Tuesday, December 23, 2003

Dieticians Question Benefits Of Popular Atkins Diet Program

By Rita Brhel, rita.brhel~yankton.net

http://www.yankton.net/stories/1223...031223027.shtml

For many who are looking to take off a few extra pounds gained during the holidays, the Atkins diet is a dream come true.

Few dieters can turn down a menu that includes greasy bacon, juicy steaks, scrambled eggs and relatively few vegies.

While the popular diet seems to have a miracle weight-loss effect, South Dakota nutrition experts warn that losing weight fast via the Atkins diet isn't necessarily healthy.

"The biggest misconception is that people can get on these diets until they lose their weight and then go back to eating how they did before," said Dora Lynn Jarvis, registered dietician of Avera Sacred Heart Hospital, Yankton. "However, for these diets to work, they have to be a lifetime commitment. Once they get off the high-protein, low-carb program, they gain just as much weight as they lost during the diet and some extra pounds."

Jarvis said she didn't know one person who had been on the Atkins diet for more than a year. Most people stayed on the diet only long enough to lose their pounds.

"I wouldn't recommend it, because it's designed to be a lifetime program. Most people can't stand to be on it forever because of its nutritional imbalance," she added.

The Atkins diet, circulated in the 1970s and 1990s, was developed by Dr. Robert C. Atkins and is considered a ground-breaking, although highly controversial, weight loss program. It consists of four phases.

The first phase, the Induction Diet, lasts two weeks, during which dieters can only consume 20 grams of carbohydrates per day.

Because many food groups contain carbohydrates, including fruits, breads and cereals, vegetables and dairy, Jarvis said numerous vitamins and minerals are limited with the lower intake of carbs.

"A nutrient analysis of a sample menu shows that during the induction phase, dieters consume only 16 percent of their daily value of fiber, less than two-thirds of the nutrients that they should be getting," he said. "They are also getting twice the saturated fat they should be getting each day, and three times the cholesterol."

The second phase, called Ongoing Weight Loss (OWL), increases the carb intake to 60 grams per day, although 35 to 40 grams is recommended.

"Again, this phase is deficient in vitamins and minerals," Jarvis said.

OWL is where dieters start losing weight. The length of the phase depends upon the individual, as that person is to remain in the phase until he or she is within five to 10 pounds of his or her target weight. The ideal weight loss rate is one pound each week. Therefore, a person hoping to lose 50 pounds can expect to be in the OWL phase for at least 50 weeks, or a little more than a year.

The third phase, Pre-Maintenance, lasts two to three months and is a transition from major weight loss to target weight maintenance. During this time, dieters' weight-loss rates slow to less than one pound gone per week.

Dieters are allowed one deviation from the prescribed menu two times per week, such as a baked potato added to supper.

"Once again, this diet is low in fiber, vitamins and minerals, and high in saturated fat and cholesterol," Jarvis said.

The fourth phase, Maintenance, begins when the dieter reaches his or her target weight. This phase lasts for the remainder of the person's lifetime.

During this time, the person can eat as much as 90 grams of carbohydrates per day, although the typical person must limit the carb intake to 40 to 60 grams per day to maintain their target weight.

"While 90 grams of carbs per day is better than the limitations of the other phases, it is still deficient in nutrients," Jarvis said.

Federal guidelines recommend that at least 130 grams of complex carbohydrates are consumed per day. "Carbs serve as fuel for the brain," Jarvis said. "I don't think it'd be 130 grams if it didn't need to be.

"There are just so many exclusions," she added. "For example, people on the Atkins diet can't have milk, which cuts down on the calcium and vitamin D they receive. While they can have cheese, this doesn't contain vitamin D, which is necessary to absorb and utilize the calcium. Most vitamins and minerals are needed in order for others to benefit the body. The Atkins diet cuts out so many of these."

The Atkins diet does promote the use of a multi-vitamin, Jarvis said. However, this nutritional supplement still doesn't contain all the missing necessary nutrients excluded by the diet plan.

There is one good thing about the Atkins diet, Jarvis said: It recommends olive oil be used as a fat. Olive oil is a monounsaturated fat and is healthy for the heart.

However, the Atkins doesn't give any limits on fat or calorie intake. "Its only concern is the number of carbohydrates consumed," Jarvis said. "It's basis is fat."

She said children, teenagers and young adults still growing should definitely not be on the Atkins diet, because of its lack in calcium and other essential nutrients.

According to Atkins Nutritionals Inc., Ronkonkoma, N.Y., its weight-loss program is a corrective diet that reduces the intake of refined carbohydrates. The organization claims weight gain can be attributed to an over-abundance of insulin, which is stimulated by carbohydrates. Atkins Nutritionals says the American diet is grossly imbalanced in that the typical person consumes 200 to 300 grams of carbs per day.

The organization counters critics' claims that the diet lacks in essential vitamins and minerals, as long as the program is done correctly. Dieters that include at least three cups of green, leafy salad vegetables and unlimited amount of unprocessed animals foods should have no problem with nutrient deficiency, according to Atkins Nutritionals. It maintains that the healthiest carbohydrates are those found in vegetables, fruits, whole grains and legumes -- although these are to be limited throughout the entire program.

Despite Atkins Nutritionals' defense, Sherry Peer, a South Dakota registered dietician, said that while fast weight loss can be beneficial for some conditions, such as morbid obesity, the Atkins diet should not be used long-term.

"It is a low-fiber, very high-fat, unbalanced diet that contains low amount of water-soluble vitamins, calcium and vitamin D," said Peer, also a certified diabetes nutrition educator and licensed nutritionist of Sioux Valley Hospital, Sioux Falls. "There are a number of risks, including colorectal cancer because of high red meat diets and low fiber intake; and cardiovascular disease from high protein and fat intake. It is also not the diet for those at risk for renal disease and type 1 diabetes because of the extra stress put on the kidneys by ketosis, high BUN (blood urea nitrogen) and rapid weight loss. It may also cause more kidney stones."

While the Atkins diet does its job, it is never good to nearly cut out whole food groups, Peer said. "In addition, carbs are good for the body and all contain needed vitamins and minerals, fiber and iron," she added.

Peer said not to be fooled by the Atkins "miracle diet." Much of the Atkins Induction phase is fluid loss instead of fat.

"Studies show that weight loss from the Atkins is about the same as from other, healthier diet-exercise combinations," Peer said. "The problem is, if the dieter isn't exercising, he or she isn't strengthening his or her cardiovascular system which is critical with a high-protein diet. Many people depend just on the diet to lose weight, when exercise is also needed to keep themselves healthy. And, if a person isn't consuming carbohydrates and then exercises, he or she is going to be burning muscle for energy instead of fat."

The best diets are those that lose weight at the rate that it took the body to gain it, she added.

"A good diet should have a high intake of fruits and vegetables and lower intake of red meat and fats," Jarvis said.

"Balanced diets are the key to healthy weight loss and maintenance," Peer added.

Good diets are the Weight Watchers plan, which focuses on increasing fiber and certain nutritional points, and the South Beach diet, which allows for more fruits and vegetables than the Atkins diet, and limits portions of fat.

"Any diet is a lifetime commitment," Jarvis said.

Peer recommends people look at more than food selection when trying to lose weight. "With diets, you'll only lose the weight," she said. "It won't change anything on the inside. People are always counting something, whether it's calories, fat grams or carbs. They're also measuring lost pounds and inches. But, these don't do anything for who's inside the body. Losing pounds or inches won't help to boost a low self-esteem."