Positive Health Online

A few years ago, the response I got when telling people my profession, was "What do you think of food combining?" Now, in the fickle world of food fashion, it is always the Atkins Diet that people seek my opinion on.

Dr Atkins and his diet has been the target of a great deal of criticism. But having studied the instructions for the diet, I find little to fault. The advice is to restrict carbohydrate intake to a minimal level and eat mainly protein from sources such as eggs, meat and fish.

Polyunsaturated oils are also included. Two daily cups of salad and one daily cup of vegetables are suggested. This restrictive stage is followed for a short period of time only, such as two weeks, before gradually introducing healthy carbohydrate foods in stages.

The Atkins philosophy has caused controversy because it goes against the healthy eating advice which we have been used to over the last few decades. We were told that carbohydrates such as bread, pasta, grains and potatoes should form around 70 per cent of the diet, with fat and protein responsible for the remainder.

Carbohydrate foods, if unrefined, are beneficial foods. They are high in fibre and a rich source of B vitamins. However, in my practice I see increasingly large numbers of people who tend to put on weight easily, suffer cravings for sweet foods and experience abdominal bloating. These people seem to thrive on a lower intake of carbohydrates. How can this be?

Reducing carbohydrate intake reduces production of the hormone insulin. Insulin is produced by the pancreas in response to eating carbohydrates and its function is to lower blood sugar levels. One way it does this is by converting sugar into glycogen, which is stored in the liver. Excess sugar will be converted to fat by insulin and laid down in the body cells.

Diabetics have faulty insulin production and consequently, high blood sugar levels. But there appear to be an increasing number of people for whom insulin poses a problem which is not detectable by conventional medical testing. The incorrect quantity of insulin is produced, or it is produced too slowly or too quickly or the body is resistant to the insulin. The result is fluctuating blood sugar levels and the associated symptoms of food cravings, irritability and weight gain. Bingeing on sweet foods leads to further insulin surges and weight gain.

When insulin converts sugar into fat, it is particularly laid down around the abdominal area. Dr Kristen Newby who led a study on the effects of white bread consumption on waist measurement[1] says, "I think abdominal fat cells may be more sensitive to the effects of insulin than other fat cells in the body".

The conventional view of weight loss is that if you take in more calories than you burn up you will put on weight. If you eat excess sugar it will be turned into fat by insulin. But this theory does not take into account individual metabolic differences. Atkins addresses this. In the 'ongoing weight loss' phase of the diet, you are encouraged to work out what your own personal right intake of carbohydrates should be in order to avoid weight gain. According to the Atkins creed, each person's maximum intake of carbohydrates is different, even taking into account levels of activity, age and sex.

So, in theory, the Atkins Diet looks like a good idea. If followed properly, the diet is done in several stages, with the very restricted carbohydrate intake stage lasting for only two weeks or so. After this comes the gradual re-introduction of more and more healthy carbohydrates and incorporating supplements.

The problem is that many of the 'post Atkins' people that I see in my practice do not have the motivation or understanding to take on board the full Atkins programme. Looking for a shortcut to fast, effective weight loss, the temptation is to grasp onto the appealing principles of the diet which are to indulge freely in fat and protein foods so long as carbohydrates are avoided. Many of the people I see who have been on Atkins do not eat the suggested daily allowance of three cups of salad and vegetables and they are consuming high quantities of red meat and fatty foods. It is then that critics of Atkins find themselves vindicated.

Simon, a 28 year-old IT consultant came to see me after successfully losing two stone on the Atkins Diet. Before starting the diet he had symptoms of blood sugar imbalance, including cravings for bread which disappeared on the diet. However, he felt lethargic and constipated.

I recommended that Simon maintain a high protein, low carbohydrate diet, but emphasized vegetable protein. As well as limited animal protein from lean meat and fish, he was to increase consumption of protein from tofu, seeds, nuts and soya milk. This type of vegetable protein does not come with the saturated fat content of many animal products and is less constipating.

To help him monitor his carbohydrate intake, I gave Simon a simplified chart which lists the carbohydrate content of foods. Vegetables and fruit would still be included in his diet, taking care to avoid the ones with particularly high carbohydrate indices, such as sweet potatoes and bananas. Rye bread, which stimulates less insulin production compared to wheat bread, was introduced. A totally carbohydrate free lunch led to a significant increase in energy and alertness in the afternoon. His energy boost inspired him to start exercising.

Forty-one years-old Karen had also achieved a weight loss of two stone on the Atkins Diet. But she had very dry skin and aching joints.

The likely explanation for this was that she had not paid enough attention to the content of essential fatty acids in her diet from sources such as nuts, seeds and a daily dose of flax oil. Most of her fats had been saturated fats from fatty meats, butter and cream which are allowed in abundance on the Atkins Diet.

With the help of the carbohydrate counter, Karen introduced healthy carbohydrate foods back into her diet. She lost a further half stone in six weeks and her skin improved.

Once again, this goes to show that changing one's diet, particularly if it involves drastically reducing a whole food group, is a complicated process which involves thought and often the advice of a professional to get it right and avoid potential health problems.

Reference

1 Newby PK, et al. Dietary patterns and changes in body mass index and waist circumference in adults. American Journal of Clinical Nutrition. 77 (6): 1417-25. 2003.