The Atkins diet , officially called the Atkins Nutritional Approach , is a low-carbohydrate diet created by Dr Robert Atkins from a diet he read in the Journal of the American Medical Association and used to resolve his own overweight condition. He later popularized the Atkins diet in a series of books, starting with Dr. Atkins' Diet Revolution in 1972. In his revised book, Dr. Atkins' New Diet Revolution , he modified or changed some of but remained faithful to the original concepts.
Atkins franchise, a business formed to provide products to those individuals on the diet, was highly successful due to the popularity of the diet, and is considered the driving entity of the larger "low-carb craze" during the early millennium. However its success dwindled and Atkins Nutritionals of Ronkonkoma, New York, the company founded by Dr. Atkins in 1989, filed for Chapter 11 bankruptcy in January 2005, two years after his death. The company re-emerged in January 2006, and the Atkins logo is still highly visible through licensed-proprietary branding for food products and related merchandise.
Nature of the diet
The Atkins Diet is a departure from the previously prevailing metabolic theories. Atkins said that there are important unrecognized factors in Western eating habits leading to obesity. Primarily, he believed that the main cause of obesity is eating refined carbohydrates, particularly sugar, flour, and high-fructose corn syrups.
The Atkins Diet involves restriction of carbohydrates to more frequently switch the body's metabolism from burning glucose as fuel to burning stored body fat. This process (called ketosis ) begins when insulin levels are low; in normal humans, insulin is lowest when blood glucose levels are low (mostly before eating). Caloric carbohydrates (e.g., glucose or starch (itself made of chains of glucose)) produce most of the blood sugar after meals and can be calculated to determine the insulin needs of diabetics. Because of its low digestibility, fiber provides little or no food energy and does not significantly impact glucose and insulin levels. Ketosis involves lipolysis in which some of the lipid stores in fat cells are transferred to the blood.
In his book Dr Atkins' New Diet Revolution , Dr. Atkins made the controversial argument that the low-carbohydrate diet produces a metabolic advantage in which the body burns more calories, overall, than on normal diets, and also expels some unused calories. He cited one study where he estimated this advantage to be 950 calories (4.0 MJ) a day. However, a review study published in the Lancet concluded that there was no such metabolic advantage and dieters were simply eating fewer calories due to boredom. Professor Astrup stated, "The monotony and simplicity of the diet could inhibit appetite and food intake" The Atkins Diet restricts "net carbs" (digestible carbohydrates that impact blood sugar). One effect is a tendency to decrease the onset of hunger, perhaps due to longer duration of digestion (fats and proteins take longer to digest than carbohydrates). Dr. Atkins says in Dr. Atkins' New Diet Revolution (2002) that hunger is the number one reason why low-fat diets fail. Although studies show the efficacy of the Atkins approach after one year is the same as some low-fat diets, it was easier, according to Atkins, to stay on the diet because low-fat dieters "were often hungry and always felt deprived" .
Net carbohydrates can be calculated from a food source by subtracting fiber and sugar alcohols (which are shown to have a smaller effect on blood sugar levels) from total carbohydrates. Sugar alcohols contain about two calories per gram, and the American Diabetes Association recommends that diabetics count each gram as half a gram of carbohydrate. Fructose (e.g., as found in many industrial sweeteners) has four calories per gram, although it has a very low glycemic index and does not cause insulin production, probably because ß cells have low levels of GLUT5.
Preferred foods in all categories are whole, unprocessed foods with a low glycemic index, although restrictions for low glycemic carbohydrates (blackrice, vegetables, etc.) are the same as those for high glycemic carbohydrates (sugar, white bread). Atkins Nutritionals, the company formed to market foods which work with the Atkins Diet, recommends that no more than 20% of calories eaten while on the diet come from saturated fat.
According to the book Atkins Diabetes Revolution , for people whose blood sugar is abnormally high or who have Type 2 diabetes mellitus, this diet decreases or eliminates the need for drugs to treat these conditions. The Atkins Blood Sugar Control Program (ABSCP) is an individualized approach to weight control and permanent management of the risk factors for diabetes and cardiovascular disease. Nevertheless, the causes of Type 2 diabetes remain obscure, and the Atkins Diet is not accepted in conventional therapy for diabetes.
Ketogenic Diet
The induction phase of the Atkins diet is a ketogenic diet. In ketogenic diets there is production of ketones that contribute to the energy production in the Krebs cycle. Ketogenic diets rely on the insulin response to blood glucose. Since, in ketogenic diets, dieters do not eat carbohydrates, there is no glucose that can trigger the insulin response. When there is no glucose-insulin response there are some hormonal changes that cause the stored fat to be used for energy. Blood glucose levels have to decrease to less than 3.58 mmol/L for growth hormone, epinephrine, and glucagon to be released to maintain energy metabolism. In the adipose cells, growth hormone and epinephrine initiate the triacylglycerol to be broken down to fatty acids. These fatty acids go to the liver and muscle where they should be oxidized and give acetyl-CoA that enters the Krebs cycle directly. However, the excess acetyl-CoA in the liver is converted to ketones (ketone bodies), that are transported to other tissues. In these tissues they are converted back into acetyl-CoA in order to enter the Krebs cycle. Glucagon is produced when blood glucose is too low, and it causes the liver to start breaking glycogen into glucose. Since the dieter does not eat any more carbohydrates, there is no glycogen in the liver to be broken down, so the liver converts fats into free fatty acids and ketone bodies, and this process is called KETOSIS. Because of this, the body is forced to use fats and ketosis as a primary fuel source, and that is why Atkins is a ketogenic diet.
Main Risks/ Benefits
The risks and benefits of the Atkins diet remains a subject of much debate. Whereas many studies have shown that Atkins diet prevents Cardiovascular Disease, lowers the LDL cholesterol, and increases the amount of HDL cholesterol, other studies claim that the diet contributes to cardio-vascular disease, coronary heart disease, arrhythmia, osteoporosis, and kidney stones.
Cholesterol
According to Harper (2004) in a year long study, the concentration of high density lipoprotein cholesterol increased, and insulin resistance improved much more in dieters that were following the Atkins Diet compared to the ones following a low fat, calorie restricted diet. Harper also mentions that there has not been enough research prior to that date to allow him to confidently say that Atkins is safe to be recommended to patients. In later studies, as Barnett et al. reported in 2009, cholesterol levels have increased in almost one third of dieters using low-carbohydrate diets, like Atkins, and since then two cardiac deaths have been reported, one due to coronary heart disease, and the other due to arrhythmia. In this study, a 51 year old, healthy, non-smoker, and physically active man decided to start practicing the Atkins diet, in order to get back to his original weight. His LDL (low density lipoprotein) cholesterol went up drastically after just one month, but he continued following the diet. Two years after he began consuming the diet’s recommended foods, he began to take medicine for erectile dysfunction and after a few months he was hospitalized for critical stenosis of the coronary artery. He stopped following the Atkins diet and was started on medication therapy, which resulted in his blood cholesterol and triglycerides going back to normal, at the same time as the ending chest pain and erectile dysfunction. Here we can see that these two studies are contradicting.
Methylglyoxal
In a study conducted by Beisswenger and colleagues in 2005, they compared the glycotoxin methylglyoxal (MG) before and after starting the Atkins diet. MG is a toxin that is responsible for blood vessel and tissue damage, and is higher in people with poorly controlled diabetes. The study found that the MG increased to the amount of two times bigger then before the diet was started, and it was noted that the MG rise was related to the presence of ketosis. Also a rise in acetol and acetone was noted, which indicated that MG was produced from oxidation. MG arose also as a side product of triglyceride breakdown and from lipoxidation (ketosis related to fat intake). The possible effects of MG presence for a prolonged period could lead to tissue damage and vascular complications.
Other
High protein diets may cause the loss of calcium and also a lowering in urinary citrate levels that can cause osteoporosis and kidney stones (Ornish,2004). Ketone bodies are excreted in urine with cations to neutralize the charge, so the body is l
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