Cutting down carbohydrate intake as a means of losing weight is not a novel concept for the modern world at all. In fact, there are several ways in which a person can do it. Although the diversity is so complex, there’s only a few methods that were able to survive at the peak of popularity for so long. Out of them, there’s one that has survived across time over many decades. And that is none other than the Atkins Diet, one of the oldest members of the low-carb diet league.
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What is an Atkins Diet?
First introduced to the world by the famous cardiologist and physician, Dr. Robert C. Atkins, in his book, Diet Revolution, in 1972, the Atkins diet has come a long way since then.
Overwhelmed by the escalating rates of obesity and other non-communicable diseases, Dr Atkins put forward the concept of limiting the carbohydrate intake as a way of losing extra weight and keeping troublesome diseases at bay.
This diet plan consists of 4 distinct phases that an individual should follow in order to get the best results and to maintain those results throughout.
- 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)– About 90-120 g of carbohydrates per day
The Science Behind Atkins
During the initial stages of starting a low-carbohydrate diet, there are a few metabolic changes which occur inside the body. There’s a transition in the main source of energy from carbohydrates to fats. As a result, instead of glucose, the by-product of carbohydrate metabolism; ketone bodies, the by-product of fat metabolism, become the principal substrate for generating energy.
This induces a state of ketosis within the body. Even the most vital organs like the brain get accustomed to using ketones as a source of energy. When the body needs more energy to carry out its day today chores, distant fat tissues get recruited into providing more substrate required for generating energy. As a result, the fat deposits inside the body decrease significantly reducing the states of overweight or obesity overtime.
Different Atkins Diet Regimens
Since the introduction of the traditional Atkins Diet, it has undergone a few minor modifications giving rise to a number of sub-regimens or variants of the same dietary plan, but with slight differences.
These regimens got commercialized over time as their main goal was to suit many individuals as possible with a variety of weight-losing goals. As a result of this diversity, the Atkins diet has gained quite popularity all over the world.
Atkins 20
This is the same old traditional Atkins diet in a different name. It consists of the 4-phase system which starts with the induction phase where the limit is 20g of carbohydrates per day.
Atkins 20 is recommended for individuals;(1)
- With more than 40 pounds to lose
- With diabetes or at the risk of getting diabetes
- Men with more than 40 inches as the waist circumference
Atkins 40
This is a slight modification of the traditional diet with more room for different food choices. It starts with 40g of net carbohydrates per day and work up accordingly in relation to reaching the weight goals. This method allows consumption of a wide array of vegetables, fruits, dairy and carbohydrate-dense food products. However, this way also strictly limits the sugar consumption.
Atkins 40 is recommended for individuals;(1)
- With less than 40 pounds to lose
- Non-diabetics and having low risk of getting diabetes
- Men with less than 40 inches as the waist circumference
- Women with less than 35 inches as the waist circumference
- Pregnant mothers
- Lactating mothers
The Modified Atkins Diet
One major fault in the traditional Atkins Diet is that it is less palatable and has a higher degree of calorie restriction. As a result, the John Hopkins Hospital took initiative in developing the Modified Atkins diet, especially targeted for children. Its application as a treatment modality in epilepsy and it will be later put into discussion in this article.
In the Modified Atkins Diet, 65% of its calorie requirement comes from fat sources. At the initial stages, the carbohydrate intake limits to 10g/day and it gradually increases over a period of one month to 15 g, then to 20–30 g/day.(2)
Health Benefits of the Atkins Diet
The Atkins Diet’s popularity among its consumers is not without good, valid reason. Even popular celebrities like Kim Kardashian, swear by many benefits that Atkins diet brings.
The concept of a low-carbohydrate diet has been put into good use all around the world in many ways. Now let’s have good look at some of the available scientific data regarding a couple of health benefits that the Atkins diet claim to provide its users.
· A fast ticket to weight loss
One of the main reasons for the Atkins diet to be so popular among everyone is that it is truly responsible for causing a certain degree of weight loss, remarkably at the initial stages of the diet. The ability to experience quick and visible results is always a promising feature for any type of dietary plan. Same goes for the Atkins diet as well.
To add to that, there are plenty of scientific evidence to back up its ability to lose some weight. For example, in a study where the subjects followed the first two phases of the Atkins diet, each for two weeks, were able to observe a significant degree of weight loss at the end of the study period.(3)
This weight loss primarily co-related with the degree of self-limitation of calorie intake by the individuals. Scientists believe that the loss of weight at the initial stages may be due mobilization of fats from peripheral tissues like the muscles and also due to the loss of body water in urine as a response to the state of ketosis created with in the body itself.
According to another study, when compared to a low-fat diet, a very low-carbohydrate diet as the Atkins is more effective in losing body weight and fat during a shorter period of time. Quite interestingly, they have observed a three-fold greater loss of fats in the trunk region when on a low-carbohydrate diet than compared to that of being on a low-fat diet.(4)
It is very well known that upper body fat imposes a greater health risk than fat stored in other regions of the body. Therefore, for weight loss to be effective, regional loss of fats has to be proportional as well. Nevertheless, how a very low-carbohydrate diet like the Atkins achieve such a leap remains a bit unclear. The experts believe it must have something to do with the changes mediated by hormones such as insulin, leptin, or cortisol in the body.(4)
· Reduces the risk of cardiovascular disease
Although the impact of an Atkins diet on overall cardiovascular well-being remains a bit controversial to begin with, one cannot simply disregard some of the scientific evidence implying a positive note on the matter.
For example, in a study conducted to determine the effects of a high-fat, low-carbohydrate diet compared to a low-fat high-carbohydrate diet, on several factors including weight loss, cardiovascular risk factors and inflammation in individuals with obesity, the results were quite interesting.
According to the results of the study, individuals who consumed the high-fat, low-carbohydrate diet for 12 weeks had demonstrated 23% lower triglyceride levels and 11% higher HDL cholesterol concentrations at the end of the study period. Not only that the study also showed improvements in blood markers of inflammation, especially the acute phase protein, also called hs-CRP, which is related to increased risk of cardiovascular disease.(5)
In addition, they could observe higher total adiponectin concentrations when the subjects were on a high-fat, low-carbohydrate diet as the Atkins. Adiponectin is an adipose tissue-derived mediator which is famous for its insulin-sensitizing and anti-inflammatory properties and acts as a protective factor against several metabolic diseases including cardiovascular disease.
· Improves glycemic control
Scientific data shows that a diet low in carbohydrates is capable of improving glycemic control by significant amounts. In one study, they were able to observe a greater 0.7% decrease in HbA1c levels when using a low-carbohydrate diet than when using a high-carbohydrate diet.(6) A reduction in the HbA1c value is said to decrease the risk of diabetes-related death by a significant amount. In other words, low-carbohydrate diets including the Atkins diet is able to lower the occurrence of diabetes-related complications quite remarkably.
In addition to improving the glycemic control, low-carbohydrate diets are also known to reduce the requirement for diabetic mediations, or for better, completely eliminate the requirement altogether. In one study, scientists were able to observe either a reduction or elimination of diabetes medications in approximately 95.2% of the subjects who consumed a low-carbohydrate diet during the period of the trial.(7)
· For treating epilepsy
The modified Atkins Diet has been a front runner in treating drug-resistant epilepsy in children and adults for nearly two decades. This particular diet involves restricting carbohydrates to 10 g/day (15 g/day in adults) while encouraging the intake of high-fat food items. Several research studies bear witness to a significant reduction in seizure frequency while being on a low-carbohydrate diet like the modified-Atkins.
A series of studies conducted on benefits of dietary therapy in the treatment of epilepsy in both children and adults revealed that 45% of the subjects had 50–90% seizure reduction while about 28% of the participants revealed >90% seizure reduction, which in fact was a quite outstanding outcome.(2)
Similarly, in another study, nearly 25% reduction in seizure frequency was observed in adults with difficult-to-treat focal epilepsy while being on the modified Atkins diet. However, they were able to identify a significant degree of variability among individuals as far as the effect of the diet is considered. (8)
What is good about the modified-Atkins diet is that it can be initiated quite efficiently in an outpatient clinic setting without much involvement of a dietitian on the set. It is important to educate the parent or the guardian regarding carbohydrate counting, reading food labels, and also about identifying and using high-fat food items. If family members of the epileptic patient decide to adhere to the diet, they will get the added benefit of getting rid of some extra weight as well.
The modified-Atkins diet is in fact on its way to become the treatment of choice in treating refractory epilepsy in patients of all ages, mainly owing to its ease in administration. It has become a field of interest in scientific research for treating new-onset epilepsy, and other neurologic conditions in many parts of the world.
Few tips that will help you at the beginning of the Atkins Diet
- Remember to count the carbs intake, instead of estimating.
- Introduce one new food item at a time so that you can be sure whether the new addition increases your cravings and reverses the weight-loss process or not.
- Increase the variety of the food items, not the quantity
- Write down what you eat as a reminder for yourself
The Atkins diet might not be everyone’s cup of tea. It definitely does not suit everyone. Especially, those who are suffering from other co-morbidities like diabetes mellitus have to be extra careful when starting a brand-new diet plan, be it Atkins or any other for that matter.
It is safe to say there are plenty of substantial scientific evidence to support many positive outcomes that a low-carbohydrate diet like the Atkins diet might bring. However, needless to say, the scientific knowledge is constantly evolving, and we learn something or another about these alternative ways of eating every other day. Hopefully, with all the scientific research going on, we will be able to know more about the long-term effects that might come out of such a dietary plan, so that we will be able to reap its health benefits to the maximum in the future.
References
1. Science behind Atkins 40 | Atkins [Internet]. [cited 2021 Feb 2]. Available from: https://www.atkins.com/how-it-works/library/articles/how-atkins-40-works-and-the-science-behind-it-1
2. Kossoff EH, Dorward JL. The modified Atkins diet. Epilepsia. 2008;49(SUPPL. 8):37–41.
3. Miller B V., Bertino JS, Reed RG, Burrington CM, Davidson LK, Green A, et al. An Evaluation of the Atkins’ Diet. Metab Syndr Relat Disord. 2003;1(4):299–309.
4. Volek JS, Sharman MJ, Gómez AL, Judelson DA, Rubin MR, Watson G, et al. Comparison of energy-restricted very low-carbohydrate and low-fat diets on weight loss and body composition in overweight men and women. Nutr Metab [Internet]. 2004 Nov 8 [cited 2021 Jan 29];1:13. Available from: /pmc/articles/PMC538279/?report=abstract
5. Ruth MR, Port AM, Shah M, Bourland AC, Istfan NW, Nelson KP, et al. Consuming a hypocaloric high fat low carbohydrate diet for 12 weeks lowers C-reactive protein, and raises serum adiponectin and high density lipoprotein-cholesterol in obese subjects. Metabolism. 2013;62(12):1779–87.
6. Tay J, Luscombe-Marsh ND, Thompson CH, Noakes M, Buckley JD, Wittert GA, et al. A very low-carbohydrate, low-saturated fat diet for type 2 diabetes management: A randomized trial. Diabetes Care. 2014;37(11):2909–18.
7. Westman EC, Yancy WS, Mavropoulos JC, Marquart M, McDuffie JR. The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus. Nutr Metab [Internet]. 2008 [cited 2021 Jan 3];5(1):36. Available from: /pmc/articles/PMC2633336/?report=abstract
8. Kverneland M, Molteberg E, Iversen PO, Veierød MB, Taubøll E, Selmer KK, et al. Effect of modified Atkins diet in adults with drug-resistant focal epilepsy: A randomized clinical trial. Epilepsia. 2018;59(8):1567–76.