The most exciting nutritional medicine development in recent memory is the fact that saturated fat consumption is not a significant cause of heart disease and premature death. The same goes for for total fat and cholesterol. When enough physicians, nutritionists, and dietitians learn this, low-carb eating will take off like a rocket.
For those unfamiliar with the Atkins diet, it is designed for weight loss via high fat consumption and major carbohydrate restriction. Protein intake is a bit higher than average. As long as carbohydrates (carbs) are kept low, other foods are mostly unlimited. Atkins has four phases. As you graduate from one phase to the next, more carbs are allowed, adding some carb sources before others (the "Carb Ladder").
Atkins has been around for years. It's not just a weight-loss diet; it's a lifetime way of eating.
Doctors Westman, Phinney, and Volek are leaders in low-carb nutritional science. The last time Atkins peaked (2003), we didn't have the scientific studies backing up safety of the diet. Now we do, in large part thanks to these guys.
Physicians see beaucoup patients with overweight-related medical conditions. We're not going to recommend a diet that causes heart attacks, strokes, and other major medical complications. Published research over the last eight years has established the relative safety of very low-carb diets, particularly Atkins. Low-carb diets may even be healthier than the low-fat, high-carb diet that has been recommended by U.S. public health authorities for the last forty years. Come to think of it, our current obesity and diabetes epidemics started around that same time.
The book covers nutrition basics, day-to-day practical application of Atkins eating, recipes and detailed meal plans, and the science behind the program.
What's New Since Dr. Atkins' 2002 Book?
1) adaptations for vegetarians and vegans
2) adaptations for Latinos
3) coffee is now OK
4) introduction of the term "foundation vegetables" and almost doubling the amount of vegetables allowed in Phase 1: "approximately six cups of salad and up to two cups of cooked vegetables, depending upon the ones you select"
5) more flexility, such as the option to skip Phase 1 (induction)
6) focus on adequate protein intake, based on your height
7) emphasis on getting enough omega-3 fatty acids
7) no emphasis on supplements and low-carb products sold by Atkins Nutritionals, Inc.
8) diet journals (a personal record of your weight-loss journey) are recommended
9) eliminate or minimize "induction flu" and constipation (in Phase 1) by eating at least 1/2 teaspoon of salt daily [I'm skeptical.]
11) discussion of the trendy omega-6/omega-3 fatty acid ratio
12) favor monounsaturated fatty acids (e.g., olive oil, canola oil) over certain polyunsaturated fats, as in oils from corn, soybeans, sunflower, cottonseed, and peanuts
13) no mention of testing urine for ketosis
14) more discussion of psychological aspects of weight
The lack of ads for Atkins Nutritionals products is welcome and refreshing. Too many of the official Atkins books read like infomercials, which diminishes credibility.
A vegetarian or vegan "Atkins diet" is just not something I can visualize.
What Could Have Been Done Better?
1) no specific amounts given for these recommended supplements: calcium, vitamin D, omega-3 fats, multivitamin, magnesium and other minerals (except "no iron"). [Is the idea to encourage a visit the official Atkins website?]
2) little guidance for physicians who are to advise diabetics doing Atkins. Few physicians are familiar enough with the program to make the necessary changes in particular diabetic medications.
3) little discussion of the constipation and leg cramps that often accompany very low-carb diets.
4) the hype on the cover: "How would you like to LOSE UP TO 15 POUNDS IN TWO WEEKS!" [To their credit, the authors note that such results are not typical.]
5) nearly all the measurements are U.S. Customary. Metric users are out of luck.
6) four phases seem a bit much. The beauty of Atkins Phase 1 is its simplicity.
My favorite sentence: "White flour is better suited to glue for kindergarten art projects than to nutrition."
My least favorite sentence: "We can't stress strongly enough that the best diet for you is one composed of foods you love." I love apple pie and Cinnabon cinnamon rolls, but they won't help me manage my weight.
The only error I found worth mentioning is minor. The authors state that the American Heart Association recommends consumption of fish three times a week. The official policy is still "at least twice weekly."
The book is very practical and easily understood by average people. Most will skip the science chapters at the end. I know the basic Atkins program works at least short-term; many of my patients have done it.
In summary, the book has nearly everything you need to be successful with the Atkins diet.
As far as I know, there are no comprehensive long-term studies (e.g., 10+ years) regarding health outcomes of Atkins-style eating. In other words, does Atkins have any effect on longevity, cancer, heart attacks, strokes, etc.? But very few of the popular diets have these data either. The best researched ways of eating in this respect are the Mediterranean diet and vegetarian diets.
-Steve Parker, M.D.
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