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Atkins diet

Definition

The Atkins diet is named for Robert C. Atkins, M.D., the diet’s founder. It is based on restrictions of carbohydrates and focuses on eating mostly protein and fat, along with use of vitamin and mineral supplements.

The Atkins diet has been one of the most popular fad diets in the United States. It started a “low-carb revolution,” leading to development of low carbohydrate choices in grocery stores and restaurants around the world. The diet’s founder, Robert C. Atkins, died in February 2003.

Origins

Dr. Atkins introduced his Diet Revolution in 1972. From the beginning, Dr. Atkins, a cardiologist, said that limiting intake of carbohydrates (sugars and starches) would improve health and aid in weight control. The original premise for developing the diet came about because of Atkins’ frustration with the increasing rates of obesity and chronic diseases such as diabetes.

Description

Throughout the diet, Dr. Atkins recommended drinking at least eight 8-oz. glasses of water each day to avoid dehydration and constipation He also recommended daily intake of nutrients through a good multi-vitamin supplement. Finally, Dr. Atkins mentioned getting plenty of exercise to speed weight loss. The Atkins diet consists of four distinct phases that participants should go through to achieve and maintain weight loss.

Induction

The induction phase is not required, but that doing so jump starts weight loss as dieters cut back significantly on carbohydrate consumption. According to Atkins Advantage notes, the induction phase can make people feel revitalized, since carbohydrates cause blood sugar spikes that lead to fatigue and other symptoms. The diet also claims that the induction phase will help dieters see the benefits of fat-burning and strengthen their immune systems.

This is by far the most restrictive of the four phases, allowing no more than 20 net carbohydrates per day. This equals roughly three cups of salad greens or other non-starchy vegetables. Participants can eat

Phases of the Atkins Diet

Induction—At least two weeks

No more than 20 net carbohydrates per day

Liberal amounts of protein, including meats, fish, poultry, and eggs, as well as healthy fats

Fatty condiments (mayonnaise, sour cream, guacamole, and butter) are allowed in unlimited quantities

Weight loss during the induction phase may be significant

Ongoing weight loss—Begin after two weeks

Slow introduction of foods with carbohydrates that are considered nutrient dense (green beans, Brazil nuts, avocados, berries, and whole grains)

In week one, add 25 grams of carbohydrates per day

In week two, 30 grams of carbohydrates are allowed

The addition of five grams per week continues until weight loss stalls, then drop back to the previous gram level

Pre-maintenance goal—Begin when within 5 to 10 pounds of weight-loss goal

Gradually increase carbohydrate intake by 10 grams per week until weight is gained, then drop back to the previous carbohydrate gram level

Level weight loss to less than one pound per week

Lifetime maintenance—Begin one month after weight-loss goal is achieved

May be able to consume from 90 to 120 grams of carbohydrates a day, depending on age, gender, and activity level

Maintaining weight goal is more likely if carbohydrate intake remains at the level discovered in pre-maintenance

(Illustration by GGS Information Services/Thomson Gale.)

liberal amounts of protein, including meats, fish, poultry, and eggs, as well as healthy fats. Healthy fats include vegetable and seed oils. High fat condiments such as mayonnaise, sour cream, guacamole, and butter are allowed in virtually unlimited quantities. The Atkins theory is that these high fat foods enhance the flavor of meals, making the Atkins diet easier to maintain. Atkins has reminded dieters that while unlimited quantities of fats and proteins are allowed, the advice is not a license to gorge. Dieters are said to feel hungry for the first 48 hours as their bodies adjust to the abrupt reduction in carbohydrates. Weight loss during the induction phase is said to be significant. The phase is recommended to last at least two weeks.

Ongoing weight loss

The second phase of the Atkins diet moves into ongoing weight loss. It involves slow introduction of foods with carbohydrates that also are considered nutrient dense. Most of the carbohydrate calories come from vegetables. Atkins dieters still eat a higher proportion of proteins and fat, but they gradually add more carbohydrates into the diet. According to Atkins, the purpose of the phase is to continue to burn and dissolve fat while maintaining appetite and craving control. This phase also introduces the dieter.

KEY TERMS

Ketoacidosis—An imbalance in the makeup of body fluids caused by the increased production of ketone bodies. Ketones are caused by fat breakdown.

to a broader range of foods and helps to determine the dieter’s threshold level of carbohydrate consumption. It is the intention of this phase to deliberately slow weight loss.

If weight loss continues, carbohydrate intake is gradually increased each week. In week one, the dieter can add 25 grams of carbohydrates per day. In week two, 30 grams of carbohydrates are allowed. This addition of five grams per week continues until weight loss stalls, then the dieter drops back to the previous gram level. Typical tolerance levels may range anywhere from 30 grams to 90 grams per day. Atkins literature says that the more a dieter exercises, the more carbohydrates he or she can tolerate. The Atkins diet recommends choosing carbohydrates first from vegetables that are low in carbohydrates, then from other sources that are fresh foods high in nutrients and fiber. Examples of low-carbohydrate vegetables are lettuce, raw celery, and cucumbers. Nutrient-rich carbohydrates are green beans, Brazil nuts, avocados, berries, and whole grains.

Pre-maintenance

The Atkins diet considers the third phase a practice for lifetime maintenance of goal weight and “healthy eating habits”. When the goal weight is within five to 10 pounds, the dieter gradually begins to increase carbohydrate intake by 10 grams per week until weight is gained, then drops back to the previous carbohydrate gram level. The purpose is to level weight loss to less than one pound per week. The dieter should continue at this rate until the goal weight is reached, then for one month past that time. The goal is to achieve a level at which weight is neither gained nor lost and to internalize the habits that become part of a permanent lifestyle.

Examples of vegetables that contain about 10 grams of carbohydrates are 3/4 c. of carrots, 1/2 c. of acorn squash, 1 c. of beets, and 1/4 c. of white potatoes. Legumes and fruit are the next preferred food groups for adding 10 grams daily. One-half apple contains 10 grams of carbohydrates, as does 1/3 c. of kidney beans.

Lifetime maintenance

This final phase of the Atkins diet occurs when a dieter reaches goal weight. Although an adult may be able to consume from 90 to 120 grams of carbohydrates a day, depending on age, gender, and activity level, maintaining goal weight is more likely if carbohydrate intake remains at the level discovered in pre-maintenance. The key, according to Atkins, is never letting weight vary by more than three to five pounds before making corrections.

Function

From the beginning, Dr. Atkins said that the traditional approach to weight loss of counting calories and cutting fat must not be working. He blamed carbohydrates for adding to the expanding waistlines and declining health of Americans. Through several updates of the Atkins diet, the same basic premise held with minor revisions. The function of the diet is to enjoy eating while severely limiting carbohydrates. Atkins Advantage mostly makes a distinction between trans fats and other fats. A more clear distinction also is made in the later version between carbohydrates in general and sugar in particular. All along, Atkins has emphasized that a focus on protein builds energy, repairs muscles and bones, and boosts the metabolism.

Benefits

Some dieters have had at least initial success with the diet and have found the liberal rules regarding protein and fats more tasteful and filling than other diets, Advice from the Atkins plan concerning behavioral changes can be helpful, such as shopping the perimeter of the grocery store, where the unprocessed foods are located. In recent years, the program has attempted to modify some of its advice to more closely fit traditional advice from registered dieticians. For example, more clearly defining the types of fats to emphasize in the diet may help avoid mistakes by some who follow the diet to overeat unhealthy fats and increase risk for heart disease. However, experts have said that the diet still contradicts mainstream views concerning health promotion and disease prevention.

Precautions

The average carbohydrate intake recommended by the Atkins diet is well below averages generally recommended by other experts. Studies have shown that even though people may lose weight on the Atkins plan, they do not necessarily keep the weight off longterm because the diet does not teach sustainable lifestyle changes.

Like many fad diets, the Atkins plan produces and promotes many food products associated with its diet plan. As of 2007, these products included bars, shakes, and candy. So although the plan argues against processed foods and snacking, the company also heavily promotes use of its nutritional products to support weight loss or maintenance.

Most importantly, followers of the Atkins diet have reported suffering from muscle cramps, diarrhea, general weakness, and rashes more frequently than people on low-fat diets. Others have reported constipation, bad breath, headache, and fatigue. The American Dietetic Association has warned that any diet that severely limits one food group should raise a red flag to dieters.

Risks

Beyond the reported side effects and concerns about the diet’s long-term effectiveness, some serious problems may arise for Atkins diet followers. One problem that has been documented is called ketoacidosis. This occurs when there is a buildup of the byproducts of fat breakdown because the body does not have enough glucose available. The condition can be dangerous, resulting in cell damage, severe illness, and even death. The low carbohydrates eaten by those on the diet are below those needed to supply the brain and muscles with sugar. Critics of the diet have also long focused on the risks of unlimited fat intake that the Atkins diet allows. Eating large amounts of saturated fat, even if weight is dropping, can lead to high levels of cholesterol and heart disease. However, this is not necessarily always the case. Cholesterol levels tend to decrease in many individuals when they lose weight, even if eating an unbalanced diet. Long-term research remains to be done in this area.

Research and general acceptance

Research results have varied over the years concerning the Atkins diet. The research has tended to support that Atkins followers have experienced comparable or higher weight loss than people on traditional low-fat diets with higher amounts of carbohydrates, but for only a six-month period. After 12 months, weight loss was about equal. Some research also has shown that the diet has not produced damaging cholesterol or heart effects, but these studies have not been large, long-term trials. For example, effects of increased fat consumption on diet followers’ hearts may take years to

QUESTIONS TO ASK YOUR DOCTOR

  • What aspects of the Atkins diet do you feel are appropriate for weight loss?
  • How often would I need to be seen by a physician or registered dietitian while following the atkins diet?

surface and in any medical research, large numbers of participants are needed to account for many variables.

In 2004, Jody Gorran, a 53-year-old businessman from Florida, sued the promoters of the Atkins diet, saying that the plan clogged his arteries and nearly killed him. Mr. Gorran claimed that he was seduced by the plan and that by eating the high levels of protein and fats touted by the plan, his cholesterol soared. His lawsuit was backed by the Washington-based advocacy group called Physicians Committee for Responsible Medicine. Mr. Gorran sought damages and to seek an injunction preventing the sale of Atkins’ books and products without fair and adequate warnings about the dangers of the diet. The lawsuit was dismissed late in 2006 by a judge, but an appeals continue.

Atkins’ company filed for Chapter 11 bankruptcy protection in July 2005. The company completed its Chapter 11 reorganization by January 2006, having streamlined some operations, and continued to operate early in 2007, making Dr. Atkins’ diet run more than 35 years long.

Controversy even surrounded Atkins’ death in 2003. Though he died when he slipped on the ice outside his office in February 2003. He spent eight days in a coma before dying, and a copy of the medical examiner’s report showed that his weight upon death was 258 pounds. Critics of Atkins’s diet said that this was considered obese for a man who was six feet tall. His allies said that most of the pounds were gained in Atkins’ time in a coma because of fluid retention. But even while Atkins was alive, he had reportedproblems with his heart, though his physician’s council said the trouble was from an enlarged heart, which had stemmed from a viral infection, not from his diet.

Though Dr. Atkins added that numerous studies pointed to the fact that carbohydrates were to blame for weight gain, an explanation for how his diet program worked was never really offered by researchers. Numerous studies continued throughout the 1990s and even after Dr. Atkins’ death. Though some studies showed that people on the Atkins diet often lost weight faster in six months than those on other weight loss programs, the long-term effectiveness and possible harmful effects of the Atkins diet required more study.

In 1992, Dr. Atkins updated his Diet Revolution and by 2004 Dr. Atkins’ New Diet Revolution had sold more than 45 million copies and been translated into 25 languages. The new plan was the same, but the maintenance portion of the diet was made a little more liberal. The diet was extremely popular, as were Atkins Nutritionals products, such as vitamin supplements and numerous food items. A later Web-based version called the Atkins Advantage emphasized the products of Atkins Nutritionals and offered additional books, software, and information on a company Website to support the program’s goals and products.

BOOKS

Atkins, Robert C. Atkins for Life M. Evans, 2003.

Atkins, Robert C. Dr. Atkins’ New Diet Revolution St. Martin’s Paperbacks, 2004. 2003.

ORGANIZATIONS

Atkins Nutritionals, Inc. New York, NY. <http://www.atkins.com>

Physicians Committee for Responsible Medicine. 5100 Wisconsin Ave NW, Suite 400, Washington, D.C. 20016. 202-686-2210. <http://www.atkinsdietalert.org>

Teresa G. Odle


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