--It's Not Necessarily the Carbs or Loss of Fluids. It's Fewer Calories
A new three-week in-hospital study of ten obese volunteers with mild type 2 diabetes mellitus compared a usual diet with a very low-carbohydrate diet (Article, p. 403).
During the first study week, participants ate about 3,000 calories and 300 grams of carbohydrates per day and remained at entry weight.
In the following two weeks, when restricted to 20 grams of carbohydrates per day as specified in the Atkins induction diet, and despite readily available protein and fat foods, the participants voluntarily ate an average of 2,164 calories per day (one-third fewer calories), did not eat protein and fat calories to make up for the lost carbohydrate calories, and lost an average of 3.6 pounds.
Their reduced calorie intake was considered appropriate to their height.
The researchers conclude that the weight loss came from eating less (reduced calorie intake), not loss of body fluid, increased metabolism or boredom with the food selection. They also believe that the carbohydrates stimulated the patients' excessive appetite during week one.
An editorial writer notes that the study was small and lasted for only three weeks (Editorial, p. 469.) The writer says, "Using many different diets with different approaches to food restriction for individual patients at different times in their efforts to lose weight may be the most effective way a clinician can use the available diets."
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2. Borderline Risk Factors Account for Only a Small Proportion of CHD Deaths
A new study of data from two large health studies showed that, despite one theory, borderline levels of risk factors for coronary heart disease (CHD) account for only a small percentage of CHD events (Article, p. 393).
Over 90 percent of CHD events took place in people with elevated levels of one or more risk factors. Fewer than 10 percent of the events in either sex occurred in those with only borderline risk factors. Nearly one-sixth of the CHD events in men and one-tenth in women occurred before age 55.
Editorial writers say that the results do not support a strategy to give all adults over age 55 a "polypill," containing low doses of several drugs that modify some CHD risk factors (Editorial, p. 467).
3. C-Reactive Protein Probably Does not Predict Risk for Colorectal Cancer (Article, p. 425.)
Annals of Internal Medicine is published by the American College of Physicians. These highlights are not intended to substitute for articles as sources of information.