How Safe Is the Atkins Diet?

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kidney disease, and even osteoporosis,” says Neal Barnard, MD, president of the Physicians Commission for Responsible Medicine, a nonprofit research group based in Washington. “The weight loss you see in low-carb diets isn’t all that much better than what you see in studies of low-fat, Atkins may not be as bad for heart health as previously believed. These stories were sparked in part by a recent study from researchers at Duke University showing most people who ate a high-protein, low-carb diet for six months lost 20 pounds.

That much was expected. What wasn’t expected was that the researchers didn’t see strong evidence of the diet causing any health problems. In fact, both breakfast every day is fun, but day after day of only meat and fat at every meal can get tiresome,” says Anderson.

So therein lies the controversy. On one hand you have lots of stories of significant weight loss on a relatively user-friendly diet. On the other, you have dietitians and nutritionists who maintain that the weight loss produced is short-term and can threaten a person’s overall health, despite the fact that the weight loss itself may have the beneficial effect of lowering cholesterol.

Who is right? Maybe both sides. It provides weight loss at a very high cost to overall health, or at least that has been the prevailing medical opinion.

“There have been reports in the medical literature that say that this low-carb diet may not be as bad as we thought,” says Susan Barr, registered dietitian in New York City. “That makes people interested again in this diet, but until there is more research on what stresses the diet places on the body, there is no way to know what it might be doing besides providing short-term weight loss.”

But Is It Safe?

According to the American Dietetic Association, low-carbohydrate diets trigger short-term weight loss through a process called ketoacidosis, a state similar to that of diabetes. This type of diet can trigger weight loss, but it can have the kinds of negative long-term effects on health that Barnard mentions.

The other big question is whether low-carb weight loss lasts.

James Hill, PhD, is director of the Center for Human at the University of Colorado Health Sciences Center in Denver. He runs the National Weight Control Registry that includes information on the diets of more than 2,600 people who maintained at least a 30-pound weight loss for a year or more.

What the registry shows, according to Hill, is that less than 1% had followed a diet similar to the Atkins program. Most followed high-carbohydrate, low-fat diets.

But a new, long-term study may resolve the risk-benefit question for low-carb diets.

The Atkins diet has never been evaluated in a large, randomized controlled trial — the only type of study that convinces doctors that something works, or doesn’t — until now. The National Center for Complementary and Alternative Medicine is funding such a study. Gary Foster, PhD, a with the University of Pennsylvania’s Eating Disorders Clinic is heading this new study to assess the short-term and long-term effects of the Atkins diet in 360 obese men and women.

According to Foster, study participants will be randomly assigned to the Atkins diet (low-carbohydrate, unlimited fat and protein) or a conventional high-carb, low-fat diet. When the study is complete, Foster and his colleagues will have gone a long way toward answering the nagging questions about Atkins and other low-carbohydrate diets.