Atkins and Independent Experts Concerned Over Erroneous News Coverage of 2001 Death of Teen Girl

NEW YORK, Nov. 11 /PRNewswire/ -- Recent media coverage concerning a case report in the Southern Medical Journal linking the 2001 death of a 16-year-old girl to a high-protein, low-carbohydrate diet has been seriously inaccurate and misleading. Despite the lack of a clear cause of death, the attending physicians suggest that one possibility is that the girl may have died as a result of having spent one or two weeks on some kind of high-protein, low-carbohydrate diet. They make this suggestion based on certain chemical imbalances noted in the girl after death.

The physicians themselves note the possibility that these chemical imbalances could have resulted from a number of factors including bulimia, anorexia and diuretic or laxative abuse. The case study even goes so far as to conclude, " ... it is possible that the patient's dietary regime had nothing to do with her sudden cardiovascular collapse ... " Furthermore, the resuscitative drugs used in an attempt to save this girl's life are also known to cause the chemical imbalances noted during her post mortem.

"While there is no link made by the authors of this case report between this young girl's death and the Atkins Nutritional Approach(TM), and the authors are not at all certain what type of diet she was following. Before anything else, we must express our condolences to the family of this teenage girl," said Paul Wolff, Chairman and Chief Executive Officer of Atkins Nutritionals Inc. Mr. Wolff continued, "All of our information explaining how to do Atkins properly advises people to consult their physician before
beginning any weight-loss program. We believe the health of all people is of paramount concern and we remain committed to spreading the message that it is always advisable to seek a doctor's care and supervision before embarking on a weight-loss program."

Mary C. Vernon, M.D., a well-respected expert in bariatric medicine [the treatment of obesity] has, like many nutrition experts, been following this story since the first media report 12 days ago. Dr. Vernon has familiarized herself with the case and emphasizes, "As a bariatrician, I frequently use a restricted carbohydrate approach such as the Atkins Diet to treat patients. I
have followed approximately 500 such patients without finding the type of outcome described in this case. My patients are prescribed supplements (as also recommended by the Atkins Diet) and medications such as diuretics are monitored or stopped. I have not seen this type of problem in patients
following my recommendations.

"In my clinical experience, the outcome described in the SMJ case report is similar to side effects of dietary programs called VLCD's (very low-calorie liquid diets). In these types of programs both calories and carbohydrates are restricted and electrolyte imbalances can result. Physicians who supervise these programs monitor for such problems."

This unfortunate association between a young girl's tragic death and some kind of low-carbohydrate diet is also based on a number of erroneous and scientifically unfounded misconceptions on the part of the attending physicians. These include concerns about ketosis, and elevated levels of serum triglycerides and LDL (often referred to as bad cholesterol). It is essential that important scientific studies relevant to this case be well understood. In fact, a recent study out of the University of Connecticut demonstrated that ketosis is not only healthful, but actually may be beneficial to heart health.(1) Other recent studies out of the University of Cincinnati(2), the Durham Veterans Affairs Medical Center of Duke University(3), the Philadelphia Veterans Administration Medical Center(4) and the University of Pennsylvania(5) have consistently shown that the Atkins Nutritional Approach (ANA(TM)) fosters consistent improvement in risk factors associated with heart disease. Triglycerides are lowered and HDL (good cholesterol) is elevated, significantly improving the critical LDL/HDL ratio that is one of the key risk factors associated with heart disease. One of these studies (University of Cincinnati) was funded by the American Heart Association. Two of these studies (Philadelphia VA and University of Pennsylvania) were funded by the government. No studies on the ANA(TM) exist showing anything to the contrary.

One of the leading researchers in this field, Eric C. Westman, M.D., M.H.S., Associate Professor of Medicine, Duke University Health System, emphasized that he and his staff have been personally monitoring clinical studies over the past few years conducted at Duke and at other research institutions around the nation; he has looked at safety results both in publication and at presentations and, he unequivocally stresses, "There have been no serious adverse events."

And while all of these studies were conducted on adults, Marc S. Jacobson, M.D., Center for Atherosclerosis Prevention, Schneider Children's Hospital and Professor of Pediatrics and Social Medicine and Epidemiology, North Shore-Long Island Jewish Health System(6), who has been studying and reporting for the past few years on the role and use of the ANA(TM) in adolescents confirms that his work is consistent with the positive results thus far demonstrated by his peers. His own study specifically focused on the fact that low-carbohydrate dieting increases weight loss but not cardiovascular risk in obese adolescents. Dr. Jacobson is widely considered to be one of the country's leading experts on adolescent medicine, including the treatment of obesity.

Dr. Jacobson stresses, "In our study of 30 adolescents randomly assigned to a low-carbohydrate vs. low-fat diet approach, the low-carb group lost more weight and had an improvement in their non-HDL cholesterol, a reliable measure of reduced long-term cardiovascular risk. There were no adverse effects on the lipid profiles in participants in either group therefore we feel the low-carbohydrate diet appears to be an effective method for short-term weight loss in overweight adolescents and does not harm the lipid profile."

Atkins has been widely misrepresented over the past years, however the millions of Americans who have been and are now enjoying the health benefits of the Atkins Nutritional Approach(TM) are done a grave disservice by media reports of this kind. There are no scientific studies on the ANA(TM) that would or should have led these physicians to suggest that a low- carbohydrate diet was in any way responsible for this terrible event.

Adds, Dr. Vernon, reflecting the opinion of many experts who have rallied to the support of the ANA(TM), "As a physician who cares about health problems related to obesity, I am deeply distressed by the media's response to the tragic death of a teenage girl. The cultural pressures facing teenage females
are destructive and pervasive, especially relating to body image. The immediate assumption by the media that this outcome was linked to the Atkins Diet does a great disservice, by decreasing attention to all the possible contributing issues. This kind of conclusion driven by media sensationalism rather than science prevents an analysis of all contributing factors. We have a huge problem with teenage eating patterns and a multifactoral analysis of this case could contribute to possible solutions. In the setting of the current media blitz, the scientific process is at risk."

References
1. Volek JS et al.: A Ketogenic Diet Favorably Affects Serum Biomarkers for Cardiovascular Disease in Normal-Weight Men. Journal of Nutrition, July 2002.

2. Brehm, BJ et al.: Effects of a Low Carbohydrate Diet on Body Weight and Cardiovascular Risk Factors, University of Cincinnati, Abstract presented at 85th Annual Meeting of the American Dietetic Association (ADA).

3. Westman, E, et. al.: Effect of 6-Month Adherence to a Very Low Carbohydrate Diet Program. American Journal of Medicine, July 2002.

4. Stern, L et al.: A Pilot Study Comparing a Low Carbohydrate and Low Fat Diet on Weight and Glycemic Control in Obese Diabetics. The Philadelphia Veterans Administration Medical Center, Philadelphia, PA. Abstract presented at 62nd Scientific Sessions of the American Dietetic Association (ADA).

5. Foster, GD: Evaluation of the Atkins Diet a Randomized Controlled Trial, University of Pennsylvania. Publication pending.

6. Sondike S et al.: The ketogenic diet increases weight loss but not cardiovascular risk: A randomized controlled trial. J Adol Health, 26: 91, 2000

http://www.prnewswire.com/cgi-bin/s...01838797&EDATE=

This is an example of everything that is wrong with the scientific community today. It's a wolf disguised in sheep's clothing; sensationalism passing itself off as "science".

I guess (with many apologies to the family of the victim), a girl dying from complications resulting from an eating disorder is boring. It's much more fun to create a splash around a contraversial diet. You get people to talk about you more !. This so called "study" really belongs in the National Inquirer.

It's shameful, it's total misrepresentation for the sake of making a buck. It's as bad as the people who tried to exploit the events of 9-11.

hmmm....

I wonder if this is the same 16 year old girl talked about on the Phil Donohue Show last night.

Yes it is!

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

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

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.

http://digmo.com:8080/digmo.nsf/slugs/1113atkins

Really??? So how come diets like Ornish, McDougall and Pritikin .. which cut fat to 10% and even 5% of total calories .. are seen as "virtuous", "healthy" and "good"?? And get the official applaud and green light from the AHA, ADA and insurance companies.

Doreen

That tells you something right there. If this is such a dangerous WOE, why is the first case just being reported?

People will believe anything.

Sheldon