The New Atkins Made Easy (42 page)

The science supporting Atkins goes back to at least the middle of the last century, but it has really picked up during the last decade. We now have a much better understanding of how and why controlling carbohydrates works to melt away fat and fend off diabetes, heart disease, cancer, and a host of other diseases.

There have been a large number of studies comparing weight-loss responses between low-carbohydrate and low-fat diets, ranging from a few weeks to as long as two years. It's clear that, on average, following the Atkins Diet results in greater weight loss than other approaches higher in carbohydrate content. When you specifically look at those studies where the low-carb diet resembled Atkins and there was good compliance to the diet protocols, the results are nothing short of dramatic. For example, when my associates and I had forty overweight men and women consume either an Atkins-like diet or a low-fat diet for twelve weeks, the average weight loss was twice that on Atkins (22 pounds versus 11 pounds).
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Weight loss varied significantly among participants, but the average loss for those on Atkins was greater than the loss by any single person on the low-fat diet. And when we X-rayed participants to determine body composition, we saw that those following Atkins had lost more total fat and specifically more belly fat.

Why does the Atkins Diet work so well for promoting weight and fat loss? This is still an open question among researchers, but the most likely reason is that restricting carbohydrates increases satiety, making it easier to restrict calories.

Approximately one in ten adults in the United States has diabetes, and one in three has metabolic syndrome (prediabetes). A primary application of very low-carbohydrate diets in adults is to manage insulin-resistant conditions. Insulin resistance (carbohydrate intolerance) is the hallmark of type 2 diabetes and is also the primary defect underlying metabolic syndrome. Like other food intolerances, the most logical and effective approach to managing carbohydrate intolerance is to restrict the offending nutrient. To get right to the point, the Atkins Diet is a highly potent therapy for managing prediabetes and type 2 diabetes. In fact, it's many times more potent, and safer, than any medications for treating these conditions. Not only can the Atkins Diet prevent type 2 diabetes and slow down its progression, but it can also actually resolve all the signs and symptoms of the disease, in effect putting it into remission permanently.

What is the evidence for such powerful statements? First let's take an overview of the work on metabolic syndrome, and then we'll look at the key studies performed on individuals with type 2 diabetes.

Metabolic syndrome is best described as prediabetes and provides an early sign the body is struggling to manage dietary carbohydrate in a healthy way. The main features of metabolic syndrome are excessive belly fat; high blood levels of glucose, insulin, and triglycerides; low HDL cholesterol; and high blood pressure. You don't have to have all these signs, but if you have more than two, then you have metabolic syndrome. Studies estimate that approximately 64 million Americans have metabolic syndrome.
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You have metabolic syndrome if at least three of the following are present:

• Waist circumference: ≥ 40 inches (men) or ≥ 35 inches (women)

• Fasting triglycerides: ≥150 mg/dL

• HDL cholesterol: < 40 mg/dL (men) or < 50 mg/dL (women)

• Blood pressure: ≥ 130/85 mm Hg or use of hypertensive medication

• Fasting glucose: ≥ 100 mg/dL or use of hyperglycemia medication

The primary driver of metabolic syndrome is consumption of more sugars and starches than an individual can tolerate. A large number of studies have shown that the features of metabolic syndrome dramatically improve with carbohydrate restriction.
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In fact, the Atkins Diet improves all the signs and symptoms of metabolic syndrome, often in dramatic fashion. Take, for example, the study in which my colleagues and I compared the Atkins Diet to a standard American diet in individuals with metabolic syndrome.
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After three months, individuals in both groups lost weight, but weight loss and fat loss, including belly fat, were greater with the Atkins Diet. In the participants on the Atkins Diet, blood triglycerides plummeted by 51 percent, HDL (“good”) cholesterol increased by 11 percent, and insulin sensitivity improved by 55 percent; there were even significant reductions in low-grade inflammation and functioning of blood vessels. This and many other studies clearly show the Atkins Diet is superior to low-fat/high-carbohydrate diets for managing metabolic syndrome.

What if you have progressed past metabolic syndrome and have type 2 diabetes? The Atkins Diet could actually reverse your situation. Going back almost four decades, researchers have noted that type 2
diabetics consuming a very low-calorie carbohydrate-restricted diet experienced major weight loss (even as they retained muscle mass), saw improvements in blood cholesterol and blood pressure, and could discontinue their diabetic medication.
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Two decades later, an even more provocative study was published, showing that improvement in diabetes is more dependent on carb restriction than calorie restriction and weight loss.
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Obese type 2 diabetics were fed two different diets, although both contained 650 calories a day, for three weeks. The two diets contained the same amount of protein but one consisted of 24 grams of carbohydrate per day, and the other 94 grams. The lower-carbohydrate diet resulted in significantly greater improvements in blood sugar control and sugar output by the liver. Interestingly, the magnitude of improvements was directly related to circulating ketone levels, indicating that the unique fat-burning state induced by the Atkins Diet specifically targets better diabetes management.

Ten years after that, it was shown that obese type 2 diabetics following the Induction Phase of the Atkins Diet (20 grams of carbohydrate per day) had remarkable improvements in plasma glucose and hemoglobin A1c, and a 75 percent increase in insulin sensitivity.
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These extraordinary effects were observed after only two weeks on the diet. There are also studies of longer duration. After more than one year of consuming an Atkinslike diet, type 2 diabetics lost significant weight and had remarkable improvement in blood sugar (down 51 percent), total cholesterol (down 29 percent), HDL cholesterol (up 63 percent), LDL cholesterol (down 33 percent), and triglycerides (down 41 percent).
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Other studies also support the long-term efficacy of the Atkins Diet in managing complications of type 2 diabetes.
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Blood lipids are the substances that transport fats (triglycerides and cholesterol) through your bloodstream. Elevated levels of these fats in
your blood can indicate a higher risk for heart disease. The ones most commonly measured are triglycerides and total cholesterol, which includes two types: LDL cholesterol and HDL cholesterol. Extensive research has shown that the Atkins Diet dependably improves all these lipid markers, and therefore reduces your risk of heart disease.
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The most consistent response to restricting dietary carbohydrates is a decrease in circulating triglycerides. The effect can be quite potent, often slashing levels of triglycerides in half. After you eat a meal containing fat, blood triglycerides gradually increase and often stay elevated for several hours. The higher blood triglycerides go and the longer they stay elevated, the higher the risk for heart disease. After you have been on the Atkins Diet for several weeks, there is a dramatic improvement in your body's ability to process high-fat meals so fats don't accumulate in the blood.

As triglycerides plummet on the Atkins Diet, HDL usually increases. This is a positive response because HDL helps remove excess cholesterol from the body. The Atkins Diet does a better job at decreasing triglycerides while simultaneously increasing HDL than any other lifestyle factor, including exercise, and even outperforms most drugs.

In many cases, LDL will decrease or stay the same, but in some people it may increase. However, this variable response in LDL concentration from person to person is just part of the story. LDL particles come in different sizes, ranging from small to large. The Atkins Diet consistently decreases the smaller LDL particles. These are the more dangerous ones, as they are significantly associated with heart disease.
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The excess accumulation of fat in liver cells is tightly linked to overconsumption of carbohydrate, obesity, and insulin resistance (carbohydrate intolerance). Fatty liver significantly increases your risk of
developing severe liver disease, diabetes, and heart disease. Fatty liver is not as simple to measure as BMI (body mass index) or blood cholesterol, and therefore statistics are not as precise, but it is estimated that between 20 million and 80 million Americans have this condition.

Similar to its effect on improving diabetes, studies indicate that the Atkins Diet has a profound benefit on fatty liver.
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In one provocative study, obese men and women with fatty liver were fed either a low-fat or a low-carbohydrate Atkins-like diet. The low-fat diet contained slightly fewer calories and significantly more carbohydrate (169 grams a day) compared to the Atkins Diet (26 grams a day). Fatty liver was measured using sophisticated imaging techniques. Despite being higher in calories, after just two weeks the Atkins Diet led to significantly greater reductions in liver fat content.
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This demonstrates that the Atkins Diet is a more effective treatment for fatty liver independent of weight loss.

At this point you might be concerned about whether eating saturated fat on the Atkins Diet will affect your health. Fortunately, that has been the focus of rigorous research, and the results may shock you. Remember, the basic concept of the Atkins Diet is to reduce dietary carbohydrates to the point that you are able to preferentially burn your stored body fat as well as the fat you eat. It turns out that when you are on the Atkins Diet your body prefers to burn saturated fat for fuel. That means that the saturated fat you eat does not accumulate in your arteries or on your hips. Instead, it is promptly burned as fuel. Two studies have shown that levels of saturated fat in the blood actually go down in individuals consuming the Atkins Diet, whether or not they lost weight.
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This is an important effect of the Atkins Diet because people with higher levels of saturated fat in their blood have an increased risk of developing metabolic syndrome,
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diabetes,
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heart attack,
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and heart failure.
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The bottom line is that there is no need
to fear or avoid saturated fat on the Atkins Diet; in fact, it provides a preferred fuel, adds flavor to food, and promotes satiety.

You might also be interested to learn that researchers are seriously reevaluating the saturated fat paradigm. Large comprehensive reviews performed in recent years have all failed to find any association between saturated fat intake and incidence of heart disease.
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Very low-carbohydrate diets have long been known to be an effective treatment for seizures. In many cases, such a diet can cure the disease within weeks, even in patients who fail to respond to epilepsy drugs.
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It is one of the more remarkable clinical benefits associated with the Atkins Diet. For children who are prone to seizures and who do not respond to medications, the diet is nothing short of a miracle. Although the medical literature is full of studies trying to understand how a low-carbohydrate, high-fat diet improves seizure control, it remains uncertain how exactly it works. The potent and rapidly expanding use of the Atkins Diet for treatment of epilepsy has inspired physicians and researchers to also study the effects of the diet on autism, brain tumors, and plaque development associated with Alzheimer's disease. Clinical trials are also under way on the use of low-carbohydrate diets like Atkins on head trauma, stroke, Lou Gehrig's disease (ALS), and depression.

Cancer is a mysterious and immensely complex disease, but emerging evidence links many types of cancer to the disturbed metabolic state observed in obesity. More specifically, the growth and progression of many cancers appear to be connected to higher intakes of carbohydrate and stimulation of insulin production. Since the Atkins Diet restricts carbohydrates and lowers insulin levels, often dramatically, it makes
intuitive sense that it might be an effective treatment and preventative strategy for some, if not most, cancers. The metabolic state induced by the Atkins Diet, with low insulin and increased levels of ketones (the by-product of fat burning), has been linked to reduced tumor growth in animal studies of brain, prostate, colon, and breast cancer. Although the basic science looks promising, there have been few published human studies to date investigating the Atkins Diet on cancer progression. One recent pilot study in women with advanced breast cancer showed that the Atkins Diet stabilized and even decreased tumor glucose uptake.
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There are, however, a growing number of case reports and pilot studies as well as several ongoing clinical trials, and the preliminary results that have been published or presented at conferences have been positive. Expect more comprehensive results soon as this relatively new application of the Atkins Diet gains traction.

The science supporting Atkins for healthy weight loss is impressive, but equally exciting is the application in a number of other conditions. The Atkins Diet causes accelerated fat metabolism, which results in production of specific metabolites called ketones that are being studied in much greater detail as therapeutic agents. It turns out that when a person's (or an animal's) metabolism runs on these small molecules, there is a host of positive effects, including decreased oxidative stress and inflammatory markers and improved tolerance to stress. Besides the neurological diseases and cancers mentioned above, basic and applied scientists are studying the mechanisms of how this fat-burning state induced by the Atkins Diet improves wound healing, ameliorates post-traumatic stress disorder, slows down the aging process, and much more. Research is not just focused on weight loss and clinical applications. Recreational and elite athletes and soldiers are also using the Atkins Diet to enhance their physical and mental performance and speed recovery from exercise.