Anyone read this?

http://www.ccjm.org/pdffiles/Blackburn901.pdf

It's enough to scare you off low-carb.

This is dusty old stuff. From 2001, before all the new low-carb studies hit the journals.

It's really a propaganda piece, training physicians how to bash the diet.

Most of the 'claims' have been long refuted.

I wouldn't worry about it.

This piece -- incidentally, from the same journal, I believe -- negates most of it, one year later.

http://atkins.com/Archive/2003/3/6-619205.html

Obviously, they have not read the book. Atkins, especially "Atkins for Life" goes deep into how maintain weight-loss for a lifetime. It is their diet and other Low-Fat diets that fail when it comes to weight maintnance. Anyone remember Weight Watchers and Slim Fast's Drop-Out Rates...I believe they were well over 50% if I remember correctly. Let's not even mention how many people have failed at Low-Fat diets overall. VIRTUALLY EVERYONE tried a Low-Fat diet in the 80s. The vast majority regained the weight [and more.] My Dad, Mom, and I have all tried Low-Fat. I can't even count the number of times my Dad reached his goal weight [on a Low-Fat Diet] only to regain it and more. I lost 22 pounds [and reached a desirable weight - 168 lbs] on a Low-Fat diet in 1997. By the end of 1997 [6 months later] I was back up to 193 pounds [3 pounds more than when I started.] After 1 year I had reached 219 pounds [+51 lbs in ONE YEAR.] At that time, I went on another Low-Fat diet. I lasted 2 months and lost about 12 pounds. By the end of 1998 [3 months after going off the 2nd diet,] I was back up to 242 pounds [+35 pounds in 3 months -- everything I'd lost plus an extra 23 pounds to keep it company.] 1 year after quitting my second LF Diet, I had reached 280 pounds [+73 pounds in ONE YEAR.] I tried a number of Low-Fat diets in the following 3 years with little to no success. Atkins is the first diet I've ever stayed on [and managed to lose weight] for more than 6 months. In fact I've been on Atkins for 13 months as of today and am down 100-110 pounds and 7-9 jean sizes.



In plain English: "Get them to quit, so we can claim Low-Carb is too restrictive, and thus prevent people from finding out we've been lying to them for the last 30 years."



Hypertriglyceridemia ? Diabetes ? A Low-carb diet significantly lowers the risk of both of these. In fact, a low-carb diet is the best diet for a person with either of these conditions...As for the others, all have been proven false.



You cannot lose more fat than your Caloric deficit. That is a fact. The problem is that the establishment refuses to accept that the body is not 100% efficient, and that it is possible to expend Calories other than through excercise. In fact, the very presence of Ketones in your Urine, Sweat, and Breath prove that more Calories are being expended. EVERY GRAM of Ketone you excrete is a loss of 13 kcal [9 kcal in the Ketone, plus the 4 kcal expended making the Ketones.] Excrete 10g of Ketones, and you have increased your Caloric Expenditure by 130 kcal. In addition, every gram of fat converted into Ketones requires the expenditure of 4 kcal. Assuming your body needs 2,000 kcal for its other needs, and all of that comes from Ketones, your body would have to break down 228g of Fat. Since you are consuming 20g of Net Carbs, it would only need 218g of Fat. To break 218g of Fat down into Ketones, the body must expend 872 kcal. That means Caloric Expenditure increases by 872 kcal. Of course, since you are also eating extra Protein, some of that will also be used for your body's needs, so the true Caloric Expenditure would be less than the 872 estimated, but would still be significant. If you expend an extra 1,000 kcal per day, you can lose 2 pounds [of fat] a week, even without decreasing Caloric intake.



As typical with Pro-LF/Anti-LC articles, it appears they made their comparisons of current intakes against those in the 1980s. You might wonder why this is relevant. Simple really...In the 1980s, the Low-Fat fad was at its height. Fat and Calorie intake were at their lowest point in modern history. In the last decade, fat and calorie intake have rebounded slightly from their 1980s lows. This allows LF Proponents to make the misleading claim that we are fat because we are eating more fat and calories. Compared to what people ate in 1911 and the 1950s/60s [when obesity and heart disease were far less prevelant,] fat intake has dropped significantly, calorie intake has dropped slightly, carb intake has increased significantly, and there isn't even a word to properly describe the increase in refined carb intake [which is up quite a bit.]



Not true...Atkins says to eat until satisfied. Fat cannot be converted to Glucose, but it can be converted to Ketones. Ketones CAN be used for energy by the Brain and most Organs. The few cells that cannot use Ketones, are able to derive the small amount of needed Glucose from the 20g of Carbs or from Protein.

Note the KEY WORDS here: "Ketosis from prolonged fasting in healthy people increases insulin resistance and glucose intolerance. It is ridiculous to compare the results of a study where skinny people starved themselves [Anorexia] to a diet for people with insulin resistance. The only common thread between an Anorexic and a LCer is they both burn fat over an extended period [Ketosis.] To conclude that LCing causes insulin resistance one must assume that Ketosis is the sole cause of insulin resistance in Anorexics...and that has never been proven. In fact, Carb restriction [with adaquete calories] has been shown to decrease the risk of and/or improve existing insulin resistance.



I've heard that the body excretes a VERY SMALL amount of insulin no matter what you eat. But, it is not this tiny secretion that causes problems. It is the huge secretion that comes shortly thereafter [when you eat high glycemic] that causes blood sugar to rise and then fall, causing hunger. As for the second half of the first paragraph...Is the author trying to claim that the blood sugar spike/fall and corresponding hunger is all in our mind ? Give me a break.

His second paragraph is the clincher. He states that Glycemic Index is the best measure of insulin response. Well, guess what...Fat has a Glycemic Index of 0. Only the lowest GI "Carbs," Sugar Alcohols come anywhere near this...and most of them are closer to 7.

Peanuts and Soy -- 20*
Green Veggies -- 20-40*
Low-GI Fruit -- 30-50*
High-GI Fruit, Bread, & White/Corn Sugars -- 60-80*
Potatoes, Instant Rice, & Some Sugars -- 90-110*

*Give or Take

It is very clear to me that the 0 GI for Steak is alot better than the 100 in Potatoes and 60-80 in some Fruits and Breads.



Many studies dating back as far as the 50s and 60s show that Low-Carb diets are associated with decreased Triglycerides and in some cases decreased Lipoproteins. Other studies have compared diets of equivelant caloric intakes to Triglyceride and Lipoprotein as well as Incidence of Heart Disease based on composition. Some of these studies have shown that Low-Carb diets produce greater improvements in these factors [especially Triglycerides] than Low-Fat diets of the same Calories. To maintain that it is all the result of losing weight, the author contradicts his prior assertion that a Calorie is a Calorie is a Calorie. If all the diets were equal in Calories and fat increases Lipoproteins, why did the LCers improve theirs as well as or in some cases better than the LFers ? The only explanation would be that they lost more weight [BTW, they did lose more weight according to the studies.] But, that would mean that eating the same number of Calories, LCers lost more weight...a claim that runs counter to the a Calorie is a Calorie is a Calorie dogma.

His second and third paragraphs can be shortened to one sentence: "I will never accept that fat [especially animal fat] is not bad for your heart and I will ignore any study that indicates otherwise and deride any person [while ignoring any evidence they may show that is contradictory to my belief] who disagrees with me."



I could practically hear the LFers screaming "Heresy !" as I read that. For once he actually got it right. The protein on LC [and as he accurately stated, LC does not mean High Protein] does not harm the Kidneys. It is a suprise that he backs an LC Diet for Diabetics here [because it lowers insulin,] while previously asserting that Carbs don't cause overeating and that the insulin response was all in our imagination. Even stranger, he previously [in this same article] asserted the dogma that a Calorie is a Calorie is a Calorie...yet, here he states that a Low-Calorie/Low-Carb diet helps Diabetics lose more weight. There are two explanations for this...Either not all Calories have the same effect, or eating Low-Carb decreased their appetite. Either way, his response here directly contradicts his prior assertions that Carbs does not increase weight gain and/or cause overeating.

Vitamin E is particularly high in a number of Hi-Fat foods, particularly Nuts and Monounsaturated Oils, as well as some Eggs. Additionally, E is a Fat-Soluble Vitamin. Without Fat, it isn't properly and fully absorbed. Vitamin E is rarely a problem on this diet. Vitamin C is high in Broccoli, Cauliflower, Cabbage, and a number of other Vegetables. Vitamin C is also rarely a problem on this diet...Especially in light of the fact, pretty much everything contains added Vitamin C. Vitamin C actually serves some function in foods [other than pumping up the Vitamin Content.] It is added to LC Breads [to strengthen the dough,] to Unsweetened Kool Aid and Other Drinks, etc... B-Vitamins vary. B1, B2, B3, and B5 (Thiamin, Riboflavin, Niacin, and Pantothenic Acid) are not a problem. They are high in Fish, Pork, and other Meats. In fact, Pellagra [a Deficiency of B3 and the Amino Acid (Protein) Trytophan] was originally a problem for those who ate little to no meat [and mostly corn] because they were poor. B6 (Pyroxydine) is very high in most animal products.

B12 (Coclabamin) can ONLY BE OBTAINED FROM ANIMAL PRODUCTS. B12 does not naturally exist in ANY land-based plant, and cannot be absorbed from Seaweed. A deficiency of B12 is usually a problem for those on unsupplemented Vegan or Macrobiotic Diets. B12 Deficiency causes brain damage and eventually death. In fact, deficiencies of most meat vitamins (B-Complex) result in brain damage or demntia. Knaw on that one for a second. It is very relevant to the current Mad Cow scare. The chances of getting Mad Cow [which causes Brain Damage and Death] are like 1 in a Billion...Yet, the chances of having the exact same thing [Brain Damage and Eventually Death] happen on a Unsupplemented Vegan Diet are close to 1 in 1. Giving up meat is much more likely to kill you than eating meat. B9 (Folate) is the only B Vitamin that is a problem. It occurs mostly in plants and is one of the vitamins added to Bread [along with B1, B2, and B3.] Folate can be easily supplemented.

As for Phytonutrients...the strongest sources of many of them are Berries and Green veggies, which are encouraged on Atkins. I dare to say that LCers probably get more Phytonutrients than the Average American...and maybe even more than LFers and Vegans, who typically eat mostly Grains, which are not only not a good source of Phytonutrients, but contain antinutrients which block the absorption of nutrients by the body.



For starters, Fiber intake is not low on LC. I ate 50g+ of Fiber 2 days ago, 20g+ yesterday, and 40g+ today. Second, none of those problems have been directly linked to lack of fiber. They have been linked to diets low in fiber, which are typically high in refined carbs. Diabetes is caused by excessive carb intake over a prolonged period. Fiber can reduce the glycemic effect of these carbs, reducing the risk of diabetes from them. But, that does not change the fact Diabetes is still caused by carbs.

As for Carotenoids and Lycopene, the author is wrong when he states these cannot be supplemented. Alpha and Beta Carotene, Crytozphan (sp?), and Lycopene are all sold at health food stores. Lycopene is primarily found in Tomatoes and Watermelon. Tomatoes are allowed on LC Diets, so Lycopene is easily obtainable for those who like Tomatoes. Carotenoids are also found in some green veggies such as Spinach. These are also easily obtained on an LC Diet. Flavenoids are found in very large quantites [many times the amount in other foods] in Berries, which are the primary fruit on a LC Diet. In fact, several of the top 10 sources of Antioxidants, Flavenoids, and Phytonutrients are berries.



Guess which carbs most Americans are eating lots of...I'll give you a clue, its not the Complex ones. Americans aren't eating lots of Vegetables...They're eating lots of Bread, Cereal, and Processed Foods. LCers are encouraged to eat lots of Vegetables...something LFers are not always encouraged to do. As for Nutrient Poor, that is not true. Most B-Vitamins can be obtained from Meat. Vitamins A, C, E, and K can be obtained from Low-Carb Green Veggies. Iron, Potassium, and Calcium are obtained from Meat and/or Dairy. About the only nutrient that is more difficult to obtain is Folate, and even that can be obtained while eating less than 20g of Net Carbs and is easily supplemented.

As for hypertriglyceridemia...That is caused by ANY absorbable carbs [not just Simple Carbs, though they are more likely to raise TGs,] Alcohol, and Trans-Fats. The first and last are too high on LF Diets...which is why they tend to raise Triglycerides.



Atkins advises Kidney Patients not to try his diet. Confusion, Nausea, Fatigue, and Sleep Problems are all problems I had while eating LF/HC, which went away when I went LC.



Studies have shown Ketones to work as effectively or even better for Endurance Sports. Also, when one exercises alot, his or her CCLM increases, allowing him or her to eat more Carbs on a LC Diet. BTW, I don't think most 300-500 pound guys who can barely walk are that worried about their Athletic performance taking a hit. In fact, losing weight will [and did in my case] do more to help Athletic Performance than Carbs ever will. If you weigh 300, 400, or 500 pounds [because you ate too many carbs,] exercise is pretty much impossible. I didn't start exercising until I hit 260-280.



He stated earlier that the Osteoperosis link has never been proven. Now, he's using it to say that Atkins is bad. Get your story straight.

I'm not going to bother with the rest. It is all crap about how eating little to no vegetables is bad for you, and how all that fat will raise your Cholesterol. I'll let my test results peak for themselves.



Blood Pressure: 110-120/70 (Before: 140+/??)
Dizziness: NOPE
Headaches: NO MORE THAN BEFORE
Fatigue: FAR LESS THAN BEFORE
Irritability: FAR LESS THAN BEFORE
Gout: NOPE

Blood Glucose: 84 (NORMAL)
Sodium, Potassium, Chloride: ALL NORMAL
Bicarbonate: NOT TESTED [IF I REMEMBER CORRECTLY]
Urine Specific Gravity: NORMAL
Urine pH: NORMAL
Urine Protein and Acetone: I DON'T REMEMBER IF THEY DID THAT ONE, BUT ALL OF THE URINALYSIS RESULTS WERE NORMAL
Urine Glucose: NEGATIVE
Urine Ketone: NEGATIVE [That one is wierd, but I continue to lose weight despite not excreting extra Ketones (anymore.)]

Cholesterol: 175 (GOOD)
LDL: 122 (GOOD FOR A PERSON WITH 2 RISK FACTORS)
HDL: 33 (LOW...BUT, CONSIDERING MY DIET PREVIOUSLY WAS MOSTLY GRAIN, SUGAR, AND TRANS-FAT...IT WAS PROBABLY VIRTUALLY NON-EXISTENT BEFORE ATKINS.)
VLDL: 19 (GOOD)
Triglycerides: 96 (GOOD)

Wow! I really appreciate the time you've spend writing this post for us. I have to admit, that despite all the success I see on this board, I still have a little voice in my head trying to scare me away from the Atkins program. Thank you for sharing your knowledge!