Safety of Atkins Diet Questioned 38553

Safety of Atkins Diet Questioned

COPENHAGEN, Denmark--The trendy Atkins diet may not be idealdue to a multitude of reported side effects, increased risk of second-lineeventual cardiovascular disease and cancer, and lack of long-term clinicaltrials, according to a review published in the September issue of The Lancet(364, 9437:897-99, 2004) (www.thelancet.com).

According to Arne Astrup, Ph.D., the author of the review, the carbohydraterestriction of the Atkins diet may produce weight loss through ketosis andexcretion of water, while the high protein intake and limited food choices ofthe diet may create satiety and help curb energy intake, respectively.Paradoxically, these factors allow low carb dieters to eat a high fat, highprotein diet ad libitum yet lose weight, at least over the short term.Further, Astrup stated clinical evidence has shown weight loss on an Atkins-typediet is primarily attributable to depletion of fat stores rather than lean bodymass or water excretion, which is normally supported by beneficial changes incardiovascular risk factors.

However, Astrup questioned the safety of the diet since adherents havereported side effects including halitosis, muscle cramps, diarrhea, generalweakness and rashes. Further, the long-term effects of the diet on diseaseprevention are unknown, and the mechanisms by which the diet produces weightloss require clarification, Astrup added.

Restricted intake of carbohydrate-rich foods including fruits, vegetablesand grains may lead to long-term nutritional inadequacy and second-lineincreased risk of cardiovascular disease and cancer, said Astrup, who is alsoa medical adviser for Weight Watchers, Denmark.

However, Ronkonkoma, N.Y.-based Atkins Nutritionals Inc. begs to differ.

All of the studies to date--and there are currently 36 studies that lookat cardiovascular risk factors for up to one year--show improvements incardiovascular risk factors, said Colette Heimowitz, vice president ofeducation and research with Atkins Nutritionals Inc. Astrups comments areassumptions and we need to go by what the science has demonstrated, not by whatsomeone assumes will happen. And, after one year, those following the Atkinsdiet can begin to integrate a lot more vegetables and fruits into the plan.

Astrup called for further research to clarify the mechanisms by which theAtkins diet produces weight loss and long-term studies to assess the dietseffects on nutritional status, body composition, and fasting and postprandialcardiovascular risk factors as well as adverse effects.

There is an urgent need for longer and larger studies in obese andmoderately overweight individuals to assess weight-loss efficacy, with carefulassessment of energy balance and cardiovascular and diabetes risk factors,constipation, markers of kidney and bone health, nutritional adequacy, dietarycompliance and quality of life, Astrup said. Without such studies, Astrupconcluded, low carbohydrate diets cannot be recommended.

One year is the longest any dietary program has been studied to date,Heimowitz said. There are no studies longer than one year on anyprogram--including low fat. NIH [the National Institutes of Health] is currentlydoing a three-year study [on low carb dieting]. Im sure the study willreflect the long-term effects Dr. Atkins observed in his clinical practice for30 years. But scientists need to find it out for themselves.