Atkins – too good to be true

The Lancet has published a review of the data regarding low-carbohydrate diets, such as Atkins. Here are some conclusions:

Although these studies provide evidence that a low-carbohydrate diet does produce increased weight loss over 3-6 months and might be superior to the recommended calorie-reduced low-fat diet, the 12-month studies also indicate that the low-carbohydrate diet may be no better in the longer term.

The most frequent complaints with low-carbohydrate diets are constipation and headache . . . Also, halitosis, muscle cramps, diarrhoea, general weakness, and rashes are more often reported on low-carbohydrate than on low-fat diets.

And we have the bottom-line:

There is no clear evidence that Atkins-style diets are better than any others for helping people stay slim, and despite the popularity and apparent success of the Atkins diet, evidence in support of its use lags behind . . . the long-term effects on health and disease prevention are unknown.

So, what can physicians recommend? People who want to try Atkins should be told that although safety cannot be guaranteed, low-carbohydrate diets seem to be safe for short-term use (up to 6 months).

Based on the evidence, the most solid recommendation would be (not surprisingly) a permanent switch to a reduced fat and calorie diet in combination with increased physical activity. It may not sell as many books, but this approach certainly has the evidence to back it up.

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  • Lee Cheshire

    Dr. Pho, Congratulations on the article in the Telegraph today. This blog idea is Outstanding and a really great way to communicate. Your leading us to big change for the 21st century in how to communicate with a doctor.

    I do have a concern, however, with your leaning toward Atkins. Let me provide some feedback on my experience with Atkins right at the Nashua Medical Group. I was diagnosed with Type II Diabetes about a year and a half ago. I was given a special diabetic diet because I was 40 lbs overweight. Having read the government material on the diet, I noticed it emphasized the low carbohydrate approach. I also confirmed that this was similar to the Atkins diet.

    Here is a key point: I followed Dr. Atkins EXPLICITLY! Here are the key disciplines that are critical to the diet’s success that others do not follow:
    - Manage your carbohydrates  Concentrate on the heavy hitters at first: Sodas, white bread, noodles, sugars, etc.
    - Begin regular exercises!!!
    - Drink plenty of fluids – min. 4 glasses of water a day
    - Take vitamin supplements

    It WORKS!!! Simple as that. I lost 40 lbs in the first 6 months. Maintained that lost after 1 year. Guess what - all my lab test are in line now, everything, cholesterol included a year an a half later.

    After a year and a half, I’m in steady state Atkins but I still could loose more weight and may decide to go through another period of weight loss. I do not avoid carbs entirely particularly fresh fruits. Today there are great foods out there that make it far easier to do low carb.

    Why does it work. Mentally it is ideal for men who like to eat meats and need a full stomach feeling. This is particularly true of todays high stress lifestyle. Also, once entered into, your tasks for sugars change. Fruits taste sweeter, diet drinks are excellent where before they were intolerable. Emphasis on exercise is also ideal for men. Again the key is to do the FULL Atkins approach with water, vitamins, exercise and carb management.

    In the 21st century, patients like me who are highly educated, like to read up on what the diagnosis is and work with the doctor as a team. I read all I could on Atkins and his book and other supporting and non supporting opinions. I began trying it and it worked. But, I found no Doctor at your facility that would support me. This is like politics. People grow up in a home of one party and even later in life refuse to question that party even when the party changes dramatically from what it was when their parents were members. It is a case of prejudice. My challenge is to think freely. There may be something to this approach to dieting. It may not be perfect but it’s far more effective than other diets for men.

    My primary health care physician is Dr. Kelly.

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