Atkins Diet

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The Atkins diet , named after its inventor Robert Atkins , is a diet based on the low-carb principle. It drastically reduces the intake of carbohydrates at the beginning and uses fat as the main source of energy and protein as a supplier of amino acids. This approach is believed by the Atkins Diet to force the body to convert fat into ketone bodies for energy.

Atkins Nutritionals Inc. , founded by Atkins in 1989, was a rapidly growing company providing a wide range of appropriate products to millions of people who were committed to the low carbohydrate lifestyle . After the "Atkins wave" subsided in the USA, however, the company went steeply downhill. On July 31, 2005, a company spokesperson announced that Atkins Nutritionals Inc. had filed for bankruptcy . The bankruptcy proceedings were successfully completed in 2007 and the company was sold to Roark Capital in 2010.

The principles of the Atkins diet

When Atkins published his diet book in the 1970s, his motto was: Fat and protein are allowed, an amount of more than 5 g of carbohydrates per day is prohibited during the 14-day entry phase I. He later modified this principle so that carbohydrates are now are also part of the diet in small amounts (up to 20 g per day) in the initial phase. The low-carbohydrate diet is designed to keep blood sugar levels low. Vitamins and minerals should be absorbed through additional preparations. It is essential that, unlike carbohydrates, the body cannot store protein, so that excess protein is excreted. This leaves mainly fat for energy production.

There are four different phases in the Atkins diet, which differ in the amount of carbohydrates they consume. People who are very overweight should start with phase 1 in order to get into lipolysis as quickly as possible , especially so-called ketosis , in which the body uses up fat. Phases 2 and 3 mean approaching a higher amount of carbohydrates, but the client continues to lose weight. In phase 4, the client finally eats so many carbohydrates that they neither lose nor gain weight. Atkins saw phase 4 as a lifelong form of nutrition, comparable to today's LOGI method.

In his first book The Diet Revolution , Dr. Atkins suggests on several occasions that there is no need to count calories. Exercise is also not necessary for the (original) Atkins diet to be successful.

According to Atkins, dietary supplements , vitamins and minerals should be taken in through additional preparations, otherwise a deficiency will result.

The ketosis

Carbohydrates absorbed by the body are converted into energy or body fat. If no carbohydrates are supplied with food, the body converts the metabolism to fat utilization. In the liver , fatty acids are converted into so-called ketone bodies as glucose substitutes . Ketones are basically created with every fast as soon as the body switches to the metabolism of endogenous fats. An increased concentration is called ketosis, recognizable by a distinct bad breath as a result of the metabolite acetone . Increased ketone bodies in the blood are said to have an appetite suppressant effect. Derived from the word 'ketosis', Atkins followers also call themselves “ketarians”.

Phase I (introductory diet)

Here you should only eat up to 20 g of carbohydrates per day for 14 days. According to Atkins, meat offers the optimal combination of amino acids alongside eggs . Soy products can also be used. The allowed amount of carbohydrates should be consumed as a salad and vegetables to avoid constipation. Bread is forbidden.

It is recommended that you discuss the Atkins diet with a doctor to check for changes in blood values. Due to the very small amount of carbohydrates, the body is quickly forced to use fat for energy production. The ketone bodies that appear as an intermediate product can be detected in the urine with the help of so-called ketosticks .

Phase II (basic weight reduction diet)

After phase I, nutrition is continued; Now, after the modification of the diet, more nutrient-rich carbohydrates such as vegetables, nuts, berries, seeds as well as beans and legumes can be incorporated into the diet week after week. The amount of carbohydrates consumed daily should be increased by 5 g every week, so that in the first week it is increased to 25 g, in the second week to 30 g, etc.

As soon as you stop losing weight, the amount of carbohydrates should be reduced again by 5 g. You now know the maximum amount of carbohydrates you can consume in order to keep losing weight. For most people, the amount should be between 40 and 60 g permanently.

Phase III (pre-maintenance diet)

Now the weight loss should almost stagnate. To do this, the amount of carbohydrates can be increased by 10 g each week or an additional 20 to 30 g of food with a high nutrient density can be added to the diet two days a week, as long as one is still losing weight.

Phase IV (lifelong maintenance diet)

Once the target weight has been reached, the choice of permitted foods increases dramatically: We recommend lots of vegetables, lots of fish and also fruit. Pasta and potatoes are still only enjoyed in exceptional cases. Phase 4 is to be understood as a permanent form of nutrition.

discussion

Studies

In April 2003, the renowned medical journal Journal of the American Medical Association (JAMA) published the first systematic data analysis from 96 relevant studies (from 2,503 articles between 1966 and 2003) on the effectiveness and safety of low-carbohydrate diets. The result of this meta-evaluation (ie a study that summarizes the current state of research) was the determination of insufficient data in research to make a well-founded recommendation for or against low-carb diets in terms of effectiveness and safety for broader population groups, especially for high-carbohydrate diets, long periods of time and elderly patients.

In contrast, positive consequences were found in individual studies. In a randomized comparative study of four diets (Atkins diet, ZONE , Ornish and a traditional low-fat diet) published in JAMA in 2007, the 300 test subjects were initially trained in one of the four nutritional approaches for eight weeks; the following year, both weight loss and the development of the main risk factors for cardiovascular disease were examined. According to the study, the subjects in the Atkins group lost the most weight at 4.7 kg in twelve months. However, the study notes that this weight loss is relatively small. No negative effects on cholesterol or insulin levels were found; the values ​​for the risk factors high blood pressure, blood fat values ​​and blood sugar levels were either indistinguishable from other diet groups or even better. The head of the study could not answer the question of whether the possibly better development of the risk factors in the Atkins group is due to the greater weight loss or the restriction of carbohydrates.

A meta-analysis from 2008 in the journal Obesity Reviews also confirmed the effect of low-carbohydrate diets with simultaneous health safety, as did a comparative study in 2008. A US meta-analysis from 2010 in humans also showed that an increased amount of saturated fatty acids in food, as recommended in the Atkins Diet, does not affect coronary heart disease (CHD) or cerebral infarction.

For several years now, a low-carbohydrate diet has been carried out under medical supervision on the Benjamin Franklin Charité Campus in Berlin. The blood gases , cholesterol , blood sugar and basal metabolic rate are checked at regular intervals . Glucose tolerance tests are also done multiple times to see how well the pancreas is working.

According to recent studies, a new mechanism of action of the Atkins diet is being discussed: test subjects lose weight not (only) because of the change in metabolism to ketone bodies, but because they reduce their food intake due to a stronger or earlier feeling of satiety . It is possible that those affected feel full earlier because of the low-carbohydrate diet; the underlying biochemical mechanism is, however, still unclear. It is also believed that the high protein diet is responsible for this. Scientists working with Rachel L. Batterham were able to show that a satiety hormone is produced when protein is absorbed by the body.

criticism

The Atkins diet is controversial and is rejected by many nutrition experts and the German Nutrition Society (DGE) as too one-sided and potentially harmful to health. The fat content of the Atkins diet is over 50 percent, according to the DGE recommendation, the diet is therefore not balanced. The same points of criticism apply as for other low-carb diets.

A long-term study from 2010 on children and young adults suggests that ketogenic diets are harmless to health, even over longer periods of time.

In sick people, especially with internal diseases such as metabolic disorders (e.g. diabetes mellitus ) or disorders of the activity of the internal organs (e.g. kidney failure ), one-sided diets are always associated with special and increased risks, which is why they are never done without good medical advice Advice should be given.

In 2005 the result of American researchers was published that the Atkins diet leads to a significant increase in methylglyoxal production due to the ketosis effect . This chemical compound is thought to be toxic to cells, and it can lead to vascular and tissue damage, especially in diabetics. Individual cases of life-threatening acidosis are known.

The Deutsches Ärzteblatt reported in 2005 that “low-carbohydrate diets, as expected, showed a tendency towards higher LDL cholesterol, uric acid and urea levels and an increased risk of kidney stones”. On the total serum triglycerides, however, these diets would always have had a more positive effect than normal, moderate calorie-reducing diets. Patients with renal insufficiency and diabetics, especially if the latter are treated with metformin , are advised against the Atkins diet by doctors, as the resulting ketone bodies cannot be sufficiently excreted through the kidneys and the risk of ketoacidosis  - a life-threatening acidification of the blood - threatens.

A prospective cohort study of 40,000 Swedish women published in 2012 found that low-carb, high-protein diets increased the risk of cardiovascular diseases such as heart attack or stroke. The study assumes that low-carb diets are generally also high-protein diets, but does not want to make any statements about diets that do not have this connection.

The study also suggests that regular (long-term) dietary consumption and failure to consider the nature of the carbohydrates and the source of protein are crucial for the negative consequences. According to Spiegel, there are indications that the negative consequences of diets are not due to the effects of carbohydrates and proteins themselves, but to other changes in the nutrient composition, which are caused by a change in food choices in the case of low-carb (less fruit, Vegetables & cereals) and high-protein (more animal foods). Der Spiegel also reports that the women in the study often did not actually adhere to the specifications of the advertised diets, but rather “ate a balanced diet”. Under changed conditions, low-carb diets could be "nutritionally acceptable".

According to a study by the Johns Hopkins Children's Center, in which 101 epilepsy patients aged 2 to 26 years participated and followed a ketogenic diet (under medical guidance and control), these suffered less or no more uncontrolled seizures. After a 16-month to 8-year ketogenic diet, no health damage induced by this diet could be demonstrated in these patients.

Overall, the criticism presented in this section does not provide any conclusive evidence that the Atkins diet is expected to have negative effects on health in the short or long term in otherwise healthy people - provided that the diet is actually carried out as directed. In the event of deviations from the dietary requirements or certain illnesses, it can no longer be assumed that there is no harm to health. Appropriate advice from a good doctor in advance of and / or during the diet is always recommended.

Misconceptions about the diet

There is a widespread misconception that the Atkins diet advocates the consumption of unlimited amounts of fatty meals and cheese. This is the key Enlightenment thesis that Atkins is addressing in the current revision of his book. While the Atkins diet has no calorie or absolute limits on protein, Atkins points out in his book that this plan is "not a carte blanche". Atkins Nutritionals' director of research and education, Collette Heimowitz, said that “The media and opponents of Atkins often simplify the diet for sensation rather than the steak-as-you-eat diet. This does not correspond to the truth. "

Another common misconception arises from the confusion between the introductory phase and the remainder of the diet. The first two weeks of the Atkins diet are strict with only 20g of carbohydrates allowed per day. Atkins explains that if you want to lose a lot of weight, you can stay in the induction phase for a few months without risk. Initiation, however, is just a phase of getting the body used to fat and satisfying the cravings for unacceptable food. Gradually, carbohydrate intake is increased to slow weight loss and more acceptable foods (berries, more dairy products, nuts, etc.) are added. However, the carbohydrates are still well below the USDA norm. Once the desired weight loss is achieved, the carbohydrate intake is increased again and brought into balance so that the weight remains stable. The carbohydrate intake can then be below or above the USDA norm, depending on the individual metabolism, age and level of training.

literature

  • Robert C. Atkins: Atkins for Life. Permanently slim and healthy; with a 6 month plan and loads of delicious recipes. Goldmann Verlag, Munich 2004, ISBN 3-442-16625-X ( Goldmann 16625).
  • Monika Berger-Lenz, Christopher Ray: We are fat! The Truth About The Ketogenic Diet. Atkins diet, low carb and ketarian. FAKTuell-Verlag, Görlitz 2003, ISBN 3-9809203-1-3 .
  • Monika Berger-Lenz, Christopher Ray: We're fed up with hunger! The LowCarb ABC. FAKTuell-Verlag, Görlitz 2005, ISBN 3-9809203-4-8 .

Web links

Individual evidence

  1. ^ Fiona Walsh: Atkins diet firm sells out to Roark Capital . The Guardian . Retrieved July 28, 2014.
  2. ↑ Dena M. Bravata et al .: Efficacy and Safety of Low-Carbohydrate Diets: A Systematic Review . In: JAMA . 14, No. 289, April 13, 2003, pp. 1837-1850. doi : 10.1001 / jama.289.14.1837 . Retrieved March 5, 2011. " Conclusions: There is insufficient evidence to make recommendations for or against the use of low-carbohydrate diets, particularly among participants older than age 50 years, for use longer than 90 days, or for diets of 20 g / d or less of carbohydrates. Among the published studies, participant weight loss while using low-carbohydrate diets was principally associated with decreased caloric intake and increased diet duration but not with reduced carbohydrate content. "
  3. ↑ CD Gardner et al .: Comparison of the Atkins, Zone, Ornish, and LEARN Diets for Change in Weight and Related Risk Factors Among Overweight Premenopausal Women
  4. ↑ Hession M, Rolland C, Kulkarni U, Wise A, Broom J: Systematic review of randomized controlled trials of low-carbohydrate vs. low-fat / low-calorie diets in the management of obesity and its comorbidities . In: Obes Rev . 10, No. 1, August 2008, pp. 36-50. doi : 10.1111 / j.1467-789X.2008.00518.x . PMID 18700873 . " There was a higher attrition rate in the low-fat compared with the low-carbohydrate groups suggesting a patient preference for a low-carbohydrate / high-protein approach as opposed to the Public Health preference of a low-fat / high-carbohydrate diet . Evidence from this systematic review demonstrates that low-carbohydrate / high-protein diets are more effective at 6 months and are as effective, if not more, as low-fat diets in reducing weight and cardiovascular disease risk up to 1 year. "
  5. ↑ Shai, I. et al.: Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet . In: New England Journal of Medicine . 359, No. 3, July 17, 2008, pp. 229-241. doi : 10.1056 / NEJMoa0708681 . " Conclusions: Mediterranean and low-carbohydrate diets may be effective alternatives to low-fat diets. "
  6. ↑ Patty W Siri-Tarino, Qi Sun, Frank B Hu and Ronald M Krauss: Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease Archived from the original on October 18, 2010. In: Am J Clin Nutr . January 13, 2010. doi : 10.3945 / ajcn.2009.27725 . Retrieved March 4, 2011. " A meta-analysis [...], showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD. [...] "
  7. ↑ a b Does the Atkins Diet Really Work? (2004)
  8. ↑ Arne Astrup, Thomas Meinert Larsen, Angela Harper: Atkins and other low-carbohydrate diets: hoax or an effective tool for weight loss? . In: The Lancet . 364, No. 9437, September 4, 2004, pp. 897-899. doi : 10.1016 / S0140-6736 (04) 16986-9 . Retrieved March 5, 2011.
  9. ↑ Christina Schlatterer: How proteins make you full; Slow rethinking of dietary guidelines . NZZ -Online. October 18, 2006. Archived from the original on November 16, 2006. Retrieved on March 5, 2011: “ Those study participants who had received the protein-rich meal reported the most pronounced satiety. They also had the highest increase in the amount of PYY [a satiety hormone] in their blood after meals. "
  10. ↑ Peter Stehle et al .: Graphical implementation of dietary guidelines - traditional and new approaches (pdf), Volume 4, Ernahrungumschau, 2005, pp. 128–135 (accessed on January 21, 2011).
  11. ↑ a b Low carb - high fat? - DGE-aktuell 05/2004 . DGE . June 16, 2004. Archived from the original on May 25, 2011. Retrieved March 1, 2011.
    Full quote under: Low Carb vs. High Fat News . June 21, 2004. Retrieved January 7, 2018.
  12. ↑ Johns Hopkins Medical Institutions: High-Fat Ketogenic Diet to Control Seizures Is Safe Over Long Term, Study Suggests ( English ) Science Daily. February 17, 2010. Retrieved March 4, 2011: “ Despite its temporary side effects, we have always suspected that the ketogenic diet is relatively safe long term, and we now have proof. "
  13. ↑ K. Widhalm, D. Fussenegger: Life-threatening complications in the Atkins diet. (PDF; 42 kB)
  14. ↑ Hans Hauner: Risks of low-carbohydrate diets. In: Deutsches Ärzteblatt , 2005; 102 (11): A-750 / B-628 / C-586.
  15. ↑ Hans-Christoph Diener: Internal Therapy 2012/2013. Elsevier Health Sciences, 2012, ISBN 9783437416514 , p. 966.
  16. ↑ Low carbohydrate-high protein diet and incidence of cardiovascular diseases in Swedish women: prospective cohort study , June 26, 2012
  17. ↑ a b Dennis Ballwieser : Diets: Low-carb increases the risk of cardiovascular diseases. spiegel.de, June 27, 2012.
  18. ^ " Despite its temporary side effects, we have always suspected that the ketogenic diet is relatively safe long term, and we now have proof. In: High-Fat Ketogenic Diet to Control Seizures Is Safe Over Long Term, Study Suggests. In: SienceDaily.com. Johns Hopkins Medical Institutions, February 17, 2010, accessed March 4, 2011 .