Dr. Robert Atkins shook up the nutrition establishment in 1972 when he published "Dr. Atkins' Diet Revolution." In that book and others that followed, he asserted that dieters could lose weight eating bacon, eggs, steak and rich sauces. His low-carb diet has remained controversial even as its popularity has waxed and waned through the years.
Atkins died in 2003, and three other doctors have taken up his cause with an updated Atkins diet book, published last March. More than 300,000 copies of their book, "The New Atkins for a New You," are in print, according to publisher Fireside.
"The New Atkins" explains the four phases of the diet, starting with a two-week induction period that focuses on protein, fat and vegetables and strictly limits "net carbs." Readers are told how to gradually incorporate more carbohydrates into their diets until they reach a maintenance phase. The book includes dieter testimonials, recipes, menu plans and tips on changing behavior.
The updated book also addresses the science behind the low-carb diet. Drs. Eric C. Westman, Stephen D. Phinney and Jeff S. Volek cite medical studies — including their own — in arguing that the diet has benefits for those concerned about obesity, cardiovascular disease and Type 2 diabetes.
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Not everyone agrees. "The content of the diet is inconsistent with everything we know about a heart-healthy diet," says Dr. Robert Eckel, past president of the American Heart Assn. and a professor of medicine at the University of Colorado Anschutz Medical Campus. Eckel is concerned about "what's in it and what's not in it" — too much saturated fat and not enough fruits, vegetables and whole grains, he says.
We discussed the book and the diet with co-author Westman — an internist and director of the Duke Lifestyle Medicine Clinic in Durham, N.C. Our interview, edited for brevity and clarity, follows.
How did you get involved with the Atkins diet?
Back in the late 1990s, I was a doctor at the Veterans Affairs hospital here in Durham, N.C. A couple of my patients lost weight, and that was unusual because most of the time I spent telling people how to lose weight or sending them to my dietitian, it didn't work very well.
It piqued my curiosity to see that something had worked. My patients said, "It's just this little book; it's the Atkins diet." I got the book and thought, "This can't be good for you." One of my patients ate steak and eggs and vegetables and lost a lot of weight. The next time he came back, I checked his cholesterol because I was convinced it was going to be worse. And it was better.
So I wrote Atkins a letter. He called back and, after a brief conversation said, "Why don't you just come up and see the clinic?" We went for a day. We saw people were losing weight. We looked over the shoulder of one of the nurses and saw chart results getting better. And so we said, "Why don't you fund us to do a study in Durham at Duke University?" And they said OK.
What happened with the studies?
In a pilot study of 50 people over six months, there was good weight loss and improvements in blood cholesterol. But we said we really can't call this a done deal yet. We had to do a randomized trial to make sure there wasn't any bias in the study. We also wanted to be sure that it was a safe thing to do.
In our second study, 120 people were taught either a low-carb or a low-fat diet and followed for six months. Both groups showed improvements, but the low-carb diet did better for weight loss and metabolic syndrome [a cluster of medical factors that raises someone's heart disease risk]. That randomized trial was published in the Annals of Internal Medicine in 2004.
How did the book come about?
Along the way, I met Steve Phinney and Jeff Volek. We're all university professors — Steve published his first paper when I was in high school, and Jeff and I were the ones who went to Atkins in the late 1990s to ask him to fund research. When the Atkins company was thinking it wanted to redo the Atkins book with university professors, they got Steve and Jeff and myself together. We call it the "new Atkins" because essentially we're bringing in the science that Steve has done for 30 years and Jeff and I have done for about 15 years each.
In what ways is the book different from the original Atkins diet book?
Atkins didn't teach the "net carb" idea. That's bringing in the low-glycemic research from experts around the world who taught us that the fiber in the foods isn't really absorbed and has a negligible effect on the blood sugar. That opens up more options because people can have more vegetables early on.