Weight loss diets: The Atkins diet

The Atkins diet (named after its proponent Dr. Robert Atkins) is the extreme form of the dietary approach that restricts consumption of carbohydrates, a.k.a. low-carbohydrate diets.

The Atkins diet is often promoted as a weight loss breakthrough of the nineties. In actuality, the basic idea behind the Atkins diet is decades old. In a nutshell, the goal of Atkins diet is to restrict carbohydrates so dramatically as to (1) markedly lower the levels of the hormone insulin and (2) put the body in an abnormal metabolic state called ketosis. The proponents of Atkins diet believe that these changes push the body to burn fat rather than store it. In essence, Atkins diet restricts all foods that contain significant amounts of carbohydrates. The choices that remain include mainly meats, fish, eggs, cheese, butter and certain vegetables. If you are considering the Atkins diet, there are a number of things you should know:

Atkins diet is hard to follow because it is very restrictive. It restricts bread, cereals, pasta, candy, ice cream, milk, potatoes, most fruits, and other carbohydrate-rich foods.

Since carbohydrates are restricted, people consume a lot of protein and fat. Excess protein puts extra load on the liver and kidneys. Furthermore, some experts caution that high consumption of fat may push cholesterol levels 'through the roof' and thus increase the risk of heart disease. The latter seems to occur in some people on Atkins diet, but not in the majority. In fact, most people on Atkins diet either see no change or improvement in their lipid profile. Still, it is prudent to monitor blood lipids when on Atkins diet.

Atkins diet creates ketosis, an abnormal metabolic state associated with a variety of side effects including nausea, lightheadedness, electrolyte imbalance, bad breath and others.

Most people cannot stay on the Atkins diet very long due to its restrictions and side effects.

There are more sustainable and less risky ways to reduce insulin levels than severe carbohydrate restriction.

What about clinical studies of Atkins and/or low-carbohydrate diets? Short-term studies (weeks to months) indicate that Atkins diet does help achieve some degree on weight loss and tends may improve lipid profile in some people, although large individual variations are observed. Atkins diet seems to produce the greatest benefits in people who have insulin resistance and excess insulin (such as people with pre-diabetes).

Unfortunately, long-term data on Atkins and/or other low-carbohydrate diets are scarce. Foster and colleagues, from the University of Pennsylvania School of Medicine, have conducted a 12-month study comparing low-carbohydrate, high-protein, high-fat diet or a low-calorie, high-carbohydrate, low-fat (conventional) diet. The researchers observed that low-carbohydrate diet produced greater weight loss at six month (6.8% vs 2.7% of body weight) but the difference between the diets almost vanished by 12 month converging towards 3-4% weight loss. The researchers noted poor adherence of participants, which may explain the deterioration of results by the end of the study (especially so for Atkins diet).

See the list of various studies related to Atkins diet and low-carbohydrate diets overall.

Bottom line

The Atkins diet has a reasonable goal of reducing excessive insulin level. Additional benefits of ketosis are debatable. In the short-term, properly followed Atkins would produce weight loss in many people and may yield other health benefits, such as lower blood pressure and improved blood lipids. However, it is difficult to stick with and its long-term risk and benefits are unknown. It may be wiser to try less extreme ways of reducing insulin levels.

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