by Westman, Dr. Eric C. ; Phinney, Dr. Stephen D. ; Volek, Dr. Jeff S.
As mentioned above, type 2 diabetes and hypertension sometimes improve dramatically when you are on a low-carb program, so the need for certain medications diminishes. Close cooperation with your doctor is essential so that you don’t confuse the effects of too high a dose of a medication with doing Atkins itself. Also, it’s not a good idea to begin a new or more intense exercise program at the same time you start the program. Give your body the benefit of two to three weeks to adjust before pushing the exercise envelope. On the other hand, if you are already very active or work out regularly and can continue to do so without any loss of energy, feel free to continue.
Consuming carbohydrates makes you retain water, but shifting over to fat burning has a diuretic effect, meaning you’ll excrete more salt along with fluid. If you used to feel bloated and no longer do, that’s a good thing. Moreover, if you have high blood pressure, the diuretic effect may mean that your numbers will come down nicely in the first few days or weeks. But for many of the rest of us, fluid loss can be too much of a good thing. To manage this problem, simply drink plenty of water and other fluids and make sure to consume a minimum of half a teaspoon of salt each day. You can do this with salt itself, a couple of cups of salty broth, or a measured amount of soy sauce. Follow this regimen from the start, and headaches, dizziness, fatigue, or constipation should not be a problem. Adding this modest sodium supplement—no, this does not make Atkins a high-salt diet—is one of many science-based changes in Atkins. We’ll give you more details about this practice (and the few exceptions for those who should not follow it) in chapter 7.
NUTRITION BASICS
You probably have a general idea that foods contain various amounts of protein, fat, and carbohydrates, which are commonly considered macronutrients. Does it matter whether you eat more or less of one or another? For that matter, what is a Calorie? And how do calories relate to carbs? Let’s start with the easy stuff. Macronutrients are the three nutrient families that provide the body with needed energy—in the form of calories—to carry out all the bodily functions necessary for life. A few foods contain a single macronutrient, such as sugar (all carbohydrate) and olive oil (all fat). Most foods, however, contain two or all three macronutrients. For example, a cup of whole milk contains 8 grams of protein and about the same amount of fat, as well as more than 11 grams of carbohydrate. Four ounces of portobello mushrooms contain almost 6 grams of carbohydrate—of which nearly 2 grams are fiber—a miniscule amount of fat, and almost 3 grams of protein.
A Calorie (aka kilocalorie) is simply a unit of food energy. In this book, we use the word “Calorie” (with a capital C) to designate a kilocalorie, and the word “calorie” in reference to energy in general. Your body needs the energy in macronutrients, not just for physical activity but also for all its other functions, including breathing, staying warm, processing nutrients, and brain activity. A gram of protein or carbohydrate contains 4 Calories, while a gram of fat contains 9 Calories. So gram for gram, fat is a more concentrated source of energy. Some of the raw materials in macronutrients are turned into energy almost immediately; others are broken down into various components that are used for energy later.
ATKINS IS DIFFERENT FROM OTHER DIETS
To succeed on Atkins, you may need to forget what you’ve learned on other diets. Here’s why:
LOW-FAT DIET
LOW-CARB DIET
COMMENTS
Methodology
Count calories, restrict all fat
Count carbs, eliminate trans fats
Satiating foods eaten on Atkins minimize hunger, moderating calorie intake
Eat mostly
Carbs of all sorts
Healthy fats, protein, healthy carbs
Avoid sugar, pasta, bread, and other refined-carb foods that raise blood sugar levels
Weigh foods
Yes
No
Who takes a scale to a restaurant?
Count calories
Yes
No
Atkins emphasizes quality, not low-calorie food
Count carbs
No
yes
All you need is a Carb Counter to track your intake
Eat prepared foods
Yes(on some programs)
No
You eat healthful whole foods, not expensive prepared meals
Snacks
Yes, but calorie restricted
Yes, twice a day
Who wouldn’t prefer cheese, nuts, or guacamole to a celery stick?
HOW FOOD BECOMES ENERGY—AND FAT
Human metabolism is complex, but we’ll make it as simple as possible. This chemical process converts food into either energy or the body’s building blocks, which then become part of your organs, tissues, and cells. Eating the right foods can improve your body’s metabolism, particularly how it handles fat. When you eat fewer carbohydrate foods—relying mostly on vegetables rich in fiber—your body switches to burning fat instead of carbs as its primary fuel source. The average normal-weight person carries about 100,000 Calories worth of energy in fat stores—hypothetically, that’s enough to run at a steady pace for more than 200 hours—and some of us have much more than that. The Atkins Diet, more than any other diet, gives you the key to unlock that energy for fuel.
The concept of carbs as a metabolic bully should help you understand the implications of the switch from burning carbohydrates to burning fat. Here’s how it works. When you eat carbohydrates, they’re digested and converted to glucose (sugar), which your bloodstream transports throughout your body. This means that carbohydrate intake is largely responsible for blood sugar fluctuations. It’s also important to understand that it’s not only the amount of carbohydrates but also their quality that determine the extent of that impact. For example, eating a bowl of brown rice and beans raises your blood sugar level much more slowly and less dramatically than, say, consuming a doughnut, a glass of OJ, or a bowl of sweetened cereal. (Food need not taste sweet to convert rapidly to glucose. Prime examples are mashed potatoes and white bread.)
The amount of sugar circulating in your blood is actually very small—just a few teaspoons—so to keep your blood sugar level normal after a big carbohydrate dose, the absorbed glucose has to be rapidly transported out of your blood and into your cells. This is the job of the hormone insulin, which signals your cells to remove glucose from your bloodstream. Once inside a cell, three things can happen to glucose:
• It can be burned immediately for energy.
• It can be stored in limited amounts for later use as a starchlike material called glycogen.
• Or it can be converted to fat.
If a cell chooses this last option, making fat from glucose, it’s a one-way street. There’s no way that fat can be made back into glucose. It has to be either burned as fat or stored as fat.
In addition to its function as a traffic cop directing glucose into cells, insulin controls the release of stored fat from your fat cells. The higher your insulin level, the less fat is released back into your system to be used as fuel. So when you eat a high-carb meal, particularly one high in refined starches and sugar, your insulin shoots up to remove the glucose from your blood and tuck it away in cells, and your fat usage simultaneously goes way down. Simply put, your body always gives carbs priority treatment.
Why do carbs always get the kid-glove treatment? It’s because your body has only a limited ability to store carbs: at most about half a day’s energy supply. (Contrast this to body fat stores: Even a thin person tends to carry a two-month reserve supply.) So it makes sense that we burn as much carbohydrate as we can as soon as it’s digested and absorbed. Otherwise we’d quickly run out of places to store it. Add to that the rapid pace at which sugar and other refined carbs are digested, and the whole process can get pretty dramatic. Now imagine this process taking place three, four, or five times a day, each time shutting off fat burning as your insulin level escalates to deal with the rising tide of blood sugar. Your body has
no other options once you’ve eaten a carb-rich meal, because this metabolic bully always has to have its way. Because of this biologic imperative, fat calories are always pushed to the back of the line—where more than likely they are stored, and stored, and stored.
This whole process is pretty silent for most of us, as long as we’re young and healthy, but some people have trouble with these wide swings in blood glucose. If your insulin response is too great or lasts too long, your blood sugar level drops—and bam! your energy level crashes. You may recognize it as a slump a few hours after lunch. You may have trouble concentrating, feel sleepy, and often crave something such as chocolate, chips, or candy. Then guess what happens a few hours later? Just rerun the tape. Keep up this pattern for years, and you may develop insulin resistance, meaning that more and more insulin is required to transport the same amount of glucose. What has happened is that your body is giving in to the bully and the stage is set for developing metabolic syndrome and even type 2 diabetes. (We’ll discuss this in depth in chapter 14.)
Compared to the span of evolution, our bodies haven’t had much time to learn how to deal with all these newfangled refined carbohydrates and sugars that have come to dominate our diet only in the last half century or so. And all along, you were blaming your thunder thighs on salad dressing and scrambled eggs! The ability to carry a “fanny pack” of energy in the form of fat actually helped our distant ancestors survive during prolonged intervals between meals (hunting doesn’t always deliver each meal on time) and in times of famine. However, today, when most people eat three big squares full of refined carbs each day—not to mention sweetened double caffè lattes and midafternoon candy bars—they seldom get the opportunity to draw on their backup fat stores. As long as we keep making glucose into fat and let the bully blockade it there, we’re doomed to being heavy.
Fortunately, finding the Atkins Edge gives you an exit pass off the blood sugar roller coaster by switching your body over to burning mostly fat for energy. When you eat foods composed primarily of protein, fat, and fiber, your body produces far less insulin. (If you eat a large amount of protein, some of it can convert to glucose, but protein doesn’t provoke the secretion of nearly as much insulin as carbs do.) And when the carbs you do eat are in the form of high-fiber foods, which convert to glucose relatively slowly, you shouldn’t experience extremes in your blood sugar levels. Your body needs to produce much less insulin, so your blood sugar level holds steady, along with your energy level.
By changing the balance of fats, carbohydrates, and protein in your diet, you convert your body to burning primarily fat instead of constantly making it switch back and forth between carbs and fat. There’s nothing strange or risky about this perfectly normal metabolic process. You burn your own body fat for energy, and as a welcome side effect, you lose weight. Just in case you missed the point earlier, eating fats doesn’t make you fat as long as you give your body permission to burn them. Place the blame where it belongs: overeating and overresponding to carbs. And herein lies the theme of this book—and the premise of the Atkins Diet.
We know that you’re raring to begin Atkins, but hold your horses. We’ve deliberately placed the next three chapters on macronutrients before part II, where you’ll get the nitty-gritty on how to do Atkins. Better to take a little bit of time reading this now than later on having to say, “Oops, I should have read that before I rushed into this and went astray!” The more you understand the importance of what you put into your mouth, the more you’ll be committed to choosing a healthful way to eat for the rest of your life. Most people who failed on Atkins in the past actually were doing some misconception of Atkins. When you understand the correct way to eat (and why) and how slower, steady weight loss leads to lifetime weight control, your likelihood of long-term success increases greatly.
REVIEW POINTS
• Atkins is a lifetime approach to eating, not just a weight loss diet.
• Atkins is comprised of four progressively liberal phases.
• Curb your carb intake, and you convert your body to burning primarily fat for energy.
• When you begin to tap into your body’s fat stores, you foil the metabolic bully that normally blocks access to your fat stores.
• This metabolic adaptation, known as the Atkins Edge, provides a steady source of energy, helping control your appetite and eliminating or reducing carb cravings.
• You’ll lose water weight first on Atkins, as you do on any weight loss diet, but fat loss will quickly follow.
• Consuming a modest amount of salt eliminates or moderates symptoms that may accompany the diet’s diuretic effect and the metabolic shift to burning fat.
• The amount and quality of the carbohydrate foods you eat impact the amount of insulin in your bloodstream.
• Fat is easily stored in your body, but there is limited storage space for carbohydrate, so any excess converts to fat.
Now let’s meet Janet Freedman, who is slim for the first time in her adult life.
SUCCESS STORY 2
SUCCESS AT LONG LAST
From age 7, when she was seriously injured in an accident, the artist and author Janet Freedman had struggled with her weight. After spending months in bed being stuffed with food—including daily milk shakes to heal her bones—she emerged as a chunky little girl who grew into a chunky woman. But that’s now history.
VITAL STATISTICS
Current phase: Ongoing Weight Loss
Daily Net Carb intake: 30 grams
Age: 64
Height: 5 feet, 3 inches
Before weight: 157.5 pounds
Current weight: 132.5 pounds
Weight lost: 25 pounds
Current blood pressure: 110/70
Former triglycerides: 181
Current triglycerides: 83
Former HDL (“good“) cholesterol: 41 mg/dL
Current HDL (“good”) cholesterol: 54 mg/dL
What was your first effort to slim down?
I began the “old” Weight Watchers when I was 19. I lost the excess weight but remember lying in bed at night unable to sleep because my stomach hurt from hunger. Needless to say, I ultimately stopped the program and regained the weight I’d lost. Over many years I’ve tried a series of unsuccessful diets. Meanwhile, I gained additional weight during two pregnancies and even more as I aged. In 2004 I entered a study at the local hospital that focused on a low-calorie, low-fat diet (DASH) that included weekly educational meetings. I lost weight slowly but was hungry most of the time.
Did you have related health issues?
Yes. My cholesterol levels required increased medication, my joints ached, and I felt old and tired. I also wasn’t able to fully participate in the exercise component of the DASH diet due to my “bad knees and hips,” which my doctor attributed to arthritis. Both coronary artery disease and diabetes run in my family, and I thought it was just a matter of time.
What made you turn to Atkins?
At the end of the study, I continued to eat the low-fat, low-calorie way, maintaining my weight through extreme diligence. I still felt deprived, and in the last year I followed that diet, I lost only 4 pounds. Meanwhile, my cholesterol numbers, which were supposed to come down, kept climbing. A friend told me how she lost weight and improved her health on Atkins. Since I still wasn’t anywhere near a normal weight and I knew I couldn’t continue the low-fat torture any longer, I decided to try it.
How did you do?
I reached my goal weight in five months and then set a goal of another 5 pounds, which I’ve surpassed. I’ve been able to reduce my cholesterol medicine dose, and my dry skin has disappeared. My joints no longer ache, so I’ve been able to increase my exercise. I fully expect to see further improvement as I continue this amazing lifestyle. And I fit into size 8 pants, which I’ve never worn in my entire life!
What is your fitness regimen?
I started walking at home on a treadmill for five minutes at 1.5 miles per hour. As I’ve lost weight a
nd my knee and hip pain has decreased, I’ve doubled my speed and added an incline. I now walk for twenty to thirty minutes three or four times a week. Other days I ride a stationary bike, do a series of core exercises, and a short free-weight routine.
What were the worst things about being overweight?
People who are of normal weight have no idea of the agonies that young overweight people endure. I know that it left its mark on my self-esteem and confidence. All those continually unsuccessful diets only added to the pain.
What do you like about Atkins?
I love that it is healthy and sensible and promotes real food. The awful gnawing hunger disappears. Hunger has always made me abandon previous attempts to lose weight. No longer. When I went to my son’s destination wedding, I was surrounded by lots of empty-calorie, high-carb foods, but I wasn’t tempted, not even by the wedding cake. The excessive hunger and cravings are gone.
What words of wisdom can you offer other people?
Read everything you can about Atkins. Follow the guidelines, and give the plan two weeks to see what it can do for you. The Atkins Community will provide you with advice and support.
Anything else you want to add?
I got fat following the government’s advice. Now my body is telling me that this is the right way to eat and the advice I’d been getting for years was dead wrong.
Chapter 3
THE RIGHT CARBS IN THE RIGHT AMOUNTS
White flour is better suited to glue for kindergarten art projects than to nutrition. Refined grains and the insidious sweet “poison” known as sugar fuel the food-processing industry, but such products damage the health and quality of life of people who are struggling with carb overload.