Atkins-Diet

Popular Diets Reviewed:

Does the Atkins-Diet make the grade?

• Introduction
• Why this diet?
• Pros
• Cons
• The Research
• Make the Grade?
• References

Introduction: Grading the Atkins-Diet

The Atkins-Diet is a high-protein, low-carbohydrate weight-loss diet developed by Robert Atkins, MD. Atkins dieters can eat as many calories from protein and fat as they want, as long as they restrict their carbohydrates.

The diet is divided into four phases:

• Induction (the first 14 days)—Carbs are limited to no more than 20 grams per day. No fruit, bread, grains, starchy vegetables, or dairy products (except cheese, cream, and butter) are allowed during this phase.

• Ongoing weight loss—Dieters experiment until they find a carbohydrate intake that allows them to continue to lose weight until their weight-loss goals are met.

• Premaintenance and maintenance—Dieters determine the level of carbohydrate intake that allows them to maintain their weight.

Best bets: Meats, eggs, dairy products (except milk), Atkins-labeled products, or check the nutrition label to see the carb content for any food. See my Low-Carbohydrate Diet article for more low-carb ideas.

More about this diet

Originally developed in the 1960s, in the early 1990s Dr. Atkins brought his diet back into the nutrition spotlight with the publication of his best-selling book Dr. Atkins’ New Diet Revolution.

The Atkins-Diet severely restricts the consumption of carbohydrate-rich foods and encourages the consumption of protein and fat. The diet is divided into four phases: Induction, Ongoing Weight Loss, Premaintenance, and Maintenance. During the Induction phase (the first 14 days of the diet), carbohydrate intake is limited to no more than 20 grams per day. No fruit, bread, grains, starchy vegetables, or dairy products (except cheese, cream, and butter) are allowed during this phase. During the Ongoing Weight Loss phase, dieters experiment with various levels of carbohydrate consumption until they determine the most liberal level of carbohydrate intake that allows them to continue to lose weight.

Dieters are encouraged to maintain this level of carbohydrate intake until their weight loss goals are met. During the Premaintenance and Maintenance phases, dieters determine the level of carbohydrate consumption that allows them to maintain their weight. To prevent weight regain, dieters are told to maintain this level of carbohydrate consumption, perhaps for the rest of their lives.

According to Dr. Atkins, most people must limit their carbohydrate intake to no more than 60 grams per day to keep lost weight off.

Note: The dietary recommendations issued by various organizations, including the United States Department of Agriculture, the National Institutes of Health, and the American Heart Association, encourage a daily carbohydrate intake of approximately 300 grams.

In addition to the dietary restrictions discussed above, Dr. Atkins’ weight loss program recommends regular exercise and nutritional supplementation.

Why do people follow this diet?

The Atkins-Diet is attractive to dieters who have tried unsuccessfully to lose weight on low-fat, low-calorie diets. Atkins-dieters can eat as many calories as desired from protein and fat, as long as carbohydrate consumption is restricted. As a result, many Atkins dieters are spared the feelings of hunger and deprivation that accompany other weight loss regimens.

What do the advocates say?

The underlying premise of the Atkins-Diet is that diets high in carbohydrates cause some people to gain weight and can ultimately lead to obesity. Such diets increase the production of insulin (a hormone secreted by the pancreas). When insulin levels are high, the food we eat is quickly and easily converted into fat, and stored in our cells. By restricting the consumption of carbohydrates, the production of insulin is moderated. In addition, the lack of available carbohydrate (the body’s preferred fuel source) forces the body to burn stored fat  and vital muscle as energy.

The changes in metabolism that occur with severe carbohydrate restriction also cause the body to excrete ketones (breakdown product of fat metabolism) in the urine. Since ketones contain calories, the loss of ketones in the urine may enhance weight loss.

Until his death in 2003, Dr. Atkins and his colleagues at The Atkins Center for Complementary Medicine in New York have used this diet to treat patients with obesity, as well as non-insulin dependent (type 2) diabetes mellitus (NIDDM), high cholesterol and triglycerides, and elevated blood pressure. His colleagues continue to treat patients at the Atkins Center for Complementary Medicine in New York using this diet. Although there has been little scientific research investigating the diet, several supportive studies were published around the time of Dr. Atkins’ death.

What do the critics say?

Many nutrition experts disagree with the basic premise of the Atkins-Diet—the notion that high-carbohydrate, low-fat diets cause obesity. For evidence of the implausibility of the Atkins-Diet, some nutritionists point out that the traditional Japanese diet is very high in carbohydrates, low in protein, and very low in fat; however, before the introduction of high-fat and high-protein Western foods, being overweight was rare in Japan. Such findings make sense because ounce for ounce, carbohydrates contain far fewer calories than do fats. These critics blame eating too many calories (from any source) and lack of physical activity as the primary causes of obesity.

Critics also express concern about the impact of the Atkins-Diet on the overall health of the dieter. Depending on the foods chosen by the dieter, the diet may contain a large amount of saturated fat and cholesterol, putting those at risk for heart disease in danger. Recent research has found that high-protein diets speed up the progression of hardening of the arteries (atherosclerosis), the main cause of heart attacks. Moreover, contrary to Atkins’ claims, extremely low-fat diets have been found to partially reverse heart disease. In addition, the lack of grains, fruits, and vegetables in the Atkins-Diet may lead to deficiencies of key nutrients, including dietary fiber, vitamin C, folic acid, and several minerals. Finally, high protein diets may increase the risk of osteoporosis and accelerate the rate of deterioration in kidney function associated with aging.

Critics concede that Atkins dieters often experience significant weight loss during the initial stages of the diet. However, these critics argue that the diet has a diuretic effect and that the initial weight loss is due to water loss, not fat loss. Eventually the body restores its water and sodium balance, and the rate of weight loss declines. Critics also note that there is no evidence showing that the Atkins-diet leads to greater weight loss than do other diets that provide more carbohydrates, yet the same number of calories.

The Research

Studies published between 2002 and 2006 tend to support the short-term effectiveness of the Atkins-diet, although not unquestionably. When compared with people who eat a low-fat diet, Atkins dieters can lose more weight in the first 6 months, but by 12 months there is no difference in the amount of total weight lost. In addition, while the Atkins-diet does not appear to cause some of the adverse effects about which critics are concerned, there is evidence that the diet might cause bone loss, and other concerns about long-term safety still remain.

In a six-month study of overweight adults, many of whom had diabetes, those following the Atkins-diet lost an average of 12.8 pounds, compared with only 4.2 pounds for those consuming a low-fat diet. Similar results were seen in a study of non-diabetic overweight adults, although the advantage of the Atkins-diet over the low-fat diet diminished after six months. In a study of overweight adolescents, the average weight loss after 12 weeks was 21.8 pounds in the children consuming the Atkins diet, compared with 9 pounds in those consuming a low-fat diet. The greater weight loss occurred even though the Atkins group consumed 67% more calories per day than did the low-fat group.

With regard to safety factors, there were no adverse effects on cholesterol and triglyceride levels. On the contrary, in one study the Atkins diet was more effective than the low-fat diet for improving triglyceride levels. Other laboratory tests, however, suggested that long-term use of the Atkins-diet could increase the risk of kidney stones and osteoporosis. Furthermore, one study found a 2.2% reduction in bone density after only six weeks on the diet.

My-Nutrition-Coach’s opinion regarding the Atkins-Diet:

Our own research conducted “in the field” and working with clients to develop healthy balanced meal plans for over 17 years is that this diet does not make the grade.  Clients that have tried an Atkins-type-diet in the past have reported feeling “flat” when they tried to exercise, lost lean muscle mass when they monitored their body fat vs. scale weight, and generally “Yo-Yo”ed back to their originally  weight “+” when they resumed normal eating (due to the temporary reduction in fluid or the dehydrating effect of the diet). 

Besides, I agree with critics of this diet on the simple fact that this diet has large holes in it for providing complete balanced nutrition, and excesses for increasing the risk of heart disease and osteoporosis. 

If you are considering using the Atkins-Diet to lose weight here are my suggestions:

1.      I suggest you have your body fat measured before you start this diet.  See just what it is you are actually losing.  You may be unpleasantly surprised.

2.      Try my online meal planner while following the Atkins-Diet and see for yourself through our interactive nutrition reportcard just how bad the diet rates in terms of vital key nutrients.

Resources:

Looking for a more permanent solution for fat loss?

Try my Smart Moves 7-Day Nutrition Action Guide instead of using the Atkins-Diet

View my Metabolism-Matters Webinar free for the truth about weight management

Read client case studies

References

Atkins, RC. Dr. Atkins’ New Diet Revolution (revised and updated). New York: Avon Books, 1999.

Bravata DM, Sanders L, Huang J, et al. Efficacy and safety of low-carbohydrate diets: a systematic review. JAMA 2003;289:1837-50 [review].

Brehm BJ, Seeley RJ, Daniels SR, D'Alessio DA. A randomized trial comparing a very low carbohydrate diet and a calorie-restricted low fat diet on body weight and cardiovascular risk factors in healthy women. J Clin Endocrinol Metab 2003;88:1617-23.

Fleming RM, Boyd LB. The effect of high-protein diets on coronary blood flow. Angiology 2000;51:817–26.

Foster GD, Wyatt HR, Hill JO, et al. A randomized trial of a low-carbohydrate diet for obesity. N Engl J Med 2003 22;348:2082–90.

Gould KL, Ornish D, Scherwitz L, et al. Changes in myocardial perfusion abnormalities by positron emission tomography after long-term, intense risk factor modification. JAMA 1995;274:894–901.

Nordmann AJ, Nordmann A, Briel M,et al. Effects of low-carbohydrate vs low-fat diets on weight loss and cardiovascular risk factors: a meta-analysis of randomized controlled trials. Arch Intern Med 2006;166:285–93.

Raykowski LK. Popular diets: what practitioners should know. Nurse Pract 2006;31:55–7.

Reddy ST, Wang CY, Sakhaee K, et al. Effect of low-carbohydrate  high-protein diets on acid-base balance, stone-forming propensity, and calcium metabolism. Am J Kidney Dis 2002;40:265–74.

Samaha FF, Iqbal N, Seshadri P, et al. A low-carbohydrate as compared with a low-fat diet in severe obesity. N Engl J Med 2003;348:2074–81.

Sondike SB, Copperman N, Jacobson MS. Effects of a low-carbohydrate diet on weight loss and cardiovascular risk factor in overweight adolescents. J Pedriatr 2003;142:25–8.

Stein, Karen. High-protein, low-carbohydrate diets: Do they work? J Am Diet Assoc 2000;100:760–1.

Volek JS, Sharman MJ, Gomez AL, et al. An isoenergetic very low carbohydrate diet improves serum HDL cholesterol and triacylglycerol concentrations, the total cholesterol to HDL cholesterol ratio and postprandial pipemic responses compared with a low fat diet in normal weight, normolipidemic women. J Nutr 2003;133:2756–61.

Volek JS, Sharman MJ, Love DM, et al. Body composition and hormonal responses to a carbohydrate-restricted diet. Metabolism 2002;51:864–70.