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The unpalatable truth about the Atkins diet: it's just fat-headed nonsense, claim scientists

Maxine Frith,Social Affairs Correspondent
Wednesday 13 August 2003 00:00 BST
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For those who have found the trials of other weight loss programmes rather too difficult to stomach, the Atkins Diet appeared to provide a more comfortable solution.

For those who have found the trials of other weight loss programmes rather too difficult to stomach, the Atkins Diet appeared to provide a more comfortable solution.

The regime turned established dietary theory on its head, encouraging two million Britons to cut out potatoes and pasta in favour of bacon and eggs - hardly an unpleasant alternative. But now experts have concluded the high-protein low-carbohydrate fare does not work, any apparent success being all in the mind. What's more, they say, it could also pose serious long-term health risks.

Britain's top nutritionist, Dr Susan Jebb yesterday condemned the theory behind Atkins as "nonsense and pseudo science". Dr Jebb, Head of Nutrition at the Medical Research Council, told a briefing at the Royal Institution - organised to express academic concern about the diet - that "there is not a shred of evidence that Atkins works". And health psychologist Dr Jane Ogden said fans of the diet were "delusional" about its real benefits.

Conventional diets have always advocated cutting down on fat and protein and using carbohydrates such as pasta, vegetables and wholegrain bread to fill you up. Atkins is the polar opposite. Followers cut out carbohydrates but can eat as much protein, such as bacon, steak and cheese, as they want.

The theory is based on the way the body processes carbohydrates. The "science bit" as Atkins adherent Jennifer Aniston used to say in the hair commercials, is that the body digests carbohydrates to form glucose, which is then converted into energy.

Insulin controls the way in which cells take up the glucose. If there is excess glucose, it is stored in the body as fat. According to Atkins, if you take carbohydrates out of your diet, the body does not have glucose for energy, so it turns to its fat stores, meaning you lose weight.

Because burning fat for fuel is also more "energy inefficient", the body uses up more calories to get the energy it needs, meaning Atkins followers can, allegedly, eat more than people on low fat, high-carb diets.

Two months ago a study in the respected New England Journal of Medicine concluded that Atkins did lead to increased weight loss.

But Dr Jebb says much of the basis for Atkins is questionable, and could be dangerous. "People lose weight on Atkins because they eat less, in the same way that all other diets work," she said. "This idea that you burn more fat is simply nonsense." She pointed to a study which showed that, after six months, people on the Atkins Diet had lost slightly more weight than those on conventional regimes, but after a year there was no difference because the Atkins followers had regained more pounds.

In addition, the drop-out rate for both diets was similar, at 30 per cent, suggesting that Atkins is no easier to follow than other weight loss programmes.

Carbohydrates have been associated with reduced cholesterol and lower risk of heart disease, as well as improving digestive function and cutting risks of bowel cancer. There are also concerns high protein diets can increase excretion of bone-building calcium from the body and are linked to kidney problems.

Dr Jebb said "At the moment it is not even a safe experiment, as nobody is following what is happening to the millions of people who are following the Atkins Diet. It is an unknown risk. The thing we can say is that the Atkins diet is nutritionally incomplete. If you cut out a whole food group like carbohydrate you take away all the vitamins and minerals you get from that food group."

She added: "We simply do not know the long-term health impact, and it is such a profound change from what we advocate as healthy eating at the moment. To recommend this as a strategy, we need serious, long-term trials. I think we should be adopting the precautionary principle on this.

"Unfortunately, the problem is best-selling diet books are not subject to the same rigorous, evidence-based precautions that we set down in medicine."

But. while the science behind Atkins may be suspect, the psychology is rock solid - which may be a better explanation of its popularity than its effectiveness.

Dr Jane Ogden, reader in health psychology at King's College London, said the diet addresses many of the reasons why, after three years, 95 per cent of other dieters have regained all the weight they lost.

Dr Ogden pinpointed three reasons for why most diets fail - confusion about what "cutting down" actually means for everyday eating; the fact that the minute you deny yourself something you become fixated on that object, and the fact that most diets equal eating boring, untasty food. "Atkins solves all of those things," Dr Ogden said.

"People love it because it is so far from what health professionals have always advocated as a healthy, low fat diet.

"People also feel they are buying into a lifestyle. If they follow the same diet as Jennifer Aniston, then they may get a scrap of her lifestyle and looks as well.

She added: "Atkins gives people what they want. It is based on pseudo-science which people like. It is a useful psychological crutch at a time when there is an epidemic of dieting."

But Dr Ogden warned many people may be relying on Atkins to change their life t. She said: "It is delusional. Nobody is able to change their diet to that extent and then stay that way.

"In reality, they are probably destined for a life of yo-yo dieting." That theory is borne out by Jenny Saunders, 26, who went on the Atkins diet last summer. Miss Saunders, who works in classified advertising, said: "To be honest, it was the lardiness of the diet that appealed." After three months on the diet, Jenny had lost about two stone, going from fourteen-and-a-half stone to twelve-and-a half, despite not exercising. But she then began to crave jacket potatoes and worried about the effects of not eating fruit and vegetables.

Miss Saunders also suffered another common problem among Atkins-ites - bad breath from high levels of proteins.

After six months she had put the weight she'd lost back on.

The diet's pioneer Richard Atkins died earlier this year, aged 72, but his legacy lives on with a multi-million dollar business. His supporters claim the sniping from nutritionists is based on jealousy that their long-held beliefs do not work.

Dr Stuart Trager, scientific consultant at Atkins Nutritionals in New York said: "I don't think nutritionists like the idea that their messages haven't worked, and Atkins does.

Whether the nutritionists do finally have to eat their words - and cut out their carbs - may soon be answered because the US National Institute of Health is now funding a five-year study of the Atkins diet.

RECIPE FOR SUCCESS THE ATKINS EMPIRE

A glance in the mirror and the discovery he had three chins persuaded Robert Coleman Atkins to search for a controlled carbohydrate diet. By the time of his death in April this year, the former cardiologist's quest for more sculpted facial features had earned him and his wife, Veronica, a fortune estimated at $100m (£60m).

The main earners have been his 13 books, the most popular of which, Dr Atkins' Diet Revolution, sold 10 million copies and is one of the 50 best-selling works of all time.

While his popularity waned in the 1980, the endorsement of the diet by Hollywood celebrities sent it soaring again in the 1990s, with the publication of Dr Atkins' New Diet Revolution in 1992.

Five years later, the hugely successful Dr Atkins' Quick and Easy New Diet Cookbook was co-written with his wife, a former opera singer he met at a party and married a year later in 1988.

The 1997 edition of Dr Atkins' New Diet Revolution has been among the top 10 books on the New York Times bestseller list for five years and in 2001 an updated edition with seven new chapters and research supporting controlled carbohydrate nutrition was brought out.

Last year, he recovered from a heart attack that doctors said was unrelated to his diet. But on 8 April this year, he slipped on an icy pavement outside his Manhattan office, suffering a fatal brain haemorrhage at the age of 72.

Despite his fame and fortune, Dr Atkins fought hard for the scientific recognition that eluded him and in 2001, Harvard University received a $285,000 grant from The Dr Robert C Atkins Foundation, which the couple launched in 1999, to start a comparative study on the low-carbohydrate ketogenic diet and low-fat regimes.

Atkins Nutritionals is a fast-growing enterprise providing convenience foods, supplements, baked goods, snacks and even diet-orientated ocean cruises for millions of dieters who have adopted a controlled-carbohydrate lifestyle. The Atkins Foundation receives a substantial percentage of of Dr Atkins' bequest.

Arifa Akbar

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