The Atkins Nutritional Approach – a.k.a. The Atkins Diet Plan

Dr. Robert Atkins

Who Was Dr. Robert C. Atkins?

If you are planning on following the Atkins Diet (Nutritional Approach) then you should first learn a little bit about the man himself, Robert Atkins, to understand why he created his “diet revolution“.

Dr. Robert C. Atkins graduated from the University of Michigan in 1951 and received a medical degree from Cornell University Medical School in 1955 with a speciality in cardiology. He became a specialist in internal medicine as well as a cardiologist.

Dr. Atkins was a working general practitioner that had specialized in internal medicine and cardiovascular biology. For many years before publishing his book he was helping overweight patients to lose weight by prescribing them a low sugar (low carbohydrate) diet. Dr. Atkins was the first person to recognise and successfully promote the health benefits of cutting sugar from diet. New studies are still showing that there is a strong relationship between the consumption of sugar and refined carbohydrates and heart disease.

During his 30 years of medical practice, Atkins saw thousands of patients. It was by advising and treating patients, some of whom were diabetic, that he noticed how a lower sugar diet also helps you the manage weight. Dr. Atkins kept detailed notes and built up numerous case studies of patients who lost weight, lowered blood cholesterol and blood pressure after changing their eating habits. This led to him developing his diet plan and  the Atkins Nutritional Approach was created in the early 1970s.

The Atkins Diet, or Atkins Nutritional Approach, rose in popularity throughout the 1980′s but then saw a decline. It has received a lot of criticism over the years, although to be fair most of this criticism stems from a lack of understanding about the diet. Typical concerns are that the high protein content is bad for health, that it causes heart disease and increase cholesterol levels.

Dr. Atkins Was Misundersood

My Copy of the Atkins Diet

One problem for Atkins is that many people misunderstand it. The media is largely to blame as very rarely are the full details of the diet published. Most people are aware of the strict diet rules during the induction phase (the first 2 weeks) but have no idea what happens after this period.

I have attached my copy of the Atkins diet just to prove that I own a copy, and have read it too. The book is just over 500 pages and is a fantastic resource on human nutrition and health.

A recent example of how the mainstream media get confused over Atkins can be found on the BBC website. The BBC have posted a quiz on diets called 7 questions on Fad Diets. The first question is on the Atkins diet (not a fad diet, but a sensible approach to eating). Dr. Atkins actually referred to the diet as a “Nutritional Approach” to make it clear that it was not a fad diet.

Question 1: Among the most famous diets of the 21st Century is the Atkins diet. Does this fit the high protein, low GI bill recommended by the Danish scientists?

If you answer yes, the BBC says:

“WRONG! It doesn’t, as the emphasis is largely on protein. The GI index applies to foods with carbohydrates – grains, fruit and vegetables. Foods with low GI ratings are digested more slowly, which decreases or delays hunger pangs.”

But the Atkins diet goes into a lot of detail about using the GI to ensure you keep sugar levels down. Atkins is not “high protein” but low sugar, it is the original low GI diet really. The induction phase (that is high protein) only lasts 2 weeks, the rest of the diet lasts the rest of your life.

The Glycemic Index - A Beautiful Tool (p.78)

Dr Atkins even advised not to eat processed meat, offal etc. Page 80 of the book (in my 2003 edition) provides a list of low GI foods. Atkins refers to it as “The Glycemic Index – A Beautiful Tool“. Sounds pretty pro-low GI to me. Here is a quote from the book:

“By choosing low-glycemic foods you can insure yourself a stable, smoothly running metabolic engine. The low carbohydrate foods you’ll eat during the weight loss phases of Atkins have a good deal of overlap with the low-glycemic foods you’ll see listed on the glycemic index table….

eating foods high in the glycemic index leads to elevated blood-sugar and insulin levels, which in turn leads to hypertension, undesirable cholesterol and triglyceride levels and other risk factors for heart disease.” The Atkins New Diet Revolution, p.79,82, 2003 edition.

Later research has shown that a high GI diet also poses increased cancer risk.

The problem of learning about diets from the press is that they just get it wrong most of the time. I expected better from the BBC though. The lesson for the day – if you chose to follow a diet plan, buy the book and read the book. If you plan to criticise a diet plan (BBC and others) buy the book and read the book first.

The Basic Principal of the Atkins Diet

The basic principal of the Atkins Diet is to reduce sugar intake (sugar in all its forms, not just pure refined sugars) and to compensate with an increase protein and healthy fat intake. Atkins recognized the relationship of sugar and insulin and how it affects appetite and metabolism. When people consume large amounts of sugar they stop burning fat, accumulate more fat, and feel hungrier quicker after eating. Weight gain leads to a wide range of health problems. All of this can be counteracted by eating less sugar.

Dr. Atkins divided his nutritional approach into four phases. Each phase plays an important role in ensuring that the diet is successful. Generally people that are critical of the Atkins diet are not aware of how the diet works after the short 2 week induction phase.

The Induction Phase of the diet is a ketogenic diet – a high protein, high fat, and very low carbohydrate regimen. The aim of this phase is to induce ketosis, by changing the metabolism from burning sugar as its primary fuel source, to burning both body and dietary fat.

After the induction phase you can eat a wide range of healthy, low GI fruits, vegetables, pulses and nuts. Plus all the meat you want and dairy too. You should still try to keep bread and pasta to a minimum, but that applies to all diets really. Refined flours are our worse enemy. Flour is really just a form sugar, and too much sugar is simply turned to body fat when it is not required to fuel muscle.

The phases of Atkins are

Phase one: Induction

This is designed to force the body into lipolysis, a metabolic state that occurs when there are no carbohydrates left to fuel glucosis. During the induction period, which should last at least 2 weeks, no alcohol or caffeine can be consumed, and carbs are restricted to 20 grams per day.

Phase Two: Ongoing Weight Loss

This is geared toward finding the “Critical Carbohydrate Level for Losing Weight.” This process involves increasing the carb intake by five grams per week until a person is within 10 pounds (about 5 kg) of their target weight. Carbohydrates should be in the form of highly nutritious vegetables and not refined sugars.

Phase Three: Pre-maintenance

Like phase two, this phase calls for an increase in carbohydrate consumption. The difference between the phases two and three is that this phase is designed to find the “Critical Carbohydrate Level for Maintenance.” So really it is a transitional phase from “weight loss” to “maintenance”. This is a vital phase as without it you are left guessing at how many calories in the form of carbohydrate you can eat before you put the weight back on again.

Phase Four: Lifetime Maintenance

This phase should be continued for the rest of your life. It is important to remind you hear that this is a well balanced and healthy diet which sees a reduction in sugar and increase in healthy proteins and fats. Dr. Atkins clearly stated that you should still avoid processed meats and favor organic meat wherever possible. To avoid regaining the weight lost during the diet Dr. Atkins also emphasizes making use of the option to return to any of the other phases if weight begins to return -commonly people will do 1 week of induction again to help kickstart fat burning metabolism once again.

The Atkins Diet has helped many people lose weight over the last 40 years, however, it has received a lot of criticism. Some people are mostly concerned with the increased fat and protein consumption, others are concerned that it has simply become a commercial operation and is no longer concerned with helping the individual. For example, Forbes Magazine produced a report stating that people on Atkins that purchased the Atkins Nutritionals range of foods to help with their diet spent 80% more on food than non-dieters.

He has authored a number of further books on his diet and nutrition, including Dr. Atkins’ New Diet Revolution (1992), Dr. Atkins’ Quick and Easy New Diet Cookbook (1997), and The Vita-Nutrient Solution: Nature’s Answer to Drugs (1998).

40 Years of Atkins - Atkins Diet Review

The question that many people ask today is, is the Atkins Diet safe? The Atkin’s Diet Revolution was first published in 1972, 40 years ago. Ever since then, the dieting community have been split into two groups – those that have tried it and lost weight, and support the method whole heartedly, and those that claim that it is a high risk, unhealthy diet that will lead to heart disease, high blood pressure and dangerously high cholesterol.

Dr. Atkins provided many case studies of people that had shown reduced blood pressure, bad cholesterol and other indicators of heart disease, however, critics claim that this is not the whole picture.

So, where are we now, in 2012, with the Atkin’s diet? The Atkins Diet is certainly not in the press as much as it was before. When celebrities such as Jennifer Aniston, Geri Halliwell and Minnie Driver were all “on Atkins” many people followed suit, as often happens. However, there has certainly been no recent press regarding celebs on Atkins. In addition to that, some libraries in reviewing their diet book collections, have discarded copies of the Atkins approach.

The most important opinion however, is that of the scientific community. So, how does the medical and scientific community feel about Atkins today?

Scientific Timeline on Atkins:

In 2003, research carried out by the Weight and Eating Disorders Program at the University of Pennsylvania showed that the Atkins diet can actually reduce the risk of heart disease. The results of the study came as a surprise to lead researcher Gary Foster. In this study, following the Atkins diet raised HDL (good cholesterol) levels by 11%, compared with only a 1.6% increase for low-fat dieters. Also, triglycerides were reduced by 17% after a year on Atkins, whereas low-fat diets showed no improvements. Research did not determine how the diet worked, but suggested that increased weight loss was the result of more structure eating, and from dieters feeling fuller sooner, rather than the role of lipolysis and insulin control.

Also in 2003, Belinda Linden, head of medical information at the British Heart Foundation made a statement on the Atkin’s diet, based on their research: “Previous studies have shown that weight loss from the Atkins Diet may involve muscle loss rather than body fat. Another potential problem is that it is so far unclear from studies whether weight loss is sustained over a longer period than six months. One of the studies shows no significant difference at 12 months. With minimal fruit and vegetables included in the diet, it holds serious implications for coronary heart disease and cancer. Diets need to be varied to protect against these conditions – and this one isn’t. This diet requires further long term and larger studies before its effectiveness can be confirmed.”

Some controversial news came out in 2003, which shortly after of Dr. Atkin’s death in April. A nutritionist condemned the Atkins Diet, saying there was not a “shred of evidence” to suggest that it worked. However, it emerged that the nutritionist, Susan Jebb, who was the head of nutrition and health research at the Medical Research Council (MRC), had been commissioned by Fab, the organisation which is recognised as the lobbying arm of the National Association of British and Irish Millers. The MRC was to be paid GBP10,000 by Fab to fund the research, which mostly involved reviewing scientific papers on low and high carb diets.

In May 2004, the Annals of Internal Medicine, (vol 140, p778) reported on research comparing followers of the Atkins Diet with those on a low fat diet. This was the longest study to date – a year long. Blood analysis showed that Atkins dieters had lower levels of triglycerides, potentially harmful blood fats which can trigger heart disease. Concentrations of beneficial high density cholesterols (HDLs) were also greater in the Atkins group. Also, these favourable changes remained until the end of the study, suggesting that there might be lasting benefits.

In another six month study, this time on 120 overweight patients at the Duke University Medical Center in Durham, North Carolina, more positive results were shown for Atkins. The low-carbohydrate dieters lost an average of 12 kilos, twice that lost by those on a low-fat regime (Annals of Internal Medicine, vol 140, p769). And the pattern of blood fats and sugars mirrored that in the first study.

In 2005 a Belgian study indicated that the Atkin’s diet was effective, but not as a result of lipoysis, but just because when on the Atkins Diet people just eat less. The theory put forward was that putting on weight following a high-carb meal is how our hunter-gather bodies are programmed to respond. Before humans developed agriculture, humans relied on hunting and gathering. Large quantities of carbs would appear briefly each year just before a winter famine. To survive human would have to eat as much as possible before the food rotted, or someone else ate it. For the rest of the year, high-quality carbohydrate was scarce and leafy plants, ants and meat formed that main part of the diet. The Atkins approach essential replicates the winter famine scenario, where appetite is reduced, and less food consumed. However, the results of the research did still show that it was effective at losing weight.

In March 2006 came some worrying news for the Atkins corner. A 40-year-old obese woman developed ketoacidosis, a potentially deadly blood disorder, after one month on the Induction phase of Atkins. However, some scientists did point out that vomiting, from a clinical problem which is not triggered by diet, would have led to the ketoacidosis. So the low-carb diet may not have been to blame after all.

In July 2006, some of the most important research was carried out. A study showed that a diet of low GI foods reduces body fat while also reducing levels of “bad” cholesterol, that contribute to the risk of heart attack and stroke. 189 overweight and obese adults were studied at the University of Sydney, Australia. The Atkins approach emphases that carbs should come from low GI sources, such as leafy green vegetables, and not high GI sources, such as potatoes and carrots.

In March 2007, Stanford University in California studied a group of female dieters, to compare the effects of four different diets. Subjects of the study had a choice of diet to follow:

• The Atkins Diet Approach
• The Zone Diet, which cuts carbs less severely than Atkins
• LEARN, a low-fat, high-carb diet based on US government guidelines
• Ornish, a more extreme low-fat plan.

Results were published in the Journal of the American Medical Association (vol 297, p 969) and showed that the Atkins dieters had lost 4.7 kilograms on average, which was significantly more than the Zone group, but only marginally more than the Ornish and LEARN. So, the Atkin’s diet in this study was the best, but only by a small margin. However, Dr. Atkins had documented that women do find this approach more difficult due to hormonal responses to contraceptive medicine.

In 2007 research started to reveal that the Atkin’s diet may help sufferers of epilsepy – although results are still not conclusive yet. Research was reported in the journal Epilepsia (Volume 48 Issue 1 Page 182-186, January 2007)

Overall there, there is more evidence and research supporting the Atkins diet revolution. There have been cases in the press of people developing heart problems after being on Atkins for a year, and Dr. Atkin’s himself warned pregnant women not to go on a low-carb diet. However, a majority of research still supports the view that the critics of Atkin’s mostly base their arguments on a few isolated cases, whereas the supporters of Atkins carry out scientific trials and studies, which are published in the scientific and medical press.

So far, there has been no support of the view that an Atkins diet is bad for your health in the scientific press. Therefore, we conclude, that following the Atkin’s Diet Revolution is good for your health. Dr. Atkin’s actually pointed out in his book, that the risks associated with being obese are generally greater than the risk of consuming a diet high in fat. If you are obese, you are more likely to suffer diabetes, heart disease and stroke, and the Atkin’s diet is an effective method of losing weight, and kick-starting a healthier way of life, as well as reducing bad cholesterol and triglycerides.

Health Benefits of Low Carb Diets Proved

In early 2010 recent study published in the Archives of Internal Medicine revealed that eating a low carbohydrate diet is more effective at reducing blood pressure than taking weight-loss pills such as Orlistat.

High blood pressure can lead to more serious health conditions such as heart disease, stroke and kidney problems. Doctors often prescribe weight loss pills to patients that are overweight and are suffering from high blood pressure. However, studies reveal that a change in diet may be more effective.

Dr. Atkins firmly believed that a low-carb diet was very effective in preventing many illnesses. His “Diet Revolution” was very popular in throughout the 1990′s but then lost favor. The main criticisms were that the high-protein approach had to include too much fat also, especially saturated fats. Also many people consumed too much red meat while on the diet, which is now known to increase risk of developing colonic cancer.

In the study patients that received counseling lost the most weight, proving also the effectiveness of support networks in weight loss.

Both the low carb diet and the weight loss pills (orlistat) were equally effective at controlling cholesterol, managing weight loss and reducing stomach fat.

“The findings send an important message to people with high blood pressure who are trying to lose weight. While weight loss typically induces improvements in blood pressure, it may be that the low-carbohydrate diet has an additional effect. It’s important to know you can try a diet instead of medication and get the same weight loss results with fewer costs and potentially fewer side effects.” Lead Researcher Dr William Yancy, Duke University Medical Centre

Possibly the key determinant in the success of the low carb diet with respect to weight loss is the counseling sessions that were provided. In the study group the subjects that attended at least 15 sessions in a year lost much more weight that those that received less or no counseling.

The diet pill used in the study was orlistat. It is sold as Alli and Xenical and is available in many pharmacies over the counter. The drug works by preventing dietary fat from being absorbed into the body, so rather than being a “fat burner” it is essentially a “fat blocker”. The idea is that it is taken while also following a calorie controlled diet and exercise regime, but is not recommended for people with a BMI below 28. It is only intended for very overweight and obese people.

Is Atkins Any Better Than Other Diets?

The Atkin’s approach is by no means the only or the best way of losing weight, but it is very effective, and for many people that have failed a low-fat approach, Atkins can work. It is vital to read the rules, and follow the plan. There are many misconceptions about the Atkins diet, and most negative responses to Atkins actually comes from these misconceptions, rather than direct from the rules of the Atkins Diet Revolution.

Studies have shown that in the long term the Atkins diet is not actually any better than other diets systems. Although it has good short term success, after one year weight loss results are more or less the same between all diet plans. Proof really that lifestyle and the individual is the key factor in determining the success of a diet, not the diet plan itself.

Two peer reviewed studies were also published on the Atkins diet, both of which did state that Atkins was a better method of dieting. The New England Journal of Medicine and the American Journal of Medicine stated Atkins is the best diet plan for short-term weight loss. However, they both stated that Atkins dieters do have a greater risk of developing coronary heart disease. Dr. Atkins did touch on this subject though, and it was in his opinion that the positive health benefits of losing weight outweighed the negative effects of increased fat intake.

Nearly forty years later, Dr. Atkins is still recognized for his approach to weight loss. Recently we have started to see diet plans that are very similar to Atkins but repackaged and marketed. For example, the stone age diet (or caveman diet) is based on the same principals – low sugar, no refined foods, no processed foods, highly nutritious organic vegetables.

If you do decide to “go on the Atkins diet” the single most important piece of advice anyone can give you is, go out and buy a copy of the book and read it, understand it and then get to work.

Tags: carbohydrates, diet, protein