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Jan. 6 - Which Diet Works?

Four popular diets—Atkins, Ornish, Weight Watchers, and the Zone—showed nearly identical weight-loss results among followers, according to a study published Tuesday in the Journal of the American Medical Association. But researchers also found that the majority of participants had a hard time sticking to any of these diets for a year.

In the study, the first comparison of commercial diets published in a major medical journal, Dr. Michael Dansinger and his colleagues at Tufts-New England Medical Center assigned 160 overweight or obese people aged 22 to 72 to one of the four diets for 12 months. Forty went on the Atkins diet, which reduces consumption of carbohydrates in favor of meat and other proteins; 40 tried the Zone, which is based on a diet that’s 40 percent carbohydrates, 30 percent fat and 30 percent protein. The other patients were split between Weight Watchers, which restricts calories through a points system, and Ornish, a largely vegetarian diet that limits fat to 10 percent of calories.

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Though some lost substantial amounts of weight initially, only about 25 percent were able to follow their diet closely throughout the year. Still, the average weight loss for all the diets was 10 pounds over the 12-month period, enough to reduce their heart-disease risk factors by 10 to 20 percent. The Atkins and Ornish diets had the highest dropout rates in the study, but those who stuck with them enjoyed additional health benefits. Atkins proved best at increasing levels of HDL cholesterol (known as "good" cholesterol because, at high levels, it seems to protect against heart attacks) while Ornish was the best diet for reducing LDL (or “bad” cholesterol), which can build up in the inner walls and clog the arteries that feed the heart and brain.

Tip: Pick a plan that works for you, and stick with it.

New Tool for Fighting Heart Disease?

Reducing the amount of a protein secreted during inflammation may be just as important as lowering cholesterol in slowing the onset of heart disease, according to two studies published Thursday in the New England Journal of Medicine. The researchers, analyzing data from larger studies of heart patients, found that lowering levels of C-reactive protein (CRP) in patients with severe heart disease led to fewer heart attacks and deaths. Lower CRP levels were also linked with slowing the progression of heart disease.

The studies offer strong evidence that inflammation is a major factor in the progression of heart disease and may make statins—including best-selling cholesterol drugs such as Pravachol, Zocor and Lipitor—even more popular. While genetics plays a part, higher CRP levels also tend to be found in people who smoke, have high blood pressure, are overweight or don't exercise. Eating and smoking less, and exercising more, can lower CRP levels. But the studies indicate that statins, which have commonly been used to lower LDL cholesterol levels, may help fight heart disease by lowering CRP levels as well.

Tip: Who should get a CRP test? Those with an intermediate risk of heart disease, according to recommendations from an advisory committee to the American Heart Association in 2003 (though these latest studies might provide more evidence for expanding the use of such tests). Who should take statins? Anyone with type 2 diabetes and coronary artery disease or those who have type 2 diabetes and another heart-disease risk factor like high cholesterol, according to recommendations issued last spring by the American College of Physicians.