http://abcnews.go.com/Health/Diet/story?id=5389423&page=1

Another data point for your consideration.

Best Diet: Low-Fat, Low-Carb or Mediterranean?
Research Belies Long-Held Belief That Low-Fat Diets Are Best
By AUDREY GRAYSON
ABC News Medical Unit
July 16, 2008‹

In the ongoing battle royale between the hottest American trend diets,
it seems one of them in particular always wins title of "most widely
followed trend diet"  the standard low-fat diet.
The idea, it seems, has been that the lower in fat a diet is, the better
its results. But this notion is one that is under fire from new research
released today. And the study has already reignited a debate within the
diet and nutrition community that could determine the eventual fate of
the low-fat diet.
Researchers at Ben-Gurion University of the Negev in Israel found in a
study of 322 obese subjects that the so-called Mediterranean diet  a
diet plan characterized by high levels of healthy fats, fruits, and
vegetables  beat out the low-fat diet both in terms of how much weight
patients lost, as well as how many health benefits they gained as a
result of the diet.
To determine this, researchers put study subjects on one of three diet
regimens: a low-carb diet, a low-fat diet or a Mediterranean diet. Those
on the low-carb diet lost the most weight in two years  about 12 pounds  
while those on the Mediterranean diet lost about 10 pounds.
And in a finding that may surprise some, those on the low-fat diet lost
the least weight  about seven pounds after two years.
Moreover, researchers found that a low-fat diet bestowed the least
health benefits on the dieters compared with the Mediterranean and
low-carb diets. Those on the Mediterranean diet were most likely to have
improvements in blood sugar levels, while those on the low carb diet had
the most improvement in cholesterol levels.
Lead study investigator Dr. Meir Stampfer, co-chair of Brigham and
Women's Hospital's Channing Laboratory in Boston, Mass., said the study
provides hard evidence that a low-fat diet is not necessarily the best
diet.
"[The] main findings are that low-carb  as long as the protein and fat
sources are healthful  and Mediterranean diets are good, and even
preferential diets for weight loss, and they are safe," Stampfer said.
But some diet experts went so far as to say that the study provides
further evidence that one of the biggest misconceptions about dieting is
that dietary fat is anathema if you want to achieve the best results.
"The common misconception that low-carbohydrate, high-fat diets raise
blood cholesterol is shown, again, not to be true," said Dr. Eric
Westman, director of the Lifestyle Medicine Clinic at the Duke
University Medical Center. "In fact, the diet with the highest amount of
fat [the Mediterranean diet] lowered the total cholesterol/HDL ratio the
most!"
Moreover, Dr. Paul Shekelle, director of the Southern California
Evidence-Based Practice Center at the RAND Corporation, said that in his
own experience he has found that the Mediterranean diet is the one that
dieters are more likely to stick with for an extended period of time.
"The Mediterranean diet is the one I find patients are most likely to
maintain long-term compliance with," Shekelle said, adding that the
low-carb, high-protein diet commonly known as the "Atkins" diet is the
one that dieters have the hardest time sticking to.
"If any primary care physician & has a patient on the Atkins diet two
years on, you should probably find that patient and & find out how they
did it," Shekelle explained. "I've not seen anyone in my practice who is
still on the diet two years later. Compliance past a few months is the
number one problem with the Atkins diet."

Low-Fat Diet Proponents Fire Back
But some experts said that because of the specific diet plans used in
the study, the results are far from conclusive in determining the "best
diet."
"The study has important technical flaws," said Dr. Neal Barnard,
founder and president of the Physicians Committee for Responsible
Medicine. Specifically, Barnard pointed to the study's use of a
"low-fat" diet plan, "which is not low in fat at all."
Rather than a traditional low-fat diet plan  such as the Ornish Diet,
which designates that only 10 percent of calories should be derived from
fat  researchers assigned subjects in the low-fat diet group to a plan
based on the American Heart Association guidelines, which derives 30
percent of its calories from fat.
According to Barnard, the heart association guidelines for a low-fat
diet are "very similar to the current U.S. average" for the amount of
calories derived from fat in a diet.
"I fear that this study will be reported as a reason to load on the fat
and cholesterol," Barnard explained. "In truth, none of the groups
actually followed a low-fat regimen."
In addition, some experts pointed out that the low-fat diet did not meet
the traditional goal of increasing carbohydrate and fiber intake, which
is required in order to see any weight loss or cholesterol-lowering
benefits of the diet.
"I do not think the diets met the stated goals; the 'low-fat' diet did
not change the percent of fat in the diet or increase the carbs, as
would be expected," said Dr. James Anderson, professor emeritus of
medicine and clinical nutrition at the University of Kentucky. "It is
difficult for me to draw conclusions from this study."
ABC News Medical Editor Dr. Timothy Johnson said he believes this study
actually shows that there is no clear-cut "winner" among the diets
compared.
"I'm amazed at all the hoopla over the diet," said Johnson on Thursday's
Good Morning America. "There were 300 people [in the study]. They were
in a controlled company environment where the cafeteria cooperated. They
had registered dietitians even with all that help, at the end of a whole
two years the best [weight loss] was 12 pounds? I mean, that's nothing,
and 12 pounds versus 10 pounds [is a] two-pound difference, and you call
that a winner?"

Individual Approach Best
But regardless of the shortcomings of this research based upon the
specific diet plans used in the study, many experts say there is still a
great deal of good information to be taken away from this.
Dr. David L. Katz, director of the Prevention Research Center at the
Yale University School of Medicine, said the study highlights that
weight loss can be achieved in a number of different ways, and rather
than focusing on one single diet plan, the better approach is to take
the best elements of each diet and combine them into a plan that works
for the individual with specific health needs.
"We can do better than a beauty pageant approach to diet and weight
loss, and actually pull together what we know about diet and good
health," Katz explained. "Sure, cut some carbs  but only refined
starches and simple sugars. Sure, cut some fat  but focus on trans fat
and saturated fat. Sure, adopt a Mediterranean diet, but go easy on the
refined pasta or white bread, and be sure to control calories."

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