Among all the eating plans available at the moment, there’s one that has remained at the spotlight for many decades. It is none other than the Atkins Diet, first introduced to the world by the renowned cardiologist and physician, Dr. Robert C. Atkins in 1972, in his book, Diet Revolution.
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A pioneer in low-carb diets
Atkins diet marked the beginning of the “low-carb” diet generation, which later underwent several changes and modifications giving rise to many other popular dietary regimens like the keto diet.
The main goal of the Atkins diet is to cut down the carbohydrate intake as a means of losing extra weight. This diet plan comes in 4 distinct phases that must be followed to get the best results and most importantly to maintain those results in the long run.(1)
- Phase 1 (Induction Phase)– No more than 20 net carbohydrates per day (for at least 2 weeks)
- Phase 2 (Ongoing Phase) – Up to 25-30 g of carbohydrates per day (over two weeks)
- Phase 3 (Pre-maintenance Phase)– Up to 80 g of carbohydrates per day until achieving the goal weight and maintain it for at least 1 month
- Phase 4 (Maintenance Phase)– 90-120 g of carbohydrates per day
During the initial stages of starting a low-carbohydrate diet, the body shifts its main source of fuel from carbohydrates to fats. This metabolic change results in various effects on the body. Some of them can be useful while others tend to be a bit troublesome.
A source of controversy
Atkins diet has been raising eyebrows for quite some time now. Both scientists and consumers alike have mixed feelings regarding this diet plan. According to some experts, the degree of restriction of carbohydrates in the Atkins diet is way too much than the recommended amount for an individual to maintain. They believe that this can lead to unnecessary consumption of unhealthy fat-containing food items as consumers try to complete their calorie requirements.
Not only that, some experts claim that the initial weight loss that gets everyone so hyped about at the beginning of the diet is not truly sustainable nor long-lasting. Besides Atkins diet does not encourage enough lifestyle modifications in its consumers, in form of physical exercise.
In a study, where out of 2681 individuals who followed a low-carbohydrate dietary regimen, only less than 1% were able to demonstrate at least 30 lb./or approximately 13 kg of weight loss at the end of a one-year period.(2)
Furthermore, like many other dietary plans, Atkins also promotes various food products like snacks, bars, and candy that can be included in the diet, as a part of its marketing campaign. These food items receive a lot of media coverage encouraging people to try them on their own. So, it leaves a bit of dilemma whether promoting consumption of processed food items as a part of a diet which is meant for good health is truly appropriate or not, since in reality, including processed food items in a dietary plan might actually bring down its value.
Atkins Diet’s road to popularity was not without its setbacks. In 2004, Jody Gorran, a 53-year-old businessman from Florida, sued the promoters of the Atkins diet, claiming that the dietary plan was responsible for obstructing blood vessels in his body, which almost cost his life.
He also added that as he was misled into consuming high levels of protein and fat as part of the dietary plan and it has ultimately resulted in sky-high levels of serum cholesterol in his body. This famous lawsuit was supported by a Washington-based advocacy group known as the Physicians Committee for Responsible Medicine at the time. Although the case was dismissed by a judge in late 2006, no one can deny that the concerns this issue highlighted are still valid to date up to a certain extent and is applicable for modern-day consumers as well, by some degree or another.(1)
What are the Downfalls of Atkins Diet?
There’s very limited scientific evidence available to back up the so-called “side effects” of an Atkin’s diet. Most of these effects seem to be temporary and seems to be to waning off after some time of getting used to this novel way of eating. Well documented data regarding life-threatening serious side-effects is quite rare.
Most of these side-effects are similar to those which occur at the beginning of other low-carbohydrate diets including the ketogenic diet. However, one cannot simply disregard any possible serious implications this dietary plan might bring.
Even the American Dietetic Association does not recommend severely restricting a single component of a diet as it might raise red flags while challenging the overall health and well-being of an individual.(3)
Here we are trying to probe into the available scientific literature to discover any potential unfavorable outcomes that could come out of consuming a low-carbohydrate diet like the Atkins.
· Ketosis
Cutting down the carbohydrate intake in Atkin’s Diet or in any other form of low- carbohydrate diet means inducing a state of “ketosis” in your body. So, what does this state of ketosis actually bring about?
When there’re lack of sufficient amounts of carbohydrates in the body to produce energy, the body changes its main source of fuel from carbohydrate to fats. Using fats as the principal source of energy means there is an accumulation of “ketone bodies” produced by fat metabolism inside the body.
Although, achieving a certain degree of ketosis is in fact a goal in consuming a low-carb diet, too much of ketone bodies build-up could actually be problematic, especially in the initial stages, in which some degree of getting used to is needed for the body.
When there is a state of ketosis, it can bring about many unpleasant effects on the body such as fatigue, dizziness, headache, nausea, bad breath and constipation. In addition, other side-effects of ketosis including keto-flu, and keto rash which are known unfavorable outcomes of a ketogenic diet, might occur as well.
Luckily enough, these effects usually do not last that long and disappear in a majority of consumers after a couple of weeks without leaving any serious consequences.
Unfortunately, that is not the case for everyone. Especially those who are having Type-1 diabetes mellitus or people who are consuming large amounts of alcohol or even people starving for longer durations can hit unfavorable levels of ketosis bringing about harmful effects. They are at the risk of damaging their livers and kidneys. (4)
Therefore, it is advised for people with Type-1 diabetes mellitus to refrain from making any major dietary modification at all or at least not to follow a new diet plan without receiving proper medical guidance.
· Increased risk of heart disease
Although Atkins suggests that restriction of carbohydrates would lead to improvement of lipid levels, some studies show that the results can sometimes be quite the opposite. According to such data, despite weight loss; low-carbohydrate, high-fat diets can in fact give rise to increased serum cholesterol levels.(5)
There is alarming evidence demonstrating that low-carbohydrate diets are capable of increasing unfavorable LDL-cholesterol levels in the body in addition to making serum cholesterol levels rise as a whole.(6)
Atkins diet could increase serum cholesterol values by approximately 25%. Astonishingly enough, every 1% rise in serum cholesterol values is estimated to increase the chance of getting coronary heart disease by at least a 2% to 3%. Applying that logic in use, Atkins diet is actually capable of increasing the risk of getting coronary heart disease by more than 50%.(5) Statistically speaking, this is a huge degree of risk as far as cardiac diseases are concerned.
Not only that, but high-fat diets are also capable of increasing postprandial triglyceride levels in the body as well. As a result, a rise in the concentration of atherogenic chylomicron remnants which are responsible for blocking important arteries might occur, making way for ischemic heart disease.
Therefore, it is no brainer that cutting down carbohydrates does no good if you start consuming loads of fatty food items to compensate for the carb loss without any control. In fact, it increases the risk of getting a heart disease quite alarmingly.
So, the best thing to do is to include more and more plant-based, high fiber, low animal fat-containing food items in your diet.
· Hyperuricemia
Whether a low-carb diet as Atkins could cause gout or not remains a bit controversial. Although there are not many strong scientific data to support this claim, to utterly dismay, individual incidents where gout and joint pain have affected people consuming high-protein, low-carb diets come to the light every now and then. Most of these unfortunate incidents have been reported at the initial stages where the dietary transition had just begun.
When an individual loses weight, the body starts to metabolize its own tissues with the final result being the production of metabolites like purines and also uric acid. In a rapidly weight losing dietary plan as Atkins, this transition is quite remarkable. Accumulation of purines and uric acid like metabolites in the body could accelerate the process of development of disease conditions like gout, especially in people with a genetic predisposition as it might trigger the entire disease process.(2)
· Hypercalciuria
Some studies show that a low-carbohydrate, high-protein diet like Atkins, can increase the risk of kidney stone formation while decreasing the overall calcium balance in the body.(7) Besides, there’s evidence showing increased risk of bone loss which can ultimately lead to osteoporosis in its consumers. However, further studies are needed to properly understand the long-term effects on the skeletal system.
With increased bone resorption, the serum calcium levels can rise to alarming levels causing kidney failure. In fact, there exists evidence showing that even permanent kidney damage can occur in people with already compromised kidney function.(2)
· Metabolic Dehydration
Some research findings demonstrate that the rapid loss of weight which occurs at the very beginning of a low-carb diet as Atkins is mainly due to water loss and hardly due to anything else.(8) Ketosis triggers loss of water. This could be one of the reasons for having symptoms like headache and dizziness, symptoms of dehydration.
Metabolic dehydration has the potential of imposing fatal outcomes. Since it results in electrolyte imbalance in the body, mainly of potassium, heart muscles can be severely affected leading to heart failure. In addition, kidney failure might also occur as a result of severe dehydration.
· Increases the risk of cancer?
It is believed that when the energy production shifts in the Atkins diet from carbohydrates to fats, it can lead to a rapid boost of free radical production in the body, inflicting increased oxidative stress upon the vital organs like the heart.
Furthermore, studies show that if coupled with low fiber consumption, this increased load of free radicals and the oxidative stress can wreak havoc inside the body, ultimately resulting in the formation of cancers in the lungs and the gastrointestinal tract.(2)
So, what can you do to avoid unfavorable effects of an Atkin’s Diet?
- Drink plenty of water to keep you hydrated
- Take supplements to prevent nutritional deficiencies
- Consume more food items containing fibers and whole grains to prevent constipation
- Avoid alcohol
- Reduce intake of unhealthy fats
There’s no point in denying that the Atkins diet does in fact has the potential of causing a few unfavorable health outcomes in its consumers. Still, we need more scientific data to arrive at definite conclusions. Especially, high-quality, large scientific research conducted with the intention of identifying the long-term impact of a low-carb diet like the Atkins are quite rare to come across.
However, on a positive note, there exists simple remedies that you can practice in the meantime, to minimize or completely overcome most of these side-effects. For individuals already suffering from other co-morbidities like diabetes mellitus and coronary heart disease, it is recommended to seek medical advice before embarking on any novel dietary journey. Even for those people with other disease conditions, low-carbohydrate dietary plans can be an option, as long as the benefits they might receive overweigh the potential risks.
References
1. Atkins Diet | Encyclopedia.com [Internet]. [cited 2021 Jan 30]. Available from: https://www.encyclopedia.com/medicine/divisions-diagnostics-and-procedures/medicine/atkins-diet
2. Mahdi GS. The Atkin’s diet controversy [3] [Internet]. Vol. 26, Annals of Saudi Medicine. King Faisal Specialist Hospital and Research Centre; 2006 [cited 2021 Jan 22]. p. 244–5. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6074441/
3. Closing Off His Heart to the Atkins Diet | AtkinsFacts.org [Internet]. [cited 2021 Jan 30]. Available from: https://atkinsfacts.org/closing-off-his-heart/
4. Kossoff EH, Dorward JL. The modified Atkins diet. Epilepsia. 2008;49(SUPPL. 8):37–41.
5. Anderson JW, Konz EC, Jenkins DJA. Health Advantages and Disadvantages of Weight-Reducing Diets: A Computer Analysis and Critical Review. J Am Coll Nutr. 2000;19(5):578–90.
6. Retterstøl K, Svendsen M, Narverud I, Holven KB. Effect of low carbohydrate high fat diet on LDL cholesterol and gene expression in normal-weight, young adults: A randomized controlled study. Atherosclerosis [Internet]. 2018 Dec 1 [cited 2021 Jan 2];279:52–61. Available from: https://pubmed.ncbi.nlm.nih.gov/30408717/
7. Reddy ST, Wang CY, Sakhaee K, Brinkley L, Pak CYC. Effect of low-carbohydrate high-protein diets on acid-base balance, stone-forming propensity, and calcium metabolism. Am J Kidney Dis. 2002;40(2):265–74.
8. Yang MU, Van Itallie TB. Composition of weight lost during short term weight reduction. Metabolic responses of obese subjects to starvation and low calorie ketogenic and nonketogenic diets. J Clin Invest. 1976;58(3):722–30.