Ask Dr. Gourmet

Which is better: the Atkins diet or the Mediterranean Diet?

My husband is driving me insane. We are originally from Europe and moved to the US 2 years ago. I have always eaten a Mediterranean diet, just because I like that way of cooking and we lived in that area.

Ever since we moved to the US my husband has gone overboard, a coffee on his way to work with a scone for breakfast, lunch way past 2 or 3 PM (unhealthy foods) and dinner at 9:00 PM.

A blood work up showed nasty results, high LDL, low HDL, high glucose, high insulin etc. A history of cardiovascular disease run in his family. His father died 2 months before he was born from a unexplained heart issue and did brothers and sisters of his father.

So my husband got scared and he totally went in the other direction instead of making healthy choices. He totally cut out all carbs (or as much as possible) and started exercising. In a few weeks he lost a lot of weight. His LDL went down but his HDL didn't go up.

I warned him he was poisoning his body leaving out all carbs, that body need carbs to function properly. Last Thursday night he started not feeling well, dizzy, spaced out, pressure on his chest, tingling in his shoulder. I called 911 and off we went to ER. After 6 hours of tests, no disturbing facts were found, no heart attack took place and we were sent home with a follow up with a cardiologist this week.

He's on sick leave for now and now he's even more obsessed with what he eats.

I am disabled because I have been diagnosed with ME (CFS as it's called here in the US) and Lupus. As part of my ME/CFS I have cardiomyopathy and also Orthostatic Intolerance (I faint a lot). It's often a chore for me to cook and it often takes all my energy for that day but I keep it up because it's important.

It was easy to think up healthy meals but now my husband makes all kinds of demands that makes it impossible to cook a decent meal and I don't want to go along with his no carbs routine. Which basically means I have to cook 2 meals.

Last night I wanted to cook grilled salmon with basmati rice (low Glycemic Index). But he refused to eat it, saying brown basmati rice is bad for him because it's carbs.

We have a share in a farm that gives us a week worth of veggies, last year that worked wonderful, I love cooking with what's in season. Now I can throw half away because according to my husband they contains too much carbs, he didn't want to eat the lovely fresh of the cob cooked corn, not 1 steamed potato etc.

Tell me Dr. Harlan am I wrong to say that a diet with almost no carbs is unhealthy?

We have already had many discussions about this and even fights. I'm afraid this will drive us apart instead of supporting each other in this difficult period. I just don't have the energy to cook 2 different meals and I want to keep eating healthy.

Dr. Gourmet Says...

The interesting thing is that both of you are correct.

There is more and more evidence that eating a carbohydrate restricted diet like Atkins can help with weight loss. Research is mixed, but low carbohydrate may help better with cholesterol but not quite as well for blood sugar. The fact of the matter is that for most of those eating a Western style diet any change is a change for the better.

That said, I don't believe that the research yet supports low carbohydrate diet plans as being significantly better than other diets in prevention or treatment of heart disease. We do know that a Mediterranean style diet does and that making even small changes can have a major impact on heart disease. Such research has not been established with low carbohydrate type diets, however. (You and your husband can read about the positive effects of Mediterranean style diet here.)

I wouldn't say that a person could "poison" one's body with eating low carbs. The real issue boils down to not only the fact that there's not very good evidence for it helping treat the issues that cause heart disease. For me the question is why would anyone want to eat like that. True Atkins diet and South Beach Diet plans are just plain awful. Yuk!

There is simply no reason to give up carbohydrates. Eat better quality foods like whole wheat pasta, brown rice, whole grain breads, sweet potatoes, barley, oatmeal and other high fiber, low sugar carbohydrates. The other basics of Mediterranean style diets such as less red meat (and leaner meats), more fish, high quality monounsaturated oils, more fruits, nuts and veggies are the way to eat.

So, in truth, you are not right to say that a diet that is low in carbs is unhealthy. That has now been pretty much dis-proven. It has not been proven to be of more benefit than a Mediterranean diet, however.

You are right, however, that a Mediterranean diet is proven to be healthier and one gets to eat real food.

Thanks for writing,

Timothy S. Harlan, MD, FACP
Dr. Gourmet