Is the Atkins Diet for You?

Introduction
Obesity in America has reached epidemic proportions. With more than half of the population considered overweight or obese (Gupta 1), Americans are constantly searching for an effective and permanent weight loss solution. Not surprisingly, the weight loss industry has tried to cash in on this epidemic with countless diet books and weight loss products, all of which promise weight loss miracles. With so many options available for dieters, it is sometimes difficult to separate the fad diets from those that actually work. Many Americans, frustrated with traditional low calorie, low fat diets, have turned to the Atkins Diet. This low carbohydrate, high protein diet has been the cause of much controversy, as nutritionists and doctors debate whether the benefits of the diet outweigh the potential dangers it presents.

The Atkins Diet: A Brief Background
The Atkins Diet first became popular in 1972, with the publication of the book, Dr. Atkins' Diet Revolution. Created by Doctor Robert Atkins, a New York City cardiologist, the Atkins diet emphasizes eating foods high in protein and avoiding foods that are high in carbohydrates. According to Dr Atkins, when carbohydrates are eliminated from the diet, the body goes into a metabolic state called ketosis. During ketosis, the body burns fat at a faster rate than normal, resulting in quicker weight loss (Muha 3).

Furthermore, eating carbohydrates increases insulin levels in the body, which, in turn, causes the body to store fat. When the body is inundated with carbohydrates, it converts these carbohydrates into simple sugars. Simple sugars stimulate the pancreas, which produces insulin, the body's principle energy regulator. Too much insulin causes the body to store sugar as fat. By greatly reducing or eliminating carbohydrates from the diet, and thus reducing blood-sugar levels, the body begins to use stored fat for its energy needs, again causing weight loss (Stein 5).

The Atkins Diet
How much and what kinds of food does the Atkins diet deem permittable for consumption? Surprisingly, there are no limits on the number of calories a person can consume while on the Atkins Diet, just as long as less than twenty percent of them come from carbohydrates. According to the more recently released Dr. Atkins New Diet Revolution, "no fruit, bread, grains, starchy vegetables, or dairy products other than cheese, cream, or butter" are allowed during the first two weeks of the diet (Tufts 1). However, foods high in fat and saturated fat like bacon, eggs, and steak can be eaten without limitation.

The Four Phases
The Atkins Diet is divided into four separate phases: Induction, Ongoing Weight Loss, Pre-Maintenance, and Maintenance (Tufts 1). During the two-week Induction Period, participants are allowed no more than twenty grams of carbohydrates per day. This is equal to the amount of carbohydrates found in a small corn muffin, or glass of orange juice. During the Ongoing Weight Loss Period, up to sixty grams of carbohydrates are permitted, though many people can eat only up to forty grams or less and still experience weight loss. This stage of the diet is to be followed until the dieter has only five to ten pounds of fat left to lose. Then the dieter progresses onto the Pre-Maintenance phase of the diet, which lasts approximately two to three months, or until the dieter has reached his or her goal weight. While on the Pre-Maintenance stage, dieters are allowed up to one indulgence or deviation from their diet, such as a bagel or piece of fruit, up to two times a week. The fourth and final phase of the Atkins diet, called Maintenance, is designed to help dieters maintain their goal weight. During Maintenance, dieters are allowed up to ninety grams of carbohydrates per day, though according to Atkins, most people must stay between forty and sixty carbohydrates per day so as not to regain any weight. At any time that a person on the Maintenance stage of the diet regains more than five pounds, he or she must temporarily return to the Induction Phase until that weight is lost. According to Tufts University Health and Nutrition letter, this means that "you're always only a few pounds away from having to return to a twenty-carbohydrate-gram limit" (4).

Does the Atkins Diet Work?
For most people, a diet with no calorie restrictions sounds too good to be true. No longer are dieters required to count calories and carefully measure portion sizes. Instead, they are encouraged to fill up on indulgence foods like steak, cheese, and bacon. It is no surprise then, that ever since the introduction of the Atkins diet in 1972, it has been enormously successful. Over the past thirty years, Dr. Atkins' Diet Revolution has sold over fifteen million copies worldwide, making it one of the fifty best selling books of all time (Muha 3). It is estimated that twenty-five million people in the United States have tried or are currently on the Atkins Diet (Rawe 1), and that seventeen million people have tried the Atkins Diet within the past year (Stein 2).

The Atkins Diet has thousands of devout followers. Many overweight people who failed to lose weight with traditional diet and exercise finally found success with the Atkins Diet. According to one Atkins enthusiast, Jan Rowell, low fat diets were always a struggle for her, often leaving her feeling hungry and deprived. But with the Atkins Diet, she "felt free of the cravings and the drive to eat" (Stein 1).

Two recent studies conducted by the New England Journal of Medicine have shown that the Atkins Diet can be an effective way to lose unwanted pounds. The study compared low carbohydrate diets to low fat diets. The results showed that those on the low carbohydrate diet lost twice as much weight than those on the low fat diet. Furthermore, the low carbohydrate diet seemed to raise levels of high-density lipoprotein (LPD), also known as the "good cholesterol" while lowering levels of triglyceride fats (Gupta 1).

Cons of the Atkins Diet
Although many people have experienced weight loss success on the Atkins Diet, the majority of medical doctors and nutritionists do not advocate it. Most members of the medical establishment discourage the Atkins Diet because of the potential health risks it poses, negative side effects, and because they question the diet's long-term effectiveness in keeping weight off.

Potential Health Risks
Because the Atkins diet is basically an animal-food diet, it is extremely high in fat and saturated fat. As any doctor will tell you, diets high in saturated fat increase one's risk for heart disease, stroke, and cancer (Liebman, 1 and Song 6). The Federal Drug Administration (FDA) recommends that no more than ten to twenty percent of one's diet consist of fat. Some studies have found that up to fifty-nine percent of the food eaten on the Atkins diet is fat, three times the recommended amount. The Atkins diet also contains three times the daily limit for cholesterol (Tufts 2). Studies have also found that diets high in red meat, such as the Atkins diet, are associated with an increased risk of colon and prostrate cancer (Liebman 2).

The Atkins diet has also been criticized because it deprives its adherents of essential vitamins and minerals found in carbohydrates. Because Atkins dieters are restricted from eating foods like milk, yogurt, whole-wheat breads, and cereals, they miss out on much needed calcium, vitamin D, and whole-wheat phytochemicals, which may help prevent heart disease and diabetes. Furthermore, the Atkins diet is extremely low in fiber, which can lead to constipation (Tufts 1).

Negative Side Effects
As previously mentioned, the Atkins Diet is lacking in fiber, which can lead to constipation and other digestive problems (Song 11). According to JoAnn Hattner, a clinical nutritionist at the UCSF Stanford University Medical Center, diets high in protein and fat and low in fiber also cause fluid dehydration, weakness, and nausea, and put a strain on the kidneys (Stein 2). Many people on the Atkins diet also experience fatigue and nausea (Anderson 2).

Long-term effectiveness
Currently, not enough research has been conducted on the Atkins diet to accurately predict its long-term effectiveness (Harvard 1). Studies have found that although people on the Atkins diet initially lose more weight than those on conventional diets, after a year they have gained back considerably more weight than their low fat counterparts (Gupta 1). In fact, less than one percent of all dieters who succeed in sustaining long-term weight loss use low carbohydrate diets like the Atkins'. In spite of all the indulgent foods that are permitted on the Atkins diet, many people have difficulty staying on the diet. One doctor reports that none of his patients who tried the Atkins diet were able to stay on it for longer than four months. These same patients then responded positively when placed on a low fat diet and exercise regime (Andersson 2).

Some doctors even question Dr. Atkins' premise for the diet. Says Gary Foster of the University of Pennsylvania, "All of Atkins's fancy hypotheses haven't been borne out in other research" (Liebman 2). In fact, it has been speculated that the reason the Atkins diet works for some people is because it causes them to constantly feel ill. According to Dr. Pi-Sunyer, a chief endocrinologist at St. Luke's Roosevelt Hospital, "If you go on a strict high-protein diet, you feel nauseated and a little sick to your stomach after about four to five days, so you lose your appetite and eat less" (Stein 3). Headaches and halitosis are also common side effects of the Atkins diet.

Conclusion
Although the Atkins diet has been around for more than thirty years, much still remains unknown regarding the safety and effectiveness of the diet. Not until thorough scientific investigations have been carried out on the Atkins diet can we determine with any certainty the true risk associated with low carbohydrate, high protein diets. Until then, it is the responsibility of the individual dieter, along with his or her physician, to determine if the Atkins diet is an appropriate weight loss plan.

Furthermore, it should be emphasized that most of the medical community views the Atkins diet as unhealthy and potentially dangerous. In addition to the numerous health risks and negative side effects that have been associated with the Atkins diet, several short-term studies have found that the Atkins diet is ineffective in maintaining weigh loss for periods over one year.

Recommendations
In spite of the many negative aspects of the Atkins diet, it has undoubtedly helped hundreds of people achieve their weight loss goals. Because the Atkins diet has been proven effective for short-term weight loss and for quickly dropping unwanted pounds, it can be appropriate for some people's weight loss purposes. For those who wish to quickly shed a few extra pounds for an upcoming event or reunion, the Atkins diet should not be completely ruled out. When followed responsibly and for a short period of time, the Atkins diet poses no great risks to healthy adults. It is when the diet is followed irresponsibly, and for long periods of time, that it becomes a health threat.

Bibliography
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"Is it Possible to Follow the Atkins Diet Healthfully?" Tufts University Health & Nutrition Letter. Dec. 2003. 1-4.

Liebman, Bonnie. "The Diet Wars." Nutritional Action Health Letter 2 June 2002: 10-13.

Muha, Laura. "Dr. Atkins and His Wildly Successful, Wildly Controversial Diet." Biography Jan. 2001: 101-105.

"Poll Survey: What is the Biggest Challenge of Controlling Carbs?" Atkins Nutritionals 5 May 2004. .

Rawe, Julie. "Snacks Go Low Carb." Time 18 Aug. 2003: 46-49.

Song, Sora. "We're Fat. Now What?" Time 22 March 2004: 17.

Stein, Joel. "Paging Dr. Fatkins?" Time 23 Feb. 2004: 37.

---, et al. "The Low-Carb Diet Craze." Time 1 Nov. 1999: 72-80.