Annals of Internal Medicine is published by the American College of Physicians, an organization of more than 115,000 internal medicine physicians and medical students. These highlights are not intended to substitute for articles as sources of information. For an embargoed fax of an article, call 1-800-523-1546, ext. 2656, or 215-351-2656.
Two randomized trials in this issue of Annals of Internal Medicine compared low-carbohydrate diets with low-fat diets and found that people on the low-carb diets had improved triglyceride levels and slightly improved HDL ('good') cholesterol levels. Changes in LDL ('bad') cholesterol levels were not significant (Article, p. 769; Article, p. 778).
One study followed 120 overweight people for six months and found that participants on the low-carb diet lost an average of 26 pounds, compared to an average of 14 pounds lost by those on the low-fat diet.
The second study followed 132 obese adults for 12 months. While the low-carb dieters had lost more weight at the six month mark, by 12 months both groups had lost about the same amount of weight (11 to 19 pounds for the low-carb group and 7 to 19 pounds for the low-fat group. The twelve-month study is the longest comparative study of the two types of diets.
An editorial writer says, "We can no longer dismiss very-low-carbohydrate diets." Because the effect of one type of diet varies from person to person, doctors should encourage patients to try different diets and stick with the diet that works for them (Editorial, p. 836). (NOTE: the one-year study is the subject of the Internal Medicine Report video news release series. Airdate: Monday, May 17, 2004. Call for coordinates.)
The U.S. Preventive Services Task Force examined published research on screening for suicide risk (Guideline, p. 820; Evidence Paper, p. 822).The accuracy of methods to screen for a high risk of suicide is unknown. Further, few studies show that screening for suicide risk reduces suicide attempts or death from suicide. Finally, no research directly addresses the potential harms of screening for suicide. The Task Force concluded that the evidence isn't strong enough to recommend screening office patients for risk of committing suicide.
Regulations now restrict the number of hours per week and the number of consecutive hours that residents in training can work. These regulations have caused considerable controversy among educators. Four commentators discuss the effects of the regulations.