Download The Atkins Nutritional Approach

The Atkins Nutritional Approach™
(ANA)
Colette Heimowitz, MS
VP, Education, Research
Atkins Health and Medical Information Services
What is the ANA?
The Atkins Nutritional ApproachTM (ANA) is an easyto-follow four-phase controlled carbohydrate
program.
Initially, you cut back significantly on carbohydrates
to lose weight; then you gradually add back into
your diet a variety of “good” carbohydrates as you
get closer to your goal weight.
The ANA brings your nutritional intake into balance,
helping you to re-energize, lose weight and lay the
foundation for a healthy life.
How Does the ANA Work?
 Carbohydrates and fat provide fuel for the body.
 When carbohydrates are available, the body
transforms them into energy first.
 Any excess carbohydrates are stored as fat.
 When carbs are sufficiently restricted, the body burns
fat for fuel, including already stored own body fat,
which allows people to lose weight or maintain their
goal weight.
 Studies show that certain risk factors for heart
disease improve when individuals follow a controlled
carbohydrate programme (e.g. triglyceride levels can
decrease by up to 55%).
What Controlling Carbs Means
 Finding each individual’s tolerance level for Net Carbs
(carbohydrates that impact blood sugar levels), first to
lose weight and then maintain a healthy weight for life.
 Cutting out processed foods full of sugar and white
flour, as well as restricting other high-carb foods.
 Eating a wide variety of delicious foods, including
protein, “healthy” fats and nutrient-dense carbs.
 It does NOT mean eating no carbs, eating only steak,
bacon and eggs, or eliminating fruit and vegetables.
 It DOES mean retaining “good” carbs full of
nutrients, found in foods like dark green leafy
vegetables, nuts and berries.
Atkins Carbohydrate
Equilibrium
(ACE)
The amount of carbohydrate an
individual can eat each day while
neither gaining nor losing
weight.
What are Net Carbs?
 Carbohydrates can have different metabolic
effects on the body. Net Carbs are the
carbohydrates that significantly impact the bloodsugar level and are the only carbs that count
when following Atkins.
 Certain ingredients, such as glycerine and sugar
alcohols, have a minimal impact on blood sugar,
and therefore, are not included in a Net Carb
count.
Note: In the US, fibre is reported as a carbohydrate. In the UK, fibre is
reported separately and is not part of the carb count.
Benefits of the ANA
 Weight loss and weight maintenance
 Improved health indicators (e.g. triglycerides,
cholesterol HDL / LDL)
 Better mood regulation
 Increased energy levels
 Increase in concentration and alertness
 Increased ability to cope with stress
 Decrease in gastrointestinal symptoms
 Decreased fatigue
 Decreased preoccupation with food and the need
to snack
 Decreased need for caffeine
 Decreased reliance on medications in certain
individuals
The Atkins Nutritional Principles
Four principles:
 Weight loss
 Weight maintenance
 Good health and well-being
 Disease prevention
The Atkins Nutritional Principles
 Weight Loss
o Both carbohydrate and fat provide fuel for the
body’s energy needs. Carbohydrate is the first fuel
to be metabolized. However, when the intake of
digestible carbohydrate is sufficiently restricted
(without caloric restriction), the body converts from
the primary metabolic pathway of burning
carbohydrate to burning fat as its main energy
source. This results in weight loss.
The Atkins Nutritional Principles
 Weight Maintenance
o For each individual there is a tightly regulated
carbohydrate threshold below which fat burning and
weight loss occurs. However, if the individual’s
carbohydrate intake exceeds this threshold,
carbohydrate burning predominates, allowing fat to be
accumulated, resulting in weight gain. Therefore, each
individual has a level of carbohydrate intake at which
weight is maintained.
The Atkins Nutritional Principles
 Good Health
o By adhering to a controlled carbohydrate
nutritional approach, an individual who
chooses to eat nutrient-dense foods (including
adequate fiber, healthy fats and
supplementation as needed) is more likely to
meet his nutritional needs and promote good
health than he would by following a calorierestricted, fat-deficient diet. Exercise is also
essential for controlling weight, enhancing
energy and maintaining a sense of well-being.
The Atkins Nutritional Principles
 Disease Prevention
o By following an individualized controlled
carbohydrate nutritional approach that lowers
carbohydrate intake resulting in lower insulin
production, people at high risk for or diagnosed
with certain chronic illnesses, including
cardiovascular disease, diabetes and hypertension,
can see improvement in clinical parameters.
The Atkins Nutritional Approach
 The Atkins Nutritional Principles form the core of
The Atkins Nutritional Approach
 Four Phases:
o Induction
o Ongoing Weight Loss
o Pre-Maintenance
o Lifetime Maintenance
Phase 1: Induction
 Limit carbohydrate consumption to 20 grams of Net
Carbs per day for a minimum of 2 weeks.
 For those with a significant amount of weight to lose,
Induction can be followed for longer periods of time.

Satisfy appetite with foods that combine protein and
fat, such as fish, poultry, eggs, lamb, pork and beef.

Consume a balance of healthy natural fats such as
monounsaturated, polyunsaturated, and saturated.
 Avoid trans fats (e.g. hydrogenated or partially
hydrogenated oils)

Consume carbohydrates in the form of nutrientdense foods such as leafy green vegetables.

Drink at least eight 250 ml glasses of water daily.

Exercise regularly.

Don’t forget to take nutritional supplements.
Example of Induction Menu
Breakfast
Three-Egg Omelette with Avocado
Mozzarella Cheese and Tomato
Decaffeinated Coffee with Cream
Lunch
Sirloin Steak ( 8 oz.)
Spinach and Mixed Lettuce Salad
with Mushrooms, Onions, Celery and Parmesan Cheese
Dinner
Poached Salmon ( 9 oz.)
Kale or Broccoli with Garlic, Lemon and Sesame Seeds
Phase 2: Ongoing Weight Loss
 Slow down weight loss by gradually increasing daily
Net Carb intake in weekly increments of 5 grams.
 Go from 20 grams/day of Net Carbs one week to
25 grams/day the next week.
 Increase carbs by 5 each week until weight loss stops.
 Choose additional carbs wisely, adding back nutrientdense foods:
 More non-starchy veggies (e.g., asparagus, broccoli)
 Berries (e.g. raspberries and strawberries)
 Nuts and seeds (e.g., hazel nuts, almonds)
 Soft cheeses (e.g., cottage cheese, Stilton, brie)
 Once weight loss stops, drop daily intake of Net
Carbs by 5 grams to continue losing weight slowly.

Average grams of Net Carbs are 40-60 for this phase.

Phase 2 lasts until you are within 5-10 lbs of goal.
Phase 3: Pre-Maintenance
 Goal is in sight – 5 to 10 pounds from goal weight.
 Lose the last few pounds very slowly to ease into a
permanently changed way of eating.
 Each week add more grams of Net Carbs (as much as 10) to
the daily allotment.
 As long as weight loss continues, gradually introduce
foods such as lentils, melon, starchy vegetables (turnips,
swedes and carrots) and whole grains.
 When goal weight is achieved and maintained
a month, you have found your ACE.
for at least
The Carbohydrate Ladder
 As the programme progresses, moving from one
phase to another, add more carbohydrate foods
back – in this order:








Salads and leafy Vegetables
Hard and Soft Cheese
Seeds and Nuts
Soft Fruits such as Berries
Beans and Pulses
Other Fruits such as Melon and Pineapple
Higher carbohydrate Vegetables
Whole Grains
The Power of Five
These portions contain roughly 5 grams of
Net Carbohydrate each:

Vegetables:
o
o
o
o
o
180g or 6.4oz cooked Spinach
98g or 3.5oz Red Peppers
1 medium Tomato (62g or 2.2oz)
156g or 5.5oz cooked Broccoli
12 Medium Asparagus spears
(180g)
o 180g or 6.4oz cooked Cauliflower
o ½ medium Avocado (86g or 3oz)
o 2/3 cup Courgettes

Fruits:
o
o
o
o
48g or 1.7oz Blueberries
92g or 3.3oz Raspberries
125g or 4.4oz Strawberries
44g or 1.6oz honeydew Melon

Dairy:
o
o
o
o

142g or 5oz Hard Cheese
142g or 5 oz Mozzarella Cheese
158g or 5.6oz Cottage/Ricotta
Cheese
¾ cup Double Cream
Nuts and Seeds: (1 ounce)
o
o
o
o
o
o
o
Macadamia (10-12 nuts)
Walnuts (14 halves)
Whole Almonds (14 nuts)
Hazelnuts (14 nuts)
Pecans (14 halves)
Sunflower Seeds (3 tablespoons)
Pumpkin Seeds (3 tablespoons)
Phase 4: Lifetime Maintenance
 To maintain goal weight, stay at your ACE.
 Average grams of Net Carbs is 40 to 120 per day,
depending on metabolism, age, gender, activity
level, or other factors.
 Engage in regular exercise; those who exercise
usually have a higher ACE.
 Changes in activity level, hormonal status or
other factors may raise or lower your ACE.
Conditions That Need Guidance
While Following the ANA
Kidney disease
 Protein intake must be monitored in renal patients.
Diabetes
 Monitoring blood sugar levels is an essential
component to following the ANA for diabetics,
especially those individuals who may need
adjustments in medication levels due to improved
glucose regulation.
Gout
 Those with a pre-existing gout condition need to be
monitored by their doctors
Conditions That Need Guidance
While Following the ANA
Pregnant & breast-feeding women
 Regardless of the programme, dieting and weight loss
is not recommended during pregnancy or
breastfeeding.
 However, pregnant and breast-feeding women can
safely follow the Lifetime Maintenance phase of Atkins.
 Dieter’s Advantage and Accel nutritional supplements
should not be taken during pregnancy or breastfeeding.
Top 10 Myths - and the FACTS
Myth No. 1: The ANA Is Unbalanced and
Deficient in Basic Nutrition
FACT:
 People frequently mistake the 20 gram Net Carbs per
day Induction phase for the whole programme!
 Even during the Induction phase, the ANA calls for 5
daily servings of veggies such as 2 cups of salad
(leafy greens like spinach and watercress), 1 cup (two
½-cup servings) of broccoli, and half an avocado.
 After this phase, individuals raise their carb count
gradually until they reach their ACE.
 A person’s ACE could be up to 120 grams or more
daily of nutrient-dense carbohydrates, including fruit,
occasional potatoes, brown rice and whole grain
bread!
Example of 20 Gram CHO Daily Menu
Breakfast
Three Egg Omelet with Avocado,
Mozzarella Cheese and Tomato
Decaffeinated Coffee with Cream
Lunch
Beef Round Steak (8 oz.)
Spinach and Mixed Lettuce Salad
with Mushrooms, Onions, Celery
and Parmesan Cheese
Dinner
Broiled Salmon (9 oz.)
Kale topped with Garlic, Lemon and Sesame Seeds
Nutrient Analysis of 20 Gram CHO
Sample Menu Based on Daily Values /RDI
2000 Calorie Diet
500
450
Percent 400
of Daily 350
Values 300
250
200
150
100
50
0
Vita-Nutrients
Vitamin A
Vitamin C
Vitamin D
Vitamin E
Thiamin
Riboflavin
Niacin
Pyridoxine
Folate
Cobalamin
Pantothenic Acid
Vitamin K
Nutrient Analysis of 20 Gram CHO
Sample Menu Based on Daily
Values/RDI
2000 Calorie Diet
400
350
300
Percent
of Daily 250
Values 200
150
100
50
0
Vita-Nutrients
Sodium
Potassium
Calcium
Iron
Phosphorus
Magnesium
Zinc
Copper
Manganese
Selenium
Chromium
Molybdenum
Myth No. 2: You Lose Mostly Water Weight
on the ANA
FACT:
 A portion of initial weight loss on any diet is water
weight.
 When one follows a controlled carbohydrate
eating plan the body switches from burning
carbohydrate to primarily burning stored fat for
energy, resulting in the loss of stored fat.
 This is evident through the loss of inches!
 Research results have consistently demonstrated
that weight lost after the first few days on a
restricted carbohydrate programme is primarily
fat and not water or lean body mass.
Myth No. 3: The ANA Is Only Effective Because
Calories Are Restricted
FACT:
 Calories are not restricted when doing Atkins
 Individuals may end up eating fewer calories
because they are generally less hungry and no
longer obsessed with food.
 Stable blood sugar throughout the day ensures
fewer food cravings.
 The food on this program is less processed and
more nutritious than on the typical pre-Atkins
menu.
Myth No. 4: The High-Protein Content of the
ANA Causes Kidney Problems
FACT:
 No one has as yet produced a study for
review, or even cited a specific case in
which the protein content of ANA causes
any form of kidney disorder.
 When someone is already diagnosed with
kidney disease, they need to modify their
total protein intake and consult closely
with their doctor.
Myth No. 5: Fat Intake is Detrimental and Will
Lead to Heart Disease
FACT:
 A growing body of scientific literature
demonstrates that a controlled carbohydrate
eating plan, if followed correctly, reduces risk
factors for heart disease and improves clinical
health markers.
 The body needs fats to survive and fats provide
many health benefits.
 Natural fats make individuals feel full sooner and
keep dieters feeling less hungry for longer.
 Low carb v low fat – followed correctly, studies
show that a low carb eating plan can be more
effective than a low fat plan in improving risk
factors for heart disease
Quintiles of Dietary Glycemic Load (Women)
Quintile
1
2
3
4
5
Quintile mean
glycemic load
117
145
161
177
206
CHO gm/day
144 + 20
171 + 11
186 + 11
200 + 11
226 + 20
#CHD Cases
139
128
148
160
186
10 YEAR Prospective Study: n=75,521 Women
TEST FOR INTERACTION, P<.0001
Liu et al. A Prospective Study of Dietary Glycemic Load, Carbohydrate Intake, and
Risk of Coronary Heart Disease in US Women. AM J Clin Nutr. 71:1455-61, 2000.
Myth No. 6: Ketosis Is Dangerous and Causes a
Variety of Medical Problems
FACT:
 The primary fuel in the body is glucose,
generated from carbohydrate consumption.
 When sufficient carbohydrates are not available
the body turns to its secondary fuel source: fat.
 Fat is burned as energy (lipolysis), producing
byproducts called ketones. The process is called
ketosis.
 Ketosis should not be confused with the
abnormal metabolic state, ketoacidosis.
 Ketoacidosis is only a concern for diabetics
whose blood sugar is out of control, or for
alcoholics.
““ Doctors are scared of ketosis” says Richard Veech, an NIH
researcher who studied medicine at Harvard . .. . “But
ketosis is a normal physiologic state. I would argue it is the
normal state of man. Rather than being poison, which is
how the press often refers to ketones, they make the body
run more efficiently and provide a back-up fuel source for
the brain.” Veech calls ketones “magic” and has shown
that both the heart and brain run 25% more efficiently on
ketones than on blood sugar.”
Taubes G. NYT Magazine Section, July 7, 2002.
The Human Metabolic Response to Chronic Ketosis Without Caloric
Restriction: Physical and Biochemical Adaptation
Summary:
In view of the tests done to screen for ill effects of the EKD,
the remarkably benign nature of a diet providing 85% of
calories as fat is notable. After 4 weeks there was no
measurable impairment of hepatic, renal, cardiac, or
hematopoietic function. The serum uric acid level, elevated
by competition from ketone bodies for excretion, was
almost back to normal by that time.
Phinney SD, Bistrian BR, Wolfe RR and Blackburn GL. Metabolism 1983;32(8):757-768.
Myth No. 7: The ANA Causes Constipation
Because It Lacks Fibre
FACT:
 Doing Atkins means including fibre-rich foods such as
spinach, aubergines, broccoli, asparagus and leafy greens.
After the initial phase, it also includes soft fruits such as
berries.
 If the Induction phase is followed properly and all 5
servings of vegetables are included, the majority of
individuals do not suffer from constipation. If more fibre
is needed during the Induction phase, a fibre supplement
is recommended.
 Supplementing with fibre is unnecessary in the Ongoing
Weight Loss (OWL) phase and beyond because fruits and
more vegetables are introduced into the eating plan.
 Drinking plenty (2 litres) of water each day is very
important.
Myth No. 8: The ANA Increases the Risk
of Osteoporosis
FACT:
 During the first week of any weight loss programme,
one loses water weight. When water is lost, so are
calcium, potassium and magnesium. That’s why
taking a multivitamin is so important. Calcium is not
being leached from the bones.
 Actual studies have shown urinary calcium loss
lasted a few days. The body then re-adjusts itself to a
regular state of homeostasis and the calcium loss in
the urine stops.
 In several studies published in peer review journals
researchers followed adults and studied the shortterm and long-term effects of a high-meat diet on
calcium metabolism. The studies found no significant
changes in calcium balance, nor was there any
significant change in the intestinal absorption of
calcium during the high-meat diet.
Myth No. 9: Lipolysis / Ketosis Causes Loss of
Muscle Mass
FACT:
 Typically, individuals on very low calorie
diets can lose muscle mass because
they have inadequate intake of protein.
 Atkins is not calorie restricted and the
high protein intake offsets any possible
loss of lean body mass.
STUDIES EXAMINING THE EFFECTS OF A
KETOGENIC DIET ON BODY COMPOSITION
Reference
Diet
Subjects
Day Energy CHO
(kcal) (g)
BMD
(kg)
FMD
(kg)
Benoit et al. '65
Fasting
7M obese
10
0
0
-9.6
-3.4
-6.2
10
1000
10
-6.6
-6.4
-0.2
Ketogenic
LBMD Metho
(kg)
UWW
Young et al. '71 Ketogenic
2M obese
63
1800
104
-11.2
-8.4
-2.8
Ketogenic
3M obese
63
1800
60
-12.3
-10.2
-2.1
Ketogenic
3M obese
63
1800
30
-15.6
-14.9
-0.7
Phinney et al.
'80
Ketogenic
5F/1M
obese
42
-10.6
-7.1
-3.5
UWW
Willi et al. '98
Ketogenic
6 obese
56
25
-15.4
-16.8
1.4
DXA
Volek et al. '01 Ketogenic
12M lean
42
500750
650725
2335
46
-2.2
-3.3
1.1
DXA
Volek et al. '02
12 norm M
42
2335
46
-2.2
-24.6
1.8
DXA
low CHO
K40
Myth No. 10: Atkins Will Cause Weakness, Fatigue
and a Lack of Energy
FACT:
 During the first few days on Atkins, people may
experience a mild fatigue as the body switches
metabolic pathways.
 After 3-4 days, the body has switched from a glucose
metabolism to a fat metabolism.
 Reducing caffeine and sugar intake can lead to shortterm withdrawal symptoms, but they typically pass
within the first week.
 After the transition, individuals consistently report
high energy levels.
The Science Behind Atkins
Science Supports the ANA
Perhaps the biggest myth of all is that there is no
science supporting the ANA:
 There are more than 400 peer-reviewed and published
studies supporting the concepts of Atkins Nutritional
Principles.
 In the last three years, there have been 16 studies
focusing on the ANA, all supporting the safety and
efficacy of controlled carbohydrate eating.
 Information on all of these studies and more supporting
scientific information is available for review at
www.atkins.com
Weight Loss in Teenagers
What this graph tells us – Teenagers who followed a low carbohydrate diet lost more
weight than teenagers who followed a low fat diet. The low carbohydrate group was
able to lose more weight even while consuming more calories - an average of
730kcal more a day than those following the low fat diet.
1830 kcal
LBS
20
18
16
14
12
10
8
6
4
2
0
8%
n=30
Carbohydrate
12 Week Study
1100 kcal
Low Fat
Ketogenic
56%
Carbohydrate
Weight Lost
Sondike, S.B., Copperman, N., Jacobson, M.S., "Effects of a Low-Carbohydrate Diet on Weight
Loss and Cardiovascular Risk Factor in Overweight Adolescents," The Journal of Pediatrics,
142(3), 2003, pages 253-258.
Weight Loss in Adults
What this table tells us - Adults who followed a low carbohydrate diet lost more
weight than adults who followed a low fat diet. The low carbohydrate group was
able to lose more weight both while consuming the same or more calories - an
average of 300kcal more a day than those following the low fat diet.
Decrease in:
Low Fat 1*
(1500/1800kcal)
Weight (pounds) 17 (± 2.4); 8%
Low Carbohydrate 1*
(1500/1800kcal)
Low Carbohydrate 2*
(1800/2100kcal)
23 (± 4.6); 11%
20 (± 3.4); 10%
Waist (inches)
2.6 (± 0.54); 7%
4.3 (± 0.73); 11%
3.8 (± 0.68); 10%
Hip
1.9 (± 0.71); 4%
2.6 (± 0.68);
2.9 (± 0.71); 7%
(inches)
6%
* Calories: Women/Men, respectively
Greene PJ, Willett W, et al. “Pilot 12-Week Feeding Weight-Loss Comparison: Low-Fat vs.
Low-Carbohydrate (Ketogenic) Diets,” NAASO meeting Oct. 13, 2003 Obesity Research,
Sept. 2003, Oral Abstract #95.
Harvard Nurses Health Study: Summary
“Our findings suggest that a high intake of rapidly
digested and absorbed carbohydrate increases the
risk of CHD independent of conventional coronary
disease risk factors. These data add to the concern
that the current low-fat, high carbohydrate diet
recommended in the United States may not be
optimal for the prevention of CHD and could actually
increase the risk in individuals with high degrees of
insulin resistance and glucose intolerance.”
Liu et al. A Prospective Study of Dietary Glycemic Load, Carbohydrate Intake, and Risk of
Coronary Heart Disease in US Women. AM J Clin Nutr.71:1455-61, 2000.
Triglycerides are Important
 Perhaps the most important cardiac risk factor of all,
especially when combined with low HDL
(Tanne D. et al Circulation. 2001)
 High triglycerides are a known substitute marker for
abnormally high insulin levels
 Triglycerides are known to decrease with carbohydrate
restriction
The Effect That High Carbohydrate Diets
Have on Triglycerides
What this graph tells us – Carbohydrates raise blood triglyceride(TG) levels. In this study one
group consumed a 40% carbohydrate diet while the other group consumed a 60% carbohydrate
diet. Notice the high carbohydrate group had higher TG levels before and after meals. The more
carbohydrates consumed the higher the blood triglyceride levels.
8am
4pm
CHO = Carbohydrate TG = Triglycerides
Triglycerides were measured every 2 hours from 8AM-4PM (Breakfast at 8am and Lunch at 12pm)
Abbasi et al. High Carbohydrate Diets, Triglyceride Rich Lipoproteins,and Coronary Heart
Disease Risk. Am J Cardiol. 85:45-48, 2000.
The Copenhagen Study: An 8 Year Study of 2906
Men Without Heart Disease
12.2
12.5
I 15
N
C 10
I
D
E 5
N
C 0
E
9.5
9.3
8
5.8
What this graph tells us Fasting triglycerides is a
stronger indicator of
Ischemic Heart Disease
than HDL (which is part of
your total cholesterol)
Worst
141-400
Mid
4.5
4
6.5
97-141
Best
Best
Mid
Worst
57-133
46-56
11-45
TG, mg/dl
39-96
HDL-C, mg/dl
Jeppesen et al. Triglyceride Concentration and Ischemic Heart Disease An Eight-Year Followup in the Copenhagen Male Study. Circulation. 97: 1029-36, 1998.
The relationship between Triglycerides and
Relative Risk of CHD in Males and Females
3
CHD
Relative
Risk
2.5
2
MALES
FEMALES
1.5
1
0.5
0
50
150
250
350
Miller M. Is Hypertriglycerideaemia an Independent Risk Factor for
Coronary Heart Disease? The Epidemiological Evidence. Eur Heart
J. 19 (suppl H18-22), 1998.
Triglyceride Levels in Teens
What this graph tells us – Even though the low carbohydrate group ate on average 730 more
calories each day than the low fat group, the low carbohydrate group had a much greater
reduction in blood triglyceride levels.
10
4.1
n=30
0
Mean % -10
Change -20
-2.4
-6.2
-8.6
-10
12 Week Study
-10.3
-17.1
-30
Low Fat-1100kcal
Low Carbohydrate 1830kcal
-40
-50
-52.3
-60
Chol
TG
HDL
LDL
Sondike, S.B., Copperman, N., Jacobson, M.S., "Effects of a Low-Carbohydrate Diet on
Weight Loss and Cardiovasculaisk Risk Factor in Overweight Adolescents," The Journal of
Pediatrics, 142(3), 2003, pages 253-258
Changes in Cardiovascular Risk Factors While
Following Either A Very Low-Carbohydrate Diet
With Nutritional Supplements or A Low-Fat/LowCalorie Diet
What this table tells us –The low carbohydrate group experienced greater than 50% reduction
in blood triglyceride levels
Chol
Low Fat
mg/dl
(n=18) Baseline 217.8 (29.7)
Week 24 204.3 (35.5)
Change -13.5 (22.5)*
TG
mg/dl
196.0 (114.6)
135.8 (82.3)
-60.2 (100.2)*
HDL-C
mg/dl
48.8 (9.6)
49.1 (9.7)
+0.3 (6.4)
Low Carb
(n=22)
Baseline 251.4 (29.4)
Week 24 237.9 (45.5)
Change -13.5 (35.6)
181.5 (86.7)
89.3 (56.2)
-92.2 (85.5)*
56.4 (18.6)
61.6 (18.6)
+5.2 (10.6)*
LDL-C Chol./HDL
mg/dl
ratio
133.2 (28.4) 4.5 (0.8)
127.7 (28.6) 4.2 (0.8)
-4.0 (17.6) -0.3 (0.7)
158.2 (25.6)
158.0 (39.1)
-0.2 (34.2)
*p<0.05, for within-group change from baseline to Week 24
No significant differences existed between diet groups
Yancy WS, Bakst R, Bryson W et.al. Obesity Research (abstract) 9:184S, 2001
4.7 (1.3)
4.0 (1.1)
-0.7 (1.1)*
Evaluating the Atkins Nutritional Approach:
A 12 Month Study
What this table tells us - After one year on either a low carbohydrate or low-fat diet,
subjects lost weight. The low carbohydrate diet was associated with greater
improvement in risk factors for coronary artery disease (better cholesterol profile and
triglyceride levels)
Conventional
Diet (n=20)
Atkins Diet
(n=17)
% change
% change
Weight
-4.5  7.9
Total Chol
-5.5  10.4
0.2 12.7
0.23
LDL-C
-5.8  16.1
0.5 21.2
0.47
HDL-C
3.1 15.2
18.2  22.4
0.04
TG
1.4 52.5
-28.1 23.6
0.04
Foster G, Wyatt H, Hill J, et al. NEJM 348:2082-90, 2003
-7.3  7.3
P
0.27
Weight Loss and Cardiovascular Risk Factors in
Women Following Either A Low Carbohydrate
Diet or A Low Fat Diet
What this table tells us – Women following a low carbohydrate program lost more weight at 3
months and kept the weight off even after 6 months. In contrast the low fat group lost less
weight at three months and at 6 months gained back 25% of the original weight lost. Once
again, triglyceride levels decreased much more in the low carbohydrate group.
3 Months
Low CHO
Wt Loss, kg
8.0 1.0
7.9  1.4, p=<0.02
Body fat, % 
1.7 0.46
2.2  0.58
TG 
Low Fat
6 Months
65.3 17.2
Wt Loss, kg
4.4  1.1
3.2  1.3
Body fat, % 
1.3 0 .48
0.74 0.49
TG 
15.2  8.2
Brehm BJ, Seeley RJ, D’Alessio DA, et al. “A Randomized Trial Comparing a Very Low
Cabohydrate Diet and a Calorie- Restricted Low Fat Diet on Body Weight and Cardiovascular
Risk Factors in Healthy Women,” The Journal of Clinical Endocrinology and Metabolism,
88(4),2003.
Low Carbohydrate 6 - Month Study
What this table tells you - Adults who followed a low carbohydrate diet lost more weight
than adults who followed a low fat diet. In addition, the low carbohydrate group had a
greater improvement in cardiovascular risk factors (greater reduction in triglycerides).
6 months
Low-CHO, Low-Fat,
P Value
n=28
n=30
Baseline wt, lbs
293.2
295.1
ns
Wt change, lbs
-20.4
-6.5
0.002
Chol. Change, mg/dl
-1.3
+4.7
ns
HDL change, mg/dl
-0.6
-1.4
ns
LDL change, mg/dl
-1.8
-6.4
ns
TG change, mg (non-DM)
-65
-8.0
0.02
Insulin change, U/ml (non-DM)
-8.9
-1.1
ns
Samaha, F.F., Iqbal, N., Seshadri, P., et al., “A Low-Carbohydrate as Compared with a
Low-Fat Diet in Severe Obesity,” N Engl J Med, 348(21), 2003, pages 2074-81.
Dietary Fat Intake and Risk of Stroke1
The team concluded, "Our findings from this large cohort of middle-aged US
male healthcare professionals, without a history of cardiovascular disease or
diabetes, indicate that intakes of total fat, specific types of fat, or dietary
cholesterol do not seem to be related to the development of stroke."
Relative Risk (95% CI)
total fat
animal fat
vegetable fat
saturated fat
monounsaturated fat
polyunsaturated fat
trans unsaturated fat
dietary cholesterol
0.91 (0.65 to 1.28)
1.20 (0.84 - 1.70)
1.07 (0.77 - 1.47)
1.16 (0.81 - 1.65)
0.91 (0.65 - 1.28)
0.88 (0.64 - 1.21)
0.87 (0.62 - 1.22)
1.02 (0.75 - 1.39)
P value
0.77
0.47
0.66
0.59
0.83
0.25
0.42
0.99
1Comparing
the highest fifth of intake with the lowest fifth, the multivariate relative risk of ischaemic
stroke was (95% confidence interval; P for trend) From the Health professional follow up study
of 43,732men aged 40-75 years, during 14 years of follow up.
He,K.,Merchant, A.,Rimm, E.B., et al., "Dietary fat intake and risk of stroke in male US
healthcare professionals: 14 year prospective cohort study," British Medical Journal, 327, 2003,
pages 777-782.
One Year Effectiveness of the Atkins, Ornish, Weight Watchers, and Zone Diets
Decreasing Body Weight and Heart Disease Risk
All Subjects(40/arm) 12 mo. completers
%Wt loss %FRS* %Wt loss
% FRS*
Atkins 2.1
6.4
3.9(n=21) 12.3 (52%)
Ornish3.1
3.3
6.2(n=20)
6.6 (50%)
Wt Watch
3.0
9.6
4.5(n=26)
14.7 (65%)
Zone
3.0
6.9
4.6(n=26)
10.5 (65%)
Conc: All diets showed significant in FRS, and promoted wt loss especially in
adherent subjects indicating that various strategies can be effective
* FRS= Framingham Risk Score, a measure for reducing 10 yr. heart disease risk.
Dansinger ML, Gleason JL, Griffith JL et al. AHA Scientific Sessions, Orlando, FL 2003
Comparison of Inflammatory Markers
between low-fat and low-carb diets
Conclusion: C-reactive protein and serum amyloid A levels did
not change with a low fat diet, but both levels decreased with
a low carb diet. This suggests that for short periods of time, a
low carb diet is more efficacious, both in causing weight loss
and in reducing serum inflammatory markers, than is a
calorically-matched low fat diet.
O'Brien, K.D., Brehm, B.J., Seeley, R.J., "Greater Reduction in
Inflammatory Markers With a Low Carbohydrate Diet than with a
Calorically Matched Low Fat Diet," American Heart Association's
Scientific Sessions 2002, Nov 19, 2002, Abstract ID: 117597.
Exploding Nutrition Myths
“The relationship of fat intake to health is one of the areas
that we have examined in detail over the last 20 years
in our two large cohort studies:
the Nurses Health Study and the Health Professionals
Follow-up Study.
We have found virtually no relationship between the
percentage of calories from fat and any important
health outcome.
But what does seem important is the type of fat and the
form of carbohydrate.”
Willett W. World Health News, Boston. March 29, 2000
Discrepancies between Published Reports
and Prevailing Assumptions
of Low Carb Diets
 When fat is converted from its energy storage role to
the primary energy fuel ketosis occurs
 Most studies measuring the effects of dietary fat on
lipids use protocols containing considerable amounts
of dietary carbohydrate.
 Most published observations on high fat ultra-low
carbohydrate diets (below 20% of total calories) show
beneficial results.
How the Atkins Lifestyle Works for You
Healthy convenient foods that taste great!
 Atkins™ products contain
o No added Sugar
o No Aspartame
o No Hydrogenated or partially Hydrogenated Fat