Yes it is!

I was actually just about to post this article published yesterday in the Columbia Missourian, an online newspaper.

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Doctors cite concerns about diet in teen's death

They say the case isn't conclusive, and advocates call the Atkins diet safe.

By LAURA MONTGOMERY, reporter~digmo.com

November 13, 2002

MU doctors reported what they think could be the first case of a death from a high-protein, low-carbohydrate diet in the September 2002 issue of the Southern Medical Journal. Tonight (Nov. 13), one of the doctors will appear on the Phil Donahue show with the victim's mother and a representative of Atkins Nutritionals to discuss the case.

About two years ago, a 16-year-old girl was admitted to University Hospital's emergency room with heart arrhythmia, said Paul Robinson, an assistant professor of clinical child health. The girl was at school walking from her chair to the trash can when she collapsed.

She and her mother had been on the Atkins diet for two months. The girl had gone off the diet for three weeks, but when school started, she returned to the diet for about nine days before she died, Robinson said. She lost 15 to 20 pounds over the course of the diet, he said.

When the girl was admitted, doctors found that her levels of potassium and calcium were very low. Such low levels can induce heart arrhythmia, meaning that the heart is not beating adequately, Robinson said.

The cause of the girl's death is not conclsively known.

"One case does not prove causality," Robinson said. "We can't absolutely say this diet did it; we're just concerned."

The doctors wrote the paper to ask the medical community to pay attention to this possible side effect of high-protein, low-carbohydrate diets, Robinson said. "We wouldn't have written the paper if we didn't think it was likely."

The bodies of people on high-protein, low-carbohydrate diets consume their glycogen because they are eating so little sugar, Robinson said. This causes heavy urination, which means that the body loses electrolytes like sodium, potassium and calcium.

The loss of electrolytes can also be caused by the eating disorder bulimia nervosa, Robinson said, but in speaking with the girl's mother, he found there was "absolutely no sign" that the girl had bulimia.

"The autopsy was absolutely negative for drugs and diuretics," Robinson said.

The death might also be explained by a heart condition called prolonged QT syndrome. The condition is associated with people who are overweight, and Robinson said the girl was overweight.

Atkins consultant Stuart Trager defended the Atkins diet.

"The concern is that at a time where there's never been in the literature any clinically significant abnormalities of electrolytes or cardiac events for patients actually following an Atkins diet, we find it concerning to automatically make a link," he said. "There has never been a reported electrolyte abnormality of this sort reported on someone following the Atkins diet or anyone who's passed away."

Studies at Duke University and the University of Pennsylvania have shown the diet to be safe and effective, Trager said.

The Atkins diet is recommended only under physician supervision and with vitamin and electrolyte supplements. The girl was taking some potassium, but not salt supplements, Robinson said.

"It's our understanding that she wasn't taking the supplements. Then that's really not following the Atkins diet as we recommend it," Trager said.

"We're completely committed to getting to the bottom of this," he said.

Trager and Robinson agreed that dieting adolescents should be supervised by physicians.

Robinson recommends an "old and boring" approach of lifestyle changes rather than dieting for teenagers.

The Atkins diet may be reasonable for some but not the majority of people, Robinson said. "We have very little research data on children, and we really don't have a lot of good research data on adults yet."

Robinson is waiting for more scientific evidence before judging the diet conclusively. Atkins has helped people realize that simple sugars are bad, maybe just as much as fat, Robinson said. However, he doesn't believe complex carbohydrates are also bad.

"Any diet that excludes one whole food group is suspect," Robinson said.

The Atkins diet has been in use for more than 30 years, with tens of thousands of followers at its center in New York alone, Trager said.

MU professors Ted Groshong and Joseph Tobias, medical student Amy Stevens and dietician Julie A. Turpin also co-wrote the Southern Medical Journal article.

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