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Articles Written by Rehan JalaliNutrition ArticlesAtkins Diet Revealed
We have all seen the type--pulling up to their favorite fast food restaurant and ordering a cheese burger without the bun or walking into trendy LA café's and getting the cheese and beef wraps minus the croissant or gorging on large ribeye steaks and disposing of the accompanying potato like it was toxic waste and sending the pasta back to Italy. The Atkins high protein/ low carbohydrate/ high fat diet seems to be everywhere nowadays. From your cousin Larry to celebrities like Dennis Franz and Whoopi Goldberg, all have been on the diet. Thanks to national promotion of the diet through the many books published by the man himself Dr. Robert Atkins, the Atkins diet seems to be spreading like a wildfire. In the quest of American's to lose weight quickly, the Fad or quick-fix diet has emerged. In fact, weight loss is such a big issue for so many people that Americans spend nearly 33 billion dollars each year on the diet industry. Maybe it’s because even though America is the richest country in the world, it is also the fattest with an estimated 54% of the population overweight. In fact, the NIH (national institutes of health) mentioned that as much as 80% of the heart disease cases in America are linked to the person's diet. But is the Atkins diet the answer? Supporters of the diet will mention real world results and the estimated 20 million people who have been on the diet. Detractors will talk about the lack of clinical research and health risks associated with the diet. So what is the REAL truth behind the Atkins Diet? Is it just the "same 'ole" marketing hype diet that follows the key formula for making lots of money -- Identify a problem, give a quick fix solution to the problem, market the heck out of the solution and make tons of money? But does it really work? How did it start? Is there good clinical research behind it? Let the truth be told!
Before we indulge in the diet itself, lets review a brief history behind the diet. Dr. Atkins published his book "Dr. Atkins Diet Revolution" about 30 years ago discussing a diet (or lifestyle as it is now called) that consisted of high protein/low carbohydrate/ high fat foods to help lose weight quickly. But the little known "Banting Diet" was a similar diet introduced by the English physician Harvey in the mid 19th century. Maybe we can even trace the diet back to the caveman days since meat was the main food group back then and you know those cavemen were lean! The "Scarsdale Diet" was a another similar diet introduced in the 70's. Nowadays there seems to be all kinds of varieties of essentially a low carbohydrate/high protein/ high fat diet like "Protein Power", "Sugar Busters!", and the "Carbohydrate Addicts Diet". Atkins still reigns as the most well known of these plans and Dr. Atkins is definitely known as the person who put it on the map.
The Atkins diet is composed of eating unlimited amounts of meat, fish, eggs, and some cheeses but no more than 20 grams of carbohydrates daily for at least the first two weeks. Foods rich in fats and protein are encouraged. It has various phases according to Dr. Atkins book "Dr. Atkins New Diet Revolution" including the induction phase, the ongoing weight loss phase, and the maintenance phase. A typical meal on the diet is a cheeseburger with no bun and small tossed salad with oil and vinegar. The premise of the diet is based on a physiological process called ketosis (there are some modified ketogenic diets which incorporate carb loading that do work well). To explain ketosis, we need to put the old biochemistry hat on and hope we don’t lose anyone. When carbohydrates are removed from the diet, the body's glycogen (carbohydrate) stores are depleted quickly. The body then starts running on free fatty acids to provide the necessary metabolic energy it needs. But unfortunately the brain cannot run on free fatty acids but it can run on ketone bodies (such as acetoacetate and acetone), which are a by-product of the incomplete breakdown of free fatty acids in the liver. Since little carbohydrates are being consumed in the Atkins diet, all of these ketone bodies in the bloodstream cause ketosis to occur. So basically the premise is that since fat is primarily being used as fuel and carbohydrates are not being stored as fat, fat loss will occur. That's a "good story" as they say in the marketing world. So the Atkins diet addresses the problem of weight loss which impacts millions of people, it gives a diet solution for the problem, it uses real world testimonials including celebrities and a medical doctor behind it, and the books are awefully convincing. A group of people are definitely profiting greatly from this "miraculous" diet. So what are the REAL benefits and dangers of the diet?
There are thousands of testimonials around saying that weight lost on the diet was abundant, even upwards of 100 lbs in some cases. Some people even say they feel better on the diet and are less hungry. They seem to have less mood swings and some even report greater energy levels. Initial weight loss on a ketogenic diet is water weight loss and some lean muscle loss. Since water weight is dropped so quickly, some people see results in a week which again gives them the quick fix they were looking for. It gives some individuals a false sense of confidence and weight loss. With rehydration, the water weight tends to re-appear. Carbohydrate stores in muscle tissue (glycogen) also store water (each gram of glycogen stored in muscle tissue also stores 3 grams of water with it) which tends to create an anabolic environment inside muscle cells. When carbohydrates are depleted in the Atkins diet, the water stored along with them is lost and the muscle cells tend to become dehydrated which could cause muscle breakdown in the long term. The less muscle mass one has, the lower their metabolism tends to be--not good for fat loss. The Atkins books won’t mention that one openly! But the challenge by the medical community to Dr. Atkins has always been "Show us a long term independent published clinical study that shows the diet to be safe and effective in promoting fat loss and lean muscle mass sparing/gain." In fact, Dr. Dean Ornish (Author of "Eat More, Weigh Less") has been an avid antagonist of Dr. Atkins-- always challenging him to conduct a long term study on the diet. Unfortunately Dr. Atkins doesn’t have much to say to the detractors as there are no long term studies evaluating the safety and effectiveness of the diet. The problem is that Dr. Atkins promotes this diet as a lifestyle/long term dieting solution. To be fair to Dr. Atkins, there are two newly presented studies (NOT published) that suggest that the Atkins diet is safe and effective in the short term. One of the studies was conducted at the Atkins Center for Complementary Medicine in New York so the credibility of the study has to be questioned. The other study was conducted at the Durham VA Medical Center in North Carolina and showed that on average mildly obese individuals lost an average of 21 lbs. in four months on the diet and had reduced cholesterol levels. But keep in mind that the subjects in this study were also taking a vitamin and fish oil supplement regularly and they were exercising. Fish oil supplementation has been previously shown to reduce bad (LDL) cholesterol levels. These studies were presented at the Southern Society of General Internal Medicine in New Orleans. There are dozens of published studies that criticize the diet and show it may be very risky in the long-term. One review published by "The Medical Letter on Drugs and Therapeutics"(1) states that "Physiological and epidemiological studies suggest that a high protein diet may increase calcium loss from bone. The dehydrating effect of ketosis can lead to fatigue, constipation, orthostatic hypertension, and urinary tract stones. Substituting saturated fats for carbohydrates could increase the risk of stroke and myocardial infarction."
Dr Atkins actually admits in his book "Dr. Atkins New Diet Revolution" that "the program is capable of aggravating certain conditions, notably: Gout and uric acid, kidney stones, gall bladder colic, constipation, digestive deficiencies involving ability to digest fat or protein, and a small percentage of lipid disorders." Other adverse effects of a build up of ketones in the body can include headaches, dizziness, nausea, and bad breath. Dr. Atkins actually acknowledges that bad breath is a by-product of his diet due to excess ketone production. This does not help out at a nightclub on a Friday night! Another possible and little known effect of this Fad diet is negative impact on immune function. One study (2), published in Life Sciences Journal in 1996 states "these data indicate that extensive aerobic exercise causes impaired neutrophil bactericidal function, probably due to the induced increases in both cortisol and ketone bodies. This impaired neutrophil function may cause the susceptibility to infection after an extensive exercise." So if your on the Atkins diet and just finished a hard workout, you may want to bust out the echinacea and anti-bacterial hand lotion quickly. This decrease in immune function with ketosis is not conclusive but it is certainly something to look at further. But since the Atkins diet eliminates many fruits and vegetables, key phytonutrients are void from the Atkins dieters bodies. This may put them at greater risk for certain illnesses. Also, cortisol is always an issue with the Atkins program. The hormone Insulin actually suppresses cortisol (a catabolic hormone in the body that can cause muscle breakdown) but with low insulin output due to the absence of carbohydrates, cortisol levels could increase. High levels of cortisol have been linked to many diseases including HIV and some cancers. The Atkins diet is even receiving criticism from national organizations such as the American Dietetic Association which calls low-carb diets "a nightmare". Since the diet removes a lot of key dietary fiber from the daily meals, it could cause serious constipation, kidney strain, and fluid dehydration as mentioned previously. Mineral and PH imbalance can also result from long term ketosis. This can have major health implications such as increased kidney stress. That is why Dr. Atkins always recommends a good multi-vitamin and multi-mineral supplement when on the diet (the Atkins brand actually has a decent multi vitamin/mineral supplement for people on this diet). Many published studies from the 70's (when the diet was first popular) bash the diet in a big way saying things like "hypercholesterolemia (high cholesterol) is to be expected in a greater part of the adherents to such a diet"(3), "the Atkins diet seems to be potentially hazardous to health"(3), and "Aktins theories are at best half-truths and the results he claims lack credibility"(4). Another recent study published in the Journal of the American College of Nutrition in October 2000 (5) says "While high fat diets may promote short-term weight loss, the potential hazards for worsening risk for progression of atherosclerosis override the short-term benefits." The Atkins diet supporters say that the diet actually reduces appetite but in one research study (6), a minimum-carbohydrate, hypocaloric ketogenic diet did not reduce appetite any more than a diet that did not promote ketosis. There is overwhelming evidence that the Atkins diet may have long term adverse health effects. Remember, most of these medical naysayers are not getting paid any money to go against the diet while Dr. Atkins has a direct (and very large) financial interest in promoting the diet to the public.
The Atkins diet may be beneficial for losing quick weight within one month before a wedding or a major event but for the long term, it doesn’t look too appetizing. It is an option for someone who has tried everything and has nothing else to turn to—but remember to monitor cholesterol and other physiological measurements while on the program. As long as Americans are looking for a quick fix weight loss solution, no matter what the consequence, the Atkins Diet will be there for them. And of course our good friend Dr. Atkins will continue profiting from his many Atkins health products and books. So get that rib eye steak with extra butter and mayo for the short term but watch out for the long term effects. But after all, isn’t that what a good diet should be for--fat loss with all the long term health benefits associated with it? And of course exercise and dietary supplementation along with a solid nutrition program are all key elements in achieving a lean and healthy body. References Cited
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