Quantity's no issue on Atkins diet; quality is
By Megan Murphy April 21, 2003
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Megan Murphy is a Tennessee-licensed registered dietitian and assistant professor of nutrition at Southwest Tennessee Community College. Her column Recipe for Health appears weekly in Health & Fitness.

Last week at my daughter's basketball practice, I asked a small group of parents if they knew someone who was following the Atkins diet. Several of them reported they were either currently following it, had followed it in the past or had plans to do so soon.

Janine James, a nurse and mother of three active girls from Jonesboro, spends a lot of time commuting to Memphis for work and her children's activities. She says her life is too hectic to follow a diet with a certain amount of calories, or fat grams or point totals. James likes the Atkins diet because she can eat all the meat, eggs and cheese she wants. She can get full and satisfied. Besides, she said, "I can have pork skins, so I don't miss the chips so much."

Even while friends and family mourn the passing of Dr. Robert Atkins, the diet doctor whose books have sold more than 15 million copies, the controversy continues over the low-carbohydrate diet he made famous. Atkins encouraged his followers to eat all the bacon, eggs, meat and cheese they wanted, but to significantly limit carbohydrates in their diet. His diet was successful, he said, "because it's the only one where you don't have to cut quantities to lose weight."

Certainly, Americans have a hard time reducing the quantities of the food they eat, so it's no wonder that not having to cut back on certain foods is appealing. Our portions are distorted, as we have become accustomed to mega amounts of food in restaurants and at home. This all-around supersizing has left us with supersized waistlines as well. It's estimated that more than 60 percent of Americans are overweight or obese.

It is difficult to know how many people are following a low-carbohydrate plan, but restaurants have noticed trends that indicate a significant number of people are.

Christian Georgi, president of the Memphis Restaurant Association and owner of the East End Grill restaurants in Memphis, says a lot of people are ordering sandwiches and hamburgers without the bread or buns. And Michelob Ultra, a low-carbohydrate beer, has "taken off like wildfire" at Georgi's establishments. "It's a great marketing ploy," says Georgi, especially since the Ultra beer is only slightly lower in carbohydrate than some other light beers.

Does the Atkins diet have a place in the treatment of obesity in this country? Some health care professionals think so. Dr. George Woodman, a general and bariatric surgeon at Mid-South Bariatrics in Memphis, said the low-carbohydrate regimen may work for those who aren't severely obese.

Woodman observes that many of the obese patients he sees for laparoscopic band surgery to reduce the size of their stomach have followed the Atkins diet, often more than once. Most have never been able to stick to it, or any other diet, long enough to produce the results they need. If the diet worked by itself, notes Woodman, the bariatric surgery he performs wouldn't be in such high demand.

One of the criticisms Atkins received throughout the years was that he did not have scientific data to prove that his diet worked. During the last few years, Atkins and other medical professionals did studies comparing his low-carbohydrate method to other weight-loss methods.

In a study published this month in the Journal of Clinical Endocrinology and Metabolism, 53 women were followed for six months to determine the effects of a very low carbohydrate diet on body composition and risk factors for cardiovascular disease. Forty-two women completed the trial in which half followed a very low carbohydrate diet such as Atkins's and the other half followed a calorie-restricted, moderate-fat diet. The women following the low-carbohydrate diet lost more weight and more body fat than the women on the more moderate diet. Both groups saw healthy changes in their levels of blood lipids, fasting glucose and blood pressure.

Dietitians long have prescribed balance and moderation in the eating plans to their overweight clients. This includes plenty of carbohydrates, good quality protein and a moderate amount of fat.

Clearly, however, traditional dieting has not worked. Adults and children alike in America increasingly battle the bulge. It's tempting to follow a plan that promises less restriction but good weight-loss results.

Some of the women I talked to at my daughter's basketball practice said avoiding carbohydrates altogether was easier for them than trying to include them moderately in their diet. But most people find they can't leave them off forever. Leigh Stone, a Grahamwood Elementary School kindergarten teacher with two busy kids and a hectic lifestyle, says that life without many carbohydrates is no problem - until you take that first bite of french fries, or taste the smoothness of a chocolate bar. Then it's all over and it's difficult to get back to restricting the carbohydrates again.

Barbara Scobey, clinical dietitian and diabetes educator at the outpatient center at Baptist Hospital of Memphis, recognizes some positive aspects of the Atkins diet. Scobey says the diet's emphasis on increasing water intake and including green vegetables, along with encouraging regular exercise, is helpful for anyone wanting to lose weight or just maintain good health. But she is concerned about the limits on high fiber foods such as some fruits, whole grains and starchy vegetables.

Other popular diets also leave off whole food groups. While Dr. Atkins's plan limits carbohydrates, Dean Ornish, another doctor with a well-known diet plan, recommends extremely low amounts of fat, and restricts meats.

The problem is diets that are so lopsided get old. The foods themselves become repetitive, and the restriction gets cumbersome. It's not surprising that most people just don't stay on these diets for very long.

And that's just the problem, isn't it - sticking with a diet?

Atkins came out with the first edition of Dr. Atkins' Diet Revolution in 1972, more than 30 years ago. If it works so well, wouldn't there be a number of long-term followers who have lost weight, kept it off, and had good health because of it? Where are they? I suspect their voices are quiet because there aren't very many of them.

Even if the diet enables people to lose weight, the question has to be asked: Is it a livable, long-term way to eat? And is it truly healthful in the long run?

When I am asked my opinion of the Atkins diet, I always bring up this point: Populations in the world that have less heart disease, less cancer and less obesity than Americans do not consume a low carbohydrate, high protein, high fat diet.

Consider the Japanese, who have one of the lowest rates of obesity, diabetes, cancer and heart disease in the industrial world. The traditional Japanese diet is high in carbohydrates, with rice, grains and vegetables making up the bulk of their food choices. Their intake of high protein, high fat foods, is minimal. If carbohydrates are the culprit in corpulence, the Japanese people should have higher rates of obesity than Americans.


The problem of obesity, the main focus of Dr. Atkins, is complex and encompassing. It is not just about management of diet, but lifestyle and emotional obstacles as well. People who lost weight and kept it off over time eat lower calorie, lower fat diets and have incorporated exercise and stress management into their lifestyle.

Maybe the Atkins diet plan is partly right. Americans would do well to eat less refined carbohydrates, such as cookies, chips, sugary sodas and candy. But they could benefit from adding more complex carbohydrates, such as whole grain breads and cereals, fresh fruits and a wide assortment of vegetables, including the starchy, higher carbohydrate veggies such as sweet potatoes and corn.

Perhaps Atkins did revolutionize the diet industry in a way. His works have fostered more obesity research, and certainly much debate over how to best help people who are overweight. It's an ongoing problem with no single or easy answer.