Wed 6 Aug 2003

A diet in the dock

TARA WOMERSLEY HEALTH CORRESPONDENT

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SHE piled on the pounds to play Bridget Jones, but shed them all for her high-kicking role in the musical Chicago.

But has Renee Zellweger, an avid follower of the Atkins diet, found herself a healthy way to stay slim or is she putting herself at risk from heart disease, kidney stones and cancer?

The high protein diet that has been condemned by nutritionists has become the most talked about and tried in recent history.

When Dr Robert Atkins first published his radical text on dieting in the 1970s, he could not have conceived the brouhaha his ideas would prompt two decades later.

Although he died this year, after falling on an icy New York footpath, Dr Atkins’s methods and his influence have not weakened, as some predicted. The book Dr Atkins’s New Diet Revolution is now Britain’s best-selling text after Harry Potter and The Order of the Phoenix.

The formula is simple: avoid those foodstuffs you were always told were good for you - bread, pasta, potatoes, rice and cereal, which are all high in carbohydrates - then substitute them with fry-ups for breakfast and juicy rump steaks for dinner.

But amid the claims that the diet could lead to an increased risk of heart disease and cancer, the Atkins diet is not the panacea for losing weight that many believe.

And add into the equation the fact the dieters frequently suffer from bad breath, and it’s easy to see why it is not perfect.

The Atkins diet works on the principle that by cutting down on the carbohydrates, there is less glucose in the body that can be end up as fat.

Excess glucose is converted by the liver to glycogen, to give additional energy, but the body can only store a limited amount of glycogen and the remaining glucose is turned into fat.

Atkins diet supporters believe that by cutting down on carbohydrates the body will start using its existing fat stores for fuel. In doing this, the body gives off ketones, which are released through the breath and urine, and then enters into ketosis.

Less than three months ago, research published in the New England Journal of Medicine suggested the Atkins regime was just as effective as more conventional diets. In a six-month trial, volunteers lost twice as much weight as those on more traditional low-calorie, high- carbohydrate diets. However after a year, the weight loss gap between the diets had closed.

Researchers also found the diet seemed to protect against heart disease by increasing levels of good cholesterol.

But a study published in the Annals of Internal Medicine, looking at 1,600 female nurses aged between 42 and 68 over an 11-year-period, claims a high-protein diet may place extra strain on the kidneys in women, with declining renal function.

Dr Toni Steer, a nutritionist at the Medical Research Council Resource Centre for Human Nutrition Research, in Cambridge, said the reason Atkins dieters lost weight was not due to "magic" metabolic change in their body but because they ate fewer calories.

She added that this was partly due to the fact they filled up quicker on high-protein food, and also the monotony of the food they ate and complexity of the rules they had to follow meant some people found eating too much bother.

Dr Steer said: "The problem with the Atkins diet is that we do not know the long-term effects. There is also evidence that eating fruit and vegetables can cut reduce the risk of cardiovascular disease and certain cancers and the Atkins diet goes against the public health messages put out.

"Also, by cutting out on carbohydrates, people are cutting out essential nutrients from their diet, such as B vitamins and folates. Research has suggested that reducing the intake of folates may increase levels of plasma homocysteines, which have been linked with an increased risk of cardiovascular disease.

"The studies published in the New England Journal of Medicine do not look at the long-term effects of the diet, as one lasted six months and the other 12 months, while evidence from low-fat, high-carbohydrate diets span three, four, five and six years."

She added: "People wanting to lose weight should try and do things that are achievable. For instance, cut down from two teaspoons of sugar in their tea to one teaspoon instead. If they have six cups of tea a day, they will cut down on 120 calories daily."

It was claimed yesterday that the diet’s popularity had led to an increase in egg sales. Sales of British Lion eggs were said to be up 8 per cent this year.

The Meat and Livestock Commission has also stated that total meat consumption is up 10 per cent since the height of the BSE crisis in 1996.

But the British Potato Council is spending £1 million to promote the vegetable to resolve any "confusion" in the wake of anti-carbohydrate regimes.

And John White, the director of the Federation of Bakers, said production of bread had dropped between 1.5 and 2 per cent over the past three years - and that sales were down due to the Atkins diet.

He added: "Bread is one of the best foods that you can buy. It is full of vitamins and minerals and while most people know about the fibre benefits of wholemeal bread, there is also a lot of calcium contained in white bread."

Those following the Atkins diet have to first follow an "induction" period of at least two weeks limiting their carbohydrate intake to 20g a day. After that, they can increase their carbohydrate intake by 5g a day until they start to put on weight. They are then allowed to increase carbohydrate intake in 10g amounts each week - so long as very gradual weight loss is maintained.

Annie Anderson, a professor of food choice at Ninewells Medical School, said: "The best way to lose weight is with a balanced diet and plenty of fruit and vegetables, low in fat and high in carbohydrates, such as whole grains and wholemeal bread."


FOR the Atkins diet

KATE Wemyss, a lawyer from Edinburgh, has never been a fan of diets. But with her wedding scheduled for the end of the month, she decided to give the Atkins regime a try.

She began the diet earlier this year and within six weeks her weight dropped from 11 stone to 10 stone. Although Ms Wemyss, 26, has not been quite as strict as when she started out on the diet, for the past two months she has not put the weight back on.

She admits feeling ill during the first couple of days and did suffer from bad breath - one of the drawbacks of Atkins - but would still recommend the diet to anybody wanting to lose weight.

She said: "I bought the book, but for the first two weeks did not really lose anything as I just think I was eating too much with huge fry-ups in the morning. But I then started not to eat quite as much and the weight started to come off. I had never really been on a diet before, but with the Atkins diet you were told exactly what to do which I liked and it was a challenge."

Despite critics claiming that the Atkins diet is monotonous, Ms Wemyss said that she was not bored by the food that she ate. "You can have all sorts of different salads and fish, such as monkfish that you would not usually eat," she said.


AGAINST the Atkins diet

DR TONI Steer, a nutritionist, warned that Atkins diet was not a magic solution. She said that the reason dieters lose weight is because they are eating fewer calories, but at the same time missing out on vital nutrients. She added the methodology of studies claiming Atkins is safe and effective needed to be questioned as they do not look at long-term effects and involve a small number of subjects.

She said: "One study involving 1,600 female nurses aged between 42 and 68 over an 11-year period suggested that women on high protein diets who have declining renal function could be putting an extra strain on their kidneys because they have to filter the protein they eat.

"There is evidence that people who eat more fruit and vegetables have a lower incidence of cardiovascular disease and certain cancers. But the Atkins diet goes against public health messages put out.

"People on the Atkins diet lose weight because they are taking in fewer calories partly because the protein in the Atkins diet makes them feel full up very quickly but also because the diet is very monotonous and people sometimes can’t be bothered to eat."