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For the Nay-Sayers :)

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  • For the Nay-Sayers :)

    Reading a few posts here today and then the general reaction from coworkers this afternoon when I tossed around the idea of a few of us doing Atkins, I decided to post some very good points on Atkins that can help anyone arm the nay-sayers with a little bit of diet education..

    And like a recent physican stated in an article on MSN, "If you are eating poorly already, really any basic diet that works is going to be healthier to use than continuing to eat poorly and continuing to be obese.":

    Evidence in favor of the diet

    Several randomized, controlled studies, published in peer-reviewed journals, have concluded that dieters on the Atkins diet have achieved weight loss comparable to or greater than other diets, up to 1 year. Blood lipids have also improved, and no serious adverse effects have been observed. There are no rigorous studies to show the results after 1 year.

    In the largest, most recent randomized, controlled study, published in JAMA (March 7, 2007), by Gardner at Stanford University, women "lost more weight and experienced more favorable overall metabolic effects at 12 months" than in other diets. The study followed 311 premenopausal, nondiabetic women, age 25-50. The women lost significantly more weight (mean 4.7 kg) on the Atkins diet than on 3 higher-carbohydrate diets (LEARN 2.6 kg, Ornish 2.2 kg, and Zone 1.6 kg), without increasing cardiovascular risks. Changes in HDL cholesterol, triglycerides, and mean blood pressure significantly favored Atkins over the other three diets. The authors conclude: "Concerns about adverse metabolic effects of the Atkins diet were not substantiated within the 12-month study period."[9]

    When the Atkins diet was introduced in the 1970s, it was immediately attacked by existing experts, who claimed it was unhealthy and would fail. Subsequent studies have not supported those fears:
    • "The low-carbohydrate diet produced a greater weight loss for the first six months, but the differences were not significant at one year. The low-carbohydrate diet was associated with a greater improvement in some risk factors for coronary heart disease. Adherence was poor and attrition was high in both groups. Longer and larger studies are required to determine the long-term safety and efficacy of low-carbohydrate, high-protein, high-fat diets." — New England Journal Of Medicine, Volume 348, Pages 2082-2090, 22 May2003, Number 21
    • A study comparing weight loss and metabolic changes in obese adults randomly assigned to either a low-carbohydrate diet or a conventional weight loss diet at the Philadelphia Veterans Affairs Medical Center concluded the following: "Participants on a low-carbohydrate diet had more favorable overall outcomes at 1 year than did those on a conventional diet. Weight loss was similar between groups, but effects on atherogenic dyslipidemia and glycemic control were still more favorable with a low-carbohydrate diet after adjustment for differences in weight loss." [10]
    • "sustained weight loss [at 6 months]" — Atkins funded, non-randomized, non-control intervention trial, American Journal of Medicine, Volume 113, Issue 1, July 2002, Pages 30-36.
    • A 2-week study on studying restricted carbohydrate intake in 10 obese patients with type 2 diabetes concluded: "In a small group of obese patients with type 2 diabetes, a low-carbohydrate diet followed for 2 weeks resulted in spontaneous reduction in energy intake to a level appropriate to their height; weight loss that was completely accounted for by reduced caloric intake; much improved 24-hour blood glucose profiles, insulin sensitivity, and hemoglobin A1c; and decreased plasma triglyceride and cholesterol levels. The long-term effects of this diet, however, remain uncertain." This was not a controlled study in that there was no control group; it merely observed the effect of putting ten obese diabetics on a carbohydrate restricted diet - not specifically the Atkins diet. [11]
    The strongest evidence is randomized, controlled studies published in peer-reviewed journals. The greater the number of subjects, and the longer the subjects are followed, the more powerful the study. To date, the longest studies are 1 year, so the effects of the diet over longer durations are not known.

    The medical principles and scientific theory behind the Atkins diet were first explained in a series of articles by Dr. Richard D. Feinman, a professor of biochemistry and medical researcher at State University of New York (SUNY) Health Science Center (Downstate) at Brooklyn. Feinman, president of the Nutrition & Metabolism Society, published work attempts to prove the common idea that "a calorie is a calorie" is not correct. His research demonstrates why the diet is nutritionally sound and elucidates the principles that prove Atkins scientifically correct.[12]

    Proponents of the Atkins diet feel much of the criticism leveled at the diet comes from statements and opinions of individuals and associations, rather than from controlled and reviewed studies. Advocates of the diet dispute criticisms based on the fact that a low-carb diet is likely to be high-fat and allegations that fat, especially saturated fat, is harmful. Atkins backers maintain that, unlike trans fat, which can result from partial hydrogenation, fully saturated fat is not harmful. Proponents cite The New York Times award-winning science writer Gary Taubes who, in a 2001 article in Science, 291 (5513): 2536, claims that the oft-cited "consensus" opinion against saturated fats derives from political rather than scientific motives. Taubes' 2007 book Good Calories, Bad Calories: Challenging the Conventional Wisdom on Diet, Weight Control, and Disease also makes this point, but in a lot more depth as it's based on more comprehensive research.

    Critics of the Atkins diet may focus particularly on Atkins, or on low-carb dieting in general. Proponents claim that critics fail to consider that people are built differently, and as with any diet, the Atkins may not be effective for some people.

    Continuing research supports the idea that saturated fat may be cardio-protective in some populations.[13][14]

    The May 22, 2003, issue of the New England Journal of Medicine published two scientific, randomized studies comparing standard low-fat diets to low-carbohydrate diets such as the Atkins Diet. In both studies, subjects lost more weight on the low-carbohydrate plans at 6-months but not at 1-year. The editors noted that "Adherence was poor and attrition was high in both groups. Longer and larger studies are required to determine the long-term safety and efficacy of low-carbohydrate, high-protein, high-fat diets."[15]

    A research study carried out by the Weight and Eating Disorders Program at the University of Pennsylvania, reported in May 2003 that the Atkins diet raised levels of HDL (or "good") cholesterol by an average of 11% and reduced the amount of triglycerides in the bloodstream by 17%. This counters one of the chief criticisms of Atkins' approach, which is that cholesterol is raised by eating fatty foods and meat.

    In another study, conventional dieters' HDL cholesterol raised by 1.6% while their triglyceride levels improved. Weight loss was also statistically greater in the Atkins dieters after three and six months compared with the conventional dieters (although this did not remain statistically significant after a year).[15] The study followed the diets of 63 obese men and women. (See New Scientist, 21 May2003.)

    The results of studies from Stanford University (2007) and Duke University (2005) favored low-carbohydrate diets for both weight loss and health indicators.[16][17]

    Misconceptions about the diet

    Many people incorrectly believe that the Atkins Diet promotes eating unlimited amounts of fatty meats and cheeses. This is a key point of clarification that Dr. Atkins addressed in the more recent revisions of his book. Although the Atkins Diet does not impose limits on certain foods, or caloric restriction in general, Dr. Atkins points out in his book that this plan is "not a license to gorge." The director of research and education for Atkins Nutritionals, Collette Heimowitz, has said, "The media and opponents of Atkins often sensationalise and simplify the diet as the all-the-steak-you-can-eat diet. This has never been true."[1]

    Some criticism of the diet seems to be based on a confusion between benign dietary ketosis and the less benign ketoacidosis. Ketosis is a normal metabolic process that results when glucose is not available as a source of energy. The body then burns mostly fat, both directly and through conversion to ketone bodies which make the energy of fat available in water soluble form. Ketoacidosis is a metabolic crisis due to the inability to utilize glucose because of a lack of insulin and in which there is an abnormal accumulation of ketones exacerbated by severe dehydration as the kidneys spill the useless glucose, losing water in the process. This occurs in diabetes and starvation, and in a related form in alcoholism.

    Another common misconception arises from confusion between the Induction Phase and rest of the diet. The first two weeks of the Atkins Diet are strict, with only 20g of carbohydrates permitted per day. Atkins states that a dieter can safely stay at the Induction Phase for several months if the person has a lot of weight to lose.[18] Once the weight-loss goal is reached, carbohydrate levels are raised gradually, though still significantly below USDA norms, and still within or slightly above the definition of ketosis.

    The Induction Phase is also known for its comparatively lower intake of dietary fiber, and this is often misconstrued as characteristic of the diet as a whole. In fact fiber supplements, such as psyllium seed husks, are recommended for the early stages. It is often misstated that those on the diet do not consume enough vegetables and fruits. However those who follow it properly should not face this problem as even the Induction Phase allows for adequate amounts of dark green leafy vegetables, for example.

    (info courtesty of Wikipedia)
    Start: 162.0 | Current: 161.0 | Goal: 120 | Age/Height: 25/4'9" | RESTART DATE: 09-01-2008 | PHASE: Induction



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