Atkins diet - attractive but may be risky

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This unique diet which has become the fad of late, was first introduced by Dr Robert Atkins, a cardiologist in the early 1970's.  It was sold as the "Drinking Man's Diet" because some hard liquor was low in carbohydrates.  It sounded attractive - eat all you want of meat and protein and limit food groups like vegetables (which most folks don't miss).

Robert Atkins devised the diet for himself, based on research which dead-ended in the 1950's.  He apparently followed his own diet for several decades however, in his late 60's, early 70's experienced coronary artery disease (Mrs Atkins apparently told an interviewer that her husband did have mild clogged arteries) and also heart disease which the Atkins corporation insists was NOT from the low carb plan.  Two years after Atkins death which was originally stated as from a fall, a biographical book revealed that Atkins had actually died from a stroke which CAUSED the fall.  The high consumption of saturated fats which many low carbers indulge in is considered by many in the medical profession to be a risk factor for coronary artery disease, clogged arteries and stroke, all of which Dr Atkins had.

Dr Atkins revised his book a few times and the latest incarnation has some significant modifications on the original plan.  Readers are told that they should eat low carb protein food until "pleasantly satisfied" but to NOT overeat because too many calories of protein will cause a weight gain (a new discovery).  In other words, basically portion control and no more eating all the steak you want!

Another significant change is that the Atkins book talks about "USEABLE CARBS" which is lower than total carbs.  This would allow a bit more leeway in what foods can be eaten.

Robert Atkins in his latest book included a section showing the scientific basis for his theory that cutting carbs made for more efficient weight loss but unfortunately all but one of the studies he cited were from the 1960's and 1970's and were not on plans which limited carbs that drastically (for example the studies limited carbs to 35 percent of food eaten).  Most medical authorities, even those who prefer the Atkins plan, admit that Atkins' explanations of why it works were flawed.

The diet as it is today is quite limited.  Saturated fat is limited to 60 percent of calories but transfat like margarine etc is restricted.  Omega III and VI fats are encouraged.  Sugar, white carbohydrates, pasta, breads, all forbidden. Carrots, potatoes and other starchy vegetables are extremely restricted. Fruits also are extremely restricted and often forbidden.

Low carbers are allowed about 3 cups of salad a day (just lettuce and other no calorie veggies) or 1 cup other low carb veggies like broccoli or cauliflour and 2 cups of salad.  People on low carb maintenance can add 1 fruit or 1 glass of milk. 

Low carbers feel that sugar is the enemy and that carb cravings come from eating sugar. This is one of the points of controversy because some authorities feel the the cravings many low carbers get, come from the body starving for the carbs it requires - about 200 carbs a day to function normally.

Induction or the Atkins quick weight loss plan still is 20 grams of carbs a day which will cause ketosis - a condition which some feel is not safe. However, most medical authorities agree that 2 weeks or so of Atkins will cause a weight loss and will not cause damage unless the individual has kidney or liver disease etc.

A unique thing about Atkins is that dieters still lose weight by cutting the calories but some low carbers may not drastically cut calories enough to cause the metabolic damage seen on other diets.

Dr Atkins still believed (according to his newest book) that a high content in saturated fat was a good thing and he cites the French as eating higher fat and still staying lean. Another scientist discovered that the French also walk 10,000 steps a day - whereas the average American is lucky to walk over 900 steps a day. Mystery solved)

The diet remains very controversial and generally is NOT recommended by most medical authorities for anything longer than 2 weeks. (In his new book, Dr Atkins admitted that the Ornish and MacDougall (low fat plans) were advantageous but stated that he felt they were too difficult to follow.)

Caveats

  • It is unclear whether weight loss is from less calories (by not eating some caloric carbohydrates) or from less carbs.  Medical evidence suggests less calories which means if you are a big eater you may not lose much weight
  • The brain requires about 170 carbs to function well - if you eat less you may be undermining your cognitive abilities
  • The New Atkins plan ends up very restrictive because it no longer offers "all you can eat" options.
  • Carb cravings can be bad enough to cause discomfort
  • Fruit is very restricted on the Atkins diet. Fruit has been proven to provide vitamin C and be protective against illness and cancer.
  • Up to 60 percent of the day's calories can be fat.  This is twice of what the heart-healthy suggestion is (no more than 30 percent of the day's calories in fat.)
    • 30 minutes after eating a meal high in saturated fat (like a lot of prime rib etc), the blood has a yellowish tinge and is sludgy
  • High fat diets can raise blood sugar levels in diabetics who handle fat no better than they handle sugar (fat is turned into simple sugar by the body)
  • Milk and dairy is restricted on the Atkins plan - thus possibly raising the risk of osteoporosis.  We do not absorb calcium well from supplements because Vitamin D is needed which is why milk is thus fortified.
  • Ketosis can cause dehydration.  (part of the "better" weight loss on the Atkins plan)
  • The Atkins high protein/high fat plan was shown to decrease blood flow to the heart by as much as 40 percent in an independent study (not financed by the Atkins Corp). Of course this study was NOT carried by the popular media. [6]
  • High Protein diets are hard on the kidneys - also some studies have shown that the Atkins diet may raise the risk of kidney stones.  Even Atkins aficionados state that the Atkins diet is contraindicated if you have kidney disease.
  • A survey run by the Chicago Sun Times of 100 dieticians and nutritionists rated the Atkins diet as the least effective way to lose weight and keep it off. NONE of those polled had ever seen a long term success on the Atkins plan.
  • the Atkins Corp states that many of the criticisms about long term kidney damage and coronary artery disease are unproven at this point which is probably true since the longest study on the Atkins Plan is less than 2 years long.  However, there are many studies available detailing the risks of a diet high in saturated fat and protein and low in fiber.

Endnotes - references:

  1. Ornish, Dean: REVERSING HEART DISEASE (NY, 2000)
  2. Powter, Susan: STOP THE INSANITY
  3. Bailey, Covert: THE FAT OR FIT WOMAN
  4. Gaesser, Glenn, PhD: THE SPARK
  5. Atkins, Robert, MD: THE NEW DIET REVOLUTION (NY, 2003)
  6. Phil McGraw, PhD: THE ULTIMATE WEIGHT SOLUTION COMPANION (NY, 2003)
  7. American Cancer Society: The Pitfalls of the low carb diet
  8. Center for Science in the Public Interest: The truth about low carb diets by Bonnie Liebman
  9. Fleming RM. The effect of high-protein diets on coronary blood flow. Angiology 2000;51(10):817-826.
  10. Article in the Chicago Sun Times interviewing 100 dieticians : "How obesity has become an epidemic and how to fight it" by Keith Hale, Chicago Sun Times, July 01, 2003
  11. Study - low fat diet better for reducing heart risks than low carb diet
  12. http://atkinsdietalert.org/