Atkins Nutritional Approach

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The Atkins Nutritional Approach is the most popular and marketed low-carbohydrate diet in the world. It is commonly known as the Atkins diet or just Atkins. It was created by Dr. Robert Atkins in the 1960's, who used it to solve his own overweight condition. After treating over 10,000 patients with the diet, he released a series of books to popularise the diet, starting with Dr Atkins' Diet Revolution in 1972. He later on updated his own ideas in his new book Dr Atkins' New Diet Revolution, however, remaining faithful to his old concepts. Dr Atkins was also aware of alternative medicine views on the effects of Candidia Albicans overgrowth, and prescribed an anti-fungal variety of his diet in his book Dr Atkins' New Diet Revolution.

Nature of the diet

Dr Atkins claimed that there are two main factors common in western eating habits, firstly, that obesity is caused by eating refined carbohydrates such as sugar, flour, and high-fructose corn syrups. Secondly, that saturated fat is over hyped and that only avoiding hydrogenated oils with trans-fat need to be avoided. Dr Atkins was against the suggestions of the food pyramid and believed that over-eating of carbohydrates is the main cause of metabolism disorders. With most emphasis being on the diet, nutritional supplements and regular exercise are considered equally important elements.

Phases

The diet has 4 phases: Induction, Ongoing weight loss, Pre-maintenance, and Lifetime maintenance. However, it is not necessary to start with the induction phase, the diet may be started according to the required weight needed to be lost.[1]

Induction

The induction phase is a, brief, jump-start phase that triggers the body to predominantly burn fats. The net carbohydrate intake is limited to 20 grams per day. It usually takes 48 hours to for the fat burning process to start. The induction phase typically lasts for 14 days.

In this phase, all meats, and all non-starchy vegetables are allowed. Dairy products such as milk and yogurt are not allowed, however, cheese and butter are allowed (cheese limited). The primary source of carbohydrates is non-starchy vegetables. Caffeine is allowed in moderation, as long as it does not cause cravings or low blood sugar. Alcohol beverages are not allowed.[2]

Ongoing weight loss

The Induction limit of 20 Net Carbohydrates a day is increased up to 25 Net Carbohydrates daily in Ongoing weight loss. Gradually the daily carbohydrates tally is increased, in 5-carbohydrate increments, until weight loss slows.

Pre-maintenance

The carbohydrate content is increased by a notch, ideally 10 grams, and is generally done so as the goal weight approaches. The carbohydrate content can be increased as long as the fat burning process continues.

Lifetime maintenance

The goal of this phase is to maintain weight. Typically, an average person limits his carbohydrate intake by 40 to 60 grams daily, and a person who exercises an average of 45 minutes a day limits his carbohydrate content to 90 grams of carbohydrates a day, when following this phase of the diet.

Dr. Atkins tells readers to expect their weight to shift upwards sometimes and that when it rises by 5 pounds, a temporary return to the Induction phase is crucial for taking off what has been regained. In other words, you’re always only a few pounds away from having to return to a 20-carbohydrate-gram limit.

Scientific evaluation

See also Obesity:Low carbohydrate versus low fat diets

Diets low in carbohydrate content have become a matter of controversy in part because they run counter to the WHO recommendations to reduce consumption of sugars and rapidly digestible starches. When a person follows a low-carbohydrate diet, one of the common metabolic changes that ensues is ketosis. Low-carbohydrate diets produce a reduction of the circulating concentration of insulin, which in turn raises the levels of circulating fatty acids, which are used for oxidation and production of ketone bodies. When carbohydrate availability is reduced, the body is thought to respond by maximize fat oxidation for energy needs. The currently scientific literature shows that, in the short-term, low-carbohydrate diets induce rapid weight loss, reduce fasting glucose and insulin levels, reduce circulating triglyceride levels and lower blood pressure. However, there are other unfavourable immediate effects such as greater lean body mass loss, increased urinary calcium loss, increased plasma homocysteine levels, and increased low-density lipoprotein-cholesterol. The long-term effects of these is not known. [3][4]

In 2004, a review in the Lancet made that point very strongly, saying that "Long-term studies are needed to measure changes in nutritional status and body composition during the low-carbohydrate diet, and to assess fasting and postprandial cardiovascular risk factors and adverse effects. Without that information, low-carbohydrate diets cannot be recommended." [5][6] In 2005, the journal Nutrition in Clinical Practice invited two reviews that put the cases for and against low-carbohydrate diets. The review in favour, by an author from the Dr. Robert C. Atkins Foundation argues that "The controlled-carbohydrate regimen could be a viable alternative dietary approach for weight management used by clinicians managing patients who are failing with conventional approaches."[7]. The contrary case was made in an article that "systematically reviews and refutes the 6 major physiologic claims made by proponents of low-carbohydrate diets. Any benefits or advantages resulting from these diets must therefore be derived from factors other than those stated by the alternative theory."[8]

References

  1. Atkins phases
  2. Acceptable foods during induction
  3. Adam-Perrot A, Clifton P, Brouns F. (2006) Low-carbohydrate diets: nutritional and physiological aspects. Obes Rev 7:49-58. PMID 16436102
  4. Gardner CD et al. (2007) Comparison of the Atkins, Zone, Ornish, and LEARN diets for change in weight and related risk factors among overweight premenopausal women: the A TO Z Weight Loss Study: a randomized trial.1: JAMA 297:969-77 PMID 17341711
  5. Astrup A, Meinert Larsen T, Harper A. (2004) Atkins and other low-carbohydrate diets: hoax or an effective tool for weight loss? Lancet364:897-9 PMID 15351198
  6. Lara-Castro C, Garvey WT (2004) Diet, insulin resistance, and obesity: zoning in on data for Atkins dieters living in South Beach. J Clin Endocrinol Metab. 89:4197-205. PMID 15356006 ("Popular low-carbohydrate, high-fat diets are being fervently embraced as an alternative to challenging modifications in lifestyle and intentional calorie reduction. Current data do not support such unbridled enthusiasm for these diets, particularly in relationship to high-fiber, high-carbohydrate diets emphasizing intake of fresh vegetables and fruits.")
  7. Bloch AS (2005) Low carbohydrate diets, pro: time to rethink our current strategies. Nutr Clin Pract 20:3-12. PMID 16207641.
  8. Kushner RF (2005)Low-carbohydrate diets, con: the mythical phoenix or credible science? Nutr Clin Pract 20:13-6. PMID 16207642