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NEWS: Atkins still best for weight loss BMJ 2007; 334: 559 [Full text]

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As long as weight is the primary outcome

Claire S. Lightfoot   (17 March 2007)

mixed methods

John C Oldroyd   (20 March 2007)

RE: Atkins still best for weight loss

Nigel G Kinbrum   (30 March 2007)

As long as weight is the primary outcome 17 March 2007
Claire S. Lightfoot, Registered Dietitian Campbell River Hospital, Campbell River, BC, Canada, V9W 3V1 Send response to journal: Re: As long as weight is the primary outcome	I suppose we will continue to see headlines such as "Atkins still best for weight loss" as long as total weight loss is the primary outcome being measured. It is like saying that driving my car at 160 km/hour (100 mph) is still the "best" way to get from A to B when the only outcome being measured is the length of time it will take me. What about the potential harmful effects? Not only is the Atkins diet nutritionally unsound so has the potential for nutrient deficiences and the development of other health problems, but registered dietitians such as I regularly see the years of eating disorders and disordered eating resulting from such extreme diets. We need to reconsider what is truly "best" for weight loss, which means promoting life-long healthy eating practices, and above all, do no harm. Competing interests: None declared
mixed methods 20 March 2007
John C Oldroyd, Lecturer in Public Health Deakin University, 221 Burwood Highway, Burwood, Victoria, Australia, 3125 Send response to journal: Re: mixed methods	I fully agree with Claire Lightfoot’s comments above. Quantitative outcomes in dietary research are increasingly of limited value as more and more diets become available. The authors correctly point out that evaluation of the long term effects and mechanisms are needed. However, I think that it is time that dietary studies used mixed methodologies in their evaluations, incorporating qualitative assessments of palatability, acceptability and compliance to the diet for each participant. These would add value to the studies above the use of weight alone as an outcome. Competing interests: None declared
RE: Atkins still best for weight loss 30 March 2007
Nigel G Kinbrum, Retired GU46 7SE Send response to journal: Re: RE: Atkins still best for weight loss	To quote from the abstract "Their lipid profiles and other cardiovascular risk factors got no worse, and their systolic blood pressure came down significantly during the year." That's just SO unhealthy, isn't it? In fact, the study by Dashti et al showed significant improvements in weight, total chol, LDL-c, HDL-c, TGs and serum glucose using a low- carbohydrate diet (admittedly not Atkins). Very fat people can afford to lose a little muscle mass, not that much is lost as the high protein intake on Atkins is muscle-sparing. See http://homepage.ntlworld.com/nigel.kinbrum/Long%20term%20effects%20of%20ketogenic%20diet%20in%20obese%20subjects%20with%20high%20cholesterol%20level.pdf Competing interests: None declared