Actually, I Do Mean the Atkins Diet

When I tell people (including doctors, dietitians, and other health professionals) that I specialize in low carbohydrate diets,  a typical response is, "But you don't mean the Atkins Diet, right?" Because I'm a dietitian, they usually assume I'm referring to a low-carb, low-fat, high-protein plan such as the South Beach or Dukan diets.

My friend Mike told me he wanted to refer his boss to me but that the man was leery of carbohydrate restriction because he'd had a bad experience with Atkins. When I asked him what the bad experience was, he replied, "Well, he almost died."

"Really? How?" I asked. Mike wasn't able to give me any other information -- apparently this is something his boss had told him -- but I'm pretty skeptical about this. If the man had diabetes or hypertension and went on the diet without notifying his doctor and having his medications adjusted -- which Dr. Atkins and all responsible medical professionals always advise -- then, yes, he could have experienced severe hypoglycemia or hypotension, both of which are very dangerous. But the diet itself wouldn't have been to blame. 

I've been thinking about Dr. Atkins a lot lately because I'm reading Atkins Diabetes Revolution: Control Your Carbs to Prevent and Manage Type 2 Diabetes, by Dr. Mary Vernon and Jackie Eberstein, RN, and I recently watched a video of Jackie's presentation given on this year's Low Carb Cruise.  Last week I watched a series of videos  about Dr. Atkins on You Tube (It's actually one hour-long program broken up into four parts). If you have time, I highly recommend watching it:
Part 1
Part 2
Part 3
Part 4
Part 5

Unfairly Demonized 

I think most people are aware that Dr. Atkins received more than his fair share of criticism regarding the merits of his diet (safety, effectiveness, sustainability), but I didn't realize that for many years he spent almost all of his revenue on legal representation and other costs associated with lawsuits brought against him. Many in the medical establishment criticized his high-fat, low-carb plan as a dangerous, unbalanced fad diet. However, in his original 1972 book, Dr. Atkins Diet Revolution, he proposed a whole foods, balanced, sustainable plan designed to lower insulin levels and promote weight loss while providing satisfying, luxurious foods. Dr. Atkins didn't encourage people to eat until bursting but to simply stop eating when no longer hungry -- a strategy much easier to implement in the context of carb restriction with moderate amounts of protein and fat than on a low-fat, higher-carb diet. 


He also recommended lots of nonstarchy vegetables and, depending on personal tolerance, even occasional indulgences like ice cream or other treats. His concept of an individual's "critical carbohydrate level" (the point at which the person must cut back on carbs in order to continue losing weight or improve blood sugar levels) is identical to today's "n=1" and "eat to your meter" methods. Even though he was routinely criticized and dismissed by many as a "quack," he never wavered from his advocacy of carb restriction because he believed so strongly that he was right.
The millions of people around the world who have lost weight, improved blood glucose and lipid levels, lowered blood pressure, and improved or resolved other health issues  are a testament to the validity of his approach.

In many ways, Dr. Atkins was ahead of his time as far as understanding the complex relationship between carbohydrate intake, hormones, and weight balance. He also believed strongly in optimizing health and preventing disease aside from maintaining a healthy weight. As a doctor of complementary medicine, he encouraged people to follow a balanced low-carb diet and take appropriate supplements when needed rather than rely on medications with unpleasant and potentially dangerous side effects.

Research supported by the Atkins Foundation

For many years, one of the biggest roadblocks standing in the way of carbohydrate restriction acceptance was the lack of research supporting its safety and effectiveness, in large part because getting funding for studies was so difficult. However, once Dr. Atkins had the money to pay for the research himself, he began doing so in earnest. Today, even after his death, the Atkins Foundation continues to fund independent studies devoted to carbohydrate restriction -- which have demonstrated its suitability for people struggling with obesity, metabolic syndrome, and diabetes -- and nutrition's impact on metabolism and health.  Some people criticize studies by Dr. Eric Westman, Dr. Jeff Volek, and Dr. Steve Phinney as being "paid for by Atkins." But although the Atkins Foundation provides funding, I think it's disingenuous to call into question the integrity of these researchers on that basis. Within the past decade, there have been many studies comparing low-carbohydrate to low-fat diets which were not funded by the Atkins Foundation, and in every case carb restriction performed at least as well as -- and typically better than -- fat restriction for weight loss and diabetes management.


A registered dietitian who supports Atkins?

I may be a rarity, but I'm not the only registered dietitian or even the first one to believe in the Atkins approach. My friend Valerie Berkowitz and her husband, Dr. Keith Berkowitz, worked with Dr. Atkins at his Center for Complementary Medicine prior to his death in 2003. Valerie told me that when many of her RD friends learned that she worked for Atkins, they weren't at all supportive and questioned how she could believe in a diet diametrically opposed to the type promoted by most government health organizations. (I've received mixed reactions from the RDs I know but am very grateful for the support of a good number of them). Valerie and her husband now work at the Center for Balanced Health  in New York, where carbohydrate restriction is one of a number of options they discuss with their patients.

The Atkins diet isn't for everybody. People with familial hyperlipidemia need to reduce intake of fat (particularly saturated fat) due to severe issues with lipid metabolism, but this condition is relatively rare.  I firmly believe those with diabetes, insulin resistance, and/or metabolic syndrome would benefit greatly by following Atkins or another diet based on carb restriction, but if they truly don't like high-fat foods (some people actually don't, apparently) and prefer eating a low-fat diet instead, of course that's their prerogative. It's important to eat in a way you enjoy and see as a lifestyle rather than a quick fix to abandon after a few months. Personally, I love eating LCHF and am extremely grateful to Dr. Atkins for continuing to speak out on what he always knew was right even in the face of so much backlash and hostility.

* Always speak with your doctor prior to starting a low-carb diet or making other dietary changes.

References

1. Westman EC, et al.A low-carbohydrate, ketogenic diet to treat type 2 diabetes. Nutr Metab 2005; 2:34
2. Volek JS, Feinman RD. Carbohydrate restriction improves features of the Metabolic Syndrome. Metabolic Syndrome may be defined by the response to carbohydrate restriction. Nutr Metab(Lond) 2005 ;2:31 
3. Dashti HM, et al. Beneficial effects of ketogenic diet in obese diabetic subjects. Mol Cell Biochem 2007;302:249-256
4. Foster  GD, et al. Weight and metabolic outcomes after 2 years on a low-carbohydrate versus low-fat diet: a randomized trial. Ann Intern Med 2010 Aug 3;153(3):147-57
5. Boden G, et al. Effect of a low-carbohydrate diet on appetite, blood glucose levels, and insulin resistance in obese patients with Type 2 diabetes. Ann Intern Med. 2005 142:403-411

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