Below is an interview with Dr. Eric Westman, director of the Duke Lifestyle Medicine Clinic in Durham, N.C. about the ‘new’ Atkins diet book he co-authored.
Q: How is the current Atkins diet different from the original?
A: We have emphasized that you have to have five servings of vegetables a day. The book hammers home right away at the myth that you don’t eat vegetables on Atkins. You have to. That’s just sound nutrition. Overall, there has been a large amount of research on low-carb diets, and we incorporated that knowledge into the book.
Q: What does the research, including your work, reveal about the diet?
A: The research shows it’s a healthy lifestyle and many more foods are a part of it. It’s also a therapeutic diet for people with diabetes, obesity, high triglycerides or high blood pressure. People who follow it have improvements.
Q: Does this plan work because it cuts most junk foods?
A: Absolutely, that’s part of it. It is shifting from a junk-food-based diet to an occasional sweet treat, much like most people ate after World War II. All popular diets eliminate junk foods. But it depends on what you call junk foods. A lot of people think of pork rinds as a junk food, but I think of them as a health food. They have no carbs, so in the context of a low-carb diet, they’re fine.
Q: What are the advantages of this plan over others?
A: You get to eat delicious foods: butter, bacon, cream. If you like meat, seafood, avocados, nuts, cheese and brie, it’s fabulous. And hunger suppression is one of the biggest advantages. People aren’t hungry when they eat this way.
Q: The Atkins diet has been criticized for being too high in saturated (animal) fat. It’s about 17% of calories vs. the recommended 7%. Is the saturated fat content unhealthy?
A: Studies have shown that in people following Atkins, the saturated fat is not a problem. People who follow Atkins had improvements in cardio metabolic risk factors such as triglycerides, good cholesterol, blood pressure, blood sugar. The diet fat issue is at the crux of the fear of this diet. But look at the Europeans and French people and all the fat they eat, and they are doing just fine.
Q: Doesn’t the diet drastically cut whole grains, even though research shows they are good for you?
A: In the last two phases (of the diet, known as pre-maintenance and maintenance), most people can eat whole grains, so it’s inaccurate to say that they are totally forbidden, although in the first two phases (induction and ongoing weight loss), you do have to limit them.
Q: Why cut so much fruit?
A: The way Atkins works is it suppresses appetite and hunger, and you can’t do that if you have a lot of sugar in the diet. Fruit is sugar with some fiber. In the induction phase, you eat avocados, olives and tomatoes, which are fruits. And in Phase 2 (ongoing weight loss), you introduce berries and melons.
Dr. Court’s Comments
It has long been a myth that the Atkins diet is bad for you. Dr. Atkins made his first observations that low carbohydrate diets were the best way to maintain health after he managed to lose weight by placing himself on a carbohydrate restricted diet. This was in the 1960’s. He published his first book in the early 70’s, which soon became a best seller. It was many years, however, before this became an accepted way to diet and manage weight.
The principle behind the Atkins diet is the control of insulin. Insulin is a hormone in the body that is secreted in response to carbohydrate intake and to a much lesser degree protein intake. Insulin has profound effects on metabolism. It causes cells in the liver, muscle, and fat tissue to take up glucose from the blood, storing it as glycogen in the liver and muscle, and stopping use of fat as an energy source. The problem occurs when excess carbohydrate is consumed. Massive amounts of insulin are released and only so much glycogen can be stored in the muscles and liver. The rest of that energy is stored at fat. When insulin is produced in low amounts, as is the case with the Atkins diet, the body begins to use fat as an energy source. It is the burning of this fat that is the very way people are able to lose weight on the Atkins diet.
Consider someone who has insulin dependent diabetes if you want to see the effects of insulin. If they are insulin dependent that means they do not produce it on their own and require it exogenously. Many times patients go months before they are aware of this fact and guess what results. Since they cannot burn the glucose they consume for energy they must burn their body fat to survive. As a matter of fact one of the hallmark signs of insulin dependent diabetes is uncontrolled weight loss. This of course is not a healthy person or way to lose weight, but it illustrates very nicely the metabolic effects of insulin (or lack there of).
Many detractors of the low-carb diet say that it is unhealthy, but they clearly do not understand physiology and have not looked at the research.
“There are nearly a dozen randomized controlled trials of obese people trying to lose weight that show those on a low-carb diet do as well or better in the short and long term as people on conventional low-fat, low-calorie diets. And the low-carb diet is associated with favorable improvements in heart disease risk factors. The research shows that many of the original concerns about the Atkins diet’s impact on LDL (bad) cholesterol and rapid regain were not realized.” Comments by Gary Foster, Director of the Center for Obesity Research and Education at Temple University in Philadelphia.
There is another positive to eating an Atkins type low-carb diet. It is inherently an anti-inflammatory diet. The low-carb diets end up being low in grains and grains are a massive source of inflammation in the American diet. I routinely check inflammatory markers before placing my patients on a diet program. I always recommend more emphasis on healthy fats and proteins and less on the carbohydrates. The markers I like to use are CRP, or c-reactive protein, and homocysteine. Clinically, the results of placing people on a low-carb diet are always favorable in terms of inflammatory markers. Their lipid profiles (cholesterol, triglycerides) always improve as well. If these markers all improve, how can the diet be unhealthy for your heart as some people claim? This is usually a question that goes unanswered by physicians that tout the low fat diet as superior.
The low-carb ‘craze’ is not a craze at all. It is here to stay and it is the most effective way to reduce weight and maintain heart health. The studies that have been done are very conclusive, but they fly in the face of many years of conventional ‘wisdom.’ The problem is that the conventional system has failed. Americans are as fat as they have ever been and diabetes is at epidemic proportions. Maybe it’s time to re-evaluate our thoughts on diet and look at the hormonal process that is required to store fat. This process, which requires insulin, can be controlled but not by eating a low fat diet. It must be controlled by controlling carbohydrate intake. If this is done, health ensues.