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{{short description|Low-carbohydrate fad diet devised by Robert Atkins}}
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The '''Atkins diet''' is a ] ] devised by ] in the 1970s, marketed with claims that carbohydrate restriction is crucial to weight loss and that the diet offered "a high calorie way to stay thin forever".<ref name=nonsense/><ref name=slg/>
The '''Atkins Nutritional Approach''', popularly known as the '''Atkins Diet''' or just '''Atkins''', is the most marketed and well-known of the ]s. It was adopted by Dr. ] (]-]) in the 1960's from a diet he read in the <i>Journal of the American Medical Association<i> and utilized to resolve his own overweight condition following medical school and graduate medical training. After successfully treating over ten thousand patients, he 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'', Atkins updated some of his ideas, but remained faithful to the original concepts.


The diet became popular in the early 2000s, with Atkins' book becoming one of the top 50 best-selling books in history, and as many as 1 in 11 ]n adults claiming to be following it. Atkins died in 2003 and in 2005 ] filed for bankruptcy following substantial financial losses.
The Atkins franchise (i.e., the business formed to provide products serving people "doing Atkins") had been highly successful due to the popularity of the diet, and is considered the iconic and driving entity of the larger "low-carb craze". However, various factors have led to its dwindling in success, and the company ] of ], founded by Dr. Atkins in 1989, filed for ] in July of 2005. The Atkins logo is still highly visible through ] ] for food products and related merchandise.


There is no strong evidence of the diet's effectiveness in achieving durable weight loss; it is unbalanced as it promotes unlimited consumption of ] and ], and it may increase the risk of ].<ref name="Longe 2008">Longe, Jacqueline L. (2008). ''The Gale Encyclopedia of Diets: A Guide to Health and Nutrition''. The Gale Group. pp. 84-87. {{ISBN|978-1-4144-2991-5}}</ref><ref name="Quackwatch">. Quackwatch. Retrieved October 14, 2020.</ref><ref name=Gud2015/><ref name=fad/>
==Nature of the diet==


==Effectiveness and risks==
The Atkins Diet represents a radical departure from prevailing theories. Atkins claimed there are two main unrecognized factors about Western eating habits, arguing firstly that the main cause of ] is eating refined ] particularly ], ], and ]s; and secondly, that ] is overrated as a nutritional problem, and that only ] from sources such as ]s need to be avoided. Consequently, Dr. Atkins rejects the advice of the ], instead asserting that the tremendous increase in refined carbohydrates is responsible for the rise in metabolic disorders of the 20th century, and that the focus on the detrimental effects of dietary fat has actually contributed to the obesity problem by increasing the proportion of ]-inducing foods in the diet.
{{Further|Low-carbohydrate diet}}
There is weak evidence that the Atkins diet is more effective than behavioral counseling for weight loss at 6-12 months.<ref name=Gud2015/> The Atkins diet led to 0.1% to 2.9% more weight loss at one year compared to control groups which received behavioural counselling for weight loss.<ref name=Gud2015/> As with other commercial weight loss programs, the effect size is smaller over longer periods.<ref name=Gud2015>{{cite journal|last1=Gudzune|first1=KA|last2=Doshi|first2=RS|last3=Mehta|first3=AK|last4=Chaudhry|first4=ZW|last5=Jacobs|first5=DK|last6=Vakil|first6=RM|last7=Lee|first7=CJ|last8=Bleich|first8=SN|last9=Clark|first9=JM|title=Efficacy of commercial weight-loss programs: an updated systematic review.|journal=Annals of Internal Medicine|date=7 April 2015|volume=162|issue=7|pages=501–12|pmid=25844997|doi=10.7326/M14-2238|pmc=4446719|quote=Atkins resulted in 0.1% to 2.9% greater weight loss at 12 months than counseling. }}</ref><ref name=Harper>{{cite journal| author = Harper, A | journal = Obesity Reviews| volume = 5| issue = 2| pages = 93–94| year = 2004| doi = 10.1111/j.1467-789X.2004.00137.x| pmid = 15086862| last2 = Astrup| first2 = A| title=Can we advise our obese patients to follow the Atkins diet?| s2cid = 40176596|quote=Despite the popularity and apparent success of the Atkins diet, documented scientific evidence in support of its use unfortunately lags behind. |type=editorial| doi-access = free}}</ref> Low-carb dieters' initial advantage in weight loss is likely a result of increased water loss, and that after the initial period, low-carbohydrate diets produce similar fat loss to other diets with similar caloric intake.<ref>{{cite journal |doi=10.1038/oby.2001.113 |pmid=11374180 |title=Executive Summary |journal=Obesity Research |volume=9 |pages=1S–40S |year=2001 |last1=Freedman |first1=Marjorie R |last2=King |first2=Janet |last3=Kennedy |first3=Eileen |doi-access=free }}</ref>


Atkins did not publish any clinical data on his patients and has thus been criticized for making unsupported statements about health.<ref>{{cite journal|author=]|year=1981|title= Foods, fads and fallacies|journal=Modern Medicine|url=https://journals.co.za/doi/epdf/10.10520/AJA02599333_832|volume=6|issue=10|pages=5–15|hdl=10520/AJA02599333_832 }}</ref> Because of its high saturated fat content the Atkins diet may increase the risk of ].<ref name="Longe 2008"/><ref name=fad>{{cite book |last1=Alters|first1=Sandra|last2=Schiff|first2=Wendy|title=Essential Concepts for Healthy Living. Chapter 10: Body Weight and Its Management|url=https://books.google.com/books?id=VegUiVbruBMC&pg=PA327 |date=22 February 2012 |publisher=Jones & Bartlett Publishers |isbn=978-1-4496-3062-1 |page=327 |edition=Sixth}}</ref> A medical report issued by the New York medical examiner's office a year after the author's death showed that he had a history of heart attack, ] and ].<ref name="wsj-ra">{{cite news |url=https://www.wsj.com/articles/SB107637899384525268 |title=Report Details Dr. Atkins's Health Problems |access-date=January 1, 2015 |newspaper=Wall Street Journal}}</ref> The Atkins diet has been criticized by the ], ] and the ] as nutritionally unbalanced.<ref name=slg/><ref name="AHA Science Advisory">{{cite journal|vauthors= St Jeor ST, Howard BV, Prewitt TE, Bovee V, Bazzarre T, Eckel RH|title= Dietary protein and weight reduction: a statement for healthcare professionals from the Nutrition Committee of the Council on Nutrition, Physical Activity, and Metabolism of the American Heart Association|journal= Circulation|volume= 104|issue= 15|pages= 1869–74|date= October 2001|pmid= 11591629|doi= 10.1161/hc4001.096152|doi-access=free}}</ref> In 2000, ] conducted a study which determined that “the very high fats of Atkins diet: 60%–68%, around 26% of which are saturates, through shifting the metabolic pathway for energy production, deliver a strong boost to free radical production, thereby increasing oxidative stress on different organs”. <ref>{{Cite journal |last1=Anderson |first1=J. W. |last2=Konz |first2=E. C. |last3=Jenkins |first3=D. J. |date=October 2000 |title=Health advantages and disadvantages of weight-reducing diets: a computer analysis and critical review |url=https://pubmed.ncbi.nlm.nih.gov/11022871/ |journal=Journal of the American College of Nutrition |volume=19 |issue=5 |pages=578–590 |doi=10.1080/07315724.2000.10718955 |issn=0731-5724 |pmid=11022871|s2cid=25815308 }}</ref>
Dr. Atkins argued that many eating disorders are the result of '']'', or excessive secretion of insulin which comes through eating too many carbohydrates. According to Dr. Atkins, this causes food cravings and unstable blood sugar levels, which can cause ]s, ], and ]. He claimed that his diet stabilizes insulin and ] levels, eliminating cravings and often reducing appetite.


=== Modified Atkins and epilepsy ===
While most of the emphasis in Atkins is on the diet, ] and exercise are considered equally important elements.
{{further|Ketogenic diet#Modified Atkins}}
]s are used to treat epilepsy in children, where there is some evidence it has a positive effect in reducing seizures.<ref>{{Cite report |url=https://effectivehealthcare.ahrq.gov/products/management-infantile-epilepsy/research |title=Management of Infantile Epilepsies |last1=Treadwell |first1=Jonathan R. |last2=Wu |first2=Mingche |date=2022-10-25 |publisher=Agency for Healthcare Research and Quality (AHRQ) |doi=10.23970/ahrqepccer252 |last3=Tsou |first3=Amy Y.}}</ref> There is some evidence that adults too may experience seizure reduction derived from therapeutic ketogenic diets, and that a less strict regimen, such as a modified Atkins diet, is similarly effective.<ref>{{cite journal|last1=Freeman|first1=JM|last2=Kossoff|first2=EH|last3=Hartman|first3=AL|s2cid=26629499|title=The ketogenic diet: one decade later.|journal=Pediatrics|date=March 2007|volume=119|issue=3|pages=535–43|pmid=17332207|doi=10.1542/peds.2006-2447}}</ref>


==Description==
Atkins involves restriction of the intake of carbohydrates in order to switch the body's ] from burning ] to burning ] (chiefly, stored fat). This process (called '']'') begins when the body enters the state of '']'' as a consequence of running out of carbohydrates to burn. Ketosis is an entirely normal state (eg, between meals or associated with heavy exercise) but can cause troubles (], most seriously) if prolonged.
]


The Atkins diet has been described as a low-carbohydrate, high-fat, high-protein ].<ref name=slg>{{cite encyclopedia|vauthors=Gardiner S, Gilman SL|editor=Gilman SL|encyclopedia=Diets and Dieting: A Cultural Encyclopedia|title=Atkins, Robert, MD (1930-2003) |url=https://books.google.com/books?id=ZWmRAgAAQBAJ&pg=PA12|year=2008|publisher=Routledge|isbn=978-1-135-87068-3|page=12}}</ref> It promotes the consumption of ], ], ] and other high-fat foods such as ], ] and ] in unlimited amounts whilst ], ], ] and other carbohydrates are forbidden.<ref name=slg/><ref name="Longe 2008"/> Atkins' book ''New Diet Revolution'' has sold 12 million copies. It has been described as "the bestselling fad-diet book ever written."<ref name=slg/>
Atkins restricts "net carbs", or carbs that have an effect on ]. Net carbohydrates can be calculated from a food source by subtracting ]s and fiber (which are shown to have a negligible effect on blood sugar levels) from total carbohydrates. Sugar alcohols need to be treated with caution, because while they may be slower to convert to glucose, they can be a significant source of ] and can stall weight loss. ] (eg, as found in many industrial sweeteners) also contributes to caloric intake, though outside of the glucose -- insulin control loop.


Preferred foods in all categories are whole, unprocessed foods with a low ], although restrictions for low glycemic carbohydrates (black rice, vegetables, etc.) are the same as those for high glycemic carbohydrates (sugar, white bread). Due to concerns from medical experts about the high-fat content of the diet, the Atkins Nutritionals company that market foods for the diet, recommends that no more than 20% of calories eaten while on the diet come from ].<ref name="eat less fat">{{cite news |publisher=BBC |date=January 19, 2004 |url=http://news.bbc.co.uk/2/hi/health/3408931.stm |title=Atkins diet boss: 'Eat less fat' |work=BBC News |access-date=September 12, 2007 }}</ref>
Preferred foods in all categories are whole, unprocessed foods with a low glycemic load.


== Phases == ==Proposed mechanism==
The diet was inspired by a low-carbohydrate approach published by Alfred W. Pennington, based on research Pennington did during World War II at DuPont.<ref name=NYTobit>{{cite news|last1=Martin|first1=Douglas|title=Dr. Robert C. Atkins, Author of Controversial but Best-Selling Diet Books, Is Dead at 72|url=https://www.nytimes.com/2003/04/18/nyregion/dr-robert-c-atkins-author-controversial-but-best-selling-diet-books-dead-72.html|work=The New York Times|date=April 18, 2003}}</ref> The Atkins diet is promoted with claims that carbohydrate restriction is the "key" to weight loss.<ref name=nonsense>{{cite journal |vauthors=Katz DL |title=Pandemic obesity and the contagion of nutritional nonsense |journal=Public Health Rev |volume=31 |issue=1 |pages=33–44 |year=2003 |pmid=14656042 }}</ref>


In his early books such as ''Dr Atkins' New Diet Revolution'', Atkins made the controversial argument that the low-carbohydrate diet produces a ] because "burning fat takes more calories so you expend more calories"; the Atkins diet was claimed to be "a high calorie way to stay thin forever".<ref name=hall/><ref name = 'ANDR'>{{cite book | last = Atkins | first = Robert | author-link = Robert Atkins (nutritionist) | title = Dr. Atkins' New Diet Revolution, Revised Edition | publisher = .Evans | date = 2003-09-25 | url = https://archive.org/details/dratkinsnewdiet000atki | isbn = 978-1-59077-002-3 | url-access = registration }}</ref> He cited one study in which he estimated this advantage to be 950 calories (4.0 MJ) per day. A review study published in ''Lancet''<ref>{{cite journal |doi=10.1016/S0140-6736(04)16986-9 |pmid=15351198 |title=Atkins and other low-carbohydrate diets: Hoax or an effective tool for weight loss? |journal=The Lancet |volume=364 |issue=9437 |pages=897–9 |year=2004 |last1=Astrup |first1=Arne |last2=Larsen |first2=Thomas Meinert |last3=Harper |first3=Angela |s2cid=24756993 }}</ref> concluded that there was no such metabolic advantage and dieters were simply eating fewer calories. Astrup stated, "The monotony and simplicity of the diet could inhibit appetite and food intake." ] has characterized Atkins' claim as nonsense.<ref name=nonsense/> The idea of "metabolic advantage" of low-carbohydrate dieting has been ] in a study of people following restricted-carbohydrate dieting.<ref name=hall>{{cite journal| author=Hall KD| title=A review of the carbohydrate-insulin model of obesity. | journal=Eur J Clin Nutr | year= 2017 | volume= 71 | issue= 3 | pages= 323–326 | pmid=28074888 | doi=10.1038/ejcn.2016.260 | s2cid=54484172 |type=Review }} </ref>
There are four phases of the Atkins diet.


==Society and culture==
===Induction===
===Commercialization===
] was founded in 1989 by Atkins to promote the sale of Atkins-branded products. Following his death, waning popularity of the diet and a reduction in demand for Atkins products, Atkins Nutritionals, Inc. filed for Chapter 11 bankruptcy protection on July 31, 2005 citing losses of $340 million.<ref>.</ref> It was subsequently purchased by North Castle Partners in 2007 and switched its emphasis to low-carb snacks.<ref name=bankruptcy2>. ''BBC News''. August 1, 2005.</ref> In 2010, the company was acquired by ].<ref>{{cite news|last1=Bills|first1=Steve|title=Atkins delivers $118 mln dividend to Roark Capital|url=https://www.reuters.com/article/buyouts-atkins/buyouts-atkins-delivers-118-mln-dividend-to-roark-capital-idUSL1N0CCCEB20130320|work=Reuters|date=20 March 2013}}</ref> In 2017, Roark Capital Group announced that it would merge Atkins Nutritionals with Conyers Park Acquisition Corp to form a public company called Simply Good Foods.<ref>{{Cite web|url=https://www.bizjournals.com/atlanta/news/2017/04/11/atlantas-roark-capital-in-deal-to-form-the-simply.html|title=Atlanta's Roark Capital in deal to form The Simply Good Foods Company|last=Allison|first=David|date=11 April 2017|website=www.bizjournals.com|access-date=2019-11-19}}</ref>


===History===
The ''Induction'' phase is the first, and most restrictive, phase of the Atkins Nutritional Approach. It is intended to cause the body to quickly enter a state of ]. Carbohydrate intake is limited to 20 net ]s per day. The allowed foods include a liberal amount of most meats, up to 4 ounces of aged, hard or soft ], three tablespoons of heavy cream, two cups of ], one cup of other low glycemic low carb vegetables. ] and ]ic beverages are not allowed.


Atkins's ideas were first published in his 1972 book ''Dr. Atkins' Diet Revolution: The High Calorie Way to Stay Thin Forever''.<ref name=slg/>
The Induction Phase is usually when many see the most significant weight loss - reports of losses up to six or eight pounds (3 or 4 kg) per week are not uncommon.


The diet gained widespread popularity in 2003 and 2004. At the height of its popularity one in eleven ]n adults claimed to be on a low-carb diet such as Atkins.<ref name="Wendy Kaufman">{{cite news| last= Kaufman| first= Wendy| url= https://www.npr.org/templates/story/story.php?storyId=4783324| title= Atkins Bankruptcy a Boon for Pasta Makers| publisher= ]| date= August 3, 2005}}</ref> This large following was blamed for large declines in the sales of carbohydrate-heavy foods like ] and ]: sales were down 8.2 and 4.6 percent, respectively, in 2003. The diet's success was even blamed for a decline in ] sales.<ref name="Larry Schooler">{{cite news|url=https://www.npr.org/templates/story/story.php?storyId=1968804|title=Low-Carb Diets Trim Krispy Kreme's Profit Line|last=Schooler|first=Larry|date=June 22, 2004|publisher=]|access-date=12 March 2017}}</ref> Trying to capitalize on the "low-carb craze", many companies released special product lines that were low in carbohydrates.
Atkins suggests the use of ], small chemically reactive strips used by ]. These let the dieter monitor when they enter the ketosis, or fat burning, phase.


Around that time, the percentage of American adults on the diet declined to two percent and sales of Atkins brand products fell steeply in the second half of 2004.<ref name=bankruptcy>{{cite news|last=Howard|first=Theresa|title=Atkins Nutritionals files for bankruptcy protection|url=http://usatoday30.usatoday.com/money/industries/health/2005-08-01-atkins_x.htm?POE=MONISVA|access-date=11 November 2012|newspaper=USA Today|date=1 August 2005}}</ref>
===Ongoing weight loss===


A 2021 ] observed that, 50 years after it was first mooted, the Atkins diet was "coming back on the quackery scene again".<ref>{{cite journal |vauthors=Schutz Y, Montani JP, Dulloo AG |title=Low-carbohydrate ketogenic diets in body weight control: A recurrent plaguing issue of fad diets? |journal=Obes Rev |volume=22 |issue= Suppl 2|pages=e13195 |date=March 2021 |pmid=33471427 |doi=10.1111/obr.13195 |type=Review|doi-access=free }}</ref>
The Ongoing Weight Loss (OWL) phase of Atkins consists of an increase in carbohydrate intake, but remaining at levels where weight loss occurs. The target daily carbohydrate intake increases each week by 5 grams. A goal in OWL is to find the "Critical Carbohydrate Level for Losing". The OWL phase lasts until weight is within 10 pounds (4.5 kg) of the target weight.


===Pre-maintenance=== ===Cost===
An analysis conducted by '']'' magazine found that the sample menu from the Atkins diet was one of the top five most expensive to eat, of the ten plans Forbes analyzed. This was due to the inclusion of recipes with some high-cost ingredients such as lobster tails which were put in the book to demonstrate the variety of foods which could be consumed on the diet. The analysis showed the median average cost of the ten diets was approximately 50% higher, and Atkins 80% higher, than the American national average. The Atkins diet was less expensive than the ] diet and more expensive than ].<ref> Forbes.com</ref>


==Failed lawsuit==
Carbohydrate intake is increased again, and the key goal in this phase is to find the "Critical Carbohydrate Level for Maintenance", this is the maximum number of carbohydrates you can eat each day without gaining weight. This may well be above the level of carbohydrates inducing ]. So it is not necessary
to maintain ketosis forever.


In 2004, Jody Gorran sued the estate of Robert Atkins and his company seeking $28,000 in damages.<ref name="The New York Times"> . ''The New York Times''. Retrieved October 14, 2020.</ref><ref>. BBC News. Retrieved October 14, 2020.</ref> Gorran stated that he had followed the Atkins diet for two years and it raised his ] so much that a major artery became clogged and he required an ] and ] insertion to open it.<ref name="Quackwatch"/><ref name="The New York Times"/> On the Atkins diet he was eating large amounts of cheese which is high in saturated fat. Gorran commented that "the issue with the Atkins Diet was not so much that my cholesterol went up but it's the fact that the Atkins empire constantly stated that in the absence of refined carbohydrates, eating a great deal of saturated fat would not be a problem and that was a lie."<ref>{{dead link|date=October 2024}}. CNN.com. Retrieved October 14, 2020.</ref> The lawsuit was dismissed in 2007 as the Atkins diet consists of only "advice and ideas" that are protected by the ].<ref>{{dead link|date=September 2024|bot=medic}}{{cbignore|bot=medic}}. Reuters. Retrieved October 14, 2020.</ref>
===Lifetime maintenance===


==See also==
This phase is intended to carry on the habits acquired in the previous phases, and avoid the common end-of-diet mindset that can return people to their previous habits and previous weight. Whole, unprocessed food choices are emphasized, with the option to drop back to an earlier phase if you begin to gain weight.
* ]

* ]
==Popularity==
* ]

* ]
The Atkins Nutritional Approach gained widespread popularity in 2003 and 2004. At the height of its popularity one in eleven adults were on the diet . This large following was blamed for large declines in the sales of carb-heavy foods like ] and ] (sales were down 8.2 and 4.6 percent respectively in 2003 ). The diet's success were even blamed for a decline in ] sales . Trying to capitalize on the "low-carb craze" many companies released special product lines which were low in carbohydrates. ] released ] and ] created ], which was scheduled to be discontinued later in 2005 . (These products seem to have been little more than marketing gimmicks designed to capitalize on carb-consciousness. Diet Coke and Diet Pepsi, both of which have been available for decades, contain no carbohydrates.)
* ]

* ]
When Robert Atkins died from a fatal head injury sustained in a fall on ice in 2003, the nutritional plan suffered from rumors and allegations that he had died from a heart condition brought about because of his weight. On ], ], the Atkins Nutritional company filed for ] bankruptcy protection after the percentage of adults on the diet declined to two percent and sales of Atkins brand product fell steeply in the second half of 2004 .
* ]

== Criticism ==

An analysis conducted by ] found that the Atkins Nutritional Approach (the boxed retail food product created by Atkins to facilitate the Atkins diet) is one of the five most expensive diet plans of the ten plans Forbes analyzed. Although Forbes found that Atkins diet was significantly less expensive than Jenny Craig and only slightly more expensive than Weight Watchers, the Atkins diet nevertheless involved more than an 80% premium over average American food expenses.

Low-carbohydrate diets have been the subject of heated debate in medical circles for three decades . They are still controversial and only recently has any serious research supported some aspects of Atkins' claims, especially for short-term weight-loss (6 months or less).

But many in the scientific community also raise serious concerns:
* The ], funded by the ] (NIH) tracked the habits of successful dieters over a longer term, 10 years. Despite this diet's overwhelming popularity compared to other diets, of the 5,000 Americans confirmed to have lost an average of 70 pounds (32 kg) and able to prove they have kept it off for at least 6 years of the decade of NIH’s data-keeping, less than 1% were confirmed to be Atkins adherents. However, of the remaining participants, many other diets were also unable to be confirmed (Wyatt HR and others. Long term weight loss and very low carbohydrate diets in the National Weight Control Registry. Obesity Research 8 (suppl 1):87S., 2000.)

* A 2001 scientific review by Obesity Research magazine concluded that low-carb dieters' initial advantage in weight loss was a result of increased water loss, and that after the initial period, low-carb diets produce similar fat loss to other diets with similar caloric intake.

* Even in studies only one year long, this diet can fail to produce the greater weight-loss which is claimed to come from factors other than calorie-reduction such as ketosis: It was compared to dieters on the ], ], and The ] for 1 year. The Atkins Diet came last in terms of weight lost at the end of the year. (Dansinger, M.L., Gleason, J. L., Griffith, J.L., et al., "One Year Effectiveness of the Atkins, Ornish, Weight Watchers, and Zone Diets in Decreasing Body Weight and Heart Disease Risk", Presented at the ] Scientific Sessions ] ] in Orlando, Florida.)

* The May 2004 Annals of Internal Medicine study showed that Atkins Dieters had significantly more diarrhea, general weakness, rashes and muscle cramps. Atkins.com now suggests a fiber supplement.

* Also, acidity from the typically high protein intake can cause ] (Feskanich D, Willett WC, Stampfer MJ, Colditz GA. Milk, dietary calcium, and bone fractures in women: a 12-year prospective study. Amer Jrnl Public Health 1997;87:992-7. See also follow-up in February, 2003 issue of the American Journal of Clinical Nutrition (Vol. 77, No. 2, 504-511); this includes 72,000+ people and 18 years of data. Cumming RG, Klineberg RJ. Case-control study of risk factors for hip fractures in the elderly. Amer Jrnl Epidemiology 1994;139:493-503.

Opponents of the diet also point out that the initial ] upon starting the diet is a phenomenon common with most diets, and is due to reduction in stored ] and related water in muscles, not fat loss. They claim that no evidence has surfaced that any diet will cause weight loss unless it reduces ] below the maintenance level, and reports have indicated that successful weight loss due to the Atkins diet may be the result of less food energy being consumed by the dieter, rather than the lack of carbohydrates. They further point out that weight loss on fad diets, which typically restrict or prohibit certain foods, is often due to the fact that the dieter has less food choices available. Also, a diet of low-carb foods may quickly become dull to many people, meaning that their appetite is somewhat naturally suppressed as they become hungry for carbs, but the dieter either has none handy or resists this hunger.

It is claimed that there is bad breath and fatigue under the Atkins diet: , , and Cleveland Clinic Journal of Medicine 68(2001): p.761

On ], ], Jody Gorran, a 53-year-old ] businessman with a family history of heart disease, filed a lawsuit against Atkins Nutritionals, Inc. and the ] of Dr. Robert Atkins, claiming that the Atkins diet regimen caused severe heart disease, making it necessary for him to undergo ]. As of ], he has been seeking a court ] banning Atkins Nutritionals from marketing its products without a warning of potential health risks, and asking for ].

Dr. Robert Eckel of the ] says that high-protein, low-carbohydrate diets put people at risk for heart disease.

The ], a PETA-connected organization which is opposed to the Atkins diet, has noted that in ]n countries such as ] or ], the average person's diet consists of mainly carbohydrates such as ] and ], yet these groups have very low rates of ]. The average ] person is also thinner and slimmer than the average ]er. This example seems to contradict the Atkin's claim that low-carbohydrate diets help to lose weight.

==Views in favor of the diet==

When the Atkins diet was introduced in the 1970s, it was immediately attacked by existing experts, who claimed it was unhealthy and would fail. Some short-term studies indicate the contrary or indicate that the long-term safety needs more research:

<ul>
<li>"The low-carbohydrate diet produced a greater weight loss for the first six months, but the differences were not significant at one year. The low-carbohydrate diet was associated with a greater improvement in some risk factors for coronary heart disease. Adherence was poor and attrition was high in both groups. Longer and larger studies are required to determine the long-term safety and efficacy of low-carbohydrate, high-protein, high-fat diets."
--New England Journal Of Medicine, Volume 348:2082-2090, ] ], Number 21</li>

<li>"better participant retention and greater weight loss...greater decreases in serum triglyceride levels"
--Annals Of Internal Medicine, ] ] | Volume 140 Issue 10 | Pages 769-777(Journal Editor's note: 'While the study suggests the efficacy and relative safety of the low-cholesterol diet, the high dropout rate, self-directed adherence to the diet, and relatively short observation period challenge the generalizability of the findings.'</li>

<li>"sustained weight loss "
--Atkins funded, non-randomized, non-control intervention trial, American Journal of Medicine, Volume 113, Issue 1, July 2002, Pages 30-36</li>

<li>"When carbohydrates were restricted , study subjects spontaneously reduced their caloric intake to a level appropriate for their height, did not compensate by eating more protein or fat, and lost weight. We concluded that excessive overeating had been fueled by carbohydrates." "In addition to the calorie reduction and weight loss, subjects experienced markedly improved glucose levels and insulin sensitivity, as well as lower triglycerides and cholesterol." This is not a controlled study in that there was no control group; it merely observed the effect of putting ten obese diabetics on the Atkins diet; this is "the only study of the Atkins diet to have been conducted in the strictly controlled environment of a clinical research center where every calorie eaten and spent was measured."
--Annals of Internal Medicine, ] ]</li>

</ul>

Two of these represent scientifically controlled studies, published in peer-reviewed journals. It should be noted, however, that the number of participants was tiny with less than 100 people completing each study. They were also short at 6 months and 1 year respectively. To date no long term study on Atkins has taken place.

Proponents of the Atkins diet feel much of the criticism leveled at the diet comes from statements and opinions of individuals and associations, rather than from controlled and reviewed studies. Advocates of the diet dispute criticisms based on the fact that a low-carb diet is likely to be high-fat and allegations that fat, especially saturated fat, is harmful. Atkins backers maintain that, aside from trans fat, saturated fat is not harmful. Proponents cite Gary Taubes who, in a 2001 article in Science, 291 (5513): 2536, claims that the oft-cited "consensus" opinion against saturated fats derives from political rather than scientific motives.

Critics of the Atkins diet may focus particularly on Atkins, or on low-carb dieting in general. Proponents claim that critics fail to consider that people are built differently, and as with any diet, the Atkins may not be effective for some people.

Continuing research supports the idea that saturated fat may be cardio-protective in some populations, see http://www.ajcn.org/cgi/content/abstract/80/5/1175, "Dietary fats, carbohydrate, and progression of coronary atherosclerosis in postmenopausal women" and http://www.ajcn.org/cgi/content/full/80/5/1102 , "Saturated fat prevents coronary artery disease? An American paradox."

The ] ], issue of the New England Journal of Medicine published two scientific, randomized studies comparing standard low-fat diets to low-carbohydrate diets such as the Atkins Diet. In both studies, subjects lost more weight on the low-carbohydrate plans at 6-months but not at 1-year. The editors noted that "Adherence was poor and attrition was high in both groups. Longer and larger studies are required to determine the long-term safety and efficacy of low-carbohydrate, high-protein, high-fat diets."

A research study carried out by the Weight and Eating Disorders Program at the ], reported in May 2003 that the Atkins diet raised levels of ] (or "good") ] by an average of 11% and reduced the amount of ]s in the bloodstream by 17%. This counters one of the chief criticisms of Atkins' approach, which is that cholesterol is raised by eating fatty foods and meat.

In another study, conventional dieters' HDL cholesterol raised by 1.6% while their triglyceride levels improved. Weight loss was also statistically greater in the Atkins dieters after three and six months compared with the conventional dieters (although this did not remain statistically significant after a year). The study followed the diets of 63 obese men and women. (See ''New Scientist'', ] ].)

In conclusion, although a small number of short-term studies have been carried out, that indicate that Atkins-style diet may help dieters achieve comparable weight loss with other dieting methods, no long term study has yet to be carried out. Thus the long term effects of Atkins on health remains unknown, and the results of these studies indicates the effectiveness of the diet for losing weight is no better.

==Misconceptions about the diet==

Many people incorrectly believe that the Atkins Diet promotes eating unlimited amounts of fatty meats and cheeses. In fact, while certain foods are allowed in unlimited quantities (i.e., are limited only by appetite), the Atkins Diet is very specific in recommending lean meats, such as seafood and poultry. This is a key point of clarification that Dr. Atkins addressed in the more recent revisions of his book.

Some criticism of the diet seems to be based on a confusion between ] and ]. ] is short for Benign Dietary Ketosis, which is a normal metabolic process that results when glucose is not available as a source of energy. The body then burns mostly fat, both directly and through conversion to ketones which make the energy of fat available in water soluble form. ] is a metabolic crisis due to the inability to utilize glucose because of a lack of insulin and in which there is an abnormal accumulation of ketones exacerbated by severe dehydration as the kidneys spill the useless glucose, losing water in the process. This occurs in diabetics and in a related form in alcoholics.

Another common misconception arises from confusion between the Induction Phase and rest of the diet. The first two weeks of the Atkins Diet are strict, with only 20g of carbohydrates permitted per day. The plan is clear that dieters should not ordinarily continue past the 2-week Induction Phase without slowly raising their daily carbohydrate count. Once the weight-loss goal is reached, carbohydrate levels are raised even further, though still significantly below USDA norms, and still within or slightly above the definition of ketosis.

The Induction Phase is also known for its comparatively lower intake of dietary fiber, and this is often misconstrued as characteristic of the diet as a whole. It is often misstated that those on the diet do not consume enough vegetables and fruits. However those who follow it properly should not face this problem as even the Induction Phase allows for adequate amounts of dark green leafy vegetables, for example.

==Books==
Robert C. Atkins (2001) Dr. Atkins' New Diet Revolution book, 560 pp, Avon Books; Revised ed., ISBN 006001203X, ISBN 0091889480
Robert C. Atkins (1999) Dr. Atkins' Vita-Nutrient Solution: Nature's Answer to Drugs, 416 pp, Fireside Books (Simon & Schuster), ISBN 0684844885


==References== ==References==
{{Reflist}}
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== See also ==
* ]
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* ]
* ]
* ]
* '']'' (TV show about the Atkins diet)
* ]


== External links == == External links ==
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* health.dailynewscentral.com

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Latest revision as of 15:22, 23 December 2024

Low-carbohydrate fad diet devised by Robert Atkins
Dr. Atkins' Diet Revolution, first published in 1972

The Atkins diet is a low-carbohydrate fad diet devised by Robert Atkins in the 1970s, marketed with claims that carbohydrate restriction is crucial to weight loss and that the diet offered "a high calorie way to stay thin forever".

The diet became popular in the early 2000s, with Atkins' book becoming one of the top 50 best-selling books in history, and as many as 1 in 11 North American adults claiming to be following it. Atkins died in 2003 and in 2005 Atkins Nutritionals, Inc. filed for bankruptcy following substantial financial losses.

There is no strong evidence of the diet's effectiveness in achieving durable weight loss; it is unbalanced as it promotes unlimited consumption of protein and saturated fat, and it may increase the risk of heart disease.

Effectiveness and risks

Further information: Low-carbohydrate diet

There is weak evidence that the Atkins diet is more effective than behavioral counseling for weight loss at 6-12 months. The Atkins diet led to 0.1% to 2.9% more weight loss at one year compared to control groups which received behavioural counselling for weight loss. As with other commercial weight loss programs, the effect size is smaller over longer periods. Low-carb dieters' initial advantage in weight loss is likely a result of increased water loss, and that after the initial period, low-carbohydrate diets produce similar fat loss to other diets with similar caloric intake.

Atkins did not publish any clinical data on his patients and has thus been criticized for making unsupported statements about health. Because of its high saturated fat content the Atkins diet may increase the risk of heart disease. A medical report issued by the New York medical examiner's office a year after the author's death showed that he had a history of heart attack, congestive heart failure and hypertension. The Atkins diet has been criticized by the American Medical Association, American Dietetic Association and the American Heart Association as nutritionally unbalanced. In 2000, Journal of the American College of Nutrition conducted a study which determined that “the very high fats of Atkins diet: 60%–68%, around 26% of which are saturates, through shifting the metabolic pathway for energy production, deliver a strong boost to free radical production, thereby increasing oxidative stress on different organs”.

Modified Atkins and epilepsy

Further information: Ketogenic diet § Modified Atkins

Ketogenic diets are used to treat epilepsy in children, where there is some evidence it has a positive effect in reducing seizures. There is some evidence that adults too may experience seizure reduction derived from therapeutic ketogenic diets, and that a less strict regimen, such as a modified Atkins diet, is similarly effective.

Description

Bacon and eggs, foods compatible with the Atkins diet

The Atkins diet has been described as a low-carbohydrate, high-fat, high-protein fad diet. It promotes the consumption of meat, cheese, eggs and other high-fat foods such as butter, mayonnaise and sour cream in unlimited amounts whilst bread, cereal, pasta and other carbohydrates are forbidden. Atkins' book New Diet Revolution has sold 12 million copies. It has been described as "the bestselling fad-diet book ever written."

Preferred foods in all categories are whole, unprocessed foods with a low glycemic index, although restrictions for low glycemic carbohydrates (black rice, vegetables, etc.) are the same as those for high glycemic carbohydrates (sugar, white bread). Due to concerns from medical experts about the high-fat content of the diet, the Atkins Nutritionals company that market foods for the diet, recommends that no more than 20% of calories eaten while on the diet come from saturated fat.

Proposed mechanism

The diet was inspired by a low-carbohydrate approach published by Alfred W. Pennington, based on research Pennington did during World War II at DuPont. The Atkins diet is promoted with claims that carbohydrate restriction is the "key" to weight loss.

In his early books such as Dr Atkins' New Diet Revolution, Atkins made the controversial argument that the low-carbohydrate diet produces a metabolic advantage because "burning fat takes more calories so you expend more calories"; the Atkins diet was claimed to be "a high calorie way to stay thin forever". He cited one study in which he estimated this advantage to be 950 calories (4.0 MJ) per day. A review study published in Lancet concluded that there was no such metabolic advantage and dieters were simply eating fewer calories. Astrup stated, "The monotony and simplicity of the diet could inhibit appetite and food intake." David L. Katz has characterized Atkins' claim as nonsense. The idea of "metabolic advantage" of low-carbohydrate dieting has been falsified by experiment in a study of people following restricted-carbohydrate dieting.

Society and culture

Commercialization

Atkins Nutritionals was founded in 1989 by Atkins to promote the sale of Atkins-branded products. Following his death, waning popularity of the diet and a reduction in demand for Atkins products, Atkins Nutritionals, Inc. filed for Chapter 11 bankruptcy protection on July 31, 2005 citing losses of $340 million. It was subsequently purchased by North Castle Partners in 2007 and switched its emphasis to low-carb snacks. In 2010, the company was acquired by Roark Capital Group. In 2017, Roark Capital Group announced that it would merge Atkins Nutritionals with Conyers Park Acquisition Corp to form a public company called Simply Good Foods.

History

Atkins's ideas were first published in his 1972 book Dr. Atkins' Diet Revolution: The High Calorie Way to Stay Thin Forever.

The diet gained widespread popularity in 2003 and 2004. At the height of its popularity one in eleven North American adults claimed to be on a low-carb diet such as Atkins. This large following was blamed for large declines in the sales of carbohydrate-heavy foods like pasta and rice: sales were down 8.2 and 4.6 percent, respectively, in 2003. The diet's success was even blamed for a decline in Krispy Kreme sales. Trying to capitalize on the "low-carb craze", many companies released special product lines that were low in carbohydrates.

Around that time, the percentage of American adults on the diet declined to two percent and sales of Atkins brand products fell steeply in the second half of 2004.

A 2021 review article observed that, 50 years after it was first mooted, the Atkins diet was "coming back on the quackery scene again".

Cost

An analysis conducted by Forbes magazine found that the sample menu from the Atkins diet was one of the top five most expensive to eat, of the ten plans Forbes analyzed. This was due to the inclusion of recipes with some high-cost ingredients such as lobster tails which were put in the book to demonstrate the variety of foods which could be consumed on the diet. The analysis showed the median average cost of the ten diets was approximately 50% higher, and Atkins 80% higher, than the American national average. The Atkins diet was less expensive than the Jenny Craig diet and more expensive than Weight Watchers.

Failed lawsuit

In 2004, Jody Gorran sued the estate of Robert Atkins and his company seeking $28,000 in damages. Gorran stated that he had followed the Atkins diet for two years and it raised his LDL-cholesterol so much that a major artery became clogged and he required an angioplasty and stent insertion to open it. On the Atkins diet he was eating large amounts of cheese which is high in saturated fat. Gorran commented that "the issue with the Atkins Diet was not so much that my cholesterol went up but it's the fact that the Atkins empire constantly stated that in the absence of refined carbohydrates, eating a great deal of saturated fat would not be a problem and that was a lie." The lawsuit was dismissed in 2007 as the Atkins diet consists of only "advice and ideas" that are protected by the First Amendment.

See also

References

  1. ^ Gardiner S, Gilman SL (2008). "Atkins, Robert, MD (1930-2003)". In Gilman SL (ed.). Diets and Dieting: A Cultural Encyclopedia. Routledge. p. 12. ISBN 978-1-135-87068-3.
  2. ^ Katz DL (2003). "Pandemic obesity and the contagion of nutritional nonsense". Public Health Rev. 31 (1): 33–44. PMID 14656042.
  3. ^ Longe, Jacqueline L. (2008). The Gale Encyclopedia of Diets: A Guide to Health and Nutrition. The Gale Group. pp. 84-87. ISBN 978-1-4144-2991-5
  4. ^ "Alleged Atkins Diet Victim Files Suit". Quackwatch. Retrieved October 14, 2020.
  5. ^ Gudzune, KA; Doshi, RS; Mehta, AK; Chaudhry, ZW; Jacobs, DK; Vakil, RM; Lee, CJ; Bleich, SN; Clark, JM (7 April 2015). "Efficacy of commercial weight-loss programs: an updated systematic review". Annals of Internal Medicine. 162 (7): 501–12. doi:10.7326/M14-2238. PMC 4446719. PMID 25844997. Atkins resulted in 0.1% to 2.9% greater weight loss at 12 months than counseling.
  6. ^ Alters, Sandra; Schiff, Wendy (22 February 2012). Essential Concepts for Healthy Living. Chapter 10: Body Weight and Its Management (Sixth ed.). Jones & Bartlett Publishers. p. 327. ISBN 978-1-4496-3062-1.
  7. Harper, A; Astrup, A (2004). "Can we advise our obese patients to follow the Atkins diet?". Obesity Reviews (editorial). 5 (2): 93–94. doi:10.1111/j.1467-789X.2004.00137.x. PMID 15086862. S2CID 40176596. Despite the popularity and apparent success of the Atkins diet, documented scientific evidence in support of its use unfortunately lags behind.
  8. Freedman, Marjorie R; King, Janet; Kennedy, Eileen (2001). "Executive Summary". Obesity Research. 9: 1S – 40S. doi:10.1038/oby.2001.113. PMID 11374180.
  9. Riche, William Harding le (1981). "Foods, fads and fallacies". Modern Medicine. 6 (10): 5–15. hdl:10520/AJA02599333_832.
  10. "Report Details Dr. Atkins's Health Problems". Wall Street Journal. Retrieved January 1, 2015.
  11. St Jeor ST, Howard BV, Prewitt TE, Bovee V, Bazzarre T, Eckel RH (October 2001). "Dietary protein and weight reduction: a statement for healthcare professionals from the Nutrition Committee of the Council on Nutrition, Physical Activity, and Metabolism of the American Heart Association". Circulation. 104 (15): 1869–74. doi:10.1161/hc4001.096152. PMID 11591629.
  12. Anderson, J. W.; Konz, E. C.; Jenkins, D. J. (October 2000). "Health advantages and disadvantages of weight-reducing diets: a computer analysis and critical review". Journal of the American College of Nutrition. 19 (5): 578–590. doi:10.1080/07315724.2000.10718955. ISSN 0731-5724. PMID 11022871. S2CID 25815308.
  13. Treadwell, Jonathan R.; Wu, Mingche; Tsou, Amy Y. (2022-10-25). Management of Infantile Epilepsies (Report). Agency for Healthcare Research and Quality (AHRQ). doi:10.23970/ahrqepccer252.
  14. Freeman, JM; Kossoff, EH; Hartman, AL (March 2007). "The ketogenic diet: one decade later". Pediatrics. 119 (3): 535–43. doi:10.1542/peds.2006-2447. PMID 17332207. S2CID 26629499.
  15. "Atkins diet boss: 'Eat less fat'". BBC News. BBC. January 19, 2004. Retrieved September 12, 2007.
  16. Martin, Douglas (April 18, 2003). "Dr. Robert C. Atkins, Author of Controversial but Best-Selling Diet Books, Is Dead at 72". The New York Times.
  17. ^ Hall KD (2017). "A review of the carbohydrate-insulin model of obesity". Eur J Clin Nutr (Review). 71 (3): 323–326. doi:10.1038/ejcn.2016.260. PMID 28074888. S2CID 54484172.
  18. Atkins, Robert (2003-09-25). Dr. Atkins' New Diet Revolution, Revised Edition. .Evans. ISBN 978-1-59077-002-3.
  19. Astrup, Arne; Larsen, Thomas Meinert; Harper, Angela (2004). "Atkins and other low-carbohydrate diets: Hoax or an effective tool for weight loss?". The Lancet. 364 (9437): 897–9. doi:10.1016/S0140-6736(04)16986-9. PMID 15351198. S2CID 24756993.
  20. Atkins Nutritionals files for bankruptcy – AP 1 August 2005.
  21. "Atkins firm seeks financial help". BBC News. August 1, 2005.
  22. Bills, Steve (20 March 2013). "Atkins delivers $118 mln dividend to Roark Capital". Reuters.
  23. Allison, David (11 April 2017). "Atlanta's Roark Capital in deal to form The Simply Good Foods Company". www.bizjournals.com. Retrieved 2019-11-19.
  24. Kaufman, Wendy (August 3, 2005). "Atkins Bankruptcy a Boon for Pasta Makers". NPR.
  25. Schooler, Larry (June 22, 2004). "Low-Carb Diets Trim Krispy Kreme's Profit Line". NPR. Retrieved 12 March 2017.
  26. Howard, Theresa (1 August 2005). "Atkins Nutritionals files for bankruptcy protection". USA Today. Retrieved 11 November 2012.
  27. Schutz Y, Montani JP, Dulloo AG (March 2021). "Low-carbohydrate ketogenic diets in body weight control: A recurrent plaguing issue of fad diets?". Obes Rev (Review). 22 (Suppl 2): e13195. doi:10.1111/obr.13195. PMID 33471427.
  28. Costly Calories Forbes.com
  29. ^ "Dieter Sues Atkins Estate and Company". The New York Times. Retrieved October 14, 2020.
  30. "Atkins dieter sues after heart op". BBC News. Retrieved October 14, 2020.
  31. "Gorran: Atkins suit a 'quest for knowledge'". CNN.com. Retrieved October 14, 2020.
  32. "Judge tosses suit of Florida man on Atkins diet". Reuters. Retrieved October 14, 2020.

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