S. population. 1993;328:1213-1219. Intensive risk factor modification. Fourth, the patients in our randomized controlled trial (JAMA. Its possible that quitting smoking, exercising and stress management, without the dieting, would have had the same effectbut we dont know; its also possible that his diet alone would not reverse heart disease symptoms. . Stevens A, Robinson DP, Turpin J, et al. Its hardly surprising that quitting smoking, exercising, reducing stress and dietingwhen done togetherimproves heart health. WebIn this article, an example of translation of the English term learning outcome into the Lithuanian system of educational terms is used to discuss semantic peculiarities of translating professional terms. Randomized controlled clinical trials, although certainly not perfect, are better tools for chipping away at causality, and they suggest that protein and fat dont deserve to be demonized. Journal of the American Medical Association 104(2004):537. The effects of weight loss on the activity and expression of adipose-tissue lipoprotein lipase in very obese humans. However, even in those with reduced numbers of LDL receptors who are not very efficient in metabolizing dietary saturated fat and cholesterol, decreasing the intake of these to a greater degree has a much bigger impact. Esselstyn CB Jr. Many dietitians and other health professionals as well as people in the general public are often confused by the fact that many people are able to lose weight on these diets. New York: MacMillan; 1933:271-322. Moyers article only adds to that confusion. DESIGN, SETTING, AND PARTICIPANTS: Am J Clin Nutr. An easier way to consume fewer calories is to eat less fat because fat (whether saturated, monosaturated, or unsaturated) has 9 kcal/g, whereas protein and carbohydrates have only 4 kcal/g. Cardiovascular effects of n-3 fatty acids. In contrast, someone who increases the amount of fat and cholesterol in their diet (eg, an Atkins diet) may increase their HDL-C because their body is trying to get rid of the extra garbage (fat and cholesterol) by increasing the number of available garbage trucks (HDL). Fiber also slows the absorption of food, thereby preventing blood glucose from rising too rapidly and reducing insulin surges. Am J Clin Nutr. It is all about energy balance. If they stop eating pasta, they are often avoiding sauces that are high in oil or cream (olive oil is 100% fat and only 1 tablespoon has 14 g fat). Paradoxically, it may sometimes be easier for people to make more comprehensive changes in diet and lifestyle because they experience the benefits so quickly and to a much greater degree (25,64). Spady DK, Dietschy JM. Ludwig DS, Pereira MA, Kroenke CH, et al. Whats more relevant to the discussion is this fact: During the time in which the prevalence of obesity in the U.S. nearly tripled, the percentage of calories Americans consumed from protein and fat actually dropped whereas the percentage of calories Americans ingested from carbohydratesone of the nutrient groups Ornish says we should eat more ofincreased. That year Ornish also founded the nonprofit Preventive Medicine Research Institute (PMRI) in nearby Sausalito. Meat has virtually no dietary fiber. Whole foodssuch as whole grain products and fruits and veggiesare healthy, but I think that dairy products, fish and lean cuts of meat or poultry can also be part of a healthy diet, Steffen says. Brody J. He says that dietary meta-analyses and systematic reviews involving humanssuch as the one I cited from 2010 that found no association between red meat consumption and heart disease or diabetescan be misleading because the noise obscures the ability to detect statistically significant differences. Meta-analyses and systematic reviews have their limitations, of course, and they must be conducted carefully. Explore our digital archive back to 1845, including articles by more than 150 Nobel Prize winners. At Pennsylvania State University, researchers found that healthy women instinctively ate about 3 lb of food a day, whether high or low in calories. In contrast, within each diet, the HDL-C and apo A-I levels were inversely correlated with apo A-I FCR both on the high-and low-fat diets but not with apo A-I transport rate (44). The fractional catabolic rate (FCR) of apo A-I increased 11%, whereas its absolute transport rate decreased 14%. Some scientists think so. Thanopoulou AC, Karamanos BG, Angelico FV, et al. (An adult who consumes two tablespoons of olive oil in, say, a portion of salad dressing has already exceeded getting 10 percent of his days calories from fat if hes eating 2,000 calories daily.). Clinical Nutrition and Dietetics. Judging the quality of a study by the number of patients is like judging the quality of a book by the number of pages. 2023 Scientific American, a Division of Springer Nature America, Inc. 2007 Jul 11;298(2):178).This says something important about the quality of that research. Lancet. Effect of 6-month adherence to a very low carbohydrate diet program. For instance, he wrote that animal proteins have been associated with higher disease and mortality risks in observational studies. Foster GD, Wyatt HR, Hill JO, et al. New York: HarperCollins Publishers; 1996. You start by eating 40 grams of net carbs, 4 to 6-ounce servings of protein and 2 to 4 servings of fat per day. The case for a low-fat, highcarbohydrate diet. When Moyer accuses me of having inadequate scientific evidence to support my statements, I must respectfully and strongly disagree. What is missing in Moyers article is the clinical experience that comes from helping people change their diet and lifestyle. J Am Diet Assoc. Thats in part because when we cut out fat, we began eating foods that were worse for us. Ornish first takes issue with the data I cite on food consumption patterns from the National Health and Nutrition Examination Survey (NHANES). Oliver MF, Yates PA. The authors also reported that among those without type 2 diabetes at baseline, those in the high animal protein group had a 73-fold increased risk of developing diabetes during the study. Secondary outcomes included lipid profile (low-density lipoprotein, high-density lipoprotein, and non-high-density lipoprotein cholesterol, and triglyceride levels), percentage of body fat, waist-hip ratio, fasting insulin and glucose levels, and blood pressure. Part of the problem in this and other studies that compare weight loss in low-fat versus low-carb diets (which is the wrong question anyway, because its the type of fats and carbs) is that adherence to different diets is often suboptimal, so its hard to make meaningful comparisons. Am J Physiol. Although this was shown in animals, it is likely true in humans as well. Ornish D, Hart J. In another study, 100 people were randomly assigned to one of four diets for 1 year: an Atkins diet; a 30% fat diet; a 15% fat, calorie-controlled diet; or a 10% fat, whole foods diet with an emphasis on complex carbohydrates. The decrease in the percentage of calories from fat during the period 1971 to 1991 is attributed to an increase in total calories consumed; absolute fat intake in grams actually increased. Mean 12-month weight loss was as follows: Atkins, -4.7 kg (95% confidence interval [CI], -6.3 to -3.1 kg), Zone, -1.6 kg (95% CI, -2.8 to -0.4 kg), LEARN, -2.6 kg (-3.8 to -1.3 kg), and Ornish, -2.2 kg (-3.6 to -0.8 kg). Ornish said that the Atkins diet contributed to his impotence and poor breath. Twenty-eight were assigned to his low-fat, plant-based diet and 20 were given usual cardiac care. These include a whole foods, plant-based diet low in refined carbohydrates, moderate exercise, stress management techniques and social support. Prev Cardiol. The percentage of calories from fat has decreased, but the amount of fat consumed has increased (6). Fleming R, Boyd LB. CA Cancer J Clin. The point here is not that Ornishs dieta low-fat, whole food, plant-based approachis necessarily bad. 2002;40:265-274. Eating a high glycemic index food along with mostly low glycemic index foods may reduce the overall glycemic load of the meal. Other large observational studies have found that diets high in fat and protein are not associated with disease and may even protect against it. In addition to promoting weight loss, Atkins claimed that this diet may help people prevent heart disease, diabetes, and possibly other chronic illnesses. Second, if subjects in dietary clinical trialswho are attending dietician-led classes and being monitored regularlyare unable to reduce their fat intake to anywhere close to Ornishs recommendations, then how could his approach possibly be a sustainable solution for the entire country? American Dietetic Association. This article was most recently revised and updated by, https://www.britannica.com/biography/Dean-Ornish, American Entertainment International Speakers Bureau - Biography of Dean Ornish, Ornish, Dean - Student Encyclopedia (Ages 11 and up). Angiology. Insulin accelerates the conversion of calories into triglycerides, which may contribute to hypertriglyceridemia. Credit: Nick Higgins. Southern Med J. Although we always need more research, there is enough science now to guide us. The reduction in HDL-C that may occur on a low-fat diet is another example of a half-truth that is confusing to many people. A case report in a peer-reviewed journal described the fatal ventricular fibrillation arrest of a 16-year-old girl who had started a high-protein/low-carbohydrate diet 2 weeks earlier and presented profound hypokalemia and hypocalcemia during resuscitation attempts (54). Create your free account or Sign in to continue. Bill Clinton is one of the more public examples of this, having lost and kept off more than 20 pounds since following the whole foods, plant-based diet I recommended for him five years ago (including salmon once a week). For 37 years he has been touting the benefits of very low-fat, high-carbohydrate, vegetarian diets for preventing and reversing heart disease. The mechanism of the effects on HDL-C levels of changing from a high- to low-fat diet differs substantially from the mechanism explaining the differences in HDL-C levels between individuals who are eating a high-fat diet. the following link: Pounds lost on Atkins diet may quickly return. Atkins R. The case for low carbs. Can lifestyle changes reverse coronary heart disease? 2003;348:2074-2081. Unfortunately, most studies of the Atkins diet and other highprotein diets measure only risk factors for CHD such as weight and lipids. In my numerous debates with Dr Atkins, we agreed that many Americans eat excessive amounts of processed foods high in simple carbohydrates, including sugar, high-fructose corn syrup, white flour, white rice, and alcohol. J Cardiovasc Risk. Accessed March 5, 2004. Editor's Note: Our April 22 article elicited a lengthy response from Dean Ornish, which we publish here, along with a rebuttal from Melinda Wenner Moyer. Weight loss was 1 lb/week on the 10% fat diet and 0.6 lb/week on the Atkins diet. These associations were either abolished or attenuated if the proteins were plant derived..

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