December 4, 2003

The highly controversial low-carbohydrate Atkins diet continues to remain popular, as those who have tried and tested it have seen results, writes N.M. Khan

Asma, 32, says she wants to kill all “diet experts” who she blames kept her fat for the last eight years when she was struggling with her weight. In the last four months, she claims to have lost 22 lbs on the Atkins diet and is now on a mission to promote it as the one “cure” to anyone who is overweight. “It works,” she says. “It is that simple.”

The Atkins diet is perhaps the most controversial diet to have ever been published, and it is a topic that has divided the medical industry and dieters across the globe. Its phenomenal popularity, aided by Hollywood celebrities, like Renee Zwelleger who went on it to lose the pounds she’d gained for Bridget Jones’ Diary has only furthered the campaign by nutritionists to denounce it as a dangerous diet.

Yet, despite these health warnings, scores of people are “doing Atkins” as it is commonly referred to. What is this diet and what is the truth around it? Dr Robert Atkins, the founder of the diet, remained a controversial figure since he published the Diet Revolution way back in 1972.

Dr Atkins discovered the diet when as a practicing doctor in the 60s, he was hugely overweight and had difficulty losing it. A chance read in a medical journal led him to an article on the concept of low-carb dieting. In short, he tried it, lost lots of weight and then began “prescribing” it to his patients. The rest is history.

Since its publication and its subsequent updated version, the book has sold over 10 million copies and has been read by an estimated 30 million readers. So what is this diet that even has scores of Pakistanis raving about it and how does it work?

The premise of the Atkins diet is that if you all but strip out carbohydrates (carbs) from your diet, and eat lots of protein, your body is forced into an unusual situation. For starters, your body will stop releasing floods of insulin, the hormone Atkins calls the “fattening hormone” which is secreted by the pancreas gland. The result, according to him, is that less fat is stored in the body.

Secondly, when you load your body full of protein, you force the kidneys to work to get rid of them. This takes energy. Without the carbohydrate to power the process, the body starts breaking down fat to make fuel.

In terms of the diet itself, it’s quite a simple claim: cut out the carbs and you’ll lose weight. So you can gorge yourself on meat, eggs and cheese and stay away from carbohydrates, especially refined carbohydrates, which Atkins believed to be the core of the obesity problem.

On this diet, calorie consumption is irrelevant and fats aren’t the enemy. The furore around low carb-diets like the Atkins and The Zone (similar concept), is understandable as they have challenged previously held notions that low-fat eating is the only way to go.

They also challenge the famous American Food Guide Pyramid, which advised people to eat plenty of carbs like pasta, rice and bread as part of a low fat healthy diet. Instead, low carb diets urge you to stay away from products labeled as “fat free” because in reality, Dr Atkins argues, they contain hidden sugar ingredients.

The notion of low-fat diets is not an age-old theory as you may think. In fact, reports show that it is only 25 years old and was highly publicized in the US in the early 80s when the National Institute of Health issued warnings against fat and encouraged an increase in carbohydrates.

Nonetheless, with the National Institute of Health (NIH) in the US purporting the fat is evil theory, the food industry was quick to jump on the bandwagon and began producing a multitude of fat-free products. Although they removed fat, products were nonetheless replaced with ingredients like high-fructose corn syrup; otherwise it wouldn’t be palatable.

At the same there was a strange revolution of sorts going on in the food industry, which was the production of cheap, fatty foods, i.e., junk food. The US food industry, according to a New York Times report, spends nearly 10 billion dollars a year on advertising junk food. Hence the notion that eating fat makes you obese being seen as the gospel truth. Atkins came along and challenged all that. He claims that groups like the NIH, which spent billions trying to prove that less fat has health benefits, were, in effect, unable to prove that.

As more and more people choose to “do Atkins”, the more negative press it receives in the media. The British press in particular has been almost raging a war against the diet with lots of nutritionists issuing warnings against it.

In August this year, Dr Bill Roberston, a biochemist at the University College Medical School in London, “warned that the Atkins diet, with its high protein intake and lack of fruit and vegetables, raised calcium levels in the urine and was a recipe for kidney stones.”

But, such warnings don’t serve as a deterrent. The Review showed a report published in The Guardian on September 21 this year to a few people who were on low carb diets. The report stated: “The Food Standards Agency, which is responsible for all the Government’s nutritional guidance, has published a statement alerting the public to the health risks of low-carbohydrate diets, including Atkins, claiming that they are linked to heart disease, cancer and even obesity.”

How did the dieters respond? “This is rubbish,” said 28-year-old Faryal. Others shared the same sentiment claiming that it was part of a “vicious” campaign to discredit a diet that “clearly worked”.

Asif, 31, said that he, “isn’t willing to trust anything the government has to say as it is the same governments which convinced us that fats were evil which is now being challenged.”

Interestingly enough, most of the “scientific research” against the diet doesn’t come up with any concrete evidence to back its claims. The statement from the above report reads: ‘Cutting out starchy foods, or any food group, can be bad for your health because you could be missing out on a range of nutrients. This type of diet also tends to be unrealistic and dull, and not palatable enough to be tolerated for a long time.’

As one dieter responded, “this hardly reads like a dangerous warning.” The report adds: ‘High-fat diets are also associated with obesity, which is increasing in the UK. People who are obese are more likely to develop conditions such as diabetes and some cancers. Low-carb diets tend to be high in fat, too, and eating a diet that is high in fat could increase your chances of developing coronary heart disease.’

Pro-Atkins dieters are quick to point out that there is nothing concrete in these claims. A Karachi-based general practitioner, who also read the report, adds that while there is nothing concrete in the warnings, he does not recommend the Atkins diet. “Any diet that deprives you of vital nutrients like fruit and vegetables cannot be healthy. It is only a matter of time before concrete research will prove the unhealthy effects of this diet,” he said.

Officials at the Atkins centre dismiss claims that following their diet could lead to coronary problems. They say that it is only a consumption of items with a “high-glycemic index, such as white bread, white rice or white potatoes, which increased the risk of coronary heart disease.” They also say that at no time does the diet deprive a person of the vital nutrients required. But nutritionists are not satisfied with this claim and continue to issue warnings against the diet.

Pro-Atkins dieters also dismiss such warnings as part of a campaign being undertaken by the “carb” industry which is losing revenue as the Atkins gains popularity. In the UK, a report in The Guardian in September this year, showed that “supermarkets report a surge in meat and cheese sales and a slump in pasta and rice. The price of eggs has risen by nine per cent, bringing fears of a shortage because devotees of the diet are using the food as a way of ensuring their daily fix of protein. Some sandwich bars are also offering ‘Atkins-friendly’ meals, such as chicken and salad, to respond to demand and counteract the fall in sandwich sales, as bread is on the banned list.”

The company Heinz is planning on launching a low-carb tomato ketchup and others are jumping on the low carb bandwagon to attract sales. Amna, 42, believes that the Atkins diet has got bad press “because it is up against a powerful lobby that controls the majority of the supermarket. Decades ago, eggs were declared lethal and then the decision was reversed. I trust what I see and on this diet, I see results.”

For decades we were taught that fats were the enemy. That too has been challenged by Dr Atkins and the likes who are now telling us that carbs are the enemy. Dieticians still maintain that even if you are trying to lose weight, you should get 50 per cent of your calories from carbohydrates, 35 per cent from fat and 15 per cent from protein. Dr Atkins has you thinking otherwise.

Despite the fact that people are losing weight on Atkins, there is a strong lobby that advocates the goodness of carbohydrates. In a report published in the UK, Dr John Hunter, a gastroenterologist wrote that, “carbohydrates are the body’s preferred energy source. Without them, the body will get its energy from fat, but this increases your risk of things like heart disease, gallstones and arterial disease and could raise your cholesterol level.”

Despite what Dr Atkins espouses, Dr Hunter argues that cutting out carbs may not have short-term effects, the long-term effects are far more harmful as it will “increase the metabolic load on the liver and kidney, and could permanently damage them.”

One shouldn’t get confused into believing that carbs are only found in rice, bread and pasta. Fruit and vegetables are carbs too and are sources of fibre and nutrients. In fact, one serious side effect of the Atkins diet is constipation. Although the Atkins does “allow” you to have fruit and vegetable after a certain period of being on the diet, critics argue that it is simply not enough.

Furthermore, nutritionists say that the brain needs the energy supplied by carbs. With all kinds of information available in the papers, and on the internet in particular, it is difficult to decide whom to believe. In May this year, two papers were published in the New England Journal of Medicine, a highly respected medical journal, which suggested that the Atkins diet wasn’t all that bad.

However, despite the findings, they still issued caution saying that the studies conducted on obese people were premature. In July last year, the New York Times magazine did its own research on the Atkins diet and also suggested that it wasn’t all that bad. It was published when Dr Atkins was alive and he is said to have “felt vindicated” by the story as he had been “finally proved right.”

It’s not only the Atkins which is causing such concern to nutritionists. For the past one year, The South Beach Diet, another low-carb diet, gained as much popularity and even managed to topple Dr Atkins’ bestseller off the charts in the US.

Its author, Dr Arthur Agatson in Miami, altered the Atkins diet but kept the basic principle of high protein and low carbs. Dr Agatson too purports the theory that if one eats a lot of fat, one will burn up fat more easily. Those who restrict their calorie intake to 1000 a day (or less) rapidly burn lots of carbs in the body which then turns to using up fat for providing fuel.

Nutritionists argue that this isn’t a healthy metabolic state and while it does lead to weight loss, chances of regaining all the weight once off the diet is high. There are sadly no health statistics specific to Pakistan to show how many people are overweight. But in western countries like the US and the UK, there are valid concerns surrounding people’s unhealthy eating habits and conditions like obesity are on the rise.

One report in the US states that 60 per cent of Americans are overweight. According to the British Nutrition Foundation, which published a report this year, over half of Britons are overweight and the figure is rising. Scientists recognize how people are turning to fad diets but they also warn that such diets, while popular, are only temporary solutions.

There’s no denying that the dieting industry is a multi-billion dollar one. In fact, Dr Atkins made most of his money selling his own low-carb products known as Atkins Nutritionals.

But there’s a paradoxical situation of sorts: people all over the world are getting fatter but there is also an obsession with dieting. So while people watch what they eat, they are so desperate to lose weight that they’ll try anything. The weight will come off quickly but it comes back on equally quickly.

A poll released in the US by Gallup, showed that “40 per cent of people who lost weight on the high protein, low carb diet regained their weight as opposed to 15 per cent of those who lost weight following the more conventional food guide pyramid.” Other studies in the US also show similar results but as aforementioned, such warnings seem almost futile because people want to lose weight quickly — and creators of fad diets appeal to those desires.

Women in particular are attracted to diets like the Atkins because the pounds are shed quite quickly. In the first phase of the Atkins diet, known as the 14-day induction period where one is allowed 20 grams of carbohydrates (around one-and-a-half slice of brown bread), there is indeed rapid weight loss. And because it shows, this lures others into trying it — hence the diet’s phenomenal success.

The war is on between proponents of such fad diets and those traditionalists, so to speak, of the low-fat healthy eating diet. At the moment, it seems that diets like the Atkins are in the lead which one doctor in Karachi said was “tragic as it’s misleading”.

“People think that these diets are healthy when there’s a lot more work involved in being healthy,” she said. “The best way to lose weight is to count your calories, eat low fat foods, and of course, exercise, an aspect that these diets don’t focus enough on. If you watch what you eat and go for a brisk walk for 30 minutes a day it will give you results, but people want instant results. It’s a bit pointless because more often than not, they gain weight when they go off the diet.”

Again, there is a dissenting voice to be found on the low-fat diet mantra. Eleftheria Maratos-Flier, director of obesity research at Harvard’s prestigious Joslin Diabetes Centre says, “for a large percentage of the population, perhaps 30 to 40 per cent, low-fat diets are counter productive. They have the paradoxical effect of making people gain weight.”

In a media-obsessed society, it doesn’t help that there is a lot of importance given to the lean look espoused by celebrities. Being thin is the new black. The media constantly reports how stars like Jennifer Aniston of Friends fame is on xyz diet which only results in scores of people following that diet without consulting any nutritionist. It is imperative to realize that celebrities aren’t qualified to give nutritional advice and that following xyz diet is not going to transform you into Catherine Zeta-Jones.

The Review recommends that you seek medical advice before starting any diet.

Please Visit our Sponsor (Ads open in separate window)