The Atkins approach

[Van Canna]

Bill, Ian,

Been reading this book. Does it really work?

Is it safe? How about if you have a reflux problem and take prevacid.

How will you digest all that fat?

Fascinating reading.

Anyone have experience with this?

[Bill Glasheen]

Van

The jury is still out on Atkin's diet.

* It's been around for a long time (since the 1970s).

* People do indeed lose weight on the Atkins diet

* The Atkins diet (very low carbs, high protein, high fat) is very similar to hunter-gatherer diets of early man, so there is a precedent for that eating style.

* Many people like Atkins because many flavor molecules are fat soluble. Higher fat diets promote satiety and please the palate.

* There's a little bit of noise now in the bodybuilding circles about the "male" advantages of Atkins and Sears vs. Ornish diets. Not a major thing yet but... Testosterone is a hormone that is made from fat and protein. Hmmm...

The problem pretty much lies in a lack of understanding of the long-term consequences of eating all that fat and consuming lots of protein. Losing weight is not a problem. What about risk for heart disease? Cancer?

IF you eat the right kinds of fats (fish fat, olive oil fat, nut oil fat) then there may actually be a positive result. A recent short-term study where the participants were taking fish-oil supplements showed no adverse lipid profile (cholesterol problems).

The jury is still out on the long-term risk of various cancers.

There is some noise in the literature about a risk of kidney stones. But if you drink lots of fluids (eight glasses a day), then that shouldn't be a problem. One also needs to be sure that all the right vitamins and minerals that you'll be missing from "starchy" sources find their way into your system. Supplements may be key here, but you can't get ALL those beneficial phytonutrients in a pill.

Basically there's not a lot known about the long-term consequences of this diet, and it is a hot topic of research as we type.

There are basically 4 diets that are worth talking about:

1) Calorie restriction

2) Barry Sears "Zone" diet (40/30/30 ratio of calories by low-glycemic-index carbs/protein/good fat)

3) Atkin's very low carb diet

4) Dean Ornish's very low fat diet

Many people that start on Atkin's eventually evolve to the Zone diet, or something close to it.

If you're going to go there, you have to give up the pasta, my friend.

Can't tell you about the GI stuff... Your best bet is to let a really good physician monitor you through this. (S)he can check the GERD problems, and make sure the ketosis doesn't cause problems with your health. Atkins would be contraindicated for conditions like gout or kidney disease, but I can't think of a GERD issue off the top of my head. If anything, loss of weight may actually help. But the personal physician would be the best companion on this.

- Bill

[Shaolin]

I have had sucsess with the diet and in fact am on it now. I agree on the surface with the notion that humans evolved over millions of years eating meat and veggies vs. eating pizza and the absolutely insane amount of carbs that most of us eat on a daily basis. I agree that the body was not intended, or most of our bodies, were not designed to handle a high carb diet.

Atkins seems to feel that once the carbs are reduced that the fat and/or cholestorol is processed differently or more efficiently - I don't know if that's true but eventually the data will be 'in.' In the mean time fish helps as would fish oil supplements.

What I have noticed as have others that I know who have or are on the diet is:

1. Acid reflux goes away (and returns with high carb intake) In my case this is a huge benefit.

2. Seems to be a reduction of general inflamation in the body.

3. Various joint, leg, muscle and back pain seems to vanish.

4. We feel stronger, more energetic and require less sleep.

5. Sex drive goes up

6. Less headaches.


The amount of carbs allowed in the 'induction phase' (first 2 weeks) does get raised as the diet moves along in time. In other words more carbs may be added as we get closer to whatever the weight loss objectives are. Many seem to think that the Atkins is NO CARBS and stays that way - this is not so.

So although long term issues are still a question the short and med term effects of the diet seem most beneficial from an all around stand-point.

Don't forget to take a really a$$ kicking multiple vitamin on this diet!

Jim

[chef]

You will lose weight on this diet quite quickly. You will have to give up carbs, sugars (also found in all vegetables that grow underground, eg. carrots, potatoes, turnips, such), and my favorite, caffeine. The caffeine simulates hunger pangs which make you hungry.

I had a terrific time giving up pastas, breads, sweets, and especially caffeine. Like Shaolin said, the induction phase was the hardest which severaly limits the amounts the carbs you can have - like none.

With any diet, you have to start somewhere. You are going to have to give up something somewhere. You can eat well on this diet, you are not starving. The goal is to get you to a certain point and then gradually allow more carbs in your diet when you have become more disciplined in what you eat.

The first two weeks you eat so many eggs that you don't know if you can look at an egg. I had them about 14 different ways. Once you get through the first two weeks, it gets a little easier, but because of all the protein you are taking in, you may have tendency to get some pretty serious halitosis in the beginning.

Essential, drink lots of water on this diet. You can get pretty backed up on this.

I firmly believe that a good regimen of exercise and diet are essential in any diet and that you should have your doctor check you before you start and monitor you during your diet.

I stopped after a few months deciding I would rather eat moderately and boost my weight workouts. That works better for me...also not looking at weight but concentrating on losing inches and firming up what I have.

I think you get to the point, after disciplined healthy eating and working out don't do it, you have to accept the body God gave you (and work on what's inside rather than outside)...... 'Course, there's always surgery. Yuck!

Good luck and good discipline, Van or anyone out there doing Atkins.

Vicki

[Susie Harrison]

Bill, Ian,

Been reading this book. Does it really work?

Is it safe? How about if you have a reflux problem and take prevacid.

How will you digest all that fat?

Fascinating reading.

Anyone have experience with this?

As a Registered Dietitian who lectures on this subject often, I absolutely DO NOT recommend the Atkins Diet, or any of the other high-protein, low-carb spin-offs. These diets put undue strain on both the kidneys and liver (I have personally worked with patients who experienced kidney and liver problems as a result). If you know anyone who has been "successful" on this diet, look at them a year later (the structure of these diets practically guarantees rapid regain of weight).

The recent study which showed that Atkins dieters lost more weight and lowered triglycerides more than those on a low-fat diet was seriously flawed. First and foremost, the study was funded by the Atkins Institute (big red flag!). Secondly, the Atkins dieters received supplements which are known to lower triglycerides. (I have seen many patients who experienced increases in cholesterol and triglyceride levels after being on the Atkins diet.) No mention was made of body composition, that is, how much of the lost weight was lean tissue, and how much was fat.

As far as how it affects reflux, my guess would be that it would cause more problems in that regard. High protein, high-fat diets delay gastric emptying, increasing the chances of experiencing discomfort.

If you truly care about your health, forget these stupid fad diets. Go with the tried and true balanced diet, including some protein, some carbohydrate, and some fat, including foods from all food groups in moderation.

[Van Canna]

Thank you all so much for the responses.

I had been tempted, so I got the book, but the question remained about GERD [could not understand how that would be eliminated, since it is precisely fats from meats,and all the other foods the diet requires, that gives me acid burn]_

I mean you eat fats, even if they are good for you how is the stomach going to digest them?

Susie,

Thank you for putting me at ease on this. I agree with you and Vicky 100/% ..

Susie,

Atkins claims dramatic lowering of cholesterol and blood pressure, among other benefits. But your experience has been negative in this respect.

And not counting the serious shock to your system, especially in the first two weeks...ouch..thanks for the information.

[Van Canna]

Had trouble posting a reply, it seemed to not go through, so I hit the submit button a few too many times.

Now it won't let me delete my own excess posts ..what gives? !@#$%

[Kay]

Everybody and his brother has been telling me to do Atkins. Its haunting me! Comes up everywhere I turn. I'd like to take off about 30 lbs., but am afraid of Atkins becuase the 4 people I know that really followed the diet lost tons of weight, and within a year had put it back on, plus some. Even so, my chiropracter (who is also a nutritionist) recommends it, and a doc friend at the dojo just recommended it last night. My son (who is a weightlifter) also does it. I feel like I can't escape. Atkins was vilified 30 years ago when he came up with this, but I'm seeing more and more info in support of his theories (New York Times ran a positive piece a few months ago). More confused than ever...

[Shaolin]

Despite those people who are saying the diet is less than ideal I can say that those that I know have felt better when doing the diet.

I am not a doctor but I find it hard to understand why following a diet that more closely represents the way people ate for millions of years of human evolution should be a bad way to go. Eating meats, Fish, eggs and veggies is after all the most natural foods that naturally occur on the planet and is what all of us omnivores ate for the first 99% of human existance. Atkins asserts that most of the health problems that are documented began to happen when processed sugars and flour were introduced into our diets - he calls them the white death.

Indeed if it is so bad to follow a diet of low carbs - just how low is too low? Again, to me getting carbs from veggies instead of CHIPS, PASTA, BREAD and TWINKIES, etc., seems indeed more natural to me.

Those people who have weight problems in my way of thinking should at least try to cut down on the amount of carbs in thier diet. We know that carbs are a very high energy source and we also know what the body does with those carbs if you don't instantly use that energy - it turns the energy into fat! Using the low carb approach helps the body begin to rely on burning fat for energy which is what we want to get rid of, while eating lots of protein prevents the loss of lean tissue.

Seems to me that 99% of the 'junk' we all eat is processed flour based carbs. Why not eliminate that garbage and replace it with natural veggies? Again, I ask just how low is too low and why should a diet of natural carbs via veggies instead of processed crapola flour and sugar be something to be wary of?

Jim

[Guest]

Years ago I got up to 190 lbs and had success with an exchange diet (weight watchers). I ended up losting 45 lbs. This wasn't a good weight for me (nor is 190). I was cold all the time and I was obsessed with exercise. I like the feel of 175. I'm off my mark right now but i'm on my way back down.

By the way, thanks Susie for posting that information.

[Susie Harrison]

Okay, here's the deal. To start with the simplest basic human nutrition needs: The human body requires 6 things: water, vitamins, minerals, protein, carbohydrate, and fat. All are essential to survival. Optimal health depends on having the correct amount of each.

We need some nutrients in greater quantities than others. For example, we require only micrograms of certain minerals (a microgram is one one-millionth of a gram), our protein, carbohydrate and fat requirements are expressed in grams, while our water needs are approximately 2.5 liters per day. So, to list requirements in quantity order: water (2.5 liters per day), carbohydrate, protein, fat, vitamins and minerals.

Carbohydrates provide the fuel our bodies need (just like gasoline provides the fuel our cars need). Your car also needs other things, such as oil, water, brake fluid, transmission fluid, etc., but it requires more gasoline than anything else. Same thing in the human body. We need more carbohydrate than any other nutrient, because we burn it up constantly.

We need AT LEAST 50%-65% of our incoming calories to be carbohydrate. In Sept. of last year the Institute of Medicine issued a report stating that the MINIMUM amount of carbohydrate need JUST TO FUEL THE BRAIN is 130 grams per day. That figure doesn't include fuel to power the skeletal muscles. So, it becomes obvious that low-carb diets, such as Atkins are ridiculously inadequate. Since the human requirement for carbohydrate is so great, your body is equipped to do what it has to do in order to survive when dietary carbohydrates aren’t available. It will cannibalize your muscles and other lean tissue in order to convert that protein into carbohydrate for the fuel that it so desperately needs. That process produces large amounts of metabolic by-products that must be detoxified by the liver and kidneys and eliminated from the body.

It is also important to be cognizant of fueling our bodies with high grade fuel. That means, not to decrease carbohydrates, but to make appropriate choices. Get rid of junky, low-nutrient, highly refined carbohydrates, and choose instead wholesome carbs ,including any whole grain (such as wheat, rice, rye, barley, etc.), fruits and vegetables and legumes. Choose abundant amounts of whole wheat bread, whole grain cereals, brown rice, and whole wheat pasta. Strictly limit refined carbohydrates (bagels, crackers, white pasta, Twinkies, cookies, white rice). By the same token, I also recommend that you avoid the junk proteins and fats as well (hot dogs, ground beef, bacon, hydrogenated fats, etc.), and choose wholesome lean meats, low-fat dairy products, vegetable oils, nuts & seeds.

So, after all that is said, we should be eating a diet that is balanced, including all food groups in appropriate amounts - not high-protein, high-carb, or high-fat - just balanced. The USDA Food Guide Pyramid illustrates that concept beautifully, and serves as a wonderful guide, as long as we choose wholesome foods in each recommended category.

Susie Harrison, RD, LD
Registered and Licensed Dietitian/Nutritionist

[gmattson]

Thanks for all the great tips. . .

[Gene DeMambro]

The Atkins Diet is NOT a "high-protein" diet. This is metabolic suicide. This will lead to the kidney and liver problems later. Everyone in the know understands this. Including Dr. A himself. People who say that Atkin's Diet, et al, are "high protein" diets are fatally flawed in their facts.

To say also that the human brain needs 130 grams of EXOGENOUS (i.e. dietary) carbs is also a mischarectization. Your brain needs 130gm of glucose, no matter the source. After the body uses circulating carbs, it will turn to the glycogen stores in the liver, and the fat stores before metabolizing muscles and other lean tissues. If this were not the case, then no one would be able to loose weight.

And the brain can readily adapt to a dearth of dietary carbs by using lipids as an energy source. This is what happens during fasting and diabetes. In fact, during periods of prolonged starvation, 75% of the fuel needs of the brain are met by lipid metabolism.

Also, it was (and still is, apparently) assumed that all the body's energy needs are supposed to come from carbs. Not true at all. The heart and the kidneys, for example, prefer to use lipids as the main energy source.

And the Good Dr. A himself never says to completely abandon vegetables. Just avoid those that are not conducive to weight-loss or weight maintenance.

Gene

[Bill Glasheen]

Susie (et al)

First of all, I am very thankful to have Susie onboard. We need people with training to come to the table.

Secondly, I've been holding back a bit, waiting for the other medical types to weigh in.

Third, this is way more complex than anyone makes out. As I stated in my very original post,

The jury is still out...

Atkins, Sears, Ornish and others have been battling it out in public for years. Atkins swears he will live to see the day where he says "I told you so." Hmm...

USDA Food Pyramid? Check out what was in the latest issue of Newsweek.

Experts are concocting new alternatives to the USDA’s decade-old Food Guide Pyramid, which is now widely viewed as flawed

See the "online" edition of the article here.

A Better Way to Eat

And here are a few tidbits from the scientific literature...

In early July, the New York Times Magazine published an article that had good things to say about the Atkins high-protein diet. It also claimed that low-fat diets might be harmful. This shocked many of us who have been following a low-fat diet to reduce our risk from heart disease. Have we been barking up the wrong tree all these years?

- Lee, TH: Harv Heart Lett 2002 Nov;13(3):8

Are low carbohydrate high protein (LCHP) diets more effective in promoting loss of weight and body fat and can individuals stay on an Atkins-like diet more easily than on a conventional weight loss diet? A pre-test/post-test randomized group design composed of three cohorts was utilized to test 1) a LCHP ketogenic diet; 2) the Zone diet; and 3) a conventional hypocaloric diabetic exchange diet that supplied < 10%, 40%, and 50% of calories from carbohydrate, respectively. Body composition was measured before and after the intervention treatment period with dual energy X-ray absorptiometry. Mean weight loss was 5.1 kg for those who completed the 12-week program. There were no significant differences in total weight, fat, or lean body mass loss when compared by diet group. Attrition was substantial for all plans at 43%, 60%, and 36% for LCHP, Zone and conventional diets, respectively.

- Landers P et al: J Okla State Med Assoc 2002 May;95(5):329-31

And now we already have review articles out...

Pickering TJ: Diet wars: from Atkins to the Zone. Who is right? J Clin Hypertens (Greenwich) 2002 Mar-Apr;4(2):130-3

Everyone is excused for either being behind the state of affairs today or being totally confused. Here are a few things worth considering.

1) The Atkins diet is commonly vilified via pointing out the problems with fat consumption. However it's only been in the last decade that researchers have discovered the beneficial effects of certain omega 3, 6, and 9 fatty acids (found in nut oils, fish oils, and certain vegetable oils). So conceivably someone could be on a low carb diet with higher levels of protein and fat, and consume fats that are both heart healthy and tend not to make you gain weight.

2) The original USDA food pyramid put carbohydrate sources as the base of the structure. However its only been recently that researchers have developed "the glycemic index" - a way of measuring a specific carbohydrate's effect on your insulin levels. Now we know that not all simple sugars are created equal. Furthermore, certain complex carbohydrates such as potatoes and rice have been shown both to promote fat storage and potentially contribute to the problem of insulin resistance (type II diabetes).

So...the latest potential proposal of the USDA is a modified food pyramid, which is different from the one they proposed 10 years ago.

But stay tuned. The wars are on, and the randomized studies of diet types are being conducted as we speak.

- Bill

[Harvey]

I did a modified (keeping such health foods as unlimited salad, wine and martinis) Atkins diet for about six weeks. I lost ten pounds. I thought the Atkins diet would be easy, if I allowed myself to continue drinking, but giving up bread and rice and potatoes was pretty tough. I think the way to do it without damage is to limit yourself to two weeks, but totally without carbs (except, perhaps, for a little salad). Then, you start phasing in good carbs. I have not had a french fry in two months. I have had a few, small baked and sweet potatoes, and a half dozen onion rings. I have had a few bagels and about six English muffins, and all the salad I want. I have not read the Zone Diet, but I think that it is something like what I am doing now. I also think that having gone to the trouble of losing some weight, a person is more attentive, and stops eating by habit. I have kept the weight off and have no lack of fulfillment, except for my eternal, fruitless longing for my favorite brunette (see that post).

What happened when people started looking for low fat is that producers increased sugar (fructose) and salt to compensate for loss of flavor. This alternative turned out to be at least as bad as fat.