Myths and Facts of the Atkins Nutritional Approach

Myth: The Atkins Nutritional Approach is only effective for weight loss because calories are restricted.

Fact: While some of those who follow the Atkins Nutritional Approach may eat fewer calories than before, it is not because the program is restrictive or unduly limits food intake. People who are doing Atkins may be eating fewer calories because they are generally less hungry and are less obsessed with food. But it's also important to understand that on Atkins someone can consume 1,800 to 2,000 (many men can consume even more) calories per day and still lose weight, a result that could not be achieved on a low-fat regimen.

The consumption of fewer calories occurs for two reasons:

Stable blood sugar throughout the day ensures that you will have fewer food cravings or false hunger pains.
A person doing Atkins eats food such as meat, fish, cheese, nuts, eggs, low-sugar/low-starch vegetables and fruit. All these foods are less processed, more nutritious and more satiating than the typical pre-Atkins menu. Provide the body with fewer empty calories and more nutrient-dense alternatives, and it will logically be satisfied sooner and require less food.

Scientific research supports the fact that you can consume more calories and lose more weight on a controlled carbohydrate program as compared to a low-fat one. In one recent study conducted at the Schneider's Children's Hospital at Long Island Jewish Medical Center, 40 obese patients, aged 12 to 18 years old, were split into two groups, with one group following a low-fat diet and the other following a controlled carbohydrate program. The groups were tracked for 12 weeks. Members of the low-fat group were restricted to 1,100 calories per day; members of the controlled carbohydrate group were allowed an unlimited amount of calories per day, although on average they consumed 1,830 calories.

The study found that despite greater caloric intake, subjects on the controlled carbohydrate program lost significantly more weight than the low-fat diet group, while actually improving their cardiovascular risk profiles. Also, those on the controlled carbohydrate program showed better long-term compliance than those on the low-fat diet. A year later, seven out of eight of those following the controlled carbohydrate approach are still involved with the program, as opposed to none on the low-fat diet. (1)

Myth: The weight lost on the Atkins Nutritional Approach is mostly water, not fat.

Fact: Typically on any weight loss plan, including the Induction phase of Atkins, during the first few days--or even the first week--weight lost is primarily water (diuresis). However, on a controlled carbohydrate plan with adequate dietary fat, after diuresis, the body's switch from burning carbohydrate to primarily burning stored body fat—along with dietary fat—for energy, results in weight loss. Moreover, the weight lost is mainly fat, not lean body mass. (2,3,4) It's worth repeating that studies have shown that despite the fact that more calories were consumed on a controlled carbohydrate program than on a low-fat program, the carb controlled subjects lost more weight than did those on a low-fat program.

Myth: Ketosis is dangerous and causes a variety of medical problems.

Fact: Ketones are one of two fuel-delivery substances in our bodies—the other is glucose. Whenever your body utilizes your alternative metabolic fuel (stored body fat), the byproducts it uses are ketones.

When you control carbohydrate intake, as you do during the Induction phase of Atkins, the body enters the fat-dissolving state called lipolysis. Byproducts of lipolysis are ketones and the process of creating them is ketosis. Both lipolysis and ketosis are perfectly normal and natural functions of the body. The more ketones you release, the more fat you have dissolved. Unfortunately, ketosis is often confused with ketoacidosis, a condition found in diabetics whose blood sugar is out of control, alcoholics and individuals in a state of starvation.

Research on patients who were studied in metabolic ward conditions for one month shows that ketosis was benign with no complications or side effects. The study documented cardiac (heart), renal (kidney), hepatic (liver) and hematopoietic (blood) functions in the patients and found no adverse effects. (5) Furthermore, in 40 years of clinical practice, including thousands of patients at The Atkins Center, such complications have never been observed. Other studies show that bone health was not compromised (6-13); that renal function was found to be stable on controlled carbohydrate diets (14-16) and there is even specific scientific literature on hyperlipidemia (elevated cholesterol and triglycerides) showing improved values when controlled carbohydrate diets were followed. (1, 6, 17)

Myth: Diets that promote a liberal intake of high-fat meats and dairy products raise cholesterol levels, ultimately leading to heart disease.

Fact: A growing body of scientific literature demonstrates that a controlled carbohydrate eating plan, if followed correctly, promotes heart health and improves clinical parameters. A study conducted by Jeff S. Volek, M.S., Ph.D., at Ball State University, showed the positive effects that a controlled carbohydrate nutritional approach had on triglyceride levels. The study consisted of 12 healthy men aged from 20 to 55 who followed the program for eight weeks. Upon completion of the study, subjects on average lowered their triglyceride levels by 55 percent, drastically reducing one of the major risk factors for heart disease. Furthermore, this study showed that a higher carbohydrate diet increases levels of triglycerides in the blood and lowers HDL levels, both of which have been associated with higher risks of myocardial infarction, ischemic heart disease and coronary heart disease events. (6) In addition, various researchers have demonstrated that high triglycerides and low HDL, not cholesterol alone, may be the most important factors in heart disease and stroke. (24-28)

Myth: Because it excludes fruits, vegetables and grains, Atkins is deficient in nutrients.

Fact: The Atkins Nutritional Approach does not exclude fruits, vegetables and grains. The initial Induction phase of Atkins, which people often mistake for the entire program, is the strictest phase, permitting 20 grams of carbohydrates each day. However, those 20 grams come in the form of up to three cups of green leafy salad vegetables each day, and can also include highly nutrient-dense, high fiber, vegetables such as broccoli, asparagus, eggplant and spinach.

A sample Induction menu containing 2,000 calories and 20 grams of carbohydrate was analyzed using the highly regarded Nutritionist V program. Results of analysis found the menu to meet or exceed RDI requirements of most vitamins, minerals and trace elements. Once Induction is completed and the next phase of the program has begun, individuals raise their carbohydrate count. This includes more nutrient-dense green leafy vegetables and low-glycemic fruits such as strawberries, which can far exceed requirements for fiber. On the Pre-Maintenance and Lifetime Maintenance phases, most people are able to reintroduce whole grains into their diet.

Myth: The Atkins Nutritional Approach causes constipation because it lacks fiber.

Fact: The Atkins Nutritional Approach includes fiber-rich foods such as spinach, eggplant, broccoli, asparagus and leafy greens. Beyond the Induction phase, it also includes low-glycemic fruits such as berries. In addition, if more fiber is needed during Induction, a fiber supplement such as wheat bran or flax meal is recommended. Supplementation is unnecessary in the Ongoing Weight Loss phase and beyond because more fruits and vegetables are introduced.

Myth: It is impossible to maintain weight lost on the Atkins Nutritional Approach long term.

Fact: Atkins is a controlled carbohydrate nutritional approach that promotes permanent healthy eating habits. The full program includes four phases, which gradually increase carbohydrate intake and will allow an individual to find his or her critical carbohydrate level for weight maintenance. The variety of foods allowed on Atkins provides a diverse menu that is neither complicated nor boring, and helps people stay motivated to change their eating patterns forever.

Myth: People following the Atkins Nutritional Approach may suffer from fatigue.

Fact: Fatigue may occur in the first few days of doing Atkins, while the body adapts to switching metabolic pathways. It typically takes about three to four days for the body to switch from sugar metabolism to fat metabolism. After the transition, so long as individuals do not skip meals, they are able to maintain high energy and clear thinking throughout the day because blood sugar is stabilized.

Myth: The Atkins Nutritional Approach is deficient in bone-building calcium.

Fact: Atkins offers a variety of foods rich in calcium, including cheese and vegetables such as broccoli and spinach. Moreover, in a study published in the American Journal of Nutrition, researchers took four male adults and studied the short-term and long-term effects of a high-meat diet on calcium metabolism. The study found no significant changes of calcium balance. There was also no significant change of the intestinal absorption of calcium during the high-meat intake. (7)

Myth: Atkins is high in fat, and we all know that fats cause gallbladder disease.

Fact: There is now overwhelming scientific evidence that gallstones (responsible for over 90 percent of gallbladder disease) are formed when fat intake is low. Two separate studies have shown that 25 percent of participants on an ultra low-fat diet developed gallstones, and in a third study, which examined the effects of a diet that provided 27 grams of fat per day, gallstones developed in 13 percent of the participants (29). The reason is that the gallbladder will not contract unless fat is taken in, and if it doesn't contract, a condition called biliary stasis develops and the bile salts crystallize into stones. Gallbladders need to be kept active to prevent stone formation.

Myth: The carbohydrate count listed on Atkins product labels is inaccurate, and the products are higher in carbohydrates than the labels say.

Fact: Atkins products are specifically formulated to minimize the impact of carbohydrates on a person's blood sugar level because elevated blood sugar and the resulting excess insulin production can inhibit weight loss, weight management and increase the risk of disease and illness.

Not all types of carbohydrates behave the same way in your body. For example, when table sugar is digested, it turns immediately into blood sugar. So sugar and most other carbohydrate is what we call “digestible carbohydrate." Other carbs, such as glycerin, can be digested but do not turn to blood sugar. Still others, such as dietary fiber, are indigestible and pass through your body without impacting your blood sugar level. To date, the FDA has not focused on these important biochemical differences and treats all carbohydrates alike. This means that when you look at most food labels, you do not see a number for the carbs that impact your blood sugar level, or what we call “the carbs that count when you do Atkins."

Atkins products do include the net grams of carbs. We believe that consumers deserve to get all the information they need to follow a controlled carbohydrate nutritional approach and make healthy eating decisions. Therefore, in the near future Atkins labels will include the net grams of carbohydrates (those that impact your blood sugar) as well as total carb grams. For example, an Atkins Chocolate Mocha Crunch Advantage™ Bar contains 19 total grams of carbohydrate as defined by the FDA. But of that total, 15.5 grams comprise dietary fiber, glycerin and other indigestible carbohydrates, so only 3.5 grams of carbs count when you do Atkins.

1. Sondike, S.B., Copperman, N.M. and Jacobson, M.S., “Low Carbohydrate Dieting Increases Weight Loss but not Cardiovascular Risk in Obese Adolescents: A Randomized Controlled Trial," Journal of Adolescent Health, 26, 2000, page 91.

2. Young, C.M., Scanlan, S.S., Im, H.S. et al., “Effect on Body Composition and Other Parameters in Obese Young Men of Carbohydrate Level of Reduction Diet," The American Journal of Clinical Nutrition, 24, 1971, pages 290-296.

3. Willi, S.M., Oexmann, M.J., Wright, N.M. et al., “The Effects of a High-Protein, Low-Fat, Ketogenic Diet on Adolescents with Morbid Obesity: Body Composition, Blood Chemistries, and Sleep Abnormalities," Pediatrics, 101(1), 1998, pages 61-67.

4. Avery, N.G., Volek, J.S., Gomez, M.R. et al., “The Effects of a Ketogenic Diet on Body Composition in Normal Weight Men," Abstract of the 48th Annual American College of Sports Medicine; Abstract #3326, Baltimore, Maryland, May 31-June 2, 2001.