Atkins Diet®

While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

Related Terms

  • Atkins, Atkins diet, Atkins nutritional approach, Atkins Nutritionals, Inc. (ANI), Calories Don't Count, diet, Eco-Atkins diet, fad diet, glycemic index, high-fat diet, high-protein diet, ketogenic diet, low-carb diet, low-carbohydrate diet, low-starch diet, Robert Atkins, South beach diet®, The Drinking Man's Diet, very-low-carbohydrate diet, W. Banting's diet.

  • Not included in this review: Other high-fat diets, high-protein diets, low-carbohydrate diets (general), and the ketogenic diet.

  • Note: Only clinical trials investigating the effect of the Atkins Diet® itself will be discussed in the evidence section. Although the Atkins Diet® is considered a low-carbohydrate, high-protein, and high-fat diet, clinical trials investigating modification in macronutrients will be used to explain the potential mechanisms of action of the Atkins Diet®.

Background

  • The Atkins Diet® is an eating style that supports an increased consumption of fats as the primary source of energy, while restricting carbohydrate intake. This is based on the idea that eating carbohydrate-rich foods like bread, cereal, potatoes, or pasta results in increased fat stores.

  • Experts have found potential long-term health risks associated with the diet, including type 2 diabetes and kidney problems. The safety and long-term effectiveness of the Atkins Diet® is a subject of debate in the medical community.

  • The role of the Atkins Diet® in reducing long-term obesity and its effects on other medical conditions need further investigation. However, short-term use of the Atkins Diet® does appear to result in weight loss in clinical trials.

Tradition/Theory

  • The Atkins Diet® is a four-step dietary plan originally described in the 1972 book "Dr. Atkins' Diet Revolution." In 1992, a revised edition entitled "Dr. Atkins' New Diet Revolution" was published. Designed for weight reduction, the Atkins Diet® is a low-carbohydrate diet with unrestricted calorie intake from protein and fat. The diet is supplemented by significant amounts of vitamins, minerals, and other nutritional agents.

  • There are four stages of the program: induction, ongoing weight loss, premaintenance, and maintenance.

  • Induction phase: The diet initially excludes all carbohydrates. During the induction phase, a gradual increase of carbohydrates is permitted to a maximum of 20 grams of carbohydrates daily. The diet consists of nearly unlimited meats, poultry, seafood, eggs, cheeses, oils, butter, margarine, bacon, and sausages. The 20-gram carbohydrate limit comes from trace amounts in sauces, dressings, cheeses, and a few cups of lettuce, greens, or vegetables consumed daily. During the two weeks of the induction phase, participants cannot have milk, fruits, grains, cereals, breads, or "high glycemic index" vegetables such as potatoes, peas, corn, or carrots. Thereafter, depending on the individual and the stage of the diet, an increase to no more than 90 grams of carbohydrates daily is permitted.

  • Ongoing weight loss phase: Dieters begin adding about five grams of carbohydrates daily to their diet weekly. This phase continues until the dieter is within 10 pounds of the target weight.

  • Premaintenance phase: At this stage, dieters typically want to lose 5-10 more pounds and may increase carbohydrate intake by 10 grams daily for a week at a time.

  • Maintenance phase: Generally, dieters consume no more than 90 grams of carbohydrates daily in the maintenance phase.

  • In general, throughout the diet, unrestricted intakes of protein and fat are permitted, caloric intake is not restricted, and vitamin and mineral supplementation is recommended. Seafood and poultry are recommended. A regular exercise plan is recommended.

Scientific Evidence

Uses

 

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

 
Weight loss

 

A carbohydrate-restricted diet has been shown to result in weight loss in obese and nonobese people. Shorter time periods may result in more significant effects. Overall, studies suggest that the Atkins Diet® does result in long-term weight loss.

 

 
Diabetes

 

Carbohydrate-restricted diets have been shown to benefit insulin levels in both diabetics and nondiabetics. Preliminary evidence suggests that the Atkins Diet® may improve metabolism in insulin-resistant women. Long-term safety studies are still required in this field before conclusions can be made.

 

 
Epilepsy

 

One study reviewed the effectiveness of the Atkins Diet® in treating epilepsy. Preliminary evidence suggests that seizure frequency may be reduced in some people. More studies are required before conclusions can be made.

 

 
High blood pressure

 

According to one study, significant differences in blood pressure were lacking when the Atkins Diet® was compared with a high-carbohydrate, low-fat, low-calorie conventional diet in obese or overweight men and women. Additional studies are needed before a conclusion can be made.

 

 
High cholesterol

 

One study found that the Atkins Diet® may be linked to greater weight loss and improvements in cholesterol levels compared to other diets. More studies are needed before conclusions can be made.

 

 

*Key to grades:

Tradition

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.

  • Alzheimer's disease, anti-inflammatory, antioxidant, arthritis, asthma, autoimmune diseases, cancer, diarrhea, exercise performance enhancement, food allergies, headache, heart disease, hepatic encephalopathy (confused thinking due to liver disorders), inflammatory skin conditions, irritable bowel syndrome, liver cirrhosis (liver scarring), liver disease, metabolic syndrome (atherogenic dyslipidemia), neurological disorders (brain disorders), overall well being, sleep aid, sleep difficulties, sleep disorders, Sturge Weber syndrome (brain and skin disorder), urolithiasis (urinary tract stones).

Safety

Los profesionales de la salud que tienen instrucción formal practican muchas técnicas complementarias, de acuerdo con los estándares de organizaciones nacionales. No obstante, este no es el caso universal; es posible que se presenten efectos adversos. Debido a la limitada investigación existente, en algunos casos solamente hay poca información disponible sobre la seguridad del tratamiento.

  • The Atkins Diet® is considered safe when used for periods no longer than 3-6 months by healthy overweight individuals who are not taking any medications.

  • Note: Vitamin supplements are recommended for people who follow the Atkins Diet® due to the potential for malnutrition.

  • In general, under the Atkins Diet®, it is recommended that dieters stop any unneeded medications. The book warns that diuretic drugs (drugs that promote urination) and antidiabetic medications (including insulin) have the potential to combine with the diet to produce an overdose.

  • The Atkins diet may lower blood sugar levels. Caution is advised when using medications, herbs, or supplements that may also lower blood sugar. People taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

  • The Atkins diet may cause low blood pressure. Caution is advised in people taking drugs, herbs, or supplements that lower blood pressure.

  • The Atkins diet may increase the amount of drowsiness caused by some drugs and herbs or supplements. Examples include benzodiazepines such as lorazepam (Ativan®) or diazepam (Valium®), barbiturates such as phenobarbital, narcotics such as codeine, some antidepressants, and alcohol. Caution is advised while driving or operating machinery.

  • The Atkins diet may interact with agents that prevent seizures, agents that promote urination, agents that treat psychological disorders, agents that treat stomach disorders, anticancer agents, antidiarrheal agents, anti-inflammatory agents, antiobesity agents, central nervous system stimulants, cholesterol-lowering agents, corticosteroids, growth hormones, heart health agents, laxatives, nonsteroidal anti-inflammatory agents (NSAIDs), and steroids.

  • The Atkins diet may interact with anticancer herbs and supplements, antidiarrheals, anti-inflammatory herbs and supplements, antiobesity agents, antioxidants, central nervous system stimulants, cholesterol-lowering herbs and supplements, ephedra (ma huang), heart health herbs and supplements, herbs and supplements that prevent seizures, herbs and supplements that promote urination, herbs and supplements that treat psychological disorders, herbs and supplements that treat stomach disorders, and laxatives.

  • Use cautiously over extended periods of time. There is a lack of safety tests over periods greater than one year.

  • Use cautiously in children, highly active people, and people who have or are taking medications for anemia, celiac disease, epilepsy and seizures, gout, hair loss, heart disease, kidney disease, malnourishment, menstrual disorders, nutrient absorption problems, osteoporosis, pregnancy, psychiatric disorders (including bipolar disorder, depression, and schizophrenia), skin disorders and rash, stomach disorders, type 2 diabetes, and thyroid conditions, due to the potential for worsened symptoms.

  • Use cautiously in people taking growth hormones, diuretics, and NSAIDs.

  • Avoid using in pregnant women, due to the potential for negative side effects in the fetus. Avoid using in breastfeeding women, due to a lack of safety data.

  • The Atkins Diet® may cause other side effects, such as abnormal heart rhythm, anxiety, bad breath, breathing difficulty, changes in arterial blood gases, constipation, decreased appetite, decreased bone density, decreased urinary pH, dehydration, diarrhea, dizziness, fatigue, Fanconi's renal tubular acidosis (kidney disease), gallbladder colic, gout, headache, heart disease, high anion, high lipase A, impaired brain function, increased body hair in women, increased calcium levels, increased cholesterol levels, increased menstrual bleeding, increased nitrogen levels, increased uric acid levels, inflammation, irritability, kidney stones, lipid disorders, low bicarbonate, low blood pH, low blood pressure, muscle cramps, nausea, negative feelings toward exercise, pain in upper stomach, panic, rash, shakiness, shortness of breath, sleep difficulties, stomach problems, tissue damage, and vomiting.

Author Information

  • This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

  1. Acheson KJ. Carbohydrate for weight and metabolic control: where do we stand? Nutrition 2010;26(2):141-145. View Abstract
  2. Chirinos JA, Williams MM, Bregman DB, et al. Efficacy of cholesterol uptake inhibition added to statin therapy among subjects following a low-carbohydrate diet: a randomized controlled trial. Am.Heart J. 2010;159(5):918-6. View Abstract
  3. Doerfler B and Keefer L. Considering the necessity of a very low carbohydrate diet on diarrhea-predominant irritable bowel syndrome. Clin.Gastroenterol.Hepatol. 2010;8(1):98. View Abstract
  4. Dyson PA, Beatty S., and Matthews DR. An assessment of low-carbohydrate or low-fat diets for weight loss at 2 year's follow-up. Diabet.Med. 2010;27(3):363-364. View Abstract
  5. Foster GD, Wyatt HR, Hill JO, et al. Weight and metabolic outcomes after 2 years on a low-carbohydrate versus low-fat diet: a randomized trial. Ann.Intern.Med. 8-3-2010;153(3):147-157. View Abstract
  6. Fukushima K, Yazaki M, Nakamura M, et al. Conventional diet therapy for hyperammonemia is risky in the treatment of hepatic encephalopathy associated with citrin deficiency. Intern.Med. 2010;49(3):243-247. View Abstract
  7. Fung TT, van Dam RM, Hankinson SE, et al. Low-carbohydrate diets and all-cause and cause-specific mortality: two cohort studies. Ann.Intern.Med. 9-7-2010;153(5):289-298. View Abstract
  8. Kossoff EH, Borsage JL, and Comi AM. A pilot study of the modified Atkins diet for Sturge-Weber syndrome. Epilepsy Res. 2010;92(2-3):240-243. View Abstract
  9. Labiner-Wolfe J, Jordan Lin CT, and Verrill L. Effect of low-carbohydrate claims on consumer perceptions about food products' healthfulness and helpfulness for weight management. J.Nutr.Educ.Behav. 2010;42(5):315-320. View Abstract
  10. Lim SS, Noakes M, Keogh JB, et al. Long-term effects of a low carbohydrate, low fat or high unsaturated fat diet compared to a no-intervention control. Nutr.Metab Cardiovasc.Dis. 2010;20(8):599-607. View Abstract
  11. Masko EM, Thomas JA, Antonelli JA, et al. Low-carbohydrate diets and prostate cancer: how low is "low enough"? Cancer Prev.Res.(Phila) 2010;3(9):1124-1131. View Abstract
  12. Neal EG. and Cross JH. Efficacy of dietary treatments for epilepsy. J.Hum.Nutr.Diet. 2010;23(2):113-119. View Abstract
  13. Triffoni-Melo Ade T, Dick-de-Paula I, Portari GV, et al. Short-term carbohydrate-restricted diet for weight loss in severely obese women. Obes.Surg. 2011;21(8):1194-1202. View Abstract
  14. Wycherley TP, Brinkworth GD, Keogh JB, et al. Long-term effects of weight loss with a very low carbohydrate and low fat diet on vascular function in overweight and obese patients. J.Intern.Med. 2010;267(5):452-461. View Abstract
  15. Zeybek C, Celebi A, Aktuglu-Zeybek C, et al. The effect of low-carbohydrate diet on left ventricular diastolic function in obese children. Pediatr.Int. 2010;52(2):218-223. View Abstract

Copyright © 2013 Natural Standard (www.naturalstandard.com)

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.