The right weigh? Atkins stirs up diet debate
SANFORD J. SCHMIDT, The Telegraph 05/16/2004
http://www.zwire.com/site/news.cfm?..._id=25271&rfi=6
It’s hard to go to a family gathering, social outing or even stand around the water cooler at work these days without hearing the name "Atkins."
People all over the area, as well as millions of men and women nationwide, have a sure conversation starter by mentioning diet in general and the Atkins Diet in particular.
Professionals in the medical field get a double dose.
"At 99 percent of my presentations in the community, one of the things they ask about is the Atkins Diet," said Karen Arensmann, clinical dietitian at Alton Memorial Hospital. "Once I finish my spiel, they say, ‘What about Atkins?’"
Cathy Willis, a registered and licensed dietitian at Saint Anthony’s Health Center in Alton, said she and her colleagues do a lot of speaking before community and corporate groups. Participants almost always bring up Atkins, after they extol the virtues of more traditional approaches.
"People are always asking about it. People even come up to me at church to ask about it," she said.
Not good for all
Dietitians seem to take a cautious approach to the Atkins Diet, because it is difficult for them to apply the same advice to everybody.
"I don’t really teach the Atkins Diet. It is not necessarily good for all conditions," Arensmann said.
There is more to nutrition than quick weight loss, they say.
"The problem I have with Atkins is that there is nothing regarding behavior modification with portion control," Willis said.
Others, including some well-established doctors, said the diet works, and what works to turn the tide of unhealthy excessive obesity should be applauded.
"Anything that can make a person lose weight, I’m all for it," said Dr. John Hoelscher, chairman of medicine at Saint Anthony’s. He said America is suffering an obesity epidemic.
"We really have to start cracking the whip here," he said.
Doctors said the shortcomings of Atkins are not a reason to rule the diet out, especially considering that all diets have shortcomings, such as the boredom factor.
"It’s boring. That’s why they call it a diet," said Dr. David Burnside, chief medical officer for Alton Memorial.
The same criticism that some apply to Atkins can also be applied to any diet, he pointed out.
A new diet is born
The diet was "invented" by the late Dr. Robert Atkins, who published a book in 1972 extolling a high protein, low carbohydrate diet that brought on a state known as "ketosis," in which the body burns more fat without decreased energy or that gnawing, nagging feeling ofhunger experienced in most diets.
The diet was panned by mainstream medicine until studies in the late 1990s and early 2000s supported the idea that it might actually work. Not only did it work in some trials, but the weight loss lowered cholesterol, implicated in heart disease.
"Cholesterol is a form of fat; your body will burn cholesterol," Burnside said.
The better cholesterol results, likely the result of weight loss, flies in the face of criticism that the Atkins Diet promotes high cholesterol.
Some of the more recent studies tending to support the diet touched off a phenomenon.
"You can’t watch television these days without seeing advertising for low-carb products," Arensmann said.
Nearly everyone you talk is either on the diet or knows someone who is or knows someone who is on a modified version of Atkins.
"It’s a revolution," said Hoelscher, who has lost about 10 pounds on what he calls a modified version of Atkins, the South Beach Diet. That diet emphasizes high protein, but it is broken into phases and includes a few more complex carbs than the pure Atkins approach.
"It’s a little more rational approach," he said.
"It can be very effective," Hoelscher said. He recommends working with a doctor, who can monitor such factors as blood fats to make sure there are no harmful side effects.
"So far, I have not seen any in my patients, but the tests should be done as a precaution," he said.
Burnside has had a lot of experience with the diet.
"I was a fat kid," he said.
He has lost 100 pounds on Atkins. As of last week, the 6-footer weighed 180 pounds. Burnside has been on the diet several times since it first emerged in the 1970s.
Keeping the weight off is the hard part, no matter what diet you choose, he said.
"Statistically, losing weight and keeping it off is harder than kicking heroin or cocaine. Nationally, the success rate of people staying off drugs is about 20 percent. For keeping off weight, its five out of 100," he said.
"I put a lot of people on the diet," he said. "There are studies that show it is probably the most effective diet."
One man’s experience
Henry Boss of Fosterburg went on the diet in September and has gone from 365 pounds down to 280. He has battled weight problems all his life, but he thinks he might be able to stay on some version of Atkins for the rest of his life.
He has an answer for those who say Atkins can be boring.
"I cheat a lot," he said.
Still, the times when he cheats can result in some of the quickest weight loss.
He bagged the diet at Thanksgiving after losing 40 pounds in the first two months. "I went off it two weeks, then, boom, I lost another eight pounds," he said.
Boss works at ConocoPhillips in Wood River and knows a lot of people on Atkins.
"There are a bunch of guys down there on it," he said.
That reflects a national trend.
Some 26 million Americans are on a hard-core low-carb diet, according to an article in the May 3 edition of Time Magazine. The magazine said sales of low-carb products are expected to be $30 billion this year, and more than 1,500 new low-carb products have hit the stores since 2002.
Burnside urges avoiding the processed foods that are advertised "low-carb" because they encourage the thought that you can eat any amount of these foods and have a chance at succeeding.
"That’s defeating the purpose," Boss said.
"Don’t buy prepared foods. To make them tasty, they cheat," Burnside said.
He recommends buying the Atkins book and sticking to it.
How the body reacts
Eating the precise amount of carbohydrates will bring about the state of ketosis, which kicks up the use of fat as fuel and prevents gnawing hunger. It is important to get some carbohydrate, however, because certain organs, notably the brain, can only use carbs as fuel.
Burnside said that in the first few days, people tend to lack energy as the body adapts to different energy sources. "Biochemical pathways in your body get better and better," he said.
It is not true, he said, that people can eat any amount of low-carb foods, defy the laws of physics and still lose weight.
"You can’t consume 4,000 calories worth of bacon every day," he said.
A flaw in the Atkins plan is that he doesn’t say that. What actually happens is that people take in about 1,000 calories a day, which means they are obeying the laws of physics in that they are losing fat by burning more calories than they take in.
Once the body adapts, the dieter has plenty of energy and does not feel hungry.
Regardless of how much weight you lose and which diet you choose, it is hard to argue with eating sensibly, including portion control, and getting adequate exercise as a long-term solution, Arensmann and Willis said.
"People do have to return to normal eating. It boils down to common sense: eat right and exercise. That’s what works in the long run," Willis said.
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