Popular Diets Can Work But Are Unbalanced.

SAN FRANCISCO -- Your obese patients can rest assured that they'll start losing weight if they carefully follow any of today's popular diet plans, Dr. David Gray said at the annual meeting of the California Academy of Family Physicians.

"There's not a diet out there that if followed, appropriately will not cause weight loss and--if maintained for a long period of time--would not cause significant weight loss," said Dr. Gray, a family physician who is in practice in Windsor, Calif.

"The big problem is that these diets are unbalanced," he said. "They are either very low in carbohydrates or very low in fat, and I submit to you that unbalanced diets are very hard to follow for a long period of time. It's nearly impossible."

Dr. Gray, also of the University of California, San Francisco, offered a summary and critique of these popular diet plans:

* The Atkins Diet. Patients start with a 2-week induction diet with less than 20 g of carbohydrate per day, followed by a gradual increase of carbohydrate intake, usually less than 60 g/day. Vitamin and mineral supplements are recommended.

No published, controlled trials have evaluated this diet. Data from uncontrolled studies suggest that the diet causes decreased lipid, glucose, and insulin levels in the short run. Dehydration, constipation, and gallbladder disease can occur, so monitor serum lipids, potassium, and uric acid.

* Carbohydrate Addict's Diet. This daily regimen consists of two meals of car- bohydrate-free protein and vegetable servings plus one "reward meal" of unlimited carbohydrate. The reward meal must be consumed within 1 hour, and its carbohydrates must be balanced with equal portions of protein and vegetable foods. No supplements are recommended.