COMMENTS AND RESPONSES Effects of Low-Carbohydrate and Low-Fat Diets

ings of many recent studies that show that low-carbohydrate diets are at least as effective as low-fat diets for weight loss and can reduce some cardiovascular risk factors to a greater extent. However, an integral, long-standing dietary recom-mendation from the American Heart Association pertaining to weight loss is to incorporate a regular pattern of physical ac-tivity (2). It is well-recognized that, despite consuming high-carbohydrate diets, endurance athletes have low levels of fast-ing and postprandial triglycerides, high levels of high-density lipoprotein cholesterol, and a lean body mass—factors that low-fat diets improve minimally or not at all (1). From a public health standpoint, the findings of an early randomized, controlled trial in moderately overweight and obese men and women who followed a hypocaloric National Cholesterol Education Program Step I diet of 55 % carbohy