by Westman, Dr. Eric C. ; Phinney, Dr. Stephen D. ; Volek, Dr. Jeff S.
Moreover, risk factors such as high blood triglycerides, low HDL cholesterol levels, and elevated blood pressure consistently showed improvement with carbohydrate restriction. Whether over months or years, the various parameters were as good, and in most cases better, with the Atkins Diet. In no case did Atkins worsen any important parameter. It’s worth mentioning that in each of these seven studies, the subjects received varying degrees of ongoing dietary support after the first few weeks or months. And they didn’t select the diet that appealed to them; instead, they were randomly assigned to one of the various diets, which would tend to limit the degree of success in the group as a whole. Nonetheless, groups assigned to Atkins did better on average than those assigned a high-carbohydrate diet.
Another study didn’t use the Atkins Diet per se, although it was initially similar to the Induction phase, nor did it compare a low-carb program to other diets. But this research, done in Kuwait, demonstrated the magnitude of beneficial change that a low-carb diet can provide when subjects receive ongoing support.11 In this case, sixty-six obese individuals, some with elevated blood sugar and cholesterol, consumed 80 to 100 grams per day of protein from meat and fish, 20 grams of carbohydrate from salad vegetables, 5 tablespoons of olive oil for cooking and dressing vegetables, and a multivitamin/multimineral supplement. After twelve weeks, the carbohydrate intake was raised to 40 grams per day (similar to that in Ongoing Weight Loss), including some berries. The subjects were monitored and supported as outpatients for a year, at which time their average weight loss was more than 60 pounds. In addition, a subgroup with elevated blood sugar (some were diabetic) experienced a rapid reduction, bringing them within eight weeks into the normal range, where it remained for the duration of the study. This diet outperformed that of any of the randomized groups in the other seven studies, due in part to the fact that the subjects chose their diet, rather than being assigned to it. Additionally, the supportive office staff counseled them, including giving them specific advice on the kind of fat to eat, showing what’s possible when a safe and effective low-carb diet is combined with an enabling support staff in a clinical setting.
In the following chapters, we’ll cover the basics of the diet and talk more about the Atkins Edge and how it enables you to remain in control—and vanquish the metabolic bully that has threatened to take over your life. We’ll also offer lots of practical advice on how to deal with the challenges you’ll face day in and day out; but first meet Traci Marshall, who lost almost 100 pounds on Atkins.
SUCCESS STORY 1
SHEDDING THE “BABY” WEIGHT
Two pregnancies left Traci Marshall heavier than she had ever been and with a number of serious health problems. Now that she’s lost more than 90 pounds on Atkins, her health is restored, along with her figure and her zest for life.
VITAL STATISTICS
Current phase: Ongoing Weight Loss
Daily Net Carb intake:
40–45 grams
Age: 42
Height: 5 feet, 6 inches
Before weight: 267 pounds
Current weight: 172 pounds
Weight lost: 95 pounds
Goal weight: 150 pounds
Former waist/hips measurement: 40 inches/48.5 inches
Current waist/hips measurement: 29.5 inches/38.5 inches
Former blood pressure: 160/90
Current blood pressure: 118/74
Current triglycerides: 48
Current HDL (“good”) cholesterol: 58 mg/dL
Current LDL (“bad”) cholesterol: 110 mg/dL
Current total cholesterol level: 178 mg/dL
Has your weight always been an issue?
Yes. I’d done Atkins in 1997 and lost 45 pounds in two and a half months. I kept that off without effort and felt terrific until 2003, when I got pregnant. I had morning sickness the whole time and spent three months in bed. By the time I became pregnant with our second son, I was 41 years old and it was an even more difficult pregnancy.
What health problems did you have?
I’d developed hypertension and had a heart murmur while I was expecting. Afterward, I also suffered from postpartum anxiety.
What got you back on Atkins?
I’d actually gone back to Atkins after my first son’s birth and had lost 25 of the 50 extra pounds I’d gained before realizing I was having another baby. I now understand that I could have done the Lifetime Maintenance phase while pregnant. My doctor was totally supportive about my returning to Atkins after my second son’s birth. By this time I’d read several of Dr. Atkins’s books and knew that I was highly intolerant of carbs and that Atkins was a lifestyle change, not just a weight loss diet. I remembered how great it felt to live Atkins every day and stay slim. I wanted that back!
What health improvements have you seen?
My blood pressure and lipids are great. My doctor is really happy with my progress. My heart murmur has disappeared. I sleep better. I have way more energy, and exercise is something I look forward to now.
What’s your fitness routine?
I walk with the kids three days a week and go by myself on other days. I belong to a gym, where I do some cardio, but have come to realize that staying active is not just going to the gym. Recently, I started doing modified push-ups, leg extensions, and other calisthenics. Almost immediately, weight loss picked up. I’ve learned to love exercise because it feels awesome!
What was the worst thing about being overweight?
I didn’t feel like me. I felt lost in a huge body. I wanted to hide, and I was so embarrassed for my children to have a heavy mom.
How did you handle the challenge of having a lot of weight to lose?
I only thought about 10 pounds at a time. Now that I’m closer to my goal, I only think about 5 pounds at a time.
How would you describe your eating style?
I eat everything that other people eat, I just eat it differently. So today I’m baking a pumpkin pie for my husband, and I’m making low carb pumpkin cheesecake for myself, baking it in single servings in muffin tins. For breakfast, I might have Brussels sprouts mashed with cream and butter and a pork chop cooked in olive oil with garlic. Lunch is usually a big salad with onion, tomato, avocado, a piece of chicken, and my own salad dressing. Snacks are usually berries and nuts. For dinner, we’ll have a protein and a vegetable. I’ll make rice or sweet potatoes for the rest of the family, and I’ll have another low-carb vegetable.
Has doing Atkins affected how you feed your family?
Absolutely. If you teach kids how to eat, they’ll eat right. I’m raising them on the Atkins lifestyle. I try not to have white potatoes in the house except at holiday times. I won’t buy anything with high-fructose corn syrup. I read the labels of everything to make sure of the ingredients.
What words of wisdom can you offer other people?
Plan ahead. Make more than you need for a single meal so that you always have something at the ready. Satisfy sweet cravings with a cup of coffee with cream and low-carb sweetener. Motivate yourself by looking at old photos when you were at a good weight. Keep a food journal. Learn to adapt recipes, like using eggplant strips in lieu of pasta.
What was the most difficult thing for you?
The hardest part is just making the commitment to start. Once you get going, it just feels so good. For me, it gets easier the longer I stay on Atkins.
Chapter 2
THE ROAD AHEAD
As long as you consider a short-term diet as a solution, you’re doomed to an on-again, off-again battle with your weight.
One of the main reasons for the failure of most efforts to slim down is that people simply can’t sustain the prescribed way of eating. Boredom or dissatisfaction with the permissible foods, concern about the adequacy of the diet, or sheer hunger ultimately causes dieters to revert to their old habits. Eating is pleasurable, and any weight control approach that makes food the enemy is doomed to failure. In contrast, Atkins makes food your friend and is all about choice, rath
er than denial. By the time you’ve completed this chapter, you’ll have a better understanding of the several pieces of the puzzle that come together to give you the Atkins Edge. This metabolic advantage will power you with a steady source of energy—and empower you to stay with the program.
THE D-WORD
Most people are hung up on the secondary meaning of the word “diet”: a limited period of deprivation to lose weight. That short-term thinking is what has gotten so many “dieters” into the same bind. They hop onto the diet wagon, lose a little excess baggage, then hop (or fall) off and regain the same old pounds.
As long as you consider a short-term diet as a solution, you’re doomed to an on-again, off-again battle with your weight. Things are different in Atkins land. First of all, losing weight the low-carb way needn’t involve deprivation. Secondly, although Atkins has all too often mistakenly been perceived as just a weight loss diet (and without question, it does help people lose weight swiftly and effectively), it’s really a lifestyle that enriches your life in many ways. That’s why the program’s formal name is the Atkins Nutritional Approach. You can still call it the Atkins Diet—we do—as long as you remember that it’s a much bigger tent. Atkins is a way of eating that will enhance the quality of your life. After three progressively liberal phases, the Atkins program culminates in Lifetime Maintenance.
LET’S PREVIEW THE PHASES
Part II of this book is devoted to the four phases, but for now we’ll briefly introduce them to make it crystal clear that Atkins is truly a recipe for life, rather than simply a weight loss diet.
PHASE 1, INDUCTION, is where most—but not all—people start. It lasts for a minimum of two weeks, but feel free to hang out there longer if you have a lot of weight to lose. In Induction, you’ll train your body to burn fat, which will kick-start weight loss. To do so, you’ll confine yourself to a daily intake of 20 grams of Net Carbs. (See the sidebar “What Are Net Carbs?”) Of those 20 carb grams, at least 12 to 15 should be in the form of what we call “foundation vegetables,” which you’ll eat every day, along with protein and healthy, natural fats. Off the menu is anything made with sugar, fruit juices and concentrates, and flour or other grains.
PHASE 2, ONGOING WEIGHT LOSS, or OWL, is when you continue to explore foundation vegetables and begin adding back foods such as berries, nuts, and seeds—and perhaps even some legumes. You’ll slowly increase your daily carb intake by 5 grams at a time until you find your personal tolerance for consuming carbs while continuing to lose weight, known as your Carbohydrate Level for Losing (CLL). You typically stay in this phase until you’re about 10 pounds from your goal weight.
PHASE 3, PRE-MAINTENANCE, broadens the range of acceptable whole food carbs in the form of other fruits, starchy vegetables, and finally whole grains. (However, not everyone can add back all these foods or eat them on a regular basis.) As long as you continue to lose weight, you can slowly increase your daily carb intake in 10-gram increments. When you reach your goal weight, you’ll test out the level of carb intake you can handle without regaining pounds or losing the precious metabolic adaptations you’ve achieved. This level is known as your Atkins Carbohydrate Equilibrium (ACE). Once your weight has stabilized for a month and your food cravings are under control, you’re ready to move on.
PHASE 4, LIFETIME MAINTENANCE, is really not a phase at all but a lifestyle. You’ll continue to consume the varied whole foods diet of Pre-Maintenance, adhering to your ACE and regularly monitoring your weight and measurements. Two approaches to Lifetime Maintenance address the needs of people across a range of ACEs. Some people may need to keep their intake of carbohydrates low and avoid certain foods to continue to enjoy the health benefits of carbohydrate restriction; others will have more latitude to consume more and a greater variety of carbohydrate foods.
In the next chapters, we’ll get into the specifics of what you should be eating from Day 1 and what you’ll add back as you slim down and your new eating habits become ingrained. We’ll also discuss the few foods that you’re better off steering clear of. The Atkins approach is not about banning foods lacking in nutrients and full of carbs, but it does make clear the dangers they present to weight control and overall good health. We trust that once you understand how these foods sabotage your good efforts, you’ll pretty much write them off for good.
WHAT ARE NET CARBS?
The only carbs that matter when you do Atkins are Net Carbs, aka digestible carbs or impact carbs. Fortunately, you don’t have to be a food scientist or math whiz to figure out how to calculate them. Simply subtract the number of grams of dietary fiber in whole foods from the total number of carbohydrate grams. How come? The answer is that although it’s considered a carbohydrate, fiber doesn’t impact your blood sugar level. So unlike other carbs, it doesn’t act as a metabolic bully. Let’s do the math. A half cup of steamed green beans contains 4.9 grams of carbs, of which 2.0 grams are fiber, so subtract 2.0 from 4.9 and you get 2.9 grams of Net Carbs. Here’s an even more dramatic example: a cup of Romaine lettuce contains 1.4 grams of carbs, but more than half the carbs (1.0 gram) are fiber, for a Net Carb count of 0.4 grams. No wonder you can eat lots and lots of salad greens on Atkins!
When it comes to low-carb foods, you subtract grams of sugar alcohols (including glycerin), as well as of fiber, from total grams of carbs to get the Net Carb count.
Tip: For a Carb Counter that provides total carbs, Net Carbs, and other nutritional data for hundreds of foods, go to www.atkins.com/tools.
WHAT ARE SUGAR ALCOHOLS?
Many low-carb products are sweetened with such ingredients as glycerin, mannitol, sorbitol, xylitol, erythritol, isomalt, lactitol, and maltitol. These forms of sugar, called sugar alcohols (or polyols), provide a sweetness and mouthfeel similar to that of sugar without all the calories and unwanted metabolic effects. Because sugar alcohols are not fully absorbed by the gut, they provide roughly half the calories that sugar does, although each one varies slightly. The incomplete and slower absorption results in a minimal impact on blood sugar and insulin response. This means that sugar alcohols don’t significantly interfere with fat burning, making them acceptable on Atkins. Other benefits may include promotion of colon health and prevention of cavities. However, a portion of sugar alcohols is not absorbed, which can produce a laxative effect and cause some gastrointestinal problems when they are consumed in excess. Individual tolerances vary, so it is best to test the waters slowly. Most people find that they can handle 20 to 30 grams a day without undesirable effects.
MEASURING YOUR PROGRESS
Most people lose pounds quickly and steadily in the first few weeks of Atkins—in fact, some people lose up to 15 pounds in the first two weeks on the program. But numerous factors influence your individual weight loss pattern. If you have just a few pounds to lose, they may be more resistant to your efforts. Men tend to lose more quickly than women do. Younger people typically have an advantage over the middle-aged or older. Hormonal changes, such as menopause, can definitely slow your metabolism and make it more difficult to banish pounds. Some people naturally have a slower metabolism. Certain prescription drugs can also interfere with weight loss. Your spouse or friend may well lose at a different rate than you do. Just remember that getting slim and trim isn’t a contest. Rather, it’s a process of discovering how your own body works.
Those of you with a significant amount of weight to lose typically see steady progress week after week, but it’s natural to experience some ups and downs, and with time almost everyone sees a slowdown in weight loss. Lost inches also indicate progress, sometimes even when pounds won’t budge. That’s why we encourage you to unroll the tape measure whenever you hop on the scale. As you’ll come to understand, your goal is not just a smaller clothing size and a trimmer body, it’s also to enjoy good health and well-being. If you start out with type 2 diabetes or hypertension, both of which tend to improve promptly on Atkins, your improved numbers will give you and your doctor evidence that the diet is working. We
’ll give you more detail on how diabetes and other serious conditions respond to Atkins in part IV.
WATER POUNDS AND FAT POUNDS
As with any weight loss program, some of the initial weight loss you’ll experience is water weight. After all, one-half to two-thirds of your body is composed of water. Atkins naturally has a diuretic effect that starts within the first few days, which is why drinking plenty of water and other fluids is important, as is taking a multivitamin/multimineral, to ensure that you don’t deplete your stores of electrolytes (sodium, potassium, magnesium). (We’ll discuss which supplements are important shortly.) So if you drop 10 to 15 pounds in the first few weeks, you’ll be saying good-bye to some unnecessary water weight along with the initial fat pounds. But once that excess water is gone, you’ll be losing primarily body fat. The Atkins Diet has been shown time and time again to result in significant fat loss, especially from the stomach area.1 In head-to-head comparisons, Atkins consistently outperforms other diets in terms of fat loss.2 The majority of studies indicate that when carbohydrate intake is reduced and protein intake is modestly increased, there’s a greater percentage of fat loss and better retention of lean body mass. But after that, as long as you follow our food intake guidelines, you can be secure in the knowledge that the vast majority of your ongoing weight loss will come from fat.
WHAT TO EXPECT
Your body makes a number of adjustments as it begins to focus on burning primarily fat, after which you will have gained the metabolic advantage we call the Atkins Edge. However, in those first few weeks, as your body makes this transition, you might encounter a few symptoms. The most common are headaches, dizziness, weakness, fatigue—sometimes referred to as Atkins flu—and constipation. Fortunately, all are pretty easy to avoid. We’ll touch on them here and then give you more complete instructions on how to manage them in chapter 7.