The Atkins Diet was created by an American doctor. It is one of the most popular weight loss plans to advise cutting back on carbohydrates.
What is the Atkins Diet?
Dr Robert Atkins, an American doctor, read about the way in which a diet low in carbohydrates can help the body to burn fat instead of glucose as fuel. He tried it out to solve his own weight problem. He then wrote a book, Dr Atkins' Diet Revolution, about his nutritional plan, which was published in 1972. The diet really took off in popularity after Dr Atkins' New Diet Revolution was published in 2002. The new book developed the ideas set out in the first book.
How does the Atkins Diet work?
Traditional weight loss plans focus on reducing energy-dense fats in the diet, and they recommend that one third of a meal should be composed of starchy foods such as pasta, bread or potatoes. Carbohydrates, whether simple sugars, which are found in sweet foods, or complex starches, are digested to become glucose. This is the usual energy source for all the body's cells. When we eat carbohydrates, the body releases a body chemical (hormone) called insulin which processes the glucose.
However, if the body does not have carbohydrates, insulin levels remain low and this triggers a process called ketosis. In ketosis, the body uses fat reserves to provide energy. In the original Atkins Diet plan, carbohydrates were severely restricted in the initial diet phase and this led to rapid weight loss. More recent updates to the plan allow a small amount of carbohydrate in the diet and weight loss is generally more gradual. It also means that less extreme ketosis occurs.
There is an initial induction phase to the diet, lasting about two weeks. During this phase, protein foods such as meat and fish are eaten freely. Recommended recipes contain much more fat than most dieters are used to, including cheese and cream. During the second phase, the carbohydrate intake is gradually increased, and weight loss continues more gradually. When the target weight is reached, carbohydrate intake is gradually increased to find the balance point at which weight is comfortably maintained.
Is the Atkins Diet effective?
Many people have found low-carbohydrate diets such as the Atkins Diet an effective way of weight loss and weight management. This may be because of the induction of ketosis as described by Atkins. However, since most of our energy intake usually comes from carbohydrates, restricting them may simply have the effect of reducing overall energy intake. Also, high-protein foods increase the feeling of fullness after eating (satiety), so that may reduce hunger pangs.
Several studies comparing the outcomes of low-fat and low-carbohydrate diets concluded that both are effective for those who are able to stick to the diet plan. There seems to be no clear advantage of one over the other in terms of short- or long-term effectiveness. The health risks and benefits are similar.
Is the Atkins Diet safe?
The mild ketosis induced by eating a low-carbohydrate diet should not be confused with the dangerous condition of ketoacidosis. Ketoacidosis can be life-threatening in those with diabetes, who are not able to control the levels of the chemical (hormone) called insulin and glucose in their bodies. However, mild ketosis during the initial phase of the Atkins Diet can cause some symptoms such as:
- Feeling sick (nausea)
Some people have found that a low-carbohydrate diet can result in depression, although this may be offset by the effective weight loss.
Because the Atkins Diet advises eating habits different from those which are traditionally recommended, many health professionals have been hesitant to recommend it. Concerns have been raised about the way in which this diet might affect those who follow it. There has been a lot of publicity, both positive and negative. A lot of research has been carried out, and is ongoing. However, it is sometimes difficult to obtain a clear answer to some of the complex questions about diet.
There have been some concerns that a high meat intake might increase the body's levels of saturated fat. This might cause a higher risk of stroke or heart disease. The results of studies done to investigate this question have been inconclusive. Some risk factors are reduced while others are increased. One study recommended that eating protein and fat from foods other than red or processed meat would reduce the risk of developing diabetes on a low-carbohydrate diet.
Other questions concern the low levels of fibre consumed in a low-carbohydrate diet. Fibre is necessary to keep our bowels moving healthily. A diet low in fibre may lead to an increased risk of developing bowel cancer. Fruits and vegetables are carbohydrate-containing foods which are restricted particularly in the initial phase of the Atkins Diet. There are concerns that people who stick to a low-carbohydrate diet for a long time may miss out on vitamins and other important nutrients in fruit and vegetables.
Other concerns which have been raised include a possible increase in non-alcoholic fatty liver disease or kidney stones, especially in people who stick to the diet for a long time. One research paper showed that following a high-protein diet could further damage kidneys if they were already failing. There was, however, no risk to healthy kidneys.
Another criticism of the diet is that it can be quite expensive to follow. A meat-based diet costs more than one based on starchy foods and vegetables.
Are there other benefits to the Atkins Diet?
High-protein ketogenic diets are used in the management of some medical conditions. Ketogenic diets have been used to treat epilepsy since about 1920. However, today they are mainly used for children with difficult-to-control epilepsy. This should only be tried under guidance from a doctor.
A low-carbohydrate diet may also benefit those with disorders such as type 2 diabetes and polycystic ovary syndrome. In these conditions one of the problems is the way the body processes sugars and the chemical (hormone) called insulin. Often they find losing weight by following a traditional low-fat diet particularly difficult.
The Atkins Diet seems to be an effective way of losing weight for many people. However, eating a low-carbohydrate and high-protein diet has many different effects on different systems in the body. These are not fully understood and are still being investigated.
Further reading and references
Johnston BC, Kanters S, Bandayrel K, et al; Comparison of weight loss among named diet programs in overweight and obese adults: a meta-analysis. JAMA. 2014 Sep 3312(9):923-33. doi: 10.1001/jama.2014.10397.
Nordmann AJ, Nordmann A, Briel M, et al; Effects of low-carbohydrate vs low-fat diets on weight loss and cardiovascular risk factors: a meta-analysis of randomized controlled trials. Arch Intern Med. 2006 Feb 13166(3):285-93.
Kossoff EH, Wang HS; Dietary therapies for epilepsy. Biomed J. 2013 Jan-Feb36(1):2-8. doi: 10.4103/2319-4170.107152.
Levy RG, Cooper PN, Giri P; Ketogenic diet and other dietary treatments for epilepsy. Cochrane Database Syst Rev. 2012 Mar 143:CD001903. doi: 10.1002/14651858.CD001903.pub2.
Paoli A, Rubini A, Volek JS, et al; Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. Eur J Clin Nutr. 2013 Aug67(8):789-96. doi: 10.1038/ejcn.2013.116. Epub 2013 Jun 26.
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