by Westman, Dr. Eric C. ; Phinney, Dr. Stephen D. ; Volek, Dr. Jeff S.
Long-term success with weight maintenance has both practical and psychological components. Fortunately, you’ve already learned and practiced many of the skills necessary for this momentous task.
You’ve done it! You’ve reached the goal for which you’ve striven long and hard and proved that you have the persistence to realize your dreams. You’re now officially out of the weight loss phases of Atkins and into Phase 4, Lifetime Maintenance, aka the rest of your life. The very fact that you’ve found your ACE and reached your goal weight is proof that what you’ve been doing works for you. Keep it up—with certain modifications—and you should be able to extend that success. If you started Atkins to resolve such health issues as high blood sugar or insulin levels, hypertension, or unfavorable lipid levels, in addition to maintaining your new weight, you’ll obviously want to maintain your improvements in these markers as well.
Regardless of your health when you began Atkins, now is the time to revisit your health care provider. (If your weight loss journey has lasted more than six months, you may have already done so.) You’ll almost surely receive good news. Obviously you don’t need your physician to tell you that you’ve lost 30 pounds (or whatever), but you’ll likely discover that you’ve also scored some significant improvements in your health indicators. That news should relieve any lingering concerns you may have about the healthfulness of following a low-carb lifestyle.
As you well know, making these changes permanent is at least as challenging as achieving them. Success with weight maintenance has both practical and psychological components, and we’ll help you deal with both. Fortunately, whether or not you realize it, you’ve already learned and practiced many of the skills necessary for this momentous task. Think about it:
• You’ve developed a whole set of new habits.
• You’ve experienced the empowerment that comes with controlling what you put into your mouth.
• You know how many carbs you can consume without regaining weight.
• You can distinguish between empty carbs and nutrient-dense carbs.
• You understand why eating sufficient fat is key to appetite control and the Atkins Edge.
• You’ve learned how to distinguish between hunger and habit and between feeling satisfied and feeling stuffed.
• You recognize the signs that a certain food or pattern of eating triggers cravings.
• You’ve experienced the exhilaration of feeling good and full of energy.
Before you started your weight loss journey, we asked you why you would consider not doing Atkins when its benefits are so obvious. Now we ask you a similar question. Knowing what you now know and succeeding as you have, why would you ever go back to your old way of eating—letting sugars and other processed carbs bully your metabolism—which is almost sure to result in weight regain and the reemergence of health problems and self-esteem issues?
PROTECT YOUR WEIGHT LOSS, BUT MAINTAIN YOUR WEIGHT
Early in this book, we talked about the two definitions of the word “diet.” Now that you’ve lost that extra padding, it’s time to focus on the word’s primary definition: a way of living. Because your weight loss diet has smoothly morphed into your permanent lifestyle, there shouldn’t be any big surprises. The lessons that you’ve learned about which foods to eat in which amounts remain valid now that your goal is to hold steady.
You want to arrive at a place where you’re mindful of your weight but not obsessed with it. Weigh and measure yourself once a week. As you know, the scale may “lie,” thanks to natural day-to-day weight fluctuations within a four-pound range, but the measuring tape tends to be less variable. (For a review of weight averaging, see page 77.) If your measurements consistently increase and your clothes feel and look tight, it’s time to act. As long as you’ve gained no more than 5 pounds, simply drop down 10 to 20 grams of Net Carbs below your ACE and the extra pounds should retreat. But it’s not just a matter of weight. It’s equally important to stay alert for cravings, unreasonable hunger, lack of energy, and other familiar indicators that you may be veering away from your fat-burning safety zone and losing the Atkins Edge. All these may signal that you’re consuming too many carbs or that you’re sensitive to the effects of one or more recently added foods. As you adjust your intake accordingly, with every passing week you’ll get a better idea of your limits.
Now that you’re no longer trying to trim pounds and inches, you clearly need more energy from food sources since you’re no longer relying on your body fat for some of your fuel. Most people find that their appetite increases slightly as they approach their body’s healthy natural weight, even as they stay within their ACE. It’s important to understand that the extra fuel to keep your weight stable should come primarily from dietary fat so that you remain in a fat-burning mode. If you find that your weight is dropping below the desired level or experience fat hunger, you’ll need to allow a little more fat into your diet.
FAT REMAINS YOUR FRIEND
When you were losing, say, an average of 1 pound a week, each day you were burning about 500 Calories of your body fat for energy. As you transition into Lifetime Maintenance, your body doesn’t really care where your favorite fuel comes from hour by hour: inside—your stores of body fat—or outside—dietary fat. Say that you’re consuming 75 grams of Net Carbs per day (300 Calories) and 15 ounces of protein (roughly 400 Calories); together they add up to just 700 Calories. If you’re a five-foot, four-inch-tall woman and your body is burning 1,800 Calories a day, the other 1,100 Calories have to come from fat. Why not simply increase your protein intake instead? Because, as you learned in chapter 5, the amount of protein you’ve been eating all along is close to optimal, and more isn’t better. As for adding more carbs, once you’ve found your Atkins Carbohydrate Equilibrium (ACE), it’s likely to remain your upper limit for the foreseeable future.
If you ignore this advice and continue to add carbs beyond your ACE, you’ll soon be revisited by the same old demons of hunger and carb cravings. Overconsuming carbs only invites that metabolic bully back into your life. Your metabolism is already adapted to efficiently moving fat into your cells and using it for energy rather than storing it for later use, providing a sustained and predictable fuel supply. Perhaps you’ve noticed that once you’ve adapted to a low-carb diet and complying with your ACE, you can be an hour or two late for a meal and not feel desperate. How so? The answer is that even when you’re at your goal weight, you still have a couple of months’ worth of energy reserve tucked away as body fat. This means that your muscles, your liver, and your heart are getting a continuous, uninterrupted flow of energy directly from fat. Even your brain, which requires more than 500 Calories per day, gets much of its energy from fat. If you’ve banished 30 pounds of body fat since you started Induction, your body has burned off an awesome 100,000 Calories more than you ate. And there’s no reason your metabolism can’t continue that same burn rate for fat—keeping the Atkins Edge—as you maintain your new weight.
How can you add fat calories in a palatable way? Follow the meal plans for Pre-Maintenance, adding small portions of salad dressings, sauces, and spreads. Many cultures have used sauces, gravies, and meat drippings this way for millennia. For more ideas, see the sidebar “Delectable Choices” and check out the recipes for sauces in part III.) There’s no need to count fat grams or calories. Just let your taste and appetite dictate, without letting fat phobia get in your way. It may take a while to learn to trust your instincts. Fat has an inherent ability to satisfy your appetite and to keep you feeling satisfied longer than the same amount of carbohydrate. You’ll probably get a chuckle out of the fact that you, who once had a weight problem, now have to be careful not to go too far in the opposite direction.
DELECTABLE CHOICES
Add some of the following healthy fats to those you’ve been eating throughout your weight loss journey to maintain your goal weight without fat hunger or carb cravings. Each portion provides 100 or so Calories of healthy fat. The difference
in energy intake between OWL and Lifetime Maintenance for most people is somewhere between 300 and 500 Calories, so making this dietary transition is as simple as adding three to five of these portions to your existing daily intake. See the recipes in part III for more delicious choices.
• 1 tablespoon oil for dressing salads
• 1 tablespoon butter or herb butter/oil mix
• 1 ounce cream
• 2 ounces cheese
• 10 large ripe olives with a teaspoon of olive oil
• ½ Haas avocado
• 1 ounce almonds, walnuts, pecans, or macadamias
• 1 tablespoon mayonnaise (made with canola, high-oleic safflower, or olive oil)
• 2 tablespoons pesto
• 2 tablespoons nut butter
Here’s one more issue not to worry about. You may be concerned that you can’t digest all this fat. With the possible exception of someone who has had gallbladder surgery, this is not likely to be a problem. Why? Have you ever eaten a pint of ice cream at one time? Honestly now, the last thing on your mind back then was worrying that your digestive system couldn’t handle 75 grams of fat in less than an hour, right? Given that experience, why would you worry about whether it can handle 50 to 60 grams of fat as part of a whole foods meal?
CUSTOMIZING LIFETIME MAINTENANCE
Throughout this book, you’ve learned how the versatility of Atkins allows you to tailor the diet to your particular needs and preferences. You’ve already made many choices as you worked toward your goal weight. Likewise, there’s no one-size-fits-all maintenance program. The single most important decision that you’ll confront is this: What do I need to do to keep off the weight I’ve lost and maintain my health long term? From experience we’ve learned that you must do something different than you did in the past because maintenance doesn’t just happen.
You already know about the tremendous variation among individual ACEs, which enables some people to consume considerably more carbs each day than others without regaining weight or seeing the return of cravings, low energy, and other symptoms. Others find that they just feel better with a lower intake of carbs. Just as we’ve advised you to increase your overall carb intake—and the variety of carb foods—slowly in the weight loss phases, we want you to think carefully about your carb intake in Lifetime Maintenance. Rather than push yourself to a level that makes maintenance hard to sustain, you may be happier and more successful at a lower level. In fact, you may even find you’ll prefer to back down 5 or 10 grams from the ACE you achieved in Pre-Maintenance. Remember, the goal here is to banish the weight you’ve lost for good, not win some contest for having the highest ACE on the block!
HEALTH AND YOUR ACE
If you have a condition such as hypertension, diabetes, a high triglyceride level, or low HDL cholesterol level, all of which indicate a risk of developing cardiovascular disease, you may find that they’re better controlled if you remain at a lower level of carb intake than the ACE determined by your ability to maintain your weight. Rest assured, there’s no risk in staying between 25 and 50 grams of Net Carbs. This is particularly worth considering if you previously needed medication to control any of these conditions. Ask yourself two interlocking questions:
• Do I feel safer and better on the medication(s) ?
• Or do I feel safer and better on a diet that gives me equal or better control of this condition with less medication or none at all?
For some people, staying at or less than 50 grams per day of Net Carbs gives them a better long-term response to these conditions. If ongoing health issues require medication or you’ve experienced weight regain despite your best efforts, you may also want to reduce your ACE. In effect, your choice of foods can work like your medicine. (Depending upon how severe the condition, you may still be able to cut back on or eliminate your medication at a somewhat lower level of carb intake.) Your best approach to Lifetime Maintenance is to understand all of your options and keep them open as you move forward. If you have to work hard to maintain your weight at a higher ACE, you may later decide that it’s too stressful to do so. Or you may find that some of your health indicators have worsened. At that point, you might choose to reduce your carb intake to improve your life. Alternatively, if you’ve been able to maintain your weight for some time and/or your blood pressure, blood sugar, blood lipids, or other metabolic indicators remain in the low-risk range, you may consider gradually increasing your carb intake. Your ACE is never carved in stone, and you can raise or lower it as experience dictates.
TWO SUSTAINABLE PATHS
If you’ve done well with Atkins so far, you’ll very likely continue to do so by following one of two Lifetime Maintenance options: one at 50 grams of Net Carbs or less and the other above 50 grams. In either case, with the exception of omega-3s (such as fish oil or flaxseed oil), it’s best to continue to stay away from high-polyunsaturated-fat vegetable oils such as corn, soybean, sunflower, cottonseed, and peanut oils. Instead, focus on olive, canola, and high-oleic safflower oils. Also feel free to continue to eat saturated fats. Each option meets all of your energy and essential nutrient needs and can be tailored to your individual metabolism. It’s likely that you already have a pretty good idea which path is the one for you, based upon your metabolism, your ACE, and your experiences in OWL and Pre-Maintenance.
LIFETIME MAINTENANCE WITH AN ACE OF 50 OR LESS
The simplest description of this approach is Ongoing Weight Loss with a bit more variety and some additional fat. Here’s how to do it.
• Remain at the ACE you identified in Pre-Maintenance.
• Continue to eat the same healthy whole foods you’ve come to rely on:
—About 4 to 6 ounces of protein foods at each meal
—Enough healthy fats to keep you satisfied
—The right balance of fats
—At least 12 to 15 grams of Net Carbs from foundation vegetables
• Continue to consume 2 servings of broth (not low sodium), 2 tablespoons of soy sauce, or half a teaspoon of salt each day unless you’re taking a diuretic medication or your doctor has advised you to restrict salt.
• In addition to Acceptable Induction and OWL foods, continue to eat any Acceptable Pre-Maintenance foods you’ve been able to reintroduce. If you find it hard to eat moderate portions of any food, new or otherwise, or it causes cravings, stay away from it.
• If you still have indicators of metabolic syndrome or type 2 diabetes despite your weight loss, don’t keep increasing your carb intake. Instead, if you’re not satiated, try increasing your fat intake as described above. (For more on how Atkins addresses these health conditions, see part IV.)
• Follow the meal plans for OWL at the appropriate number of grams of Net Carbs, but add more healthy natural fats as your appetite dictates.
• Continue your multivitamin/multimineral and omega-3 supplements.
LIFETIME MAINTENANCE WITH AN ACE ABOVE 50
This path can be best described as your last month of Pre-Maintenance, again with a bit more fat. The main difference from the lower-carb path described above is that you can select from a broader range of carbohydratecontaining foods. With greater variety, however, comes a greater risk of temptation, so you may need to exercise extra vigilance to conform to your ACE. Here’s how to do it.
• Remain at the ACE you identified in Pre-Maintenance.
• Continue to eat the same healthy whole foods you’ve come to rely on:
—About 4 to 6 ounces of protein foods at each meal
—Enough healthy fats to keep you satisfied
—The right balance of fats
—At least 12 to 15 grams of Net Carbs from foundation vegetables
• Continue to add new foods as your ACE allows as long as they don’t stimulate excessive hunger and cravings. If they do, back off and try to reintroduce them at a later date. Stay away from any foods that provoke old bad habits.
• If you drop below your desired goal weight, increase your fat intak
e as described above.
• Broth or other ways to introduce salt are no longer necessary, but you may continue to consume them, if you prefer.
• Follow the Pre-Maintenance meal plans at your ACE but add more healthy natural fats as your appetite dictates.
• Continue your multivitamin/multimineral and omega-3 supplements.
Perhaps the best way to think of the two paths in Lifetime Maintenance is like a pair of fraternal twins. They share many similarities but have some significant differences, as summarized below.
DAILY INTAKE IN TWO LIFETIME MAINTENANCE PATHS
ACE
Above 50 Grams of Net Garbs
Below 50 Grams of Net Garbs
Foundation vegetables
Minimum 12–15 grams
Minimum 12–15 grams
Total daily protein
Women: 12–18 ounces
Women: 12–18 ounces
(meals plus snacks)
Men: 16–22 ounces
Men: 16–22 ounces
Healthy natural fats
As your appetite dictates
As your appetite dictates
Total grams of Net Carbs
50–100
25–50
Range of carbohydrate
Foundation vegetables
Foundation vegetables
foods possible
Nuts and seeds
Nuts and seeds
Berries and other fruits
Berries
Legumes
Other foods possible*
starchy vegetables*
Whole grains*
Broth/bouillon/salt
Optional
2 servings (unless you are hypertensive or on diuretic medication)
*If your ACE allows.
NEW TASTES, NEW HABITS
Now that you’ve slimmed down and shaped up, you may have found that other things are changing in your life as well. Perhaps your social life has improved. The downside, of course, is that social situations can test your resolve. As long as you don’t exceed your ACE, you should have the Atkins Edge in your corner, but you also need to learn strategies for coping with situations that crop up at work, when dining out or traveling, and more. To a large extent, your carbohydrate threshold, aka your ACE, will influence how you’ll address these “real-world” issues and situations, but don’t underestimate the importance of your mind-set.