The
Atkins Controversy
by Phil Kaplan
Whew! That's me taking
a deep breath for two reasons. First, breathing is good for
you (it certainly beats the alternative). Secondly, I'm about
to tackle a topic that might very well be the most controversial
issue in the fitness and weight loss markets today.
I've written several
articles over the past few years sharing my position on the
low-carb diets and have received my share of praise and condemnation.
In writing this piece, which promises to be lengthy, I anticipate
there will be an outpouring of agreement and criticism and
I welcome both. Before I explain what I see as potential flaws
in some of the low-carb offerings, I want to extend my sympathies
to Dr. Atkins' friends and family and assure every reader
this is by no means an anti-Atkins article. In fact, I admire
much of what Dr. Atkins accomplished. I believe it was courageous
and important for Dr. Atkins to openly challenge the FDA and
the USDA on some of their rulings and theories that had infiltrated
the medical community as fact when they were merely opinions
open for debate. I fully agree with his position on simple
sugars and refined carbs and greatly appreciate that he brought
the connection between insulin and fat storage to the forefront.
I think the more material the public has available, the more
qualified the individuals who make up that public are to embark
on a sensible nutritional course.
 Periodically
an article of mine that confronts some low-carb issues gets
posted on a low-carb board and the venomous e-mails pour in.
I can almost hear the crafters of the e-mails screaming at
me through their computer screens. Many of them disregard
much of what I say and erroneously categorize me as an Atkins
hater. I'll urge you to read this in its entirety before you
form an opinion on whether or not the information I share
is sound. If, after reading this piece, you decide to pursue
the Atkins diet, or any other reduced carb program, I applaud
you for reviewing both sides of the coin and making an educated
decision.
Atkins, although he
may be the most well known low carb advocate, was not alone
in his pursuance of a low-carb lifestyle, and while there
are many who are in his corner, there are many who represent
what might best be described as the opposition. I've been
in touch with the heads of the American Dietetic Association,
of Pritikin Longevity Centers, and with nutritional experts
at Tufts and Berkeley Universities, and they express concerns
and aversions regarding the "cut carbs" mentality that's sweeping
the weight loss wanting nation.
 The
battle continues to rage and recent inconclusive studies and
reports such as those published in the Journal of the American
Medical Association just add fuel to the fire.
I don't categorize
either side as "wrong," but I do believe the truth can be
found somewhere in between their respective conclusions. Consumers
and dieters are entangled in a battle between "low carb" and
"low fat" and the "experts" tend to eliminate the middle ground
where I believe the most sensible approach for the masses
lies.
 A
part of the reality that must be considered when confronting
the impact of the low-carb diet approach is, while many of
the low carb books do provide accurate information, most of
the low carb dieters I've met NEVER READ A COMPLETE DIET BOOK!
A friend, or a friend of a friend, shares the questionable
advice, "just stop eating carbs and you can eat all the protein
and fat you want." That is absolutely not "the Atkins diet,"
although those half educated dieters will be the first to
tell you they're "on Atkins." The misinformation passed along
from person to person takes one aspect of a low carb protocol
completely out of context, but we can't blame the misinformed.
In today's society,
people are being pulled in various directions believing there's
a quick easy magical fix thanks in great part to the efforts
of slick marketers of fraudulent and potentially dangerous
diets. The hype is so powerful Americans are getting sucked
in by the millions.
 There's
an oft-aired infomercial that's cleverly disguised as a talk
show on which a low carb diet is aggressively "sold." The
"guests" discuss feasts of bacon and eggs, cheeseburgers,
and lobster dripping with melted butter. They explain that
"fat doesn't make you fat, carbs make you fat." They've all
somehow done the impossible . . . they've "melted fat." Butter
may melt in a heated pan, but bodyfat doesn't melt. Fat loss
is a two-step process. First adipose material has to be released
from an adipose cell, and then the fatty acids have to be
shuttled into the mitochondria of a muscle cell where they
can be burned as fuel.
It's fair to suspect
that the majority of viewers of that "show" do not purchase
the product being marketed, but many follow marketing hype
as fat-melting gospel. No mention is made of water. No mention
is made of caloric consumption. No mention is made of the
thermic effect of food. No mention is made of exercise. The
illusion is, "just cut carbs and you'll love life and have
the body of your dreams."
My criticism is not
one of the passionate and well-informed professionals who
inhabit the low-carb camp, but rather one of a reduced carbohydrate
diet being aggressively promoted as a solution for the masses.
But
It "Worked" For Someone I Know!
 While
any diet with millions of followers will have its fair share
of success stories, those "successes" might not be representative
of what most followers will experience. Being in the fitness
industry and having amassed a long chain of weight loss success
stories, I often meet the less successful dieters seeking
yet a new "solution." I've met far too many who have suffered
everything from minor discomforts to chronic ailments after
following a path of deprivation. Many of these unfortunate
diet victims had their bouts with a low-carb approach, and
after coming in contact with hundreds of such cases, I personally
can not find comfort in aligning with the low-carb advocates,
although I certainly welcome them into any forum for open
discussion. I've frequently seen Atkins dieters in their post
diet conditions complaining of a residual weight gain greater
than the weight lost during the diet. I've met many who reported
significantly increased LDL (bad cholesterol) levels only
weeks after diet abandonment. I am an advocate primarily of
education and my study has raised some questions and conclusions
that I believe might make the low-carb diet a contraindication
for many seeking long term healthful weight loss. I don't
pretend to be the all-knowing authority, but believe my questions
and concerns merit consideration.
 Regardless
of the stories anyone provides for public consumption, as
long as a band of people hold tightly to the extreme "carbs
are the enemy" dictum, criticism by clinicians and conventionally
trained and educated experts is inevitable. Along with medical
experts raising an eyebrow will come highly qualified fitness
professionals. Exercise experts with a background in mainstream
nutrition are certain to indict the popular diet books as
an impotent piece of the puzzle if those books do not address
the importance of exercise.
I'm going to do the
best I can to explain some of the realities the infomercials
and low-carb marketers may not share. Much of the information
that follows is excerpted or re-written from previous articles
I've released. I am hoping, with this compilation, to create
a single informational piece raising all of the significant
questions and providing all of the necessary information to
counter or support the readings of someone considering a low-carb
lifestyle.
Glycogen
= Fuel
 When
you consume a healthful and supportive diet complete with
proteins, carbs, and fats, the carbohydrates are broken down
into glucose. Glucose is actually blood sugar. Some of that
glucose is transported and stored in muscle tissue as "glycogen."
This is sort of the fuel in your fuel tank. That's important
to understand. Glycogen =
Fuel.
Glycogen is used to
produce energy that fuels muscle contraction. ALL muscle contraction!
Don't think of muscle contraction only as exercise. Any movement
requires the contraction of muscle, from blinking your eye
to rising from bed in the morning. As long as you're consuming
carbohydrates you access and burn up stored glycogen, but
quickly replace it with new muscle fuel. An understanding
of that simple fact -- that carbohydrates are the source of
muscle fuel -- should raise an immediate red flag toward anything
that suggests seriously limiting carbs for any extended period
of time.
Once you understand
the basic premise behind muscle glycogen, you should understand
that the liver also plays a role in fuel storage. Some of
the carbs that you eat ultimately wind up stored as liver
glycogen. Think of the liver as sort of a "pump" for blood
sugar. The brain burns more calories than any other organ
in your body, and guess what it uses as its primary source
of fuel. Glucose! Carbohydrates! As brain activity results
in the "burning" of blood glucose, the liver accesses its
glycogen stores to keep blood glucose in adequate supply.
Again, as you expend glycogen, the carbs that you ingest replete
your supply.
LOW
CARBS? AT FIRST YOU'LL DO FINE . . . BUT . . .
On a low carb regimen,
at first you'll do just fine because you have a limited glycogen
reserve. After a day or two, you're using up your stored glycogen
and you're not replacing it. Your body shortly thereafter
begins amplifying its production of ketone bodies. Ketones
are intermediaries in the process of metabolizing fat that
are found in abnormal amounts in the blood and urine during
periods of metabolic impairment. Give up all of your stored
glycogen without replacing it and you're likely going to be
in such a state (Note: if you take in too many protein calories,
it is possible to avoid carbs and never enter a state of ketosis
rendering the low-carb ketosis theories useless). Atkins leads
you to believe that the presence of these ketone bodies indicates
ongoing fat release. He also assures you that they feed the
brain. That is partially true. Here are just a few of the
issues he neglects to address:
-
Extended periods of ketosis
may affect the chemical composition of the blood in such
a way that you increase risk of cardiac incident (blood
ketoacidosis).
-
In a state of ketoacidosis,
carbon dioxide accumulates in the tissues. Oxygen delivery
to the cells is impaired. This can lead to a wide range
of disastrous consequences ranging from respiratory ailments
to metabolic illness.
-
Toxic ammonia buildup resulting
from severe cases of ketoacidosis can be lethal.
I don't want to sound
any false alarms here. I'm not saying everyone who enters
a state of ketosis is going to be at risk of death. I'm just
pointing out that there is potential danger in what many people
misinterpret to be an ideal physiological state to maintain.
For clarity I'd like to repeat, ketosis is not fatal, but
ketoacidosis can be. Ketosis and ketoacidosis are different
states, but there is a link. Ketone levels in the blood are
elevated during times of carb depletion. If blood glucose
rises in conjunction with blood acidity, the pH of the blood,
the actual chemistry of the blood is altered. Someone with
normal pancreatic function and efficient use of insulin would
not likely shift from ketosis to ketoacidosis, but so many
Americans have undiagnosed blood sugar irregularities and
that's where the risks come in. It is also possible for stress
to alter levels of cortisol and the "stress hormones" which
directly antagonize insulin so the possibility does exist
that someone who normally has controlled blood sugar can enter
a state of ketoacidosis when placed under undue stress with
elevated ketone levels. Ketoacidosis can lead to a reduced
heart rate, breathing difficulties, and a loss of body fluids,
all which put the heart at greater risk.
At the very least,
the risk, just as risks of medications, should be addressed
and made public. If Atkins does share that information with
readers, I couldn't find it. He also neglects to tell you
that the liver is called into play to "filter" the abnormal
chemicals building up in the blood. This leads to a residual
buildup of uric acid. This uric acid accumulation can lead
to formation of kidney stones.
Kidney stones may
be common among low-carb dieters, but don't mistake that for
an indication that they're normal! If all is working optimally,
uric acid levels stay quite manageable, the kidneys continue
to function normally, and you will likely never have stones
accumulating in your urinary tract.
BUT
DON'T YOU LOSE WEIGHT?
 By
depriving themselves of carbs and/or cutting caloric intake
down below basal metabolic needs, dieters may wind up lightheaded,
spaced out, uncomfortable, irritable, and all around miserable
. . .but when they get on the scale, there's a moment of emotional
ecstasy! They're losing weight! Suffering through fraudulent
and potentially harmful weight loss alternatives has almost
become more the rule than the exception, and I can't point
a finger at those who are victims. I blame an industry that
thrives on fraud and deception.
While the public searches
desperately to find a solution, the Cabbage Soup Diet, the
2-day miracle diets, the Papaya Diet, and the Ice Cream Diet
add to the confusion. In order to combat the marketing power
of these "quick easy" diets, marketers of more legitimate
nutritional regimens are almost forced to promote using over-the-top
hype if they're even going to compete in the same arena. Of
course, the low-carb diets being thrown into the mix serve
to further confuse as there is little unity among the diet
camps. While marketers do battle, most of the "victims" don't
realize there is an "eat right and exercise" alternative,
one that truly works, and in the absence of that realization,
they're primed to be suckered in by the "Diet Du Jour."
At this point pro-Atkins
readers of this article may be on the verge of crafting one
of those "you don't know what you're talking about"
e-mails. They will insist that I am off base because I mentioned
that dieters may feel out of sorts and they in fact feel wonderful.
If you feel wonderful on the Atkins Diet, or any other diet,
far be it from me to discourage you. This was not written
for those who may be thrilled with a low-carb lifestyle, but
rather for balanced information among those who are considering
carb reduction or are less than satisfied with a carb restricting
diet. Many people who begin a low carb diet might feel that
uncomfortable lightheadedness I described, but after a matter
of days the discomfort subsides. This may be the result of
ketones feeding the brain, or it may be the result of the
body converting amino acids into glucose. In order to scavenge
the branched chain amino acids that can be converted into
brain fuel, the "I feel OK now" might be accompanied
by muscle tissue breakdown.
Before evaluating
whether or not a low carb diet works, It's important to understand
why the initial weight loss can be substantial. When I had
the opportunity to discuss weight loss attempts with Dr. Atkins
during an interview on WZTA in Miami, I asked if he agreed
that calorie deprivation leads to metabolic slowdown. His
response was, "Absolutely." I then expressed my concern that
his diet book encourages people to judge their progress by
their pounds on the scale rather than body composition. If
muscle is lost, metabolism slows, yet the scale would indicate
weight reduction. Isn't this the major problem with the conventional
calorie deprivation diets? Isn't a reduced carb diet that
results in muscle catabolism simply another outgrowth of a
metabolism destroying plague of non-solutions categorized
as "Diets?" If "Diets Don't Work," why are the low carb gurus
selling you a Diet?
I'm not a doctor,
and I certainly defer to someone medically trained, but that
deference is not at the exclusion of my right to question.
I was educated to believe that one gram of glycogen attracts
2.4 grams of water, thus if you hold less glycogen in muscle
due to carb restriction, it's a given there will be substantial
water loss. Dr Atkins agreed that much of the initial weight
loss may in fact be water.
 Of
course this issue of rapid weight loss leaves plenty of room
for debate, but it's pretty clear that when dieters on any
restrictive program lose "10 pounds in 10 days," or "30 pounds
in 30 days," it is combined loss of water, fat, and muscle.
I believe, based on the continuous marketing of "quick
weight loss," many diet sellers are using rapid water
loss as a trick leading people to believe they're losing weight
permanently when in reality the "result" is short
term.
I am by no means suggesting
weight lost on a carb restrictive plan is ALL water weight.
I already mentioned it may be a combination of water, fat,
and muscle (which I'll get further into shortly). I'm simply
saying that in the first week, many are overly enthusiastic
as they believe the 5 or 6 pounds lost is permanent.
WHERE'S
THE RESISTANCE EXERCISE ELEMENT?
 In
Dr. Atkins' book, "The Age Defying Diet Revolution," he does
encourage people to exercise with resistance, but that encouragement
is limited to one paragraph. In his previous work, Dr. Atkins
Diet Revolution, there is virtually no mention of resistance
exercise! He offers resistance exercise in his "new" book
only as a vehicle to resisting the diseases of aging. He makes
no mention of lean body mass and its link to metabolism. This
omission allows for a host of variables that may or may not
lead to unpredictable metabolic changes. Any diet or weight
loss program that fails to consider body composition (fat
vs. lean body mass) in measuring its effectiveness is going
to generate random conclusions at best.
WHERE'S
THE PROOF?
I guess the most relevant
question asked by critics of Atkins' theories is, "where is
the proof?" Scientists have been trained to seek out published
peer-reviewed research as evidence and then to seek out an
overwhelming abundance of evidence as proof. Personally, I'd
like to see one case study, carried on over the long term
(3-5 years), not funded by Atkins that can stand as a foundation
upon which proof can be built.
I'm aware of the recent
studies and reports the low carb dieters cling to as "proof,"
but do they honestly serve as clear evidence that the diets
are a valuable long-term weight loss solution? I don't believe
they do. One of the oft-referenced studies was conducted at
Duke University. (Westman EC, Yancy WS, Edman JS, Tomlin KF,
Perkins CE. Effect of 6-month adherence to a very low carbohydrate
diet program. Am J Med 2002 Jul;113(1):30-6).
It should be noted
that the Duke study was funded by a grant from Atkins. While
that doesn't dismiss its validity, it does add question marks
to the "conclusion." Had the conclusion proved otherwise,
would the study have ever been publicized? The abstract of
that study included the following:
"While we're impressed with
the weight loss of this diet, we still are not sure about
the safety of it," Westman said. "More studies need to be
done in order to be confident about the long-term safety
of this type of diet."
For example, all participants
developed ketonuria, the presence of measurable ketones
in urine. The level seen in this study translates to roughly
that of a non-dieting person if they didn't eat for a couple
of days, said Westman. "This is a finding that we need to
learn more about. The level of ketones present was not terribly
high, but we don't know if this is safe or harmful to one's
health over a long period of time."
A part of the challenge
with using these types of studies to indicate that a diet
is "safe and effective" goes right back to the strict measure
of "pounds lost" rather than reductions in bodyfat. If muscle
is lost, that would show up as positive, yet in the long run
it would be detrimental to metabolism. Another challenge in
interpreting the study's value is it's short term. All diets
have the potential to stimulate short-term weight loss, but
to date the long term success statistics are abysmal.
Another work that
is held up in defense of low carb strategies is, The Harvard
Medical School Guide to Healthy Eating, A HARVARD MEDICAL
SCHOOL BOOK By Walter C. Willett, M.D. In his book, "Eat,
Drink, and Be Healthy," Willett clearly challenges the food
pyramid established by the FDA and I'm right in his corner
on that one. He also talks about the importance of EFA's,
essential fats, the Omega 3's and Omega 6's. That's a bit
different than consuming saturated fats in bacon, cheeseburgers,
etc. While there are similarities in Willett's findings and
Atkin's teachings, there are also enough discrepancies to
disregard it as an endorsement of the Atkins Diet.
On July 7, 2002, the
New York Times published an article by Gary Taubes titled,
"What If It's All a Big Fat Lie." I've written an entire
article in response to that Taubes feature.
Supplementing the
science we can find an abundance of opinion among those who
have pursued the Atkins Diet at one time or another. These
opinions, otherwise referred to as anecdotal "evidence,"
range across the board. Is anecdotal evidence important? Scientists
say it's to be dismissed. I believe it should be considered
if it is directly linked to the strict adherence to a given
protocol. The question then becomes, "did these opinion
forming dieters actually follow a prescribed course of action?"
As I mentioned earlier, many have never read a complete diet
book which leads to great discrepancy among the manner in
which they attempted to go "low carb." Typically,
these diet bandwagon jumpers heard from a friend who heard
from a friend that carbs are bad and are to be avoided at
all costs. While Dr. Atkins, in the "Induction Phase,"
suggests 20 grams of carbs per day, and gradually increases
carb intake over time, a passed-along "just cut carbs"
mentality is not fully representative of the advice disseminated
in "The Diet Revolution." There's just so much misinformation
circulating that rumors and conjecture abound where true science
appears to be elusive. As an example of a single risk that
is enhanced with the omission of a prescribed piece of the
dietary puzzle, those who fail to read a book before beginning
carb manipulation may fail to recognize the need for consuming
ample quantities of water, and in a glycogen depleted state,
that can further add to risk of kidney stones and other disorders.
As a result, while we can look at and begin to sift through
the opinions, there is a long way to go before science can
actually "prove" this diet concept's value.
EAT
ANYTHING?
 Let's
take a look at another low-carb premise, one that OK's the
consistent ingestion of red meat, of bacon, of butter, and
other saturated fats. I can do a complete article on this
topic alone, but I'm going to bypass it since saturated fat
has been so conclusively linked to coronary artery disease,
it doesn't even merit discussion here.
I have, as I mentioned,
met with great numbers of Atkins dieters, and I've found some
very consistent data in understanding their adherence to the
diet. They all cut out simple sugars and refined and processed
flours. That's good! I encourage people to do that as it will
help stabilize blood sugar and facilitate fat release . .
. providing that some other aspects of nutrition are in place
(not extended ketosis) and providing that they are involved
in a supportive exercise program. Another interesting thing
I found, when analyzing their food intake, is although they
are told by Atkins they don't have to cut calories, in every
case they wound up eating fewer calories than they were before
the diet!
 Here's
why I believe that's true in many cases. Firstly, while butter
and cream cheese and sour cream are permitted, you're not
allowed to eat potatoes or bread. By eliminating most foods
people tend to flavor with fats, dieters have offered themselves
fewer opportunities to consume those fats, fats that very
well may have been in their scope of daily food intake prior
to the diet. Most people I've met on Atkins' plan or a facsimile
thereof have bacon and eggs for breakfast, but they stop eating
the cereal. For lunch they have a cheeseburger sans the bun.
Bread, cakes, pastries, and other carb foods are very calorie
dense. Most Americans are filling their mouths with high carb
foods, thus if you eliminate carbs, you're eliminating MOST
of their caloric intake and a significant portion of their
pre-diet fat intake. A steak, although it is higher in fat
than many carb foods, is also more water dense, thus, when
you take out the carb foods, it becomes quite challenging
to keep caloric intake high!
It's also meaningful
to note that a diet composed primarily of protein and fat
will decrease appetite by two separate mechanisms. By eliminating
erratic sugar intake you stabilize blood sugar minimizing
sugar-induced food cravings, and by stimulating certain amino-acids
to cross the blood-brain barrier in greater amounts, you develop
a greater sense of satiety. That means that not only are you
taking in fewer calories, but your desire for food is decreasing
leading to a continual drop of caloric consumption. That is
precisely the type of calorie restrictive diet Atkins claims
has failed America!
Will people lose weight
on any diet of reduced calories? Of course! But is that healthful
and permanent? Another question up for serious debate. Let's
go back and look at some of what might happen after the water
loss. Remember, glucose (stored as glycogen) is the preferred
source of fuel for muscle contraction. In a state of calorie
deprivation combined with the absence of that preferred fuel
source the body finds a way of creating its own glucose, the
blood sugar that it's lacking. It can manufacture blood sugar
from amino acids. Amino acids are the building blocks of proteins,
and there are three of them, known as the Branched Chain Amino
Acids, leucine, valine, and isoleucine, that can be simply
converted into glucose. You can get these amino acids by breaking
apart complete proteins and simply metabolizing the other
amino acids or dismissing them from your body as waste.
If I've confused you,
I want to un-confuse you. I want you to understand this. Let
me make it a bit simpler. Carb intake is severely reduced.
Your body wants for glucose beyond that being supplied so
it makes its own. It uses amino acids as the raw material.
To get those amino acids, it must break down either dietary
protein . . . or muscle tissue! Since muscle, as opposed to
fat, is tissue that actually burns calories, this process
slows metabolism and increases the likelihood that when you
go off of the low-carb diet, you'll wind up gaining back all
of the weight you lost plus additional fat.
BUT
. . . WE'RE ALL CARB SENSITIVE?!?!?
The low carb proponents
throw the term "carb sensitivity" around and often claim that
all Americans, due to their unsupportive eating habits, have
developed a case of this mysterious ailment.
It appears, based
on clinical research, that 10-25% of Americans do have some
level of insulin resistance (carb sensitivity). Conclusive
research has clearly shown that improvements in body composition
(lean body mass vs. fat) and regular exercise are far more
important in offsetting the challenges of insulin resistance
than cutting back carbs.
IS
A CARB A CARB?
 There's
no question that a gradual American shift to pretzels, Snackwell
cookies, and processed bagel breakfasts has led to impaired
carbohydrate metabolism in some individuals, but there's no
reason to throw the baby out with the bath water. Carbohydrates
are a nutrient, and nutrient, by definition, means "something
your body needs to ingest to sustain life." There's obviously
a flaw with any program that asks people on a massive scale
to eliminate intake of a vital nutrient. With a true understanding
of the differences between complex carbs and simple sugars,
it becomes possible to eliminate the true culprits (simple
and refined sugars) and reacquaint carb sensitive individuals
with supportive metabolism of high quality valuable complex
carbs (along with protein, fats, vitamins, minerals, and an
optimal supply of water).
WON'T
THIS LOW CARB PLAN HELP MY METABOLISM?
I'm amazed that so
many people buy into the claim that these low-carb diets will
stimulate metabolism when I can't find a shred of evidence
that lends itself toward that direction. In fact, in the absence
of carbs and necessary calories, not only do you run the risk
of slowing metabolism through muscle loss, but the thyroid
gland also performs a neat little trick. It alters its production
of the hormones T3 and T4, hormones instrumental in regulating
body heat, to "protect" the body from starvation. This results
in a further slowdown of metabolism and can lead to long term
thyroid challenges.
I believe, since there
isn't any disagreement that exercise is going to be a definite
positive factor in fat reduction, fitness, health, and alleviation
of disease risks, and since glycogen is fuel for muscle contraction,
it's more than obvious that exercisers benefit from ample
supplies of glycogen, that fuel obtained from carbohydrates.
It's important to protect metabolism so the body learns to
efficiently utilize carbs as fuel, proteins for cell repair
and maintenance, and essential fats for their inherent biological
value as components of cells.
More than ever, people
need to be educated, and until enough evidence leads to indisputable
proof of a regimen's value and validity, there will be disagreement
over "the best way" to find health and well being.
I want to emphasize
that I do not hold any personal vendetta against Dr. Atkins
as a person and I'm truly sorry to hear of his passing. I
believe his stand and his presence inspired the medical community
to question, and as science is always nothing more than a
"best guess," questions are the path to obtaining
a higher level of clarity. Are there people who will lose
weight and be satisfied with the "Atkins Way of Eating?" Sure,
but I don't believe that makes this a sound weight loss solution
for the masses. Every diet being aggressively promoted, most
of which fail most people, has some sort of driving testimonial
behind it. Usually those testimonials refer to pounds lost,
not to improvements in body composition.
As a lifetime learner
myself, I encourage you to continue to seek out additional
information, to read Dr. Atkins books, and, if you are considering
a low-carb diet, to do so with professional supervision and
direction. I welcome your responses and feedback related to
this article. E-mail phil@philkaplan.com.
A
Final Note:
If you are concerned
that the information I've provided is based solely on my opinion,
I assure you I've spent years researching this. Here are some
references.
1. Entering a high Protein twilight
zone. Tufts University Diet & Nutrition Letter 1996; 14(3):4-6
2. Coyle, EP, Fat metabolism
during exercise. Sports Sci Exch 1995; 8(6):1-6
3. Coyle, EP, Coggan, AR, Hemmert
WK, et al: Muscle glycogen utililization during prolonged
strenuous exercise when fed carbohydrate. J Appl Physiol
1986; 61(1): 165-172
4. Is pasta now on the 'out'
list too? Tufts University Diet & Nutrition Letter 1995;
13(3):4-6
5. Coleman, Ellen, RD, MA, MPH,
Carbohydrate Unloading, The Physician and Sports Medicine.
1997, 25(2):97-98
6. Low Carbohydrate, high-protein
diet: the way to lose weight? University of California at
Berkeley Wellness Letter, December 1992
7. Centers for Disease Control
and Prevention, National Center for Health Statistics, Division
of Health Examination Statistics. 1996.
8. Golay A; Allis AF; Morel Y;
de tonic N; Tankova S; Reaven G. Similar weight loss with
low or hig-carbohydrate diets. Am J Clin Nutr, 1996; 63(2):174-178
9. Position Statement of the
American Dietetic Association: Weight Management
10. Weintraub M, Long term weight
control study: conclusions. Clin Pharm Ther. 1992; 51:642-646
11. Bravata DM, Sanders L, Huang
J, Krumholz HM, Olkin I, Gardner CD, Bravata DM. Efficacy
and safety of low-carbohydrate diets: a systematic review.
Center for Primary Care and Outcomes Research, Stanford
University School of Medicine. JAMA 2003 Apr 9;289(14):1837-50
12. Westman, E.C., et al. 2002.
Effect of a low carbohydrate ketogenic diet program on fasting
lipid subfractions. American Heart Association Scientific
Sessions. Nov. 17. Chicago.
13. Eric D. Westman, M.D., Duke
University, et al., American Journal of Medicine, July 2002
14. Eat, Drink, and Be Healthy:
The Harvard Medical School Guide to Healthy Eating by Walter
Willett
15. Heshka S, et al. Weight Loss
With Self-help Compared With a Structured Commercial Program:
A Randomized Trial. JAMA 2003 Apr 9;289(14):1792-8
That's only a tiny
sampling of the research material I've amassed on the topic.
I have also studied hundreds of additional relevant articles
published in the American Journal of Clinical Nutrition, International
Journal of Obesity, Journal of the American Medical Association,
Journal of the American Dietetic Association which could all
be held up as evidence to support the value of maintaining
a reasonable carbohydrate intake. I've also referenced materials
from and/or conversations with many health and fitness professionals
ranging from educators to nutritionists.
Here's a sampling
of individuals I've learned from recently in relation to the
topic of Low-Carb dieting:
Megan McCrory, Ph.D., Energy
Metabolism Lab researcher, Tufts University
Dr. James J. Kenny, Ph.D., RD,
Nutritionist at the Pritikin Longevity Center in Santa Monica,
California and Vice-President of the National Council Against
Health Fraud.
Ellen Coleman, RD
Tim Patton, RD, Florida International
University
Keith Klein, nutritionist, researcher,
consumer activitist, Klein's Eating Management Clinic, Houston
Texas
Dr. Nancy Wellman, Florida International
University
Jim Wright, PhD, Science Editor,
Weider Publications
Jeff Feliciano, researcher, Weider
Nutrition
SUGGESTED
ADDITIONAL READING From Phil Kaplan:
Read my article on the pro-Atkins New York Times story
Also visit e-Diets.
They have taken a sound and reasonable approach
to the Atkins Diet and as a first step in considering some
views that intelligently oppose some of mine you should read
the following two articles:
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