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Diet and Nutrition

Diving Deeper into the Atkins Diet

07/13/2000

Question:

I have a research background, and am trying to educate myself on the new/old Atkins diet. After having previewed subject matter posted on your website, my question/comments:

It seems that the theories of low-carb diets tend to go against conventional wisdom, or seem otherwise unusual. For example, I`ve seen the following statements in "low-carb" diet literature:

- Caffeine increases insulin levels, with apparently bad side-effects - Fats can essentially "lubricate" the interiors of arteries, preventing or limiting attachment of excess blood cholesterol, preventing blockage. - The pancreas produces a limited supply of insulin over a lifetime, so "low-fat" diets can apparently lead to diabetes?? - Ketosis is a desirable metabolic state for the body to be in (apparently different from conventional wisdom)

Since we know from history that the guy with the oddball idea is sometimes correct, I wonder if there is a chance that low-carb diets would work long-term for some people? There are many "success" stories sited in pertinant literature. Also, it seems that detractors of low-carb diets often state that the theories behind such diets are not supported by science. Is this really the case?

There have apparently been, within the last few months, results of research from Duke University comparing low-fat and low-carb diets, which are favorable for the low-carb diets in terms of weight loss, blood cholesterol, etc. Is there more (and objective) such research in the works? If Dr. Atkins (and his diet method) has been around since the 70`s, do he and other researchers have 20 - 30 yrs of data investigating the various aspects of low-carb diets, with comparisons to low-fat diets?

With new research data out now, should any answers given to inquiries about low-carb diets, especially Q`s posted on this website since 1997, be revised?

thanks for your information

Answer:

Thanks for your question. We have received many questions about Atkin`s diet in the past year. His dietary recommendations are indeed controversial since most health experts (doctors as well as nutrition experts) recommend a diet high in complex carbohydrates, low fat and moderate in protein. Currently, there have not been many studies done to test the long term effects of the Atkin`s diet. Although there was one study completed at Duke, these results have not been published in any peer reviewed medical journals. More research is underway (or will be coming in the future) at UCLA. The University of Cincinnati is currently conducting a small pilot study on the Atkin`s diet VS the American Heart Association diet, but results of this study will not be available until the study is complete. As for Atkin`s theories, there is not research to support that "caffeine acts like insulin", ketosis is "desirable" the pancreas provides "limited insulin in a lifetime" and that fat "lubricates" arteries protecting them from atherosclerosis. Caffeine may act like insulin in that it constricts arteries, which may reduce glucose flow to the brain, making a person feel hypoglycemic. Atkins suggests that you avoid caffeine to prevent hypoglycemia because when you have hypoglycemia, you`re likely to eat! If caffeine TRULY was like insulin, why wouldn`t doctors treat diabetes with caffeine? This theory does not make sense. In addition, ketosis is not an optimal state in the body. When a person does not consume carbohydrates (which get stored for energy), the body is forced to break down stored fat for energy. Ketosis is a metabolic process where fat is not broken down completely because a certain amount of carbohydrate is needed for adequate breakdown. Ketones make the blood more acidic, which is why the body gets rid of them in urine (which can cause dehydration, which appears as weight loss). Because of ketosis, the body is in an acidic state, which is not optimal metabolically. This metabolic state puts more strain on the kidneys, and can cause the body to lose calcium, potassium and other vital nutrients. Calcium acts as a buffer in the body to try to neutralize the blood. Although people may lose weight on the Atkin`s diet, it may be due to low calorie intake, and not necessarily the composition of the diet. Because people may tire of having to eat the same foods day after day, they tend to eat less, which results in weight loss. In addition, people may feel fuller by eating protein and fat all day long, and therefore eat less. As for Atkins theory that this diet reduces cholesterol, it does. But, it lowers cholesterol because ANY weight loss will lower cholesterol. We don`t know the effect on lipid levels with this type of diet long term. You can be thin but still develop atherosclerosis over time. The problem with this type of dieting long term is that it is difficult to stick with. As mentioned above, you may tire of this diet over time. Plus, your brain requires glucose (from carbohydrate) to run on. Your body will break down muscle to create glucose for your brain, resulting in muscle tissue loss. In addition, because many foods are limited in the diet (potatoes, noodles, rice, fruit, etc.), the diet is not nutritionally adequate. Current studies are evaluating the result of a high protein diet on calcium balance and potential osteoporosis since a diet high in protein may lead to calcium loss in the urine. This diet is also relatively low in fiber, which may affect bowel function over time. There have been some studies where a high protein diet may be beneficial in some patients. People that experience insulin-resistance (an altered metabolic state where the cells do not use insulin efficiently), may benefit from a higher protein diet because they cannot metabolize carbohydrates very well. It is unclear if this type of diet is useful for others without this medical condition. Lastly, the Atkins diet has not been formally tested on people with diabetes or heart disease (the very people that would benefit from weight loss!). All of his studies have been based on healthy people. Although prevention through weight reduction is optimal, patients with chronic diseases such as hypertension, diabetes and heart disease are more likely to benefit from weight reduction long term. This diet plan simply needs more research before health care professionals will embrace it. I hope this information was helpful. For more information on upcoming research studies with the Atkin`s diet, call Dr. Bonnie Brehm at UC at 558-7502.

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Response by:

Lisa Cicciarello Andrews, MEd, RD, LD Lisa Cicciarello Andrews, MEd, RD, LD
Adjunct Faculty
University of Cincinnati