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To the Editor: In a study comparing 4 popular weight-loss diets, Dr Gardner and colleagues¹ concluded that the Atkins diet (very low in carbohydrates) yielded greater weight loss than the Ornish diet (very high in carbohydrates).¹ Differences in carbohydrate quality between these diets and intervention fidelity suggest a different conclusion. We believe that the study is not a fair test of these diets because poor adherence to the Atkins and Ornish diet stipulations at the outset were evident.

Participants assigned to the Atkins group consumed greater amounts of high-quality carbohydrates than stipulated, as reflected by their dietary fiber intake. The Atkins diet limits fiber intake² for the first 2 months to no more than 2 g/d; instead, it was 11 g in the study. Atkins stipulates 8 g/d during active weight loss²; instead, it was 15.2 g at 12-month follow-up. The Ornish diet requires 38 g/d of fiber intake,² . . . [Full Text of this Article]

William J. McCarthy, PhD
wmccarth@ucla.edu
School of Public Health
Division of Cancer Prevention and Control Research

Tony Kuo, MD, MSHS
Department of Family Medicine
David Geffen School of Medicine
University of California, Los Angeles

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