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April 6, 2005

Comparison of Diets for Weight Loss and Heart Disease Risk Reduction—Reply

JAMA. 2005;293(13):1589-1591. doi:10.1001/jama.293.13.1590-b

In Reply: Dr Ornish correctly points out that no study has ever shown that an Atkins, Zone, or Weight Watchers diet can stop or reverse the progression of CHD. Our trial found that adherence level rather than diet type was the primary predictor of weight loss and CHD risk factor reduction, and one can reasonably hypothesize that strict adherence to each dietary approach would decrease CHD in properly designed clinical trials. As discussed in our article, the reduction in low-density lipoprotein/high-density lipoprotein cholesterol ratios observed for each diet is suggestive but not conclusive of net beneficial effects on lipids, and we called for longer-term studies with cardiovascular outcomes. Without well-designed randomized trials that evaluate CHD event rates, it is premature to purport that the Atkins diet affects CHD outcomes differently than other diets do.

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