Atkins consist of four stages. Very small amounts of carbohydrates are allowed (20 g) in the first stage which is termed induction. This usually leads to rapid weight loss. In he next steps carbohydrates are added in specific increments until you find the level of carbohydrate consumption at which you can continue to loose weight gradually. You stay at that level of carbohydrate consumption until you are within a few pounds of your goal, then you can move into the last phase which is considered to be a lifetime maintenance plan.
The Atkins diet was first introduced in 1972 when Dr Robert Atkins published his first book, “Dr Atkins Diet Revolution”. Dr Atkins was an American physician and cardiologist born in Columbus, Ohio in 1930. Atkins was very interested in nutrition and lifestyle measures to fight obesity. His initial methods were based on the research of another US scientist, Dr. Edgar S Gordon from Madison, Wisconsin. On October 5, 1963, Gordon and coworkers published an article in JAMA (Journal of the American Medical Association) called “A New Concept in the Treatment of Obesity”. Atkins became interested in their methods and tried them on himself with good results. Although his book, “Dr Atkins Diet Revolution, sold millions of copies his methods were strongly criticized by many colleagues and nutrition experts, some actually thought him quite mad. His methods severely contradicted mainstream nutritional recommendations. Increased consumption of fat was thought to be not only undesirable but dangerous.
Dr Atkins book, “Dr Atkins diet Revolution” was published in 1972. Since then, Atkins theories have been criticized bay many nutrition experts. However, forty years later, his theories are respected and accepted by many specialists who consider them an important tool in the fight against obesityAtkins was the first to emphasize the importance of insulin in individuals with obesity. Insulin is known to be important for the control of blood sugar and most individuals with diabetes ar acquainted with the role of insulin. Recent scientific research has illustrated the importance of insulin for cardiovascular disease, high blood pressure and aging.
Atkins explained that insulin causes the body to store fat, that some people are metabolically primed to put out more insulin than others in response to the same foods, that sugar and carbohydrates were the prime offenders when it came to raising insulin and that elevated levels of this hormone invariably resulted in increased body fat. He argued that it is not fat in the diet per se that makes you fat, but rather sugar-even more precisely, fat in combination with sugar. Atkins took serious issue with the idea that fat causes heart disease and claimed that his diet would actually improve blood lipid profile measurements, thus affecting this particular risk factor for heart disease in a positive way.
Atkins spoke in positive terms about a condition called “ketosis” and considered it a metabolic advantage. When carbohydrates are not consumed, glucose is released from glycogen stores, primarily in the liver. However, glycogen stores are limited and the body has to start using fatty acids for fuel, thus burning fat.
Ketones are byproducts from the breakdown of fatty acids. Fatty acids are however not available for the brain and central nervous system which is why these tissues have to use ketones for fuel. For Atkins, being in ketosis was the secret to unlocking your fat stores and burning fat for fuel. Ketosis was the desired goal of the induction phase. Being in ketosis was the prove that you were throwing the fat stores in the metabolic oven, using your fat, instead of sugar, for energy. The problem was that mainstream medicine considered ketosis to be highly undesirable and that it should be avoided at all times.
Atkins explained that low carbohydrate consumption would diminish the body fat sores in two different ways. Eating less carbohydrates and sugar brings down your level of insulin. Less insulin means less fat storage. Secondly, shortness of carbohydrates forces the body to use fatty acids as fuel in order to produce ketones which is necessary for the brain. Dietary fat has no effect on insulin. Atkins therefore reasoned that, even if there s a lot of fat coming into the diet, there is not enough insulin to drive the fat-storing machinery. He suggested, that even if there is a lot of fat coming in, you will not gain weight as long as carbohydrates are kept to a minimum.
The Four Stages
First stage (induction). This stage should last for two weeks. The Atkins diet is really quite simple. You do not count calories. You do not count protein. You do not count fat. You can eat all the fat you desire but trans fats should be avoided. You do have to count carbohydrates and they are very limited in the first stage, you can have up to 20 grams a day preferably in the form of salads or uncooked vegetables. Starch, grains, sugar, fruit and alcohol is prohibited. Coffee was initially not allowed because it could stimulate cravings. In a new version of the Atkins Diet, “The new Atkins” coffee is allowed because it me stimulate fat burning.
Weight loss is usually quick and may be quite dramatic in the first stage. The weight loss is due in large part to loss of water and bloat because insulin´s message to the kidneys to store salt is reduced.
Atkins suggested that you relatively soon move second phase although you may continue in the first stage for up to four weeks. The second stage is called “ongoing weight loss” (OWL). In this stage you have to define what is called “Critical Carbohydrate Level for Loosing” (CCLL). This is done by slowly adding back carbohydrates at a rate of 5 grams per week which allows you to eat 25 grams a day for the first week of the second stage. If you continue to loose weight, you go up to 30 grams a day for a week. This is continued until weight loss stalls, and then you cut back to the previous level. That level is defined as CCL.
When you are 5 to 10 pounds from your goal you move to the the third phase (premaintenance). In this phase you increase your carbs by another 10 per day for a week. Again you are looking for the level of carbohydrate consumption that will let you keep loosing, although at a much slower rate than before. Atkins thought it was important at this stage to slow the weight loss down to less than a pound a week for 2 to 3 months. At this stage you are adapting to a new long term lifestyle and preparing for the fourth step (Lifetime maintenance) where you will eat the amount of carbs that lets you stay at the weight achieved. The amount of carbohydrates people can eat at this stage varies very much but is usually between 25-90 gram a day, sometimes more among those who exercise much.
For the last 40 years the Atkins concept has met severe criticism by the medical community. These concepts have challenged main stream medicine and evoked many negative responses by physicians and other experts in the field of diet and nutrition. Much of the criticism however, has been aimed at the first stage of the Atkins diet, which may not be fair as this stage usually only lasts for two weeks. This stage is characterized by almost no carbohydrates but relatively high amounts of protein and fat. Many experts consider this to be undesirable if not dangerous. In this stage you are not allowed to eat rice, potatoes, cereals, starch, pasta, bread, fruit or milk products other than cream or cheese. However, during the later stages carbohydrates are increased and the diet is modified according to individual needs.
Does saturated fat increase the risk for heart disease?
In March 2010 the American Journal of Clinical Nutrition published an article called “Metaanalysis of Prospective Cohort Studies Evaluating Association of Saturated Fat with Cardiovascular Disease”. This scientific paper indicates that there is no association between the consumption of saturated fat and cardiovascular disease.
Main stream recommendation on diet and nutrition have for many years emphasized that a healthy diet should include 50-60% of carbohydrates, 25-35% fat and 10-20% protein. The highly respected Physicians Committee for Responsible Medicine has warned against some parts of the Atkins Diet and indicated that the amount of protein is to high and that the diet supports the consumption of to much cholesterol and saturated fats. It is interesting that, despite all the strong critics the Atkins diet has survived the test of time and is now accepted by many experts.
Many scientific studies have indicated that low carbohydrate diets may indeed be very effective to treat obesity. Many respected universities and medical clinics, like the Mayo Clinic, consider low carbohydrate diets to be important tools to fight obesity. Research indicates that low carbohydrate diets may improve diabetic control, increase HDL cholesterol (the “good cholesterol) and lower the amount of triglycerides in the blood which is considered positive.
Dietary guidelines and recommendations in the US and most European countries have for many years recommended diets with high amount of carbohydrates, and low amount of fat, mostly warning against cholesterol and saturated fats. Some critics of these recommendations consider them to be the main cause of the huge obesity epidemic in western countries.
The Atkins concept has gained support from many physicians and other experts during recent years. The concept that saturated fats are dangerous has been heavily challenged by many and experts who have pointed out the lack of scientific evidence behind this statement. In 2010 The American Journal of Clinical Nutrition published a meta analysis on studies addressing the association between saturated fats and the risk of cardiovascular disease. This analysis indicates that there does not appear to be any link between the consumption of saturated fats and the risk of cardiovascular disease.