Atkins Facts
by Michael Greger, M.D.
Reprinted from Dr. Greger's free monthly newsletter:
Latest in Human Nutrition, June 2004 (Vol. 2 Issue 6)
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When Dr. Atkins Diet Revolution was first published, the
President of the American College of Nutrition said, "Of all the
bizarre diets that have been proposed in the last 50 years, this is the
most dangerous to the public if followed for any length of time."[1]
When
the chief health officer for the State of Maryland,[2] was asked
"What's wrong with the Atkins Diet?" He replied "What's wrong with...
taking an overdose of sleeping pills? You are placing your body in
jeopardy." He continued "Although you can lose weight on these
nutritionally unsound diets, you do so at the risk of your health and
even your life."[3]
The Chair of Harvard's nutrition department
went on record before a 1973 U.S. Senate Select Committee investigating
fad diets: "The Atkins Diet is nonsense... Any book that recommends
unlimited amounts of meat, butter, and eggs, as this one does, in my
opinion is dangerous. The author who makes the suggestion is guilty of
malpractice."[4]
The Chair of the American Medical
Association's Council on Food and Nutrition testified before the Senate
Subcommittee as to why the AMA felt they had to formally publish an official condemnation
of the Atkins Diet: "A careful scientific appraisal was carried out by
several council and staff members, aided by outside consultants. It
became apparent that the [Atkins] diet as recommended poses a serious
threat to health."[5]
The warnings from medical authorities
continue to this day. "People need to wake up to the reality," former
U.S. Surgeon General C. Everett Koop writes, that the Atkins Diet is
"unhealthy and can be dangerous."[6]
The world's largest
organization of food and nutrition professionals,[7] calls the Atkins
Diet "a nightmare of a diet."[8] The official spokesperson of the
American Dietetic Association elaborated: "The Atkins Diet and its
ilk--any eating regimen that encourages gorging on bacon, cream and
butter while shunning apples, all in the name of weight loss--are a
dietitian's nightmare."[9] The ADA
has been warning Americans about the potential hazards of the Atkins
Diet for almost 30 years now.[10] Atkins dismissed such criticism as
"dietician talk".[11] "My English sheepdog," Atkins once said, "will
figure out nutrition before the dieticians do."[12]
The
problem for Atkins (and his sheepdog), though, is that the National
Academy of Sciences, the most prestigious scientific body in the United
States, agrees with the AMA and the ADA in opposing the Atkins Diet.[13] So does the American Cancer Society;[14] and the American Heart Association;[15] and the Cleveland Clinic;[16] and Johns Hopkins;[17] and the American Kidney Fund;[18] and the American College of Sports Medicine;[19] and the National Institutes of Health.[20]
In
fact there does not seem to be a single major governmental or nonprofit
medical, nutrition, or science-based organization in the world that
supports the Atkins Diet.[21] As a 2004 medical journal review
concluded, the Atkins Diet "runs counter to all the current
evidence-based dietary recommendations."[22]
A 2003 review of
Atkins "theories" in the Journal of the American College of Nutrition
concluded: "When properly evaluated, the theories and arguments of
popular low carbohydrate diet books... rely on poorly controlled,
non-peer-reviewed studies, anecdotes and non-science rhetoric. This
review illustrates the complexity of nutrition misinformation
perpetrated by some popular press diet books. A closer look at the
science behind the claims made for [these books] reveals nothing more
than a modern twist on an antique food fad."[23]
There is nothing new or revolutionary about Dr. Atkins
New Diet Revolution. Various high-fat diet fads like Atkins have been
masquerading under different names for over a hundred years, starting
in 1864 when an English undertaker and coffin maker by the name of
William Banting wrote a book called Letter on Corpulence.[24] Based on
what we know now about these diets, Banting's book may very well have
added to Banting's business.
After failing to produce the
promised sustained weight loss, the high-fat fad melted away only to
re-emerge in the 1920's with a doctor advocating a minimum of three
porterhouse steaks a day and stating that the only two perfect foods
were probably "fresh fat meat and water."[25] It then disappeared until
the 1940's with a book extolling the virtues of eating whale blubber.
Then it was recycled again in the 1960's with Dr. Herman Taller's
bestseller "Calories Don't Count" that discouraged people from
exercising. "By whatever name," one nutrition textbook reads, "the diet
is to be avoided."[26]
Taller's "Calories Don't Count" diet
empire collapsed when he was found guilty of six counts of mail fraud
for using the book to promote a particular brand of safflower capsules,
which the court called a "worthless scheme foisted on a gullible
public."[27]
That same year, Dr. Irwin Stillman wrote the
"Doctor's Quick Weight Loss Diet," allowing his patients to eat only
meat, eggs, and cheese. Stillman himself died of a heart attack, but
not before misleading 20 million people onto his diet.[28]
One
might wonder why, if this kind of diet was such a "foolproof"[29]
"ultimate"[30] path to "permanent joyful weight loss" that "WORKS 100%
OF THE TIME!" (emphasis in original),[31] they seemed to always quickly
fade into obscurity, only to be resurrected shortly after by publishers
guaranteed a new bestseller by America's short attention span. This
brings us to 1972, and the publication of Dr. Atkins Diet
Revolution.[32]
Atkins' diet was centered on fried pork rinds,
heavy cream, cheese, and meat. For Atkins, bacon and butter were health
foods and bread and bananas were what he called "poison."[33]
Drawing
on his experience as a salesman and resort entertainer, Atkins proved a
natural at self-promotion. He was featured in Vogue magazine (and hence
the Atkins Diet was actually first known as the "Vogue Diet") and soon
after evidently appeared on the Tonight Show[34] and Merv Griffen.[35]
In 1973, the publisher boasted that it became the "fastest selling book
in publishing history."[36]
The final chapter of Dr. Atkins
Diet Revolution was entitled "Why We Need a Revolution...." It detailed
his proposal to have some carbs literally banned. "Our laws must be
changed to provide a proper way of eating for everyone." He urged
everyone to start lobbying their legislators. "Political action and
protest on your part," he wrote, "can help revolutionize the food
industry, by forcing it to decarbohydratize many foods ... with a
federal law to back this change!"[37]
"Martin Luther King had a dream," Dr. Atkins wrote, "I, too, have one."[38]
Allowing a good 20 years for dieters to forget Dr. Atkins
past failure, the book was reissued as Dr. Atkins New Diet Revolution
(though there was not much new about it) in 1992.[39] Along with other
retro 70's fashions, and this time backed by an aggressive marketing
campaign, it became the best-selling fad-diet book in history[40]
achieving "fashion-cult status amongst society figures."[520]
What
may have truly made it "The Diet Fad of the 21st Century" (as an editor
of the Journal of the American Dietetics Association coined it)[41]
came a decade later with the publication of the infamous pro-Atkins New
York Times Magazine article "What If It's All Been a Big Fat Lie."[42]
Atkins quickly wrote an editorial for his Web site claiming the article
"validated" his work. Gushingly favorable follow-up stories appeared on
NBC's Dateline, CBS' 48 Hours, and ABC'S 20/20. The Atkins corporation
claimed literally billions of media hits.[43] By the time the article's
many flaws
were exposed weeks later, the book had already catapulted to #1 on a
New York Times bestseller list and Atkins' net worth zoomed to $100
million.[44]
The piece was written by freelance writer and
Atkins advocate[45] Gary Taubes (who reportedly scored a book deal from
it--and a $700,000 advance).[46] The Washington Post investigated his
pro-Atkins article and found that Taubes simply ignored all the
research that didn't agree with his conclusions.
Taubes
evidently interviewed a number of prominent obesity researchers and
then twisted their words. "What frightens me," said one, "is that he
picks and chooses his facts.... If the facts don't fit in with his
yarn, he ignores them."[47]
The article seemed to claim that
experts recommended the diet. "I was greatly offended at how Gary
Taubes tricked us all into coming across as supporters of the Atkins
Diet," said John Farquhar, a Professor Emeritus of Medicine at
Stanford. When the Director of the Center for Human Nutrition at the
Washington University School of Medicine was asked to comment of one of
Taubes' claims, he replied, "It's preposterous."[48]
"He took this weird little idea and blew it up," said Farquhar, "What a disaster."[49]
"The
article was written in bad faith," said another quoted expert. "It was
irresponsible."[50] "I think he's a dangerous man. I'm sorry I ever
talked to him." Referring to the book deal, "Taubes sold out."[51]
What
the researchers stressed was how dangerous saturated fat and meat
consumption could be, but Taubes seemed to have conveniently left it
all out. "The article was incredibly misleading," said the pioneering
Stanford University endocrinologist Gerald Reaven who actually coined
the term Syndrome X. "I tried to be helpful and a good citizen," Reaven
said, agreeing to do the interview, "and I ended up being embarrassed
as hell. He sort of set me up... I was horrified."[52]
The majority of the best-selling diet titles in history
have been sold during just the last 5 years.[53] One of the latest
steak oil salesmen is Dr. Agatston, whose South Beach Diet appeared a
year after Atkins' latest and sold its first million copies in just 2
months.[54] Currently, subscriptions to his website alone bring in a
million dollars a week.[55]
The Tufts University Health and Nutrition Letter weighed in
on the South Beach Diet in their May 2004 issue: "Disappointingly, the
South Beach Diet is simply yet another version of a fad wrapped within
a gimmick." They concluded that it was "based on fallacies... replete
with faulty science, glaring nutritional inaccuracies, contradictions,
and claims of scientific evidence minus the actual evidence."[56]
The article
notes, "The faulty and confusing science is compounded by The South
Beach Diet's own internal inconsistencies."[57] Up front, for example,
the author says that his diet doesn't depend on exercise, but then goes
on to tell people to get 20 minutes a day.[58] He tells readers to
avoid bananas in "phase 2"; then goes on to recommend: bananas dipped
in chocolate sauce. He says up front that the diet is "distinguished by
the absence of calorie counting or even rules about portion size" and
that one shouldn't "even think about limiting the amount you eat." He
then, of course, proceeds to count calories and measure out servings
every step of the way, even to the point of specifying "I recommend
counting out 15 almonds or cashews."[59] That sounded like a rule about
portion size to the reviewers.
Tufts lists
a few of the "out-and-out food and nutrition inaccuracies" in The South
Beach Diet.[60] Agatston says that whole-wheat bread is not whole
grain, but cous cous is (actually the reverse is true). He claims
watermelon is full of sugar but cantaloupe is not (they have the same
amount). For a cardiologist who claims, "I feel nearly as comfortable
in the world of nutrition as I do among cardiologists,"[61] Dr.
Agatston "sprinkled an awful lot of nutrition gaffes throughout his
book."[62] He claims eggs have minimal saturated fat--wrong. Each egg
can have as much as 2 grams,[63] giving some of his recipes over a
third of one's daily limit.[64]
To be fair, though, he does
frown on lard, although the Atkins corporation is quick to point out
that the South Beach menus do not have significantly less saturated fat
than Atkins.[65] Just as Atkins himself claimed he followed his diet
for decades yet, according to his own cardiologist, was overweight,[66]
Agatston revealed that he needs to take medication to lower his
cholesterol.[67] Agatston, at least, doesn't call fruit "poison."[68]
One of Dr. Atkins' dreams probably came true--he likely
became a billionaire before he died. The Atkins corporation is now
estimated to be worth billions of dollars.[69] In Family Practice News,
one doctor writes, "Unfortunately, Dr. Robert C. Atkins, who made a lot
of money playing on the ignorance of Americans, knew about as much
about nutrition as an Arkansas hog knows about astronomy."[70]
Of
course, pigs--in Arkansas and elsewhere--have presumably little use for
astronomy. It doesn't seem like too much to ask, however, that
cardiologists like Dr. Atkins know something about nutrition.
The
entire theoretical framework of low carb diets, like Atkins and The
Zone, hang upon the notion that insulin is the root of all evil and so
to limit insulin release one needs to limit carbohydrate intake. Dr.
Atkins, for example, has a chapter entitled "Insulin--The Hormone That
Makes You Fat,"[71] Protein Power calls it the “monster
hormone,”[487] and the author of the Zone Diet calls insulin "the
single most significant determinant of your weight."[72]
What
they overlook is that "protein- and fat-rich foods may induce
substantial insulin secretion" as well.[73] Research in which study
subjects served as their own controls, for example, has shown that
under fasting conditions a quarter pound of beef raises insulin levels
in diabetics as much as a quarter pound of straight sugar.[74]
Atkins'
featured foods like cheese and beef elevated insulin levels higher than
"dreaded" high-carbohydrate foods like pasta. A single burger's worth
of beef, or three slices of cheddar, boosts insulin levels more than
almost 2 cups of cooked pasta.[75] In fact a study in the American
Journal of Clinical Nutrition found that meat, compared to the amount
of blood sugar it releases, seems to cause the most insulin secretion
of any food tested.[76]
Low carb advocates like Atkins seem to
completely ignore these facts. Recent medical reviews have called
Atkins' feel-good theories "factually flawed"[77] and "at best
half-truths."[78] "In the scientific world, books like the Zone Diet
are generally regarded as fiction," one reviewer wrote in the Journal
of the American College of Nutrition. "The scientific literature is in
opposition..."[79] In a medical journal article entitled "Food Fads and
Fallacies," the Atkins Diet is referred to as a "'New wives' tale" with
a "sprinkling of fallacies."[80]
According to a 2003 article
in the Journal of the American Medical Association, "Dr. Atkins and his
colleagues selectively recite the literature" to support their
claims.[81] When researchers take the time to actually measure insulin
levels, for instance, instead of just talking about them like Atkins
does, they often find the opposite of what Atkins asserted.
A
study done at Tufts, for example, presented at the 2003 American Heart
Association convention, compared four popular diets for a year. They
compared Weight Watchers, The Zone Diet, the Atkins Diet (almost no
carbs), and the Ornish Diet (almost all carbs) for a year. The insulin
levels of those instructed to go on the Ornish diet dropped 27%. Out of
the four diets that were compared that year, Ornish's vegetarian diet
was the only one to significantly lower the "Monster" "Hormone That
Makes You Fat," even though that's supposedly what Atkins and The Zone
diets were designed to do.[82]
In another study researchers took over a hundred pairs of identical twins and found that the more fat they ate, the higher
their resting insulin levels were. Even with the same genes, the study
"showed a consistent pattern of higher fasting insulin levels with
intake of high-fat, low carbohydrate diets."[83]
Other studies
show that a high (70-85%) carbohydrate diet (combined with walking an
average of 15-30 minutes a day) not only can result in significant
reductions in body weight, blood pressure, cholesterol and
triglycerides, but significant drops in baseline insulin levels as
well, exactly the opposite of what low carb pushers would predict. In
just three weeks on a high (unrefined) carb vegetarian diet and a few
minutes of daily walking, diabetics reduced the amount of insulin they
needed and most of the pre-diabetics seemed cured of their insulin
resistance.[84] In general vegetarians may have half the insulin levels
of nonvegetarians even at the same weight.[85]
In an article
entitled "Americans Love Hogwash," Edward H. Rynearson, Emeritus
Professor of Medicine at the Mayo Clinic, singled out Dr. Atkins for
dispensing hogwash he defines as "worthless, false or ridiculous speech
or writings" and praised the AMA for "condemning this diet for its
dangers."[86] The "evidence" cited by Atkins has been called "nearly
all anecdotal and misleading."[87] "Carbophobia is a form of
nutritional misinformation," a 2003 review in the Journal of the
American College of Medicine noted, "infused into the American psyche
through... advertising... infomercials... and best-selling diet
books."[88]
"When unproven science becomes a sales pitch,"
declared a spokesperson for the American Institute for Cancer Research
about low carb diets, "some people get rich and the rest of us get
ripped off."[498]
We know that the Atkins Diet is successful--at
making money. What about for weight loss? We know that cutting down on
carbs will help people lose variety and nutrition in their diet,[89]
and if they buy his supplements, their wallet may get slimmer, but what
about their waistline?
Who cares if the American Medical Association
calls Atkins's theory "naive," "biochemically incorrect," "inaccurate,"
and "without scientific merit?" Who cares if it "doesn't make
physiological sense?"[90] The question is, does it work?
Carbohydrates burn cleanly. In fact the name "carbo-
hydrate" basically means "carbon (dioxide) and water," which is what
plants make carbs out of, and which is all the waste product one is
left with when one's body uses them as fuel. During the first few weeks
of the Atkins Diet, the so-called "induction" phase, a person is forced
to live off so much grease that, lacking the preferred
fuel--carbohydrates--their body goes into starvation mode.
In
biochemistry class, doctors learn that fat "burns in the flame of
carbohydrate." When one is eating enough carbohydrates, fat can be
completely broken down as well. But when one's body runs out of carb
fuel to burn, its only choice is to burn fat inefficiently using a
pathway that produces toxic byproducts like acetone and other so-called
"ketones." The acetone escapes through the lungs--giving Atkins
followers what one weight-loss expert calls "rotten-apple
breath"[91]--and the other ketones have to be excreted by the kidneys.
We burn fat all the time; it's only when we are carbohydrate deficient
and have to burn fat ineffectively that we go into what's called a
state of ketosis, defined as having so much acetone in our blood it
noticeably spills out into our lungs or so many other ketones they
spill out into our urine.
To wash these toxic waste products
out of our system our body uses a lot of water. The diuretic effect of
low carb diets can result in people losing a gallon of water in pounds
the first week.[92] This precipitous early weight loss encourages
dieters to continue the diet even though they have lost mostly water
weight[93] and the state of ketosis may be making them nauseous or
worse.[94] If one wanted to try to lose water weight, sweating it away
in a sauna may be a more healthful way.
The Director of Yale
University's Center for Eating and Weight Disorders explains the
miracle formula used by diet books to become bestsellers for over a
century now: "easy, rapid weight loss; the opportunity to eat your
favorite foods and some scientific 'breakthrough' that usually doesn't
exist."[95] The rapid loss of initial water weight seen particularly on
low carb diets has an additional sales benefit. By the time people gain
back the weight, they may have already told all their friends to buy
the book, and the cycle continues. This has been used to explain why
low carb diets have been such "cash cows" for publishers over the last
140 years.[96] As one weight loss expert notes, "Rapid water loss is
the $33-billion diet gimmick."[97]
When people do lose weight on the Atkins Diet after the
first few weeks, it's almost certainly because they are eating fewer
calories.[98] People lose weight on the Atkins Diet the same way they
lost weight on the 1941 Grapefruit Diet, the 1963 Hot Dog Diet, the
2002 Ice Cream Diet and every other fad diet promising a quick fix--by
restricting calories.
In 2001, the medical journal Obesity
Research published "Popular Diets: A Scientific Review." Claiming to
have reviewed every study ever done on low carb diets, they concluded,
"In all cases, individuals on high-fat, low carbohydrate diets lose
weight because they consume fewer calories."[99] Calories count--every
time, all the time. "No magic ingredients, strange food combinations or
pseudoscientific formulas will alter this metabolic fact."[100]
Dr.
Atkins disagreed. In fact, he accused his critics of having "subnormal
intellects" for even holding such a view.[101] For three decades he
peddled his claim that people could eat more calories and still lose
weight. Decrying what he called the "calorie hoax," Atkins had a
chapter entitled "How to Stay Fat--Keep Counting Calories." Atkins even
subtitled his book "The High Calorie Way to Stay Thin Forever." The
Zone Diet made a similar claim on its back cover: "You can burn more
fat by watching TV than by exercising."[102] (As one commentator
exclaimed, "Goodness, what channel does he watch!")[103]
Atkins
claimed people could lose 85 pounds, without exercising, eating an
incredible 5,500 calories a day.[104] The only problem, critics
claimed, was that this ran counter to the First Law of Thermodynamics,
considered to be the most fundamental law in the universe. No wonder
the AMA scolded Atkins publishers for promoting "bizarre concepts of nutrition and dieting."[105]
Atkins claimed that the key to the so-called "calorie
fallacy" was that the missing calories were explained by the excretion
of ketones. Dieters in ketosis, he argued, urinate and breathe out so
many calories in the form of ketones that "weight will be lost even
when the calories taken in far exceed the calories expended." He
claimed dieters could "sneak" calories out of the body unused.[106]
The
"Atkins Physician Council" also claims that one's body expends more
energy burning fat and thus "You wouldn't have to increase your
exercise at all because your body would be working harder, so that you
could literally sit in your armchair and lose weight."[107] As the
Secretary of the AMA's Council on Food and Nutrition tried to make
clear, "The whole [Atkins] diet is so replete with errors woven
together that it makes the regimen sound mysterious and magical."[108]
These
claims sounded so far-fetched that as part of an investigative
documentary, the BBC paid obesity researchers to design an experiment
to test it. So researchers took two identical twins and put one on the
Atkins Diet for a while, the other on a high carbohydrate diet and
locked them both in sealed chambers to measure exactly where the
calories were going. Did the twin on the Atkins Diet have any sort of
metabolic "advantage" by burning fat and protein as his source of fuel?
Was he literally flushing more calories down the toilet? Of course not.
"We found no difference whatsoever," the researcher said.[109]
As
the evidently "subnormal intellects" at the AMA concluded, "No
scientific evidence exists to suggest that the low carbohydrate
ketogenic diet has a metabolic advantage over more conventional diets
for weight reduction."[110] The only comprehensive systematic review
ever done of low carb diets found that the carbohydrate content of the
diet seemed in no way correlated with weight loss.[111] The truth seems
to be that nothing matters more than calories when it comes to weight
loss.[112] According to the director of nutrition at the Center for
Science in the Public Interest, "This whole ketosis thing is just a
gimmick to make people think there's something to blame for weight gain
and some magic solution to take it off. That's the beginning and end of
it."[489]
But what about all the scientific studies Dr. Atkins
cited in his book to back up his claims? Although his first book had
essentially no citations, by the final edition he listed over 300.[113]
Reviewing all of the studies on low carb diets, researchers concluded,
"The studies by Atkins to support his contentions were of limited
duration, conducted on a small number of people, lacked adequate
controls and used ill-defined diets."[114] Most importantly, though,
some of the very studies he cites actually refute exactly what he's claiming. And he accused the AMA of being "intellectually dishonest."[115]
Of
the few studies that did back up his claims, some had seriously
questionable validity[116] and researchers could not replicate the
findings of the rest.[117-134] One review of studies that have defended
Atkins claims concluded, "It turns out that when these data are
critically analyzed they are often found to be in error, and it's
therefore impossible to accept the validity of the conclusions derived
by the authors from such erroneous data."[135]
People lost weight on low carb diets the way everybody loses weight on any diet--by eating fewer calories.[136]
The Atkins Diet restricts calories by restricting
choices. If all one did was eat Twinkies, one could lose weight (unless
one were able to consistently force oneself to eat more than a dozen a
day). But would one's overall health be better or worse for it? In
essence, the Atkins Diet is not much different than the Twinkie Diet.
Americans
get half of their energy from carbohydrates,[137] so if people cut out
half the food they eat, what they are left with is calorie restriction.
Yes, one can eat unlimited amounts of fat on the Atkins Diet, but
people typically can't stomach an extra two sticks of butter's worth a
day to make up for the calorie deficit. Since so many foods are taboo,
people end up eating less out of sheer boredom and lack of variety. As
one obesity researcher put it, "If you're only allowed to shop in two
aisles of the grocery store, does it matter which two they are?"[138]
Yes,
all the butter one can eat, but no bread to put it on. All the cream
cheese, but no bagels. Sour cream, but no baked potato. Sandwich
lunchmeat, but, of course, no sandwiches. All the pepperoni one can
eat, but no pizza crust. Cheese, but no mac.
In later phases
of the diet, with less carb restriction, Atkins throws in a thin wedge
of cantaloupe--wrapped in ham, of course.[139] Having all the
mayonnaise one can eat only goes so far.
On the Atkins Diet
one can eat steak, but no potatoes--and watch the gravy (it may have
corn starch in it). All the shortening one can eat, just no making
cookies with it. Eat all the burgers one wants; you just can't put them
on buns, no fries--and "beware of ketchup."[140]
Atkins
described how to make cheeseburgers without the bun: "I put all the
meat on the outside... put the cheese on the inside... The cheese melts
on the inside and never gets out."[141]
Although his recipe
for "hamburger fondue,"[142] combining burger meat, blue cheese, and
butter, might top the cheeseburger recipe for heart disease risk, the
prize would probably go his recipe for "Swiss Snack,"[143] which
consists of wrapping bacon strips around cubes of Swiss cheese and deep
frying them in hot oil. The recipe, which supposedly serves one, calls
for four strips of bacon and a quarter-pound of cheese.
Atkins
rivals the creativity of the raw-food chefs of today in his uses for
pork rinds. Pork rinds are chunks of pigs’ skin that are deep-fried,
salted and artificially flavored. He recommends people use them to dip
caviar. Or, perhaps for those who can't afford caviar, one can use
fried pork rinds as a "substitute for toast, dinner rolls...You can use
them as a pie crust... or even matzo ball soup (see our recipe on p.
190)."[144] Matzo balls made out of pork rinds?--now that is a diet revolution!
In Taubes' article
in the New York Times Magazine, he reiterated a myth common among
Atkins and other greasy diet proponents.[145] "At the very moment that
the government started telling Americans to eat less fat, we got
fatter," wrote Taubes.[146] He argues that since the percentage of
calories from fat in the American diet has been decreasing, and the
percentage from carbohydrates increasing, carbs are to blame for the
obesity epidemic.[147]
Of course a quick trot across the globe
shows that some of the thinnest populations in the world, like those in
rural Asia, center their entire diets on carbs. They eat 50% more carbs
than we do, yet have a fraction of our obesity rates.[148] Taubes also
left out that the amount of added fat and total fat Americans
eat has also been increasing--we're eating more of everything now, fat
and carbohydrates. Grease and protein peddlers blame our obesity
epidemic on a low-fat diet that our nation never ate.
Thirty
years ago, the average woman ate about 1500 calories per day, now it's
closer to 2000.[149] Men also significantly bumped up their calorie
consumption. With that many extra calories, we'd have to walk about two
extra hours a day to keep from gaining weight. As analyzed in the May
2004 USDA report on obesity, with more calories, yet the same sedentary
lifestyle, of course we gained weight.[150]
The reason we're
fat is not because of bread and fruit. Much of the obesity crisis has
been blamed on eating out more (Americans spend almost twice as much
time per week eating out as exercising),[151] soft drinks, snacking,
bigger portion sizes and "the enormous amount of very clever and very
effective advertising of junk food/fast food."[152] Our children, for
example, are subjected to 10,000 ads for processed food every
year.[153] There's no way parents can compete. As one medical journal
pointed out, our children "will never see a slick high-budget (or even
low-budget) ad for apples or broccoli."
Twenty years ago, a
typical US bagel was 3 inches; now it's twice that and contains a
whopping 350 calories.[154] Outback Steakhouse now has an appetizer of
cheese fries, which breaks the scale at over 3000 calories, an
appetizer containing more calories than most people eat all day. One
would have to walk about 35 miles to burn that kind of thing off.[155]
The
standard coke bottle used to be around 6 ounces. Then came the 12 ounce
can. Now we have the 20 ounce bottles, or, of course, the 64-ounce
"Double Gulp," containing about 50 spoonfuls of sugar. In fact, the
Double Gulp is selling so well that 7-Eleven considered an even larger
size, which a company spokesperson described only as a
"wading-pool-sized drink."[156]
The National Soft Drink
Association boasts on their website that "Soft drinks have emerged as
America's favorite refreshment. Indeed, one of every four beverages
consumed in America today is a carbonated soft drink, averaging out to
about 53 gallons of soft drinks per year for every man, woman and
child."[157] Interestingly, the introduction of high fructose corn
syrup (primarily consumed in soft drinks)[1160] around 1970 seems to
exactly parallel the sudden rapid rise in obesity in this country.[158]
Thanks in part to the American food corporations, becoming overweight,
as one prominent obesity researcher pointed out, "is now the normal
response to the American environment."[159]
There is no
mystery why we are the fattest country on Earth. "We're overfed,
over-advertised, and under-exercised," says Stanford obesity expert
John Farquhar. "It's the enormous portion sizes and sitting in front of
the TV and computer all day" that are to blame. "It's so gol'darn
obvious--how can anyone ignore it?"[160]
So fine, maybe calories, not carbohydrates, are to blame
for our obesity epidemic, and maybe Atkins' claims, as described by one
of the world's leading obesity researchers, are "the most unutterable
nonsense I ever saw in my life."[161] So what if it's just a low
calorie diet in disguise? It's still a low calorie diet where one can
eat all the (albeit bunless) bacon cheeseburgers you want. So what's
the problem?
The immediate concern centers on the state of
ketosis. Pregnant women are the most at risk. Based on detailed data
from 55,000 pregnancies,[162] acetone and other ketones may cause brain
damage in the fetus, which may result in the baby being born mentally
retarded.[163] The fact that ketones seemed to cause "significant
neurological impairment" and an average loss of about 10 IQ points was
well known and aroused "considerable concern" years before Atkins
published his first book.[164] Atkins nonetheless wrote. "I recommend
this diet to all my pregnant patients."[165]
After enough
pressure from the AMA, Atkins finally relented. "There's one other
point I'm very sorry about," Atkins finally admitted, "I now understand
that ketosis during pregnancy could result in fetal damage. My pregnant
patients have never had this problem, but I realize I didn't study
enough cases to validate my recommendation. If anyone wants a
retraction, I'll be glad to give one."[166]
Subsequently at
the congressional hearing on fad diets, however, when asked by Senator
George McGovern if he had made a public retraction of his reckless
recommendation, Atkins replied, "No; I will stand by the statement I
made in the book... I have recommended it for use by the pregnant woman
with the observation of the managing obstetrician or physician..."[167]
After the Senate Select Committee hearings, the publisher added a small
print disclaimer on the copyright page in the front of the book.[168]
Highlighting
Atkins' recommendation of his diet even during pregnancy, one nutrition
textbook reads "Proponents of the low carbohydrate diet have been
extraordinarily irresponsible in ignoring these hazards."[169] The
tobacco industry similarly denied smoking was harmful during
pregnancy.[534] "The woman who goes on a ketogenic diet [like Atkins]
for six months of pregnancy," noted one fetal specialist, "is playing
Russian roulette."[170]
Although pregnant and breastfeeding women may be at most
risk, "The [Atkins] diet is potentially dangerous to everyone," warned
the Chair of the Medical Society of New York County's Public Health
Committee.[171] In all of the editions of his Diet Revolution, Atkins
cited the "pioneering" work of "brilliant" researcher Gaston
Pawan.[172] When Atkins was brought before the Senate investigation on
fad diets, the Chair of the Senate Subcommittee read a statement
submitted by Dr. Pawan himself who supported the AMA's condemnation of
the Atkins diet and explained that he used very high fat diets only for
"specific experimental purposes" (emphasis in original.) in
hospital settings and would never "recommend a very high fat diet
indiscriminately to obese subjects for obvious reasons."[173]
The
symptoms of ketosis include general tiredness, abrupt or gradually
increasing weakness, dizziness, headaches, confusion, abdominal pain,
irritability, nausea and vomiting, sleep problems and bad breath.[174]
One study found that all those subjected to carb-free diets complained
of fatigue after just two days. "[T]his complaint was characterized by
a feeling of physical lack of energy... The subjects all felt that they
did not have sufficient energy to continue normal activity after the
third day. This fatigue promptly disappeared after the addition of
carbohydrates to the diet."[175] From a review published in a German
medical journal, "[lightheadedness], fatigue, and nausea are frequent,
despite what Dr. Atkins claims."[176]
In World War II, the
Canadian Army had an illuminating experience with ketogenic diets. For
emergency rations, infantry troops had pemmican, which is basically a
carbohydrate-free mixture of beef jerky and suet (animal fat). The
performance of the infantrymen forced to live off pemmican deteriorated
so rapidly that they were incapacitated in a matter of days. As
reported in the journal War Medicine in 1945, "On the morning of the
fourth day of the diet, physical examination revealed a group of
listless, dehydrated men with drawn faces and sunken eyeballs, whose
breath smelled strongly of acetone."[177] A ketogenic diet, concluded
one medical review, "can be associated with significant toxicity."[178]
Danish obesity expert professor Arne Astrup, M.D., of the
Centre of Advanced Food Research in Copenhagen published a September
2004 review of the Atkins Diet[515] in The Lancet, one of the most
prestigious medical journals in the world.[516] Long term Atkins
adherents "start to suffer headaches, muscle cramps and diarrhea,"
Astrup concluded. "This is consistent with a carbohydrate deficiency.
They simply do not get enough carbohydrate to supply the tissues with
blood sugar. That is why the organs start to malfunction."[517]
In
a study funded by Atkins himself, most of the people who could stick
with the diet reported headaches and halitosis (bad breath). Ten
percent suffered hair loss. While most people lost weight--at least in
the short-term--70% of the patients in the study also lost the ability
to have a normal bowel movement.[511]
Authorities recommend Americans start roughing it with
"at least 30-35 grams"[179] of fiber a day "from foods, not from
supplements."[180] The initial phase of the Atkins Diet, which dieters
may have to repeatedly return to, has as little as 2 grams of fiber per
day[181]--that's less than 7% of the minimum daily
recommendation of the American College of Gastroenterology.[507] Other
independent analyses--one at Tufts[508], another published in the
Journal of the American College of Nutrition[509] and a third published
in the 2004 volume of the Journal of the American College of
Cardiology[22]--found 4 grams of fiber a day, only 16% of the FDA's
Daily Value.[510]
Atkins can't help but concede the health
benefits associated with fiber found, in his own words, in "vegetables,
nuts and seeds, fruits, beans and whole unrefined grains;" but then
asks "How can you get the benefits of fiber without the carbs contained
in these foods? The answer is supplementation." He then goes on to
basically recommend that all his followers start taking sugar-free
Metamucil. What must Mother Nature have been thinking, putting all the
fiber into such "poison" foods?
The May 2004 Annals of
Internal Medicine study which was misleadingly[182] much lauded in the
press with headlines like "Scientists Give Thumbs Up to Atkins Diet,"
showed once again that most of the Atkins Dieters suffered from
headaches and constipation. They also had significantly more diarrhea,
general weakness, rashes and muscle cramps--despite taking the 65
supplements prescribed by Atkins. One subject was so constipated he had
to seek medical attention. Another developed chest pain on the diet and
was subsequently diagnosed with coronary heart disease.[183] No wonder
Consumer Guide gave the Atkins Diet zero out of four stars for being
"outright dangerous"[184] and the editor of the Healthy Weight Journal
gave Atkins the dubious Slim Chance Award for "Worst Diet."[185]
Because of the Henry VIII-style meat load in low carb
diets, essentially every single study of low carb diets that measured
uric acid levels showed that uric acid levels rose.[186] In virtually
every instance in which it's been studied over the last 50 years, uric
acid itself has been tied to cardiovascular disease risk, and may be an
independent risk factor by increasing free radical damage or making the
blood more susceptible to clotting.[187]
There is also concern
that uric acid levels on a meat-centered diet might be forced so high
that it could start crystallizing in one's joints, triggering gout, an
excruciating arthritic condition. A March 2004 article published in the
New England Journal of Medicine documented the effect of meat intake on
gout risk.
Harvard researchers followed almost 50,000 men for
12 years and found that "each additional daily serving of meat was
associated with a 21 percent increase in the risk of gout."[188] In
fact, the Atkins Diet has been blamed directly for the rising incidence
of this so-called "disease of kings."[189] Well, Atkins did claim his
diet is "fit for a prince or princess."[190]
The presence of muscle cramps, Atkins explained, "means
you are losing too many electrolytes." Along with the ketones, one's
kidneys may also flush out critical electrolytes like calcium,
magnesium and potassium, which may result in muscle cramps or
worse.[191]
Atkins realized this potential danger and
recommended his followers take potassium supplements. In fact, some
people lose so much potassium they may need professional help.
According to Atkins himself, sales of potassium supplements "of
anywhere near the proper amount of potassium you may need are illegal
over the counter; therefore you may need a doctor to write you the
proper prescription."[192] Even Barry Sears, the author of the
flawed[193] Zone Diet, recognizes the danger the Atkins Diet might
present: "Any meal that you have to take potassium supplements, there's
something wrong with that."[194]
Experts have voiced a longstanding concern that ketosis
might fog up people's thinking, but it wasn't formally tested until
1995. As reported in the International Journal of Obesity article
"Cognitive Effects of Ketogenic Weight-Reducing Diets," researchers
randomized people to either a ketogenic or a nonketogenic weight loss
diet. Although both groups lost the same amount of weight, those on the
ketogenic diet suffered a significant drop in cognitive
performance.[195]
After one week in ketosis, higher order
mental processing and mental flexibility significantly worsened into
what the researcher called a "modest neuropsychological
impairment."[196]
Not only may the Atkins Diet impair mental functioning,
it may impair emotional functioning as well. Researchers at MIT are
afraid the Atkins Diet is likely to make many people--especially
women--irritable and depressed.[197]
The Director of MIT's
distinguished Clinical Research Center measured the serotonin levels in
the brains of 100 volunteers eating different diets.[198] Serotonin is
a chemical messenger in the human brain that regulates mood. In fact,
the way antidepressants like Prozac are purported to work is by
increasing brain levels of this neurotransmitter.
The MIT
researchers found that the brain only seemed to make serotonin after a
person ate carbohydrates.[199] By starving the brain of this essential
mood elevator, the researchers fear that the Atkins Diet may make
people restless, irritable or depressed. They noted that women, people
under stress, and those taking anti-depressants might be most at
risk.[200]
When one follower of low carb guru Herman
Tarnower's 1978 "Scarsdale Diet," wrote to him, "When I diet, I get
cranky, and my husband says, 'I like you better fat than cranky'; have
you any suggestions?" Dr. Tarnower responded, "You should be able to
diet without getting cranky. Your husband, I am sure, would like to
have you attractive, lean, and pleasant." His paternalistic
prescription may make one sympathize, as one journalist wrote, "with
his lover Jean Harris, the former school headmistress who later did
prison time for his murder."[201]
Based on the MIT serotonin
research, Judith Wurtman, Director of the Women's Health Program at the
MIT Research Center, warns that filling up on fatty foods like bacon or
cheese may make people tired, lethargic and apathetic. Eating a lot of
fat, she stated, may "make you an emotional zombie."[202]
Atkins' remedy to counteract or cover-up the toxic
effects of his diet is a list of prescriptions. Constipation? No
problem, he says, take a laxative.[203]
Leg cramps? They are
"probably due to a calcium deficiency," Atkins explained, "I treat it
with calcium supplements and Vitamins E and C. Sometimes magnesium and
potassium have to be added."[204]
What if uric acid goes up?
Not an obstacle for Atkins, who wrote: "this rarely poses a problem
because I routinely prescribe a drug to prevent uric acid formation...
if it goes above the normal range after being on the diet."[205] He
fails to mention, however, that this drug can cause irreversible liver
damage, life-threatening anemia, and, in rare cases, even death.[206]
Breath
that smells "like a cross between nail polish and over-ripe
pineapple?"[1158] Great!--that means it's "working at full
efficiency."[207] Just "carry around... one of those purse-sized
aerosol mouth fresheners, and you can have sweet breath..."[208]
Despite
the side effects of ketosis, Atkins' books encourage people to
repeatedly test their urine for ketones to ensure they remain in this
unhealthy state. Atkins almost fetishized ketosis, describing it being
"as delightful as sunshine and sex."[209] Atkins did, after all, start
his career off as a stand-up comic.[210] One dieter replied, "I don't
think Dr Atkins had much sex if he thinks that ketosis is better than
sex. It's certainly not."[211]
In fact, thanks to its side
effects, those who go on the Atkins Diet in an attempt to attract
others may find it counterproductive when a potential mate gets too
close and finds a constipated, cognitively impaired "zombie" with bad
breath.
Even if people can handle the side effects of the diet,
there are no data to show that the initial rapid weight loss on the
Atkins Diet can be maintained long term. Many of the studies on the
Atkins Diet have lasted only a few days;[212] the longest the Atkins
Diet has ever been formally studied is one year.
There have
been 4 such yearlong studies and not a single one showed significantly
more weight lost at the end of the year on the Atkins Diet than on the
control "low fat" diets.[213-215,523] In the yearlong comparison of the
Atkins Diet to Ornish's diet, Weight Watchers, and The Zone Diet, the
Atkins Diet came in dead last in terms of weight lost at the
end of the year. Ornish's vegetarian diet seemed to show the most
weight loss.[216] The Atkins website had no comment.[217]
Noting
that by the end of the year, half of the Atkins group had dropped out,
and those who remained ended up an unimpressive 4% lighter, Fat of The
Land author Michael Fumento commented, "do you really think any of them
could sell a single book copy, much less as many as 15 million (for
Atkins), by admitting to a 50 percent drop-out rate in one year with a
mere five percent of weight loss among those left?"[218]
Ornish's
vegetarian (near-vegan) diet has been formally tested for years.[219]
Even though the diet was not even designed for weight loss, after five
years most of the Ornish adherents were able to maintain much of the 24
pounds they lost during the first year "even though they were eating
more food, more frequently, than before without hunger or
deprivation."[220]
Another of the year-long studies also
compared a low fat vegetarian (vegan) diet to the "Atkins Diet."[526]
Those who ate as much as they wanted of the vegan diet lost an average
of 52 pounds--60% more than those reportedly on the Atkins diet
lost.[523] This is consistent with what research we have on vegans
themselves. Vegans are vegetarians that exclude all saturated animal
fat and cholesterol from their diet.
The biggest study on
vegans to date compared over a thousand vegans in Europe to tens of
thousands of meateaters and vegetarians. The meateaters, on average,
were significantly heavier than the vegetarians, who in turn were
significantly heavier than the vegans. Even after controlling for
exercise, smoking, and other nondietary factors, vegans came out
slimmest in every age group. Less than 2% of vegans were obese.[221]
In
a snapshot of the diets of 10,000 Americans, those eating vegetarian
were the slimmest, whereas those eating the fewest carbs in the sample
weighed the most. Those eating less carbs were on average overweight;
those eating vegetarian were not.[222]
Vegetarians may have a
higher resting metabolic rate, which researchers chalk up to them
eating more carbs than meateaters (or possibly due to enhanced adrenal
function).[223] At the same weight, one study showed that vegetarians
seem to burn more calories per minute just by sitting around or
sleeping than meateaters--almost 200 extra calories a day. Although
earlier studies didn't find such an effect,[224] if confirmed, that
amounts to the equivalent to an extra pound of fat a month burned off
by choosing to eat vegetarian.[225]
The only other two formal
yearlong studies found that although the initial drop in weight on
Atkins was more rapid, weight loss on the Atkins Diet reversed or
stalled after 6 months. The longer people stay on the Atkins Diet, the
worse they seemed to do.[226-227] None of the four longest studies on
the Atkins Diet showed a significant advantage over just the type of
high carbohydrate diets Atkins blamed for making America fat.
Anyone
can lose weight on a diet; the critical question is whether the weight
loss can be maintained and at what cost. If low carb diets really did
cure obesity, the original in 1864 would have eliminated the problem
and no more diet revolutions would be necessary. Short-term weight loss
is not the same thing as lifelong weight maintenance.
Permanent weight control is difficult to achieve. Up to
approximately 95% of repeat dieters fail, regaining the weight that
they initially lost. What about the other 5% though? Has anyone studied
them and found out their secret? In her book Eating Thin for Life,
award winning[228] journalist and dietician Anne Fletcher delved into
the habits of a few hundred folks who had not only lost an average of
64 pounds but also maintained that loss for an average of 11 years.
What did she find?
"[B]asically, they're eating the opposite
of a high-protein, low carbohydrate diet," Fletcher reported. When she
asked them to describe their eating habits, the top responses were
"low-fat" followed by "eating less meat."
These dieters with
long-term success also told her they ate "more fruits and vegetables."
Research seems to support this notion. One research study showed, for
example, that significant weight loss could be triggered in people just
feeding them extra fruit--3 added apples or pears a day.[229] Harvard
studied 75,000 women for a decade and the results suggest that the more
fruits and vegetables women eat, the less likely they will become
obese.[230] A 2004 review of the available research suggests that in
general "increasing fruit and vegetable intake may be an important
strategy for weight loss."[231]
Researchers at the National
Cancer Institute followed over 75,000 people for ten years to find out
which behaviors were most associated with weight loss and which with
weight gain. They wrapped tape measures around people's waists for a
decade and found that the one dietary behavior most associated with an
expanding waistline was high meat consumption, and the dietary behavior
most strongly associated with a loss of abdominal fat was high
vegetable consumption.[232]
Even after controlling for other
factors, men and women who ate more than a single serving of meat per
day seemed to be 50% more likely to suffer an increase in abdominal
obesity than those who ate meat just a few times per week. The
researchers conclude: "Our analysis has identified several easily
described behaviors [such as reducing meat intake to less than three
servings per week and jogging a few hours every week] that, if widely
adopted, might help reverse recent increases in adult overweight...
Increases in vegetable consumption might reduce abdominal obesity even
further."[233]
The sad thing, according to the Director of
Nutrition for the Center for Science in the Public Interest, is that
"people keep believing that the magic bullet is just around the corner
. . . if they only eliminate food 'x' or combine foods 'a' and 'b,' or
twirl around three times before each meal."[234] The reality is that
most successful dieters lose weight without the gimmicks on which
Americans spend $30 billion[235] per year.[236]
A recent
survey of 1300 adults found that low-carb diets seemed to be 50 percent
less effective at helping people reach their weight-loss goals than
weight-loss diets in general.[488] In the largest survey ever
undertaken on the long-term maintenance of weight loss, Consumer
Reports found that the vast majority of the most successful dieters
said they lost weight entirely on their own, without enrolling in some
expensive program, or buying special foods or supplements, or following
the regimen of some diet guru.[237] The most popular fad diet right now
may be Atkins, but it's not the most popular diet, and not the one that
seems to work the best.
The most formal study of lasting weight loss,
though, is the highly respected National Weight Control Registry,
funded by the National Institutes of Health. For over 10 years, the
Registry has tracked the habits of thousands of successful dieters.
They now have 5000 Americans confirmed to have lost an average of 70
pounds and who were able to prove they have kept it off for an average
of 6 years.[238] After a decade of rigorously tracking those who most
successfully lost weight--and kept it off--one of the chief
investigators revealed what they found: "Almost nobody's on a low
carbohydrate diet."[239]
These researchers, led by a team at
Brown University and the University of Colorado, found that the people
most successful in losing and maintaining their weight were eating high
carbohydrate diets--five times as many carbs as Atkins proscribed in
the "weight loss" phase of his diet.[240] Of the thousands of people in
the National Weight Control Registry, less than 1 percent follow a diet
similar to the Atkins program. "We can't find more than a handful of
people who follow the Atkins program in the registry," said one chief
investigator, "and, believe me, we've tried."[241]
Fifteen
million Atkins books sold and investigators can only find a "handful"
of followers who could qualify for the Registry? To qualify, all
dieters have to do is prove they lost just 30 pounds and kept it off
for at least one year. Twenty-six million Americans[242] supposedly on
"hard-core" low carb diets and "almost nobody" on Atkins has even
qualified?
Maybe for some reason only dieters eating lots of
carbohydrates hear about the Registry? No, the National Weight Control
Registry has been plugged in Dr. Atkins' own book for years and is
promoted on the official Atkins website.[243] The reason why anecdotes
of Atkins dieters maintaining their weight loss crop up in Atkins books
and websites but seemingly nowhere else may be because there isn't much
oversight when posting information to the web, whereas the Registry
demands proof.[244]
Atkins conceded that the "WORST [emphasis his]" feature
about his diet is the "rapidity with which you gain [weight] if you
abandon it." "But the BEST feature," he claims, "is that you don't HAVE
to go off this diet..."[245]
The reason people fall off the
wagon, Atkins claimed, is because of "carbohydrate addiction." What he
calls "addiction," though, others might call our natural urge to eat
the fuel our bodies evolved to live on--carbohydrates. Patients
inevitably cheat and then tragically blame themselves instead of the
diet for this failure.
Low carb diets, like all fad diets,
tend to fail.[246] Even Atkins admitted that there is "no formal
documentation" of long-term weight loss on his diet. He'd been
supposedly seeing patients for decades on his diet; why didn't he do a
study?
When challenged on just that point Atkins replied, "Why
should I support a study? It's all in my book." When it was pointed out
that the book was "all anecdotal," Atkins said mainstream medicine's
demand for proof simply functioned to "maintain it at its current level
of ineptitude."[247]
In February 2000, the USDA
brought Atkins in to discuss his diet. When asked why he doesn't
conduct his own study, he pleaded poverty: "But I haven't been able to
fund a study." To which the Director of Nutrition Sciences at Albert
Einstein College of Medicine, replied, "Ten million books in print and
you can't fund a study?"
The Director continued: "You market
the vitamins. You sell the vitamins. You market this. This is not for
the public good. This is a money-making proposition."[248] The Chair of
the Board of Atkins' own New York County Medical Society made a similar
charge when Atkins' book was first published, alleging it was
"clearly... unethical" and "self-aggrandizing."[249] The New York Board
of Health later tried, unsuccessfully, to revoke his medical
license.[250]
Why has the U.S. government been lax in testing
the Atkins Diet at any point in the last 30 years? One reason may have
been that it might be difficult to get approval from an ethical review
committee to put people on the diet long term, given what is known
about the dangers of a meat-laden diet. As one medical review
concluded, "There is no evidence that low carbohydrate diets are
effective for long-term weight management, and their long-term safety
is questionable and unproven."[251]
The current Director of Nutrition at Harvard advises
that all physicians should produce a handout warning about all of the
adverse effects of the Atkins Diet. Not only should the handout explain
explicitly that the diet may increase one's risk of heart disease,
cancer, and stroke, but also that "Other health risks include...
dizziness, headaches, confusion, nausea, fatigue, sleep problems,
irritability, bad breath, and worsening of gout and kidney problems;
osteoporosis, since a high ratio of animal to vegetable protein intake
may increase bone loss and the risk of hip fracture in elderly women; a
rise in blood pressure with age...and rapid falling blood pressure upon
standing up (orthostatic hypotension), which can... put older patients
at higher risk for falls."[252] After running through the adverse
effects associated with ketosis, the American institute for Cancer Research wrote, "Those are the short-term effects. The long-term effects are even more dire."[253]
The downfall of the Atkins Diet is also its one saving
grace--people may not be able to tolerate the diet for long enough to
suffer the long-term consequences. The American Heart Association
states: "Individuals who follow these diets are therefore at risk for
compromised vitamin and mineral intake, as well as potential cardiac,
renal [kidney], bone, and liver abnormalities overall."[254] Low carb
diets like the Atkins diet may also hasten the onset of type II
diabetes.[519] In short, concluded the September 2004 review in The
Lancet,[524] "low-carbohydrate diets cannot be recommended."[525]
In
Europe, hospitals have already started banning the Atkins Diet[255-256]
after the British government's Medical Research Council, backed up by
the British Nutrition Foundation and the British Dietetic
Association,[257] condemned the Atkins Diet as "negligent"[258]
"nonsense and pseudo-science"[259] posing a "massive health risk."[260]
An article out of the Cleveland Clinic Journal of Medicine entitled "Physician's Guide to Popular Low Carbohydrate Weight-Loss Diets" noted that the Atkins Diet "can jeopardize health in a variety of ways."[261] Let us count the ways.
Atkins' followers risk a number of serious nutritional
deficiencies.[262] In fact, some people have become so deficient on low
carb ketogenic diets that they almost went blind because their optic
nerves started to degenerate.[263-264]
When cutting calories,
it's especially important to eat nutrient-dense diets, but the Atkins
Diet presents a double whammy; it restricts the healthiest foods, like
fruit, and unrestricts some of the unhealthiest, like meat. Shortly
after Atkins' original book was published, the highly prestigious
Medical Letter on Drugs and Therapeutics concluded that the Atkins Diet
was "unbalanced, unsound and unsafe."[265] As noted in a Medical Times
review, Atkins has created a "ridiculously unbalanced and unsound"
"hazardous" diet.[266] Twenty-seven years later the Medical Letter
offered an update noting that the safety of the Atkins Diet had still
"not been established."[267]
Low carbohydrate diets like
Atkins maximize the consumption of disease-promoting substances like
the cholesterol, saturated fat, and industrial pollutants in meat, yet
restrict one's intake of fiber and literally thousands of antioxidants
and phytochemicals found exclusively in the plant kingdom (like the
carotenoids, lycopenes, bioflavenoids, phytic acid, indoles,
isothiocyanates, etc.) that have "anti-aging, anti-cancer and
anti-heart disease properties."[268] As a 2004 medical review
concluded, the Atkins Diet is so "seriously deficient" in nutrition
that "there is real danger of malnutrition in the long term."[269]
Where
might then one get one's vitamins on the Atkins Diet? From the Atkins
website, of course, on sale now for just over $640 a year.[270] Add
some antioxidants and the tab is up to $1000.[271] That is, of course,
in addition to the estimated $400[272]-$1400[273] the pricey Atkins
food--meat and cheese--costs every month (unless one chooses to live
off hot dogs).
Realizing his diet is so deficient in
nutrients, Atkins prescribed no less than 65 nutritional supplements in
part to help fill the nutritional gaps created by his diet.[274] A
"proper Atkins Dieter" Atkins wrote, "follows the entire program,
including the supplements."[275] In his last edition Atkins even had a
chapter entitled "Nutritional Supplements: Don't Even Think of Getting
Along Without Them."[276] Perhaps this is because his corporation sells
them.
"Who needs orange juice," Atkins wrote, "when a Vitamin
C tablet is so handy?"[277] Oranges, of course, contain much more than
vitamin C. As Sue Radd, a world leader on phytonutrient research, put
it "There's not one vitamin pill in the world that can give you
everything you need."[278] A review in the Cleveland Clinic Journal of
Medicine agreed that the Atkins Diet is "deficient in nutrients that
cannot be replaced by supplements and are excessive in nutrients that
may increase the risk of mortality and chronic disease."[279]
Responding
to the criticism that the Atkins Diet was deficient in fruits and
vegetables, Atkins-funded researchers responded that people on Atkins
could include a limited quantity of some vegetables "and even small
amounts of fruit." Even during later, more liberal phases of the diet,
though, Atkins warned readers that eating fruit will "always be
somewhat risky." The Atkins researchers continued, "It would be prudent
to take a multivitamin/mineral supplement."[280] A low carb diet is a
low nutrition diet.
Atkins' followers also risk cancer. Studies at Harvard
and elsewhere involving tens of thousands of women and men have shown
that regular meat consumption may increase colon cancer risk as much as
300 percent.[281-282] As one Harvard School of Public health researcher
noted, because of the meat content, two years on the Atkins Diet "could
initiate a cancer. It could show up as a polyp in 7 years and as colon
cancer in ten."[283] Another Harvard study showed that women with the
highest intake of animal fat seem to have over a 75% greater risk of
developing breast cancer.[285]
It's tragically ironic that
after McDonalds' CEO apparently dropped dead of a heart attack in 2004,
their new CEO was in the operating room with colo-rectal cancer only 16
days later.[284]
The most comprehensive report on diet and
cancer in history was published in 1997. It took over four years to
complete, reviewing 4500 studies from thousands of researchers across
the globe--a landmark scientific consensus document written by the top
cancer researchers in the world. After all that work, what was their
number one recommendation? "Choose a diet that is predominantly plant
based, rich in a variety of fruits, vegetables, nuts, and beans with
minimally processed starchy foods."[491] In other words, essentially
the opposite of the Atkins Diet.
In the January issue of
Scientific American it was noted: "Cancer is most frequent among those
branches of the human race where carnivorous habits prevail." That was
the January issue in 1892![492] This is nothing new. What’s the number
one recommendation of the American Institute for Cancer Research? Plant
based diets.[493] The number one recommendation of the World Cancer
Research Fund? Plant-based diets.[494] The number one recommendation of
the National Cancer Institute, the World Health Organization and the
Food and Agriculture Organization of the United Nations? More fruits
and vegetables.[495,496] The number one recommendation of the American
Cancer Society? More plants, less meat.[497] In fact the American
Cancer Society has officially condemned diets high in animal grease,
concluding that "a low carb diet can be a high-risk option when it
comes to health."[286]
Atkins' followers also risk kidney damage.[287] Like his
advice for pregnant women, Atkins once wrote "The diet is safe for
people even if there is a mild kidney malfunction."[288] We now know
this to be false.
In a press release entitled "American Kidney Fund Warns About Impact of High-Protein Diets on Kidney Health,"
Chair of Medical Affairs, Paul W. Crawford, M.D., wrote, "We have long
suspected that high-protein weight loss diets could have a negative
impact on the kidneys, and now we have research to support our
suspicions." Dr. Crawford is worried that the strain put on the kidneys
could result in irreversible "scarring in the kidneys."[289]
Three
months later, the newest edition of Dr. Atkins' New Diet Revolution was
released in which Dr. Atkins stated: "Too many people believe this
untruth [that too much protein is bad for your kidneys] simply because
it is repeated so often that even intelligent health professionals
assume it must have been reported somewhere. But the fact is that it
has never been reported anywhere. I have yet to see someone produce a
study for me to review..."[290]
Although evidence that such
diets could be risky for one's kidneys existed years before he made
that statement,[291] the definitive study showing just how dangerous
his diet could be to a dieter's kidneys was published a month before
Atkins died. The Harvard Nurse's Health Study proved that high meat
protein intake was associated with an accelerated decline in kidney
function in women with mild kidney insufficiency.[292] The problem is
that millions of Americans--as many as one in four adults in the United
States--seem to already have reduced kidney function, but may not know
it, and would potentially be harmed by high meat diets such as
Atkins.[293] And the "excessive" amount of protein which furthered
kidney damage in the women in the Nurse's Study is only about half of
what one might expect to get on the Atkins Diet.[294]
The
American Academy of Family Physicians notes that high animal protein
intake is also largely responsible for the high prevalence of kidney
stones in the United States. Kidney stones can cause severe pain,
urinary obstruction, and kidney damage. Plant protein does not seem to
have a harmful effect.[295] "If we were smart," says Dr. Theodore
Steinman, a kidney specialist and senior physician at Beth Israel
Deaconess Medical Center, "we would all be vegetarians."[1157]
High
cholesterol, which may be exacerbated by the Atkins Diet,[523] has also
been linked to a worsening of kidney function in both diabetics and
nondiabetics.[536]
The American Kidney Fund's Dr. Crawford concluded,
"Chronic kidney disease is not to be taken lightly, and there is no
cure for kidney failure. The only treatments are kidney dialysis and
kidney transplantation. This research shows that even in healthy
athletes, kidney function was impacted and that ought to send a message
to anyone who is on a high-protein weight loss diet."[296]
A 2003 review of the safety of low carbohydrate diets
reeled off an alarming list of potential problems: "Complications such
as heart arrhythmias, cardiac contractile function impairment, sudden
death, osteoporosis, kidney damage, increased cancer risk, impairment
of physical activity and lipid [cholesterol] abnormalities can all be
linked to long-term restriction of carbohydrates in the diet."[297]
There
is a particular concern that children who go on the Atkins Diet might
suffer permanent physical and mental damage as a result of starving
their bodies of critical nutrients. As one U.S. child nutrition
specialist explained, "The effect can be to dull the mind, stunt
growth, and soften bones...I wouldn't want to risk it by putting my
child on a low carbohydrate diet."[298]
The concern with bone
health arises from the fact that muscle protein has a high sulphur
content. When people eat too much of this meat protein, sulfuric acid
forms within our bodies which must somehow be neutralized to maintain
proper internal pH balance. One way our bodies can buffer the sulphuric
acid load caused by meat is with calcium borrowed from our bones.
Cheese is also a leading source of these sulphur-containing
proteins.[535] People on high meat diets can lose so much calcium in
the urine that it can actually solidify into kidney stones.[299] Over
time, high animal protein intakes may leach enough calcium from the
bones to increase one's risk of osteoporosis. People may be peeing
their bones into the toilet along with the ketones.
The
Harvard Nurse's Health Study, which followed over 85,000 nurses for a
dozen years, found that those who ate more animal protein had a
significantly increased risk of forearm fracture. While plant-based
proteins did not show a deleterious effect, women eating just a serving
of red meat a day seemed to have significantly increased fracture
risk.[300] Other studies have linked meat consumption to hip fracture
risk as well.[301]
Although Atkins conceded, "kidney stones
are a conceivable complication,"[302] Atkins dismissed any assertion
that his diet might endanger bone health. Researchers decided to test
his claim directly.
In 2002, researchers from the Universities of Chicago and Texas published a study
that put people on the Atkins Diet and measured 1) how acidic their
urine got and 2) just how much calcium they were losing in their urine.
They reported that the Atkins Diet resulted in a "striking increase in
net acid excretion." After just two weeks on the Atkins Diet, the
subjects were already losing 258mg of calcium in their urine every day.
They concluded that the Atkins Diet "provides an exaggerated acid load,
increasing risks for renal calculi [kidney stone] formation and bone
loss."[303] In addition, the Atkins Diet is actually deficient in
calcium in the first place--even if one includes his recommended 65
supplements.[304] Luckily there's a 66th, available on his
website.[305]
We don't have any long-term published data on the bone
health of Atkins' followers (or any other health parameter for that
matter). One might look to the Inuit peoples--the so-called
"Eskimos"--for hints, though. (The word Eskimo comes from the word
Eskimaux--"eaters of raw flesh.")[306] They seem to be the only
population on Earth approximating the Atkins Diet, living largely off
Atkins' dream foods like blubber.
Despite having some of the
highest calcium intakes in the world, the Inuit also have some of the
worst rates of osteoporosis.[307] Although calcium intakes vary widely,
people in some villages get over 2500mg per day, almost 5 times what
most Americans get, due to their eating many of their fish whole, bones
and all.[308] For example, their recipe for "Ice Cream" calls for "2
cups moose grease," not in and of itself high in calcium, but with the
addition of "1 dressed pike," this Atkins-friendly dessert offers up a
respectable 130mg of calcium per serving.[309] The "unusually rapid
bone loss" found in every study ever published on Inuit bone health is
blamed on the "acidic effect of a meat diet."[310-314]
Not
only does the near-Atkins level of animal protein in their diet seem to
be dissolving their bones, the near-Atkins level of animal fat leaves
the Inuit women’s breast milk with some of the highest levels of PCBs
in the world. Their blood is swimming with mercury and other toxic
heavy metals. "They're at the top of the food chain," says Dr. Russel
Shearer, an environmental physical scientist with the Canadian
Department of Indian Affairs and Northern Development, and therefore
"accumulate the highest levels of these contaminants."[315] In the last
edition of his book, Atkins did finally acknowledge the threat posed by
the industrial pollutants in animal foods and urged his followers to
choose organic free-range meat.[316]
Although ketogenic diets have caused a number of "serious
potentially-life-threatening complications,"[317] perhaps the greatest
danger of the Atkins Diet, according to the American Medical
Association, lies in the heart.
Atkins claimed a worsening of
cholesterol levels typically only occurs "when carbohydrates are a
large part of the diet."[318] We've known this to be false since 1929
when the Institute of American Meatpackers paid to see what would
happen if people lived on an all-meat diet. The blood plasma of the
unfortunate subjects was so filled with fat it "showed a milkiness" and
one of the subjects' cholesterol shot up to 800![319]
In the
head-to-head comparisons of the four popular weight-loss diets,
Ornish's vegetarian diet was the only one that showed a significant
decrease in LDL levels--the so-called "bad" cholesterol. Even
researchers paid by Atkins concede that high saturated fat diets like
Atkins' tend to increase LDL cholesterol.[321] These researchers have
to concede the truth since they publish their work in peer-reviewed
scientific journals. Dr. Atkins, though, died without ever publishing a
single paper in any scientific journal about anything, and thus had
more freedom to bend the truth.
"The truth," Atkins wrote, "is
that every one of a score of studies on [very low carb diets] showed a
significant improvement in cholesterol." He accused those who say
otherwise of simply not doing their homework. Any claim that
cholesterol doesn't significantly improve in "every one of scores of
studies" is, he wrote in the last edition, "one of the many examples of
untruths being perpetrated because the accusers don't bother to read
the scientific literature."[322] He then goes on to recommend no less
than 17 supplements for the "prevention of cholesterol elevations" on
his diet.[323]
But what about his claim that "every one of a
score of studies showed a significant improvement in cholesterol." When
the AMA and the American Heart Association question this "fact," is it
just because they "don't bother to read the scientific literature?"
That statement of his, in the latest edition of his book and in essence
repeated to this day on the Atkins website,[537], presents a clear
opportunity to test the veracity of his claims. And the actual truth is almost the exact opposite.
Unfortunately,
Dr. Atkins didn't include citations to back up his "score of studies"
statement. In fact, when pressed for a list of citations in general,
Dr. Atkins told an interviewer that "It and the papers I quoted were in
a briefcase I lost some time ago."[324] Researchers have located about
a dozen studies, though, that measured the effects of low carb diets on
cholesterol levels. Did they all "show a significant improvement in
cholesterol?" No. In fact, with only one exception, every single
controlled study showed just the opposite--LDL cholesterol either
stagnated or was elevated by a low carb diet, even in those that showed
weight loss.[325-338]
During active weight loss--any kind of
weight loss (whether from chemotherapy, cocaine use, tuberculosis or
the Atkins Diet)--cholesterol synthesis temporarily decreases[339] and
LDL cholesterol levels should go down.[340] Yet, all the
saturated animal fat in the Atkins Diet tends to instead push levels
up, and in most studies the bad cholesterol doesn't fall as it should
with weight loss. The saturated fat in effect cancelled the benefit one
would expect while losing weight and cutting out trans fats.[522] And
what happens when people on the Atkins Diet stop losing weight? People
can't lose weight forever (Stephen King novels aside). The fear is that
their LDL cholesterol level might then shoot through the roof.[341-342]
"There is no doubt that you lose weight initially," Dr Jim
Mann, an endocrinology specialist from the University of Otago, New
Zealand, told the 2003 meeting of the European Society of Cardiology,
"but there is a grave risk of a dramatic rise in cholesterol levels
during the maintenance phase [of the Atkins Diet]. "When weight loss is
maintained--or as often happens, there is weight gain [on the Atkins
Diet]," Mann continued, "we have observed that a lot of people
experience a rise in cholesterol to levels greater than when they
started the diet."[1159]
Sometimes even during the active weight
loss, however, LDL cholesterol levels became elevated on the Atkins
Diet. One study of women, for example, showed that just two weeks on
the Atkins Diet significantly elevated average LDL levels over
15%.[343] In a trial of men on the Atkins Diet, even though they lost
an average of 17 pounds after 3 months, their LDL cholesterol jumped
almost 20%.
The May 2004 Annals of Internal Medicine study
showed that a third of Atkins dieters suffered a significant increase
in LDL cholesterol. The goal is to have a double digit LDL--an LDL
under 100 (mg/dl).[344] In the study, one person's LDL shot from an
unhealthy 184 to a positively frightening 283 (which means their total
cholesterol was probably somewhere over 350).[345] With so many people
on these diets, that could mean Atkins is endangering the health of
millions of Americans.[346] LDL cholesterol is, after all, the single
most important diet related risk factor for heart disease,[527] the
number one killer in the United States for both men and women.[347]
In
another clinical trial, despite statistically significant weight loss
reported in the Atkins group, every single cardiac risk factor measured
had worsened after a year on the Atkins Diet. The investigator
concludes "Those following high fat [Atkins[526]]diets may have lost
weight, but at the price of increased cardiovascular risk factors,
including increased LDL cholesterol, increased triglycerides, increased
total cholesterol, decreased HDL cholesterol, increased total/HDL
cholesterol ratios, and increased homocysteine, Lp(a), and fibrinogen
levels. These increased risk factors not only increase the risk of
heart disease, but also the risk of strokes, peripheral vascular
disease, and blood clots."[523]
While the LDL in the Atkins
group increased 6%, the LDL cholesterol levels in the whole-foods
vegetarian group was cut in half--dropping 52%.[523] This kind of drop
would theoretically make your average American[528] almost heart-attack
proof.[529]
When the pro-Atkins journalist who wrote the
misleading New York Times Magazine piece was confronted as to why he
didn't include the results of this landmark study, which directly
contradicted what he wrote in the article, all he could do was to
accuse the researchers of just making the data up.[348]
It's
interesting to note that the one exception --a published study of the
Atkins Diet showing a statistically significant reduction in LDL--had
no control group, put subjects on cholesterol-lowering supplements and
was funded by the Atkins Corporation itself. Even in that study though,
the drop was modest--only a 7% drop (compared, for example, to the 52%
drop on the vegetarian diet)--and didn't include two subjects who quit
because their cholesterol levels went out of control.[349]
Yet
studies like this have been heralded as a vindication of the Atkins
Diet by the mainstream media.[350] As journalist Michael Fumento,
co-author of Fat of the Land, pointed out, "How peculiar when
the most you can say for the best-selling fad-diet book of all time is
that it probably doesn't kill people."[351] To which I might add, "in
the short-term." Based on an analysis of the Atkins Diet, long-term use
of the Atkins Diet is expected to raise coronary heart disease risk by
over 50%.[352] "The late Dr. A," Fumento quips, "still gets an F."[353]
Less often reported in the media is the fact that one of the
research subjects placed on the Atkins Diet in the 2003 "vindication"
study was hospitalized with chest pain and another died.[354]
Similarly, in the widely publicized May 2004 study, less widely
publicized was the fact that two people in the low carb-diet arm of the
study couldn't complete the study because they died. One slipped into a
coma; the other dropped dead from heart disease.[355] As the Director
of Nutrition at the Harvard School of Medicine has written, "there is
still much danger in the widespread fad enthusiasm for these
diets."[356]
The Atkins Corporation boasts about the supposed
ability of the Atkins Diet to significantly raise the level of HDL, or
"good" cholesterol on a consistent basis.[357] HDL transports
cholesterol out of one's arteries to the liver for disposal or
recycling. Though it is actually only a minority of controlled studies
on Atkins-like diets that have shown such an effect,[358-371] it is
important to note that the type of HDL increase sometimes seen on these
diets is not necessarily healthful.[372] When one eats more garbage
(saturated fat and cholesterol) one may need more metabolic garbage
trucks (like HDL) to get rid of it. Eating a stick of butter may raise
one's HDL, but that doesn't mean chewing one down is good for one's
heart. In any case, significantly lowering one's LDL seems more
important than significantly raising one's HDL,[373] though the studies
done on low carb diets typically show neither.
Because of these "well-known hazards," when Atkins' book was originally published the Chair of the Nutrition Department at Harvard warned physicians that recommending the Atkins Diet "borders on malpractice."[374]
Atkins claimed that one could "Reverse heart disease with
filet mignon!"[320] Until the year 2000, all people had were changes in
cardiac risk factors like cholesterol to evaluate the impact of the
Atkins Diet on the heart. But then a landmark study was published
which, for the first and only time, actually measured what was
happening to peoples' arteries on this kind of diet. The results were shocking.
Richard
Fleming, M.D., an accomplished nuclear cardiologist, enrolled 26 people
into a comprehensive study of the effects of diet on cardiac function.
Using echocardiograms, he could observe the pumping motion of the
heart, and with the latest in nuclear imaging technology--so-called
SPECT scans--he was able to actually directly measure the blood flow
within the coronary arteries, the blood vessels that bring blood to the
heart muscle and allow it to pump. It is when one of these coronary
arteries gets blocked that people have a heart attack.
Fleming
then put them all on a low saturated fat, high carbohydrate diet--a
whole foods vegetarian diet--the kind that has been proven to not only
stop heart disease, but to in some cases actually reverse it, opening
up clogged arteries.[375] A year later the echocardiograms and SPECT
scans were repeated. By that time, however, 10 of his patients had,
unbeknownst to him, jumped on the low carb bandwagon and begun
following the Atkins Diet or Atkins-like diets. All of a sudden, Dr.
Fleming had an unparalleled research opportunity dropped in his lap.
Here he had extensive imaging of 10 people following a low carb diet
and 16 following a high carb diet. What would their hearts look like at
the end of the year? We can talk about risk factors all we want, but
compared to the high carb group, did the coronary heart disease of the
patients following the Atkins Diet improve, worsen, or stay the same?
Those
sticking to the whole-foods vegetarian diet showed a reversal of their
heart disease as expected. Their partially-clogged arteries literally
got cleaned out, and blood flow to their hearts through their coronary
arteries increased 40%. What happened to those who abandoned the high
carb diet and switched over to the Atkins Diet, chowing down on bunless
cheeseburgers? Their condition significantly worsened. All that
saturated fat and cholesterol in their diet clogged their arteries
further--the blood flow to their hearts was cut 40%. Thus, the
only study on the Atkins Diet to actually measure arterial blood flow
showed widespread acceptance of a high saturated fat diet like Atkins
could be heralding a future epidemic of fatal heart attacks.[521]
Validation that "If you were trying to damage your heart," wrote the
Center for Science in the Public Interest, "you couldn't do much better
than to eat a cheeseburger."[376] Maybe filet mignon doesn't work after
all.
The blood flow scans have been posted online
so people can see the evidence for themselves. The Atkins Diet,
according to the American Dietetic Association, is “a heart attack
waiting to happen.”[490]
"We worry about this," explains Dr.
James W. Anderson, Professor of Medicine and Clinical Nutrition at the
University of Kentucky School of Medicine, "because many of the people
who love these diets are men aged 40 to 50, who like their meat. They
may be 5 years from their first heart attack. This couldn't be worse
for them. Did you know that for 50% of men who die from heart attacks,
the fatal attack is their first symptom? They will never know what this
diet is doing to them."[377]
Emerging evidence also suggests
that ketogenic diets may "create metabolic derangement conducive to
cardiac conduction abnormalities and/or myocardial dysfunction"--in
other words cause other potentially life-threatening heart problems as
well. Ketogenic diets may cause a pathological enlargement of the heart
called cardiomyopathy, which is reversible, but only if the diet is
stopped in time.[378] The Atkins Corporation denies that Dr. Atkins'
own cardiomyopathy-induced heart attack, hypertension, and blocked
arteries had anything to do with his diet.[379]
The Atkins Diet restricts foods that prevent disease and
encourages foods that promote disease.[380] No matter what Atkins or
other diet books tell people, the balance of evidence clearly shows
that the intake of saturated animal fat is associated with increased
risk of cancer,[381-382] diabetes, and heart disease.[383] For over 40
years, medical reviews have also shown the detrimental impact of
dietary cholesterol consumption.[384] Even independent of the effects
on obesity, meat consumption itself has been related to an increased
risk of coronary heart disease.[385]
The best dietary strategy
to reduce one's risk of dying from the number 1 killer in the U.S. is
to reduce one's consumption of saturated fat and cholesterol. The
evidence backing this, according to the American Heart Association, is
"overwhelming."[386]
Decreasing America's intake of saturated
animal fat is the primary reason why Johns Hopkins, supported by 28
other public health schools, launched the Meatless Mondays campaign,
trying to get Americans to cut meat out of their diet at least one day
of the week.[387] Dr. Jean Mayer, one of the most noted nutrition
figures in history-- author of over 750 scientific articles, President
of Tufts University, recipient of 16 honorary degrees--warned those
going on "this faddish high-saturated-fat high-cholesterol [Atkins]
diet" that you may be "playing Russian roulette with your heart and
with your blood vessels."[388] "The Council," wrote the American
Medical Association in their official critique of the Atkins Diet, "is deeply concerned about any diet that advocates an 'unlimited' intake of saturated fats and cholesterol-rich foods."[389]
In
return, Atkins accused the American Medical Association of being in the
pockets of carbohydrate manufacturers. “If you look at the financial
records of the AMA and the Harvard School of Nutrition,” said Atkins in
an interview, “and see the list of their benefactors, advertisers, and
endowers you'll see why they insist on our eating carbohydrates."[486]
Interestingly,
the Atkins Corporation seems like it's already backpedaling. A front
page article in the New York Times revealed that the Atkins Corporation
was quietly telling people to restrict their bacon and butter
intake, urging people to keep saturated fat intake under 20% of
calories.[390] Though nearly every major health organization in the
world recommends less than half that amount, Atkins' change in policy
does at least show that the Atkins Corporation may be recognizing some
of the dangers of their diet.[391]
The Atkins Corporation
claimed that their saturated fat guideline was nothing new and that
Atkins never said people could eat as much meat as they wanted. They
blamed the media for just misconstruing the Atkins Diet as an
eat-as-much-meat-as-you-want diet.[392] Really? Atkins wrote, "There is
no limit to the amount of... [any kind of meat in any quantity] you can
eat... You eat as much as you want, as often as you
want" (emphasis in original.)[393] In fact he specifically boasts that
his diet "Sets no limit on the amount of food you can eat."[394] Maybe
the media got it right.
The Director of Research and Education
at Atkins Nutritionals claims that "Saturated fat isn't as much of an
issue when carbohydrates are controlled; it's only dangerous in excess
when carbs are high." Dr. Frank M. Sacks, a professor of cardiovascular
disease prevention at the Harvard School of Public Health, scoffed at
such a claim. "What they are saying is ridiculous," he said. The
revision down to 20% saturated fat, he added, "has nothing to do with
science; it has to do with public relations and politics."[395]
One can still go to the Atkins website, though, and read
how innocuous saturated fat is. One reader asks, "Is it OK for me to
consume more than 20% of my calories in the form of saturated fat?" The
answer given is "Absolutely."[396]
With this kind of advice,
53-year-old businessman Jody Gorran stayed on the Atkins Diet, and
continued to recommend it to his friends even though his cholesterol
had shot up 50%. Before starting the Atkins Diet, his cholesterol was
excellent, he had no history of heart disease, and an unrelated CT scan
showed that his coronary arteries were clean.[397]
For Jody
Gorran, it took two years on the Atkins Diet before the crushing chest
pain started. By then one of his coronary arteries was 99% blocked and
his heart function was suffering for it. An immediate cardiac
catheterization and stent placement may well have saved his life. In
the opinion of his cardiologist, Gorran might well have otherwise had a
massive heart attack and died within a short period of time. Mr. Gorran
is now suing the Atkins Corporation,
alleging that they "knew, or should have known," that what they were
saying about their diet and heart disease risk were false. He is trying
to get the corporation to include warning labels on its books, website,
and products that a low carbohydrate diet "may be hazardous to your
health--check with your physician."[398]
This is not the first
time Atkins has been sued. When Dr. Atkins' Diet Revolution first came
out, a million-dollar class action suit was brought against Atkins and
his publisher to recover medical expenses incurred by the diet's side
effects.[399] A Brooklyn Assemblyman on Atkins who nearly died after a
heart attack sued Atkins and the publisher for publishing the book
"without regard to the safety, truth or accuracy of the statements
contained in the book."[400] The book Nutrition Cultism cites 3
occasions in which Atkins was sued and the cases were each settled out
of court in favor of the plaintiffs.[401]
"The point is,"
Gorran said in an NBC News interview, "Dr. Atkins lied to the public.
He didn't care. For his ego or for corporate greed, that's what this
thing's about."[402] "A successful diet has to be more than simply
losing weight" Gorran said on Good Morning America, "A successful diet
should not kill you."[403]
Most people aren't able to remain on the Atkins Diet long
enough to develop osteoporosis, kidney damage or hardening of the
arteries. Sixteen year-old high school student Rachel Elizabeth Huskey only lasted seven weeks.
Rachel
had a crush on a boy in her church. So she started the Atkins Diet to
lose weight. In part because she was so nauseated on the diet, she lost
16 pounds. She was hoping being thinner would make her more popular at
school. After a brief carbohydrate relapse, she began again "very
strictly"[404] but could only stick with it this time for 9 days.
In
history class, amidst cheering fellow students for acing a tough
question, she collapsed without warning. And then she died. Frenzied
attempts to resuscitate her failed.[405] Her doctors blame the Atkins
Diet.
The kidney uses minerals such as potassium and calcium
to help rid one's body of toxins like ketones. People on the Atkins
Diet are urinating these minerals away. And critically low levels in
the blood of these electrolytes can lead to fatal cardiac
arrhythmias--lethal heart rhythms. Rachel was on the Atkins Diet, was
found on autopsy to have critically low blood levels of both potassium
and calcium, and she died of a cardiac arrhythmia. Rachel was
previously in good health and had no history of any medical problems.
After
ruling out other potential causes, the medical team of child health
specialists that investigated her death couldn't help but conclude in
their published report, "Sudden Cardiac Death of an Adolescent During Dieting," that the Atkins Diet was the most likely cause of her death.
The
chief executive of the Atkins Corporation denied there was a link
between the diet and Rachel's death, but implied she should have
consulted her doctor before starting the diet.[406] In fact, concern
over just such an event led the Director of the Nutrition Department at
the esteemed Cleveland Clinic to declare that for people on the Atkins
Diet, "Careful monitoring of electrolytes is absolutely essential..."
Those who aren't professionally monitored on this kind of diet "are at
the greatest risk for dangerous complications."[407]
Dr. Paul
Robinson, the Director of Adolescent Medicine at the University of
Missouri, who was involved in the investigation of Rachel's death, is
afraid that "we're having lots of near misses that we don't know
about."[408] "You wonder," he said, "whether there are other people
dying and we don't know about it."[409]
"Is the diet safe for
teenagers?" Dr. Atkins was asked in an interview. Dr. Atkins replied
"The [Atkins] diet is safe for every overweight human being from the
age of 18 months..."[512] Guided by this doctrine, the Atkins
Corporation is trying to make inroads into schools. "I frankly think
it's scandalous," said the Director of the Yale Prevention Research
Center, "really very dangerous."[1155]
One would think a
teenager collapsing and dying after just 9 days on the diet might have
ruined people's appetite for Atkins, but her death was hardly reported
in the American press. When her parents held a press conference to tell
their story for the first time and warn others that Atkins "killed our little girl,"[410]
it was reported in London, Scotland, New Zealand, Australia and South
Africa. But out of the 34 reports that made it into the papers around
the world about this Missouri teen, only 3 appeared in the U.S.[411]
Despite repeated warnings from the American Heart Association,
enthusiasm for the Atkins Diet did not seem to wane.
While
tending her daughter's immaculately-kept grave, Rachel's mom told a
reporter her thoughts on the diet: "I want people to know you can
actually die doing something as stupid as this."[412]
Like the tobacco industry, as bad press mounts here in
the U.S., the Atkins Corporation is exporting their product overseas.
August 2004, for example, they hired a PR firm to "invade Latin
America."[518]
Australia seems to be the only nation in which
action to counter this move is being taken at a State level. The
Victorian Health Minister, supported by the Australian Heart Foundation
and the Australian Medical Association, issued a warning to alert
people to the dangers of the Atkins Diet and other high-fat fad
diets.[413] The government is warning the public about the potential
short-term effects--constipation, dehydration, bad breath, low energy
and poor concentration--and potential long-term effects such as the
increased likelihood of cancer, heart disease, depression, and
osteoporosis. "When we know something is bad for people, like smoking,"
the health minister explained, "then we let people know what the health
risks are."[414]
Initially, the government will distribute
educational materials in doctors' waiting rooms, gyms and universities,
probably followed by advertising in bus shelters and in the media.[415]
Australia's chief physician urged all governments to follow suit.[416]
The
Atkins empire said that this was the first government to launch a
public health campaign against them. Health Canada did propose to ban
“low-carb” product claims[1156] and the British government did issue a
warning against low carbohydrate diets, saying they were "bad for your
health" though it didn't specifically name Atkins.[417] The "US Federal
Government officials," Atkins corporate representatives said, "had a
much more positive response..."[418] Perhaps "low carb" foods aren't a
$30 billion dollar business down under.
In a medical journal article entitled "Bizarre and
Unusual Diets" the authors warn that the Atkins Diet had such
questionable safety that it should "only be followed under medical
supervision."[419] But what do doctors know about nutrition? Even
though the United States Congress mandated that nutrition become an
integrated component of medical education,[420] as of 2004, less than
half of all U.S. medical schools have a single mandatory course in
nutrition.[421] That explains the results of a study published in the
American Journal of Clinical Nutrition that pitted doctors against
patients head-to-head in a test of basic nutrition knowledge. The
patients won.[422] People off the street seem to know more about
nutrition than their doctors.
Doctors can monitor for adverse
effects, though. "The Atkins program falls short in insufficiently
warning dieters," another review of popular weight loss diets warns,
that they "need to be monitored by a physician to ensure his or her
safety."[423] According to the Chair of the Nutrition Department at Harvard
Medical School, people on Atkins "should be monitored for orthostatic
hypotension... dizziness, headaches, fatigue, irritability, gout and
kidney failure." And laboratory work should include "blood tests
(glucose, blood urea nitrogen, sodium, potassium, chloride, and
bicarbonate), urinalysis (specific gravity, pH, protein, and acetone)
and a lipid profile. Vital signs... should be monitored at least
monthly during a low carbohydrate weight-loss program."[424]
Perhaps
one should add the expense of monthly doctor visits to the already high
cost of the Atkins Diet, estimated to cost $10,000-$20,000 per year for
the food and supplements.[425-428]
Once, when Dr. Dean Ornish
was being interviewed on Dateline NBC, his interviewer swore that he
had lost 50 pounds on an Atkins Diet, ate a steak every day, and felt
great. He asked Ornish, "How bad could it be?" When Ornish turned the
tables and questioned the host, it came out that, before going on
Atkins, the guy seemed to be living off french fries, fried onion
rings, cheesecake, and at least five soft drinks per day, everyday. He
had since cut all those out and started exercising religiously. Ornish
pointed out that the reason he's now feeling better was probably in
spite of the steak, not because of it.[429]
The Atkins
Director of Education and Research is convinced that “Researchers at
Harvard and elsewhere have made it plain that trans fatty acids have
been a killer since the 1930s…”[530] Funny then that the 1972 Dr.
Atkins Diet Revolution recommended “unlimited” quantities of vegetable
shortening,[430] the single the most concentrated source of trans fatty
acids in the food supply.[531]
The Atkins Corporation tries to
paint Dr. Atkins as a “Pioneer and Innovator.”[532] Though it was
“plain” that trans fats were a killer “since the 1930s” it took Dr.
Atkins until the 1980’s before he flip-flopped and finally took a
position against trans fats.[533]
Indeed, just cutting out deep fried foods (most often fried in 100% vegetable--and 100% hydrogenated--oil)
from one's diet should alone improve one's cholesterol profile.[1152]
Atkins also encouraged everyone to cut out caffeine, eat more
heart-healthy nuts and omega-3 fatty acids and does consider daily
exercise a critical "non-negotiable" component to his plan.[431]
Anyone
completely cutting out sugary soda, pastries, ice cream, cookies, cake,
candy, kids' cereals, and Snackwells is probably going to feel better.
But does one need a 300-page diet book to tell us that? Anything that
can give Krispy Kreme's corporate profits that glazed look[432] is a
good thing for America's health.
For those who don't remember,
Snackwells were Nabisco's line of low-fat and fat-free junk food that
went from zero to a billion dollars in revenues in four short years, in
effect becoming America's most popular cookie. When Snackwells'
fat-free Devil's Food Cookie Cakes first appeared, demand was so high
that Nabisco had to ration them out to stores and fights broke out,
forcing store managers to keep boxes of the cookie under lock and
key.[433]
People were mistaking low-fat for low-calorie. The
intention of the government's recommendation to cut down on fat was to
get people to cut down on items like meat and switch to foods that are naturally
low in fat--like beans, whole grains, fruits and vegetables. These
don't have much of a profit margin though, so the food industry took
advantage of the new guidelines to market low-fat junk food like
Snackwells cookies, swapping fat for sugar. Each cookie was basically
just white flour, no fiber and two spoonfuls of sugar. Even bags of
jellybeans started boasting "fat-free." A similar phenomenon is now
happening with low carb junk food. A new Atkins-friendly ice cream, for
example, has almost twice the calories of regular ice cream (and of
course twice the fat).[434] "It's Snackwells all over again," noted one
WebMD Medical News article.[435] Junk food--low fat or low carb--is
still junk food.
People also may feel better on the Atkins Diet
because he tells people to stop drinking cow's milk. Most people on the
planet are lactose intolerant (and may not even know it).[437] That
change alone should make a segment of the people trying Atkins feel
better. In addition to those who are lactose intolerant, other easy
born-again Atkins converts might be those with an actual dairy allergy
or the one out of every few hundred Americans who is allergic to
wheat.[438]
Even at his strictest, Atkins "allowed" two small
salads a day. Although they can only be a cup of "loosely" packed
greens each, that's sadly more salad than many non-Atkins Americans may
get. Then again, Atkins' "spinach salad" recipe calls for an entire
pound of bacon and 5 eggs. No croutons, of course--"use crumbled fried
pork rinds instead."[439]
Atkins even recommended eating one's
greens organic, dark, and leafy,[440] although the word "kale" does not
seem to frequent the book sleeve. Unfortunately, people may ignore the
few reasonable suggestions that Atkins made, and just use his low carb
phenomenon as an excuse to eat whatever they want.
There seem to be two Atkins Diets: one that he describes
in his books (particularly in later editions), and the one the public thinks he describes in his books. How many Atkins Dieters, for example, only eat free-range organic bacon?
A
recent study of 11,000 people found that only one in four of those
claiming to be on a low carb diet were actually significantly cutting
carbs at all.[441] Another survey, commissioned by former Surgeon
General C. Everett Koop's organization Shape Up America!, found that
most people claiming to be on Atkins, or another of the low carb fad
diets, didn't seem to even know where carbs were found.[442] Most
didn't know, for example, that tomatoes were high in carbs. Thankfully,
about half of them didn't know apples had a lot of carbs, and 1 in 6
even thought steak was a carbohydrate.[443] Thankfully, most people on
Atkins are actually not on Atkins.
Despite the
softening of his stance on whole grains and many vegetables, Atkins
still made saturated fat-laden meat and dairy the centerpiece of his
diet. The Atkins Diet therefore remains dangerous even when "used as
directed."
Isn't it possible to do the Atkins Diet
healthfully, though? Isn't there some way to modify it to make it
safer? Those exact questions were asked of the editors at the Tufts University Health and Nutrition Letter by one of the University's Vice Presidents.
After
trying their best, the editorial staff at the Tufts Letter couldn't
help but conclude, "So, as to whether it's possible to follow the
Atkins Diet healthfully or tweak it to make it safe and healthful, the
answers are no and no"(emphasis in original).[444]
What kind of diet can cause birth defects? Or blindness?
Or require 65 supplements? Or monthly medical checkups, where the
monitoring of electrolytes is considered "absolutely essential?" Is it
too much to ask that one's diet facilitate instead of debilitate
physical activity? (Here in Boston there has yet to be a night of
pork-rind loading before the Marathon.) What kind of diet may require
prescriptions to deal with the side effects? What kind of diet has side
effects at all?
Rational people go on irrational diets because
"they're desperate," says Kelly Brownell, Director of Yale University's
Center for Eating and Weight Disorders. "If you're a person with an
overweight body living in a thin-obsessed world... something that
offers a miracle is highly attractive."[445]
The Director of
Nutrition at the Center for Science in the Public Interest is
dumbfounded that the high-fat regimes have caught on. "With all the
evidence that saturated fat promotes heart disease, it's almost
unbelievable to me that people could successfully tell people to eat
bacon, eggs, ground beef, cheese and cream," she says. "It really shows
that people care more about how they look than how healthy they
are."[446]
Obesity shouldn't be a cosmetic or moral issue, but
it does remain a health issue. Obesity, as defined by the Institute of
Medicine, is "an important chronic degenerative disease that
debilitates individuals and kills prematurely."[447] Obesity continues
to contribute to hundreds of thousands of deaths in the U.S. every
year.[448-451] Losing weight is important, but the goal should be to
lose weight in a way that enhances health rather than in ways that may
harm it. People also use cocaine, amphetamines and tobacco to control
their weight--not health promoting solutions to the problem.
The Consumer Guide
concluded that the Atkins Diet "owes its appeal, like pornography, to
the naughtiness of the approach, to the titillation we all feel in
doing something which we think is not right."[452] Diet gurus like
Atkins--the "bad boy of diets"[453]--gave "his readers what they wanted
to hear," says James Hill, Director of the University of Colorado
Center for Human Nutrition. Asks one Atkins disciple, "Who wouldn't
like a diet that allows fried eggs and bacon and all the steak you can
eat?"[454] "But what people want to hear," Dr. Hill adds, "is killing
them."[455]
Despite U.S. attempts to stall[456] and sabotage[457] the
World Health Organization's report on diet (as they tried to do with
tobacco),[458] in May 2004 the WHO Global Strategy on Diet, Physical
Activity and Health was unanimously endorsed by all 192 Member States
of the United Nations. The report blames the growing pandemic of global
chronic disease in part on "greater saturated fat intake (mostly from
animal sources), reduced intakes of complex carbohydrates and dietary
fiber, and reduced fruit and vegetable intakes," in other words, they
place blame for the global epidemic of obesity, cancer, heart disease
and diabetes on exactly the kind of diet Atkins' books recommend. As
the Harvard Health Letter put simply, the Atkins Diet "is not a healthy
way to eat."[459] The World Health Organization is calling for limiting
the consumption of saturated animal fats[460] and "increasing the
consumption of fruits, vegetables, legumes [beans, peas and lentils],
whole grains and nuts."[461]
The evidence to support their
position is "overwhelming."[462] After 11 years following 11,000
people, for example, researchers found that eating whole grains may
help people live longer. That did not seem to be the case for refined
grains, though.[463] And the Atkins Diet is based on that half-truth.
Atkins
was right in going "against the grain" in the case of refined
carbohydrates like white flour and sugar. But he was wrong to restrict
good carbs--the carbs found in whole unrefined foods--like those
recommended in the WHO's report: "fruits, vegetables, legumes, whole
grains and nuts." A bunless burger is not the answer to a fat-free
doughnut.
Just because jellybeans and Wonder Bread are not
health-promoting foods does not mean one has to switch to pork rinds
and bacon. Let's not throw the wheat germ out with the wheat.
What evidence do we have that "good" carbs are good?
Every single long-term prospective study ever performed on the foods
that the Atkins Diet restricts--fruits, vegetables, nuts and whole
grains--show that they protect people from the nations' biggest killer:
heart disease.[464] Harvard studied 75,000 women for a decade and the
results suggest that the more whole grains people eat--like brown rice
and whole wheat bread--the lower their risk of having a heart
attack.[465] Harvard studied 40,000 men for a decade and suggested that
eating whole grains may cut one's risk of developing diabetes by more
than half.[466] The only thing wrong with whole grains, perhaps, is
that they may not sell as many books.
Atkins seemed to think
that fruit was the worst thing since sliced bread. Fruit consumption
alone, however, has been linked to lower rates of numerous cancers[467]
and may reduce heart disease mortality, cancer and total
mortality.[468] The World Health Organization blames low fruit and
vegetable consumption on literally millions of deaths worldwide.[469]
Everyone should eat more fruits and vegetables as if their lives
depended on it.
The National Cancer Institute's recommendation is now up to nine
servings of fruits and vegetables every day. While Atkins preached to
restrict fruit and vegetable intake, what Americans really need is more
fruits and veggies, not less.[470]
Life-long weight control is a marathon; fad diets are sold on the 100-yard dash. The UC Berkeley School of Public Health's
#1 rated[471] newsletter's "Bottom Line" on Atkins: "Bottom Line: If
you follow the Atkins Diet, you will lose weight--but it could be
dangerous beyond a few weeks. All fad diets get you to cut down on
calories, usually by limiting the kinds of food you can eat, so of
course you lose weight. Most, like the Atkins Diet, deny that 'calories
count,' but nonetheless trick you into cutting way down on calories by
distracting you with strange rules and psychological/biochemical
babble. As with all crash diets, keeping the weight off is the hard
part. Virtually all crash dieters eventually gain the weight back,
unless they learn the basics of healthy eating, which crash diets do
not teach."[472] Diets are not something to be followed for days,
weeks, or months. They should form the basis of everyday food choices
for the rest of one's life.
So what are the "basics of healthy
eating?" According to the American Dietetics Association, "The
overwhelming majority of studies reported to date including both
epidemiological and laboratory approaches, suggest that eating
carbohydrate-rich foods such as vegetables, fruits, legumes and whole
grains, and limiting saturated fat intake, over a lifetime, is
associated with substantially reduced risk for vascular disease and
some cancers."[473] It may be no coincidence that the longest-living
people in the world, even by some accounts outlasting the Okinawa
Japanese,[474] are the California Seventh Day Adventist
vegetarians.[475]
Every study of the Atkins diet over six
months in duration found that the Atkins diet failed to significantly
outperform the exact diet Atkins blamed our entire obesity epidemic
on.[476] Why not, then, choose a healthier diet?
Fewer than
20% of Americans trying to lose weight follow what's considered the
optimal diet plan for weight control, the one most proven to be safe
and effective for losing weight, keeping the weight off and promoting
health--a diet low in saturated animal fats, and high in fruits,
vegetables and high-fiber-containing carbohydrates like beans and whole
grains.[477] How convenient that the most healthful diet also seems to
be the one most successful in controlling one's weight.[478]
To
lose weight, one can cut down on calorie intake by restricting the
amount of food one eats, or one can transition away from eating junk
food--foodstuffs long on calories but short on nutrition--toward eating
food that is nutrient-dense, but relatively calorie-dilute: foods like
fruits, vegetables, beans and whole grains. One can add nuts to the
list as well, since despite their caloric density, a 2003 review
concluded eating nuts every day might actually help one maintain or
even lose weight.[479] People placed on nutrient-dense, calorie-dilute
plant-based diets tend not to complain of hunger, but of having "too
much food."[480-482]
The healthy alternative to the Atkins Diet is not a fat-free diet, but a fad-free
diet. "Nobody wants to hear this," groaned Dr. James W. Anderson in an
interview. Anderson is a Professor of Medicine and Clinical Nutrition
at the University of Kentucky School of Medicine. "People lose weight
[on the Atkins Diet], at least in the short term. I am not arguing with
that. But this is absolutely the worst diet you could imagine for
long-term obesity, heart disease, and some forms of cancer. If you
wanted to find one diet to ruin your health, you couldn't find one
worse than Atkins'."[483]
The optimal diet is one centered
around good carbohydrates (unrefined), good fats (like nuts) and the
best sources of protein, which, according to the Harvard School of
Medicine, are "beans, nuts, grains and other vegetable sources of
protein..."[484] in other words, by eating a whole-food plant-based
diet one can control one's weight without risking one's health--or
one's life. We don't have to mortgage our health in order to lose
weight.
Thankfully the fad seems to be fading once again. Based
on surveys of thousands of American adults, the low carb craze seems to
have peaked around January 2004 and is expected to continue to drop
according to food-industry analysts at Morgan Stanley.[499] Most
industry analysts and consultants are now suggesting that this latest
low carb wave is indeed a passing fad. [500] According to Fortune
magazine, data show that the number of Americans on a low carb diet has
fallen 25% since January.[485]
The American public seems to be
finally waking up to the truth. In one survey, for example, fewer than
one in five consumers surveyed said they would even consider purchasing
a low carb product. Reasons given for not choosing low carb included
beliefs that low carb diets were neither healthy nor effective.[501]
Declining
demand is starting to affect the low carb corporate bottom-line. Food
gants clamored onto the bandwagon, Maclean's noted,"just as its wheels
started to fall off."[513] Food manufacturers are being stuck with
backlogs of low carb products[514] and a number of planned low carb
lines have been scuttled thanks to disappointing sales.[503] Articles
with titles like this one from Forbes Magazine: "A low-carb retailing
disaster: A pack of entrepreneurs chased the low-carb dream--over a
cliff" have started appearing with more frequency in the business
journals.[504] "There's been a bloodbath in the industry," admits the
head of the low-carb business association.[1153] The Wall Street
Journal calls this phenomenon the "food-fad effect."[506]
"It
reminds me a lot of investors who around 1999 thought it would be a
great time to invest in tech funds, and then proceeded to lose their
pants," says the executive editor of an industry trends publication.
"The pattern is very, very similar."[502]
A year ago, the Atkins
empire couldn't crank out products fast enough. Now, retailers are
discounting them.[505] By the second quarter of 2004, low carb product
sales growth was cut in half.[506] Layoffs at the Atkins Corporation
started in September 2004.[1154]
Food industry researchers
conclude that consumers seem to be finally wising up to the health
risks. "It defied logic," said one industry expert, "Bacon is better
for you than orange juice. Yeah, right."[1153]
Or as one Wall Street analyst explained, "Have you ever tried low carb bread?"[485]
[1] The Chronicle (Houston, TX) 9 March 1973.
[2] The New York Weekly 26 March 1973.
[3] Maryland State Medical Journal 1974:70.
[4] Obesity and Fad Diets. U.S. Senate Select Committee on Nutrition and Human Needs. 12 April 1973 CIS S581-13.
[5] Obesity and Fad Diets. U.S. Senate Select Committee on Nutrition and Human Needs. 12 April 1973 CIS S581-13.
[6] Shape Up America! news release 29 December 2003.
[7] Journal of the American Dietetics Association 102(2002):260.
[8] Chicago Tribune 18 October 1999.
[9] Tampa Tribune (Florida) 19 October 1999.
[10] Journal of the American Dietetics Association 66(1975):277.
[11] Chicago Tribune 18 October 1999.
[12] Dietician's Edge November-December 2001:42.
[13]
Institute of Medicine. Weighing the Options: Criteria for Evaluating
Weight-Management Programs, The National Academies Press, 1995.
[14]
American Cancer Society. Weighing In on Low Carb Diets. 2004.
http://www.cancer.org/docroot/SPC/content/SPC_1_A_Low_Carb_Diet_to_Prevent_Cancer.asp
[15] Circulation 104(2001):1869.
[16] The Cleveland Clinic. High Protein, Low Carbohydrate Diets. August 2003. http://my.webmd.com/content/article/46/2731_1666.
[17] Diabetes 2004. Johns Hopkins University White Paper, 2004.
[18] American Kidney Fund news release 25 April 2002.
[19] Medicine and Science in Sports and Exercise 33(2001):2145.
[20]
National Institute of Diabetes and Digestive and Kidney Diseases.
Choosing a Safe and Successful Weight-Loss Program. NIH Publ. No.
94-3700. National Institutes of Health, Rockville, MD. 1993.
[21] Circulation 104(2001):1869.
[22] Journal of the American College of Cardiology 43(2004):725.
[23] Journal of the American College of Nutrition 22(2003):9.
[24] The New York Times 10 September 2002.
[25] Donaldson, BF. Strong Medicine. Doubleday, 1960.
[26] Hamilton, EMN and EN Whitney. Nutrition: Concepts and Controversies. Second Edition. West Publishing Company, 1982.
[27] Fraser, L. Losing It. Penguin Books, 1997.
[28] Fraser, L. Losing It. Penguin Books, 1997.
[29] Agatson, A. The South Beach Diet. Rodale, 2003.
[30] Atkins, RC. Dr. Atkins New Diet Revolution. Avon Books, 1999.
[31] Atkins, RC. Dr. Atkins Diet Revolution. David McKay Company, Inc., 1972.
[32] Atkins, RC. Dr. Atkins Diet Revolution. David McKay Company, Inc., 1972.
[33] Atkins, RC. Dr. Atkins Diet Revolution. David McKay Company, Inc., 1972.
[34] Australian Magazine 10 April 2004.
[35] Deutsch, RM. The New Nuts Among the Berries. Palo Alto, CA, 1977.
[36] Modern Medicine 28 May 1973:132.
[37] Atkins, RC. Dr. Atkins Diet Revolution. David McKay Company, Inc., 1972.
[38] Atkins, RC. Dr. Atkins Diet Revolution. David McKay Company, Inc., 1972.
[39] Atkins, RC. Dr. Atkins New Diet Revolution. Avon Books, 1992.
[40] British Medical Journal 326(2003):1090.
[41] Journal of the American Dietetics Association 100(2000):760.
[42] New York Times Magazine 7 July 2002.
[43] CNN/Money 1 December 2003.
[44] Scripps Howard News Service 24 April 2003.
[45] The Washington Post 27 August 2002.
[46] Nutrition Action Healthletter November 2002.
[47] The Washington Post 27 August 2002.
[48] Nutrition Action Healthletter November 2002.
[49] Nutrition Action Healthletter November 2002.
[50] Nutrition Action Healthletter November 2002.
[51] Reason magazine March 2003
[52] Nutrition Action Healthletter November 2002.
[53] Obesity Research 9(2001):1S.
[54] Magazine Publishers of America news release 21 August 2003.
[55] Sun-Sentinel (Fort Lauderdale, FL) 11 April 2004.
[56] Tufts University Health and Nutrition Letter 22(2004):1.
[57] Tufts University Health and Nutrition Letter 22(2004):1.
[58] Harvard Health Letter November 2003:5.
[59] Agatson, A. The South Beach Diet. Rodale, 2003.
[60] Tufts University Health and Nutrition Letter 22(2004):1.
[61] Agatson, A. The South Beach Diet. Rodale, 2003.
[62] Tufts University Health and Nutrition Letter 22(2004):1.
[63] USDA Agriculture Research Service. Nutrient Data Laboratory. National Nutrient Database for Standard Reference.
[64] Agatson, A. The South Beach Diet. Rodale, 2003.
[65] PR Newswire 21 May 2004.
[66] Scripps Howard News Service 19 February 2004.
[67] The New York Times 14 April 2004.
[68] Atkins, RC. Dr. Atkins Diet Revolution. David McKay Company, Inc., 1972.
[69] Fortune 17 May 2004.
[70] Family Practice News 15 March 2004.
[71] Atkins, RC. Dr. Atkins New Diet Revolution. Avon Books, 1999.
[72] Sears, B. Enter the Zone. Regan Books, 1995.
[73] American Journal of Clinical Nutrition (1997):1264.
[74] Diabetes care 7(1984):465.
[75] American Journal of Clinical Nutrition 50(1997):1264.
[76] American Journal of Clinical Nutrition 50(1997):1264.
[77] Journal of the American Dietetics Association 1010(2001):411.
[78] Schweizerische medizinische Wochenschrift 107(1977):1017.
[79] Journal of the American College of Nutrition 22(2003):9.
[80] Australian Family Physician 6(1977):155.
[81] Journal of the American Medical Association 289(2003):1773.
[82]
"One Year Effectiveness of the Atkins, Ornish, Weight Watchers, and
Zone Diets in Decreasing Body Weight and Heart Disease Risk" by Michael
L. Dansinger, Joi L. Gleason, John L. Griffith, Wenjun Li, Harry P.
Selker, Ernst Schaefer; Tufts University, New England Medical Center,
Boston, Mass.
[83] Diabetes Care 16(1993):1459.
[84] American Journal of Cardiology 69(1992):440.
[85] Metabolism 43(1994):621.
[86] Nutrition Reviews July 1974:1s.
[87] University of California at Berkeley Wellness Letter April 2000.
[88] Journal of the American College of Nutrition 22(2003):9.
[89] Journal of the American Dietetics Association 100(2000):760.
[90] Nutrition Action Healthletter November 2002.
[91] Health 19(1996):102.
[92] Archives of Internal Medicine 112(1963):87.
[93] Journal of Clinical Investigation 58(1976):529.
[94] Cleveland Clinic Journal of Medicine 68(2001):761.
[95] The Washington Post 23 November 1999.
[96] Journal of the American Medical Association 289(2003):1854.
[97] Callaway, W. The Callaway Diet. Bantam, 1990.
[98] Lancet 2(1960):939.
[99] Obesity Research 9(2001):1S.
[100] Medical Journal of Australia 175(2001):637.
[101] Atkins, RC. Dr. Atkins New Diet Revolution. Avon Books, 1999.
[102] Sears, B. Enter the Zone. Regan Books, 1995.
[103] Scripps Howard News Service, November 13, 2003.
[104] Atkins, RC. Dr. Atkins Diet Revolution. David McKay Company, Inc., 1972.
[105] Journal of the American Medical Association 224(1973):1418.
[106] Atkins, RC. Dr. Atkins Diet Revolution. David McKay Company, Inc., 1972.
[107] BBC News 21 January 2004.
[108] The Chronicle (Houston, TX) 9 March 1973.
[109] Journal-World (Lawrence, KS) 27 January 2004.
[110] Journal of the American Medical Association 224(1973):1416.
[111] Journal of the American Medical Association 289(2003):1837.
[112] Medicine and Health 83(2000):337.
[113] Atkins, RC. Dr. Atkins New Diet Revolution 3rd edition. M. Evans and Company, Inc. 2002.
[114] Obesity Research 9(2001):1S.
[115] Atkins, RC. Dr. Atkins New Diet Revolution. Avon Books, 1999.
[116] Annals of internal Medicine 68(1968):467.
[117] Nutrition and Metabolism 17(1974):360.
[118] Lancet 2(1960):939.
[119] American Journal of Clinical Nutrition 63(1996):174.
[120] International Journal of Obesity and Related Metabolic Disorders 20(1996):1067.
[121] Journal of the American Dietetics Association 90(1990):534.
[122] Journal of the American Medical Association 228(1974):54.
[123] Journal of the American Dietetics Association 77(1980):264.
[124] British Journal of Nutrition 15(1961):53.
[125] American Journal of Clinical Nutrition 30(1977):160.
[126] American Journal of Clinical Nutrition 26(1973):197.
[127] American Journal of Clinical Nutrition 21(1968):1291.
[128] American Journal of Clinical Nutrition 20(1967):139.
[129] American Journal of Clinical Nutrition 24(1971):290.
[130] Journal of the American Dietetics Association 64(1974):47.
[131] International Journal of Obesity and Related Metabolic Disorders 3(1979):210.
[132] Nutrition and Metabolism 22(1978):269.
[133] American Journal of Public Health 76(1986):1293.
[134] New England Journal of Medicine252(1985):661.
[135] Annals of Internal Medicine 68(1968):467.
[136] Annals of the New York Academy of Science 819(1997):44.
[137] USDA. Economic Research Service. http://www.usda.gov/news/pubs/factbook/001a.pdf
[138] Reason, March 2003.
[139] Atkins, RC. Dr. Atkins Diet Revolution. David McKay Company, Inc., 1972.
[140] Atkins, RC. Dr. Atkins New Diet Revolution 3rd edition. M. Evans and Company, Inc. 2002.
[141] Australian Magazine 10 April 2004.
[142] Atkins, RC. Dr. Atkins Diet Revolution. David McKay Company, Inc., 1972.
[143] Atkins, RC. Dr. Atkins New Diet Revolution. Avon, 2002.
[144] Atkins, RC. Dr. Atkins Diet Revolution. David McKay Company, Inc., 1972.
[145] Milling & Baking News 7 March 2000.
[146] New York Times Magazine 7 July 2002.
[147] Nutrition Action Healthletter, November 2002.
[148] Asia Pacific Journal of Clinical Nutrition 6(1997):122.
[149] Morbidity and Mortality Weekly Report 53(2004):80.
[150] Economic Research Service/USDA. The Economics of Obesity / E-FAN-04-004, 2004.
[151] New York Times 6 September 1995.
[152] Journal of the Arkansas Medical Society 8(2004):255.
[153] New York Times 26 December 2000.
[154] Nutrition Action Healthletter November 2002.
[155] ABC News 20 May 2002.
[156] USA Today 20 February 1996.
[157] http://www.nsda.org/SoftDrinks/index.html
[158] Gray, G.A. An Atlas of Obesity and Weight Control. Boca Raton, FL: Parthenon Publishing , 2003.
[159] Critser, G. Fat Land. Houghton Mifflin Co., 2003.
[160] Nutrition Action Healthletter, November 2002.
[161] The New York Weekly 26 March 1973.
[162] Obesity and Fad Diets. U.S. Senate Select Committee on Nutrition and Human Needs. 12 April 1973 CIS S581-13.
[163] Maryland State Medical Journal 1974:70.
[164] Clinics in Endocrinology and Metabolism 12(1983):413.
[165] Atkins, RC. Dr. Atkins Diet Revolution. David McKay Company, Inc., 1972.
[166] The New York Weekly 26 March 1973.
[167] Obesity and Fad Diets. U.S. Senate Select Committee on Nutrition and Human Needs. 12 April 1973 CIS S581-13.
[168]
Whelan, E. The One-hundred-percent Natural, Purely Organic,
Cholesterol-Free, Megavitamin, Low Carbohydrate Nutrition Hoax.
Athenium, 1983.
[169] Hamilton, EMN and EN Whitney. Nutrition: Concepts and Controversies. Second Edition. West Publishing Company, 1982.
[170] McCall's Monthly Newsletter for Women, April 1973.
[171] The Chronicle (Houston, TX) 9 March 1973.
[172] Atkins, RC. Dr. Atkins Diet Revolution. David McKay Company, Inc., 1972.
[173] Obesity and Fad Diets. U.S. Senate Select Committee on Nutrition and Human Needs. 12 April 1973 CIS S581-13.
[174] Cleveland Clinic Journal of Medicine 68(2001):761.
[175] Archives of Internal medicine 112(1963):333.
[176] Schweizerische medizinische Wochenschrift 107(1977):1017.
[177] War Medicine 7(1945):345.
[178] Epilepsia 39(1998):744.
[179] Gastroenterology 118(2000):1233.
[180] Circulation. 102(2000):2284.
[181] Atkins, RC. Dr. Atkins New Diet Revolution. Avon Books, 1999.
[182] The Washington Times 30 May 2004.
[183] Annals of Internal Medicine 140(2004):769.
[184] Berland, T and L Frohman. CONSUMER GUIDE Rating the Diets. Publications International, Ltd., 1974.
[185] http://www.healthyweightnetwork.com/posters.htm#Slim%20Chance%20Awards%20poster
[186] Obesity Research 9(2001):1s.
[187] American Journal of Cardiology 85(2000):1018.
[188] New England Journal of Medicine 350(2004):1093.
[189] The Observer 18 January 2004.
[190] Atkins, RC. Dr. Atkins New Diet Revolution. Avon Books, 1999.
[191] Asia Pacific Journal of Clinical Nutrition 12(2003):396.
[192] Dr. Atkins New Diet Revolution 3rd edition. M. Evans and Company, Inc. 2002.
[193] Journal of the American College of Nutrition 22(2003):9.
[194] Time Magazine 1 November 1999.
[195] International Journal of Obesity 19(1995):811.
[196] International Journal of Obesity 19(1995):811.
[197] MIT News 20 February 2004.
[198] Press Association 1 March 2004.
[199] MIT News 20 February 2004.
[200] MIT News 4 November 2004.
[201] Fraser, L. .Losing It. Penguin Books, 1997.
[202] MIT News 20 February 2004.
[203] Atkins, RC. Dr. Atkins Diet Revolution. David McKay Company, Inc., 1972.
[204] Atkins, RC. Dr. Atkins Diet Revolution. David McKay Company, Inc., 1972.
[205] Atkins, RC. Dr. Atkins Diet Revolution. David McKay Company, Inc., 1972.
[206] Allopurinol. Physicians' Desk Reference. Thomson Healthcare, 2004.
[207] Atkins, RC. Dr. Atkins New Diet Revolution. Avon Books, 1999.
[208] Atkins, RC. Dr. Atkins Diet Revolution. David McKay Company, Inc., 1972.
[209] Dr. Atkins New Diet Revolution 3rd edition. M. Evans and Company, Inc. 2002.
[210] Australian Magazine 10 April 2004.
[211] BBC Two 22 January 2004, 9pm.
[212] Journal of the American Medical Association 289(2003):1837.
[213]
Dansinger, M.L., Gleason, J. L., Griffith, J.L., et al., "One Year
Effectiveness of the Atkins, Ornish, Weight Watchers, and Zone Diets in
Decreasing Body Weight and Heart Disease Risk," Presented at the
American Heart Association Scientific Sessions November 12, 2003 in
Orlando, Florida.
[214] New England Journal of Medicine 348(2003):2082.
[215] Annals of Internal Medicine 140(2004):778.
[216]
Dansinger, M.L., Gleason, J. L., Griffith, J.L., et al., "One Year
Effectiveness of the Atkins, Ornish, Weight Watchers, and Zone Diets in
Decreasing Body Weight and Heart Disease Risk," Presented at the
American Heart Association Scientific Sessions November 12, 2003 in
Orlando, Florida.
[217] http://atkins.com/Archive/2003/12/11-933145.html Accessed 1 June 2004.
[218] Scripps Howard News Service 13 November 2003.
[219] Journal of the American Medical Association 280(1998):2001.
[220] Obesity Research 9(2001):1S.
[221] International Journal of Obesity 27(2003):728.
[222] Journal of the American Dietetics Association 1010(2001):411.
[223] Metabolism 43(1994):621.
[224] Nutrition Research 10(1990):39.
[225] Metabolism 43(1994):621.
[226] New England Journal of Medicine 348(2003):2082.
[227] Annals of Internal Medicine 140(2004):778.
[228] http://annemfletcher.com/
[229] Nutrition 19(2003):253.
[230] American Journal of Clinical Nutrition 70(1999):412.
[231] Nutrition Reviews 62(2004):1.
[232] American Journal of Public Health 87(1997):747.
[233] American Journal of Public Health 87(1997):747.
[234] The Washington Post 23 November 1999.
[235] Institute of Medicine. Weighing the Options. National Academy Press, 1995.
[236] Annals of Internal Medicine 119(1993):661.
[237] Consumers Union news release 6 May 2002.
[238] Time Magazine 7 June 2004.
[239] Reason, March 2003.
[240] American Journal of Clinical Nutrition 66(1997):239 and Atkins, RC. Dr. Atkins New Diet Revolution. Avon Books, 1999.
[241] The Washington Post 27 August 2002.
[242] Time Magazine 25 April 2004.
[243] Dr. Atkins New Diet Revolution 3rd edition. M. Evans and Company, Inc. 2002.
[244] American Journal of Clinical Nutrition 99(1997):239.
[245] Atkins, RC. Dr. Atkins Diet Revolution. David McKay Company, Inc., 1972.
[246] Cleveland Clinic Journal of Medicine 68(2001):761.
[247] British Medical Journal 326(2003):1090.
[248] Milling & Baking News 7 March 2000.
[249] Modern Medicine 28 May 1973:132.
[250] The Washington Post 18 April 2003.
[251] Cleveland Clinic Journal of Medicine 68(2001):761.
[252] Cleveland Clinic Journal of Medicine 68(2001):776.
[253] American Institute for Cancer Research Newsletter 67(2000):11.
[254] Circulation 104(2001):1869.
[255] Caterer and Hotelkeeper 28 August 2003.
[256] Daily Record 25 August 2003.
[257] The Times (London) 27 September 2003.
[258] The Sunday Telegraph (Sydney, Australia) 14 September 2003.
[259] The Independent 13 August 2003.
[260] The Evening Standard (London) 12 August 2003.
[261] Cleveland Clinic Journal of Medicine 68(2001):761.
[262] Journal of the American Dietetics Association 86(1985):460.
[263] Medical Journal of Australia 1(1977):65.
[264] British Journal of Ophthalmology 63(1979):191.
[265] Medical Letter on Drugs and Therapeutics 15(1973):1.
[266] Medical Times 107(1979):31.
[267] The Medical Letter 42(2000):52.
[268] Obesity Research 9(2001):1S.
[269] Journal of the American College of Cardiology 43(2004):725.
[270] "Diet-Pak." http://atkins.com/shop/get-started.html/pg=2
[271] "Anti-Oxidant" http://atkins.com/shop/products/AntiOxidant.html
[272] USA Today 3 May 2004.
[273] CBS News. The Early Show. 25 May 2004.
[274] Journal of the American College of Cardiology 43(2004):725.
[275] Atkins, RC. Dr. Atkins New Diet Revolution. Avon Books, 1999.
[276] Dr. Atkins New Diet Revolution 3rd edition. M. Evans and Company, Inc. 2002.
[277] Atkins, RC. Dr. Atkins Diet Revolution. David McKay Company, Inc., 1972.
[278] The Sunday Telegraph (Sydney, Australia) 14 September 2003.
[279] Cleveland Clinic Journal of Medicine 68(2001):761.
[280] Cleveland Clinic Journal of Medicine 69(2002):855.
[281] New England Journal of Medicine 323(1990):1664.
[282] Cancer Research 54(1994):2390.
[283] Nutrition Action Healthletter, January/February 2004:1.
[284] Nation's Restaurant News 17 May 2004.
[285] Journal of the National Cancer Institute 95(2003):1079.
[286]
American Cancer Society. Weighing In on Low Carb Diets. 2004.
http://www.cancer.org/docroot/SPC/content/SPC_1_A_Low_Carb_Diet_to_Prevent_Cancer.asp
[287] New England Journal of Medicine 307(1982):652.
[288] Atkins, RC. Dr. Atkins Diet Revolution. David McKay Company, Inc., 1972.
[289] American Kidney Fund news release 25 April 2002.
[290] Dr. Atkins New Diet Revolution 3rd edition. M. Evans and Company, Inc. 2002.
[291] New England Journal of Medicine 307(1982):652.
[292] Annals of Internal Medicine 138(2003):460.
[293] American Journal of Kidney Diseases 41(2003):1.
[294] Journal of the American College of Cardiology 43(2004):725.
[295] American Family Physician 60(1999):2269.
[296] American Kidney Fund News release 25 April 2002.
[297] Asia Pacific Journal Clinical Nutrition. 12(2003)396.
[298] Sunday Mail (Queensland, Australia) 22 February 2004.
[299] Journal of Pediatrics 117(1990):743.
[300] American Journal Epidemiology 143(1996):472.
[301] American Journal of Clinical Nutrition 73(2001):118.
[302] The New York Weekly 26 March 1973.
[303] American Journal of Kidney Diseases 40(2002):265.
[304] American Journal of Kidney Diseases 40(2002):265.
[305] "Osteo #10" http://atkins.com/shop/products/Osteo_10.html
[306] Abram's Plains: A Poem. Editorial Emendations. http://www.uwo.ca/english/canadianpoetry/longpoems/abrams/editorial.htm
[307] American Journal of Kidney Diseases 40(2002):265.
[308] Calcium intake levels in the United States: issues and considerations. http://www.fao.org/docrep/W7336T/w7336t06.htm
[309] American Journal of Clinical Nutrition 11(1963):31.
[310] American Journal of Clinical Nutrition 27(1974):916.
[311] Human Biology 46(1974):369.
[312] Human Biology 56(1984):63.
[313] Human Biology 47(1975):45.
[314] Alaska Medicine 43(2001):1.
[315] Canadian Medical Association Journal 152(1995):1237.
[316] CNN. Larry King Live. 11 July 2003.
[317] Epilepsia 39(1998):744.
[318] Atkins, RC. Dr. Atkins New Diet Revolution. Avon Books, 1999.
[319] Journal of Biological Chemistry 83(1929):753.
[320] Atkins Health Revelations Special Report, Winter 2001.
[321] Cleveland Clinic Journal of Medicine 69(2002):855.
[322] Dr. Atkins New Diet Revolution 3rd edition. M. Evans and Company, Inc. 2002.
[323] Atkins, RC. Dr. Atkins New Diet Revolution. Avon Books, 1999.
[324] Berland, T and L Frohman. CONSUMER GUIDE Rating the Diets. Publications International, Ltd., 1974.
[325] Journal of the American Dietetics Association 77(1980):264.
[326] American Journal of Clinical Nutrition 30(1977):160.
[327] Nutrition and Metabolism 17(1974):360.
[328] Obesity Research 9(2001):1s.
[329] Journal of Nutrition. 132(2002):1879.
[330] Journal of Pediatrics 142(2003):253.
[331] Journal of Pediatrics 142(2003):352.
[332] New England Journal of Medicine 348(2003):2074.
[333] Annals of Internal Medicine 140(2004):778.
[334] New England Journal of Medicine 348(2003):2082.
[335] Journal of Clinical Endocrinology and Metabolism 88(2003):1617.
[336] Annals of Internal Medicine 140(2004):769.
[337] Journal of Nutrition 134(2004):880.
[338] Journal of Nutrition 133(2003):2756.
[339] Journal of Nutrition 129(1999):1545.
[340] American Journal of Clinical Nutrition 56(1992):320.
[341] Journal of the American Medical Association 290(2003):912.
[342] Journal of the American Dietetics Association 100(2000):1301.
[343] Journal of Nutrition 133(2003):2756.
[344]
Expert Panel on Detection, Evaluation, and Treatment of High Blood
Cholesterol in Adults, National Cholesterol Education Program. Second
report of the Expert Panel on Detection, Evaluation, and Treatment of
High Blood Cholesterol in Adults (Adult Treatment Panel II).
Circulation. 1994;89:1329-1445.
[345] Annals of Internal Medicine 140(2004):769.
[346] Reuters 26 May 2004.
[347] Circulation 89(1994):1329.
[348] The Washington Post 27 August 2002.
[349] American Journal of Medicine 113(2002):30.
[350] "Pair of Studies Vindicate Atkins Diet." Associated Press 21 May 2003.
[351] National Review Online 6 June 2003.
[352] Journal of the American College of nutrition 19(2000):578.
[353] http://www.fumento.com/fat/media.html
[354] New England Journal of Medicine 348(2003):2074.
[355] Annals of Internal Medicine 140(2004):778.
[356] Cleveland Clinic Journal of Medicine 69(2002):864.
[357] Federal Document Clearing House Congressional Testimony 3 June 2004.
[358] Journal of Nutrition. 132(2002):1879.
[359] Journal of Pediatrics 142(2003):253.
[360] Journal of Pediatrics 142(2003):352.
[361] New England Journal of Medicine 348(2003):2074.
[362] Annals of Internal Medicine 140(2004):778.
[363] New England Journal of Medicine 348(2003):2082.
[364] Journal of Clinical Endocrinology and Metabolism 88(2003):1617.
[365] Annals of Internal Medicine 140(2004):769.
[366] Journal of Nutrition 134(2004):880.
[367] Journal of the American College of Nutrition 23(2004):177.
[368] Journal of Nutrition 2003 Sep;133(9):2756-61.
[369] American Journal of Clinical Nutrition 63(1996):174.
[370] Journal of the American Dietetics Association 77(1980):264.
[371] American Journal of Clinical Nutrition 30(1977):160.
[372] Journal of Clinical Investigation 85(1990):144.
[373] Harrison's Advances in Cardiology. McGraw Hill, 2002.
[374] Medical Opinion 1(1972):13.
[375] Journal of the American Medical Association 280(1998):2001.
[376] Nutrition Action Newsletter January-February 2001:1.
[377]
CBS Healthwatch December 1999.
http://cbshealthwatch.medscape.com/medscape/p/G_Library/article.asp?RecID=203132&ContentType=Library&DietImg=1
[378] Neurology 254(2000):2328.
[379] http://atkins.com/about/recentnews/wsjresponse.html
[380] American Institute for Cancer Research Newsletter 67(2000)11.
[381]
World Cancer Research Fund/American Institute for Cancer Research.
Food, Nutrition, and the Prevention of Cancer: a global perspective.
World Cancer Research Fund/American Institute for Cancer Research, 1997.
[382] Journal of the National Cancer Institute 95(2003):1079.
[383]
Report of a Joint WHO/FAO Expert Consultation. Diet, Nutrition and the
Prevention of Chronic Diseases. WHO Technical Report Series 916, 2003.
[384] Geriatrics (1961):407.
[385] Preventive Medicine 13(1984):490.
[386] Circulation 98(1998):935.
[387] http://meatlessmondays.org/about.html
[388] Washington Post 14 April 1973.
[389] Journal of the American Medical Association 224(1973):1418.
[390] The New York Times 18 January 2004.
[391] Circulation 89(1994):1329.
[392] The New York Times 18 January 2004.
[393] Atkins, RC. Dr. Atkins Diet Revolution. David McKay Company, Inc., 1972.
[394] Atkins, RC. Dr. Atkins New Diet Revolution. Avon Books, 1999.
[395] The New York Times 18 January 2004.
[396] http://atkins.com/Archive/2004/2/3-915798.html
[397]
JODY GORRAN, Plaintiff, v. ATKINS NUTRITIONALS, INC. and PAUL D. WOLFF,
Solely in his Representative Capacity as Co-Executor of the Estate of
Robert C. Atkins, M.D., Defendants.
[398] JODY GORRAN,
Plaintiff, v. ATKINS NUTRITIONALS, INC. and PAUL D. WOLFF, Solely in
his Representative Capacity as Co-Executor of the Estate of Robert C.
Atkins, M.D., Defendants.
[399] The Chronicle (Houston, TX) 9 March 1973.
[400] New York Times 23 March 1973.
[401] Herbert, V. Nutrition Cultism. George F. Stickley Co., 1980.
[402] NBC News Transcripts. Today Show. 28 May 2004.
[403] ABC. Good Morning America 28 May 2004.
[404] MSNBC. DONAHUE 13 November 2002.
[405] Daily Mail (London) 23 August 2003.
[406] PR Newswire 11 November 2002.
[407] Cleveland Clinic Journal of Medicine 68(2001):777.
[408] Newhouse News Service 5 February 2004.
[409] The Sunday Telegraph (Sydney, Australia) 24 August 2003.
[410] Daily Mail (London) 23 August 2003.
[411]
Using Lexis-Nexis, searching all English language news, no date
restriction: "Rachel Huskey" and "Atkins Diet" on 17 May 2004.
[412] Daily Mail (London) 23 August 2003.
[413] Herald Sun (Melbourne, Australia) 13 April 2004.
[414] Herald Sun (Melbourne, Australia) 15 March 2004.
[415] Herald Sun (Melbourne, Australia) 15 March 2004.
[416] The Mercury (Australia) March 16, 2004.
[417] The Express 22 September 2003.
[418] Herald Sun (Melbourne, Australia) 16 March 2004.
[419] The Practitioner 222(1979):643.
[420] American Journal of Clinical Nutrition 72(2000):868S.
[421] Today's Dietician February 2004:21.
[422] American Journal of Clinical Nutrition 58(1997):319.
[423] Clinics in Sports Medicine 18(1999):691.
[424] Cleveland Clinic Journal of Medicine 68(2001):761.
[425] "Diet-Pak" http://atkins.com/shop/get-started.html/pg=2
[426] "Anti-Oxidant" http://atkins.com/shop/products/AntiOxidant.html
[427] USA Today 3 May 2004.
[428] CBS News. The Early Show 25 May 2004.
[429]
The Diet War: Low-Fat vs. High-Protein with Dean Ornish. 16 July 2002.
http://my.webmd.com/content/article/53/60634.htm?lastselectedguid={5FE84E90-BC77-4056-A91C-9531713CA348}
[430] Atkins, RC. Dr. Atkins Diet Revolution. David McKay Company, Inc., 1972.
[431] Dr. Atkins New Diet Revolution 3rd edition. M. Evans and Company, Inc. 2002.
[432] The Evening Standard (London) 28 May 2004.
[433]
Fumento, M and JE Manson. The Fat of the Land: Our Health Crisis and
How Overweight Americans Can Help Themselves. Penguin, 1998.
[434] Consumer Reports 69(2004):12.
[435] WebMD Medical News 10 May 2004.
[436] National Dairy Council.
Lactose
Intolerance and Minorities: The Real Story.
http://www.nationaldairycouncil.org/nutrition/lactose/lactoseIntolerance.asp?page=4
[437] Journal of the American Dietetic Association 96(1996):243.
[438] Gastroenterology 110(1996):A1.
[439] Atkins, RC. Dr. Atkins Diet Revolution. David McKay Company, Inc., 1972.
[440] Dr. Atkins New Diet Revolution 3rd edition. M. Evans and Company, Inc. 2002.
[441]
The NPD Group Reports on Low Carb's Impact on America's Diet 5 April
2004. http://www.npd.com/press/releases/press_040405.htm
[442] Shape Up America news release 29 December 2003.
[443] Newhouse News Service 5 February 2004.
[444] Tufts University Health and Nutrition Letter 21(2003):1.
[445] The Washington Post 23 November 1999.
[446] The Washington Post 23 November 1999.
[447] Institute of Medicine. Weighing the Options. National Academy Press, 1995.
[448] American Heart Journal 147(2004):841.
[449] New England Journal of Medicine 338(1998):1.
[450] Annals of Internal Medicine 138(2003):24.
[451] Journal of the American Medical Association 289(2003):187.
[452] Berland, T and L Frohman. CONSUMER GUIDE Rating the Diets. Publications International, Ltd., 1974.
[453] Harvard Health Letter 28(2003):1.
[454] Tampa Tribune (Florida) 19 October 1999.
[455] Reason March 2003.
[456] Developing Countries Attack U.N. Strategy On Obesity. UN Wire. http://www.unwire.org/UNWire/20040210/449_12957.asp
[457] U.S. Opposes WHO's Anti-Obesity Campaign. UN Wire. http://www.unwire.org/UNWire/20040116/449_12157.asp
[458]
Centre for Science in the Public Interest letter to Mr. Ed Aiston,
Director General International Affairs Directorate.
http://cspinet.org/canada/who_glstrat.html
[459] Harvard Health Letter 28(2003):1.
[460]
World Health Organization. World Health Assembly Raises Global Public
Health to New Level.
http://www.who.int/mediacentre/releases/2004/wha4/en/
[461] World
Health Organization. Frequently Asked Questions About the WHO Global
Strategy on Diet, Physical Activity and Health.
http://www.who.int/dietphysicalactivity/faq/en/
[462] Circulation 98(1998):935.
[463] Journal of the American College of Nutrition 19(2000)326S.
[464] Journal of the American Medical Association 288(2002):2569.
[465] American Journal of Clinical Nutrition 70(1999)412.
[466] American Journal of Clinical Nutrition 76(2002):535.
[467] Cancer Causes and Control 7(1996):178.
[468] British Medical Journal 313(1996):775.
[469]
World Health Organization. Fruit, Vegetables and NCD Prevention.
http://www.who.int/dietphysicalactivity/publications/facts/fruit/en/
[470] National Cancer Institute. www.9aday.cancer.gov/
[471] http://www.berkeleywellness.com/html/wl/wlAbout
[472] University of California at Berkeley Wellness .April 2000.
[473] Journal of the American Dietetics Association 100(2000):1300.
[474] Harvard Health Letter January 2002.
[475] Archives of Internal Medicine 161(2001):1645.
[476] CNN. Larry King Live. 11 July 2003.
[477]
US Department of Health and Human Services. Office of the Surgeon
General. The Surgeon General's Call to Action to Prevent and Decrease
Overweight and Obesity. 2001.
[478] Obesity Research 9(2001):1S.
[479] American Journal of Clinical Nutrition 78(2003):647s.
[480] Journal of the American Medical Association 274(1995):1450.
[481] Obesity Research 4(1996):347.
[482] Archives of Internal Medicine 164(2004):210.
[483]
CBS Healthwatch December 1999.
http://cbshealthwatch.medscape.com/medscape/p/G_Library/article.asp?RecID=203132&ContentType=Library&DietImg=1
[484]
Willett, WC, Skerrett, PJ, and Edward L. Giovannucci. Eat, Drink, and
Be Healthy: The Harvard Medical School Guide to Healthy Eating. Simon
& Schuster, August 2001.
[485] Fortune 14 June 2004:152.
[486] Berland, T and L Frohman. CONSUMER GUIDE Rating the Diets. Publications International, Ltd., 1974.
[487] Eades, MR and MD Eades. Protein Power. Bantam, 1997.
[488] The Gourmet Retailer 21 July 2004.
[489] New York Times 27 November 1996.
[490] Boston Herald 12 October 1999.
[491]
American Institute for Cancer Research/World Cancer Research Fund.
Food, Nutrition and the Prevention of Cancer: A Global Perspective.
1997.
[492] Scientific American 9 January 1892.
[493] Ibid.
[494] Ibid.
[495] http://5aday.gov
[496]
World Health Organization. Report of the Joint WHO/FAO Expert
Consultation on Diet, Nutrition and the Prevention of Chronic Diseases.
23 April 2003.
[497]American Cancer Society. Recommendations for
Nutrition and Physical Activity for Cancer Prevention. Revised 21
February 2002.
[498] Convenience Store News 2 August 2004.
[499] Business Week 9 August 2004.
[500] Los Angeles Times 25 July 2004.
[501] United Press International 14 July 2004.
[502] Maclean's 23 August 2004.
[503] Wall Street Journal 12 July 2004.
[504] Forbes 26 July 2004.
[505] USA TODAY 3 August 2004.
[506] Wall Street Journal 12 July 2004.
[507] Gastroenterology 118(2000):1233.
[508] Tufts University Health and Nutrition Letter December 2003.
[509] Journal of the American College of Nutrition 19(2000):578.
[510]
U.S. Food and Drug Administration. Center for Food Safety and Applied
Nutrition. Guidance on How to Understand and Use the Nutrition Facts
Panel on Food Labels. Updated July 2003.
[511] Annals of Internal Medicine 140(2004):769.
[512]
Guest: Robert C Atkins, M.D. Power Surge Live in Conjunction with AOL
in AOL Live's "Odeon" Auditorium.
http://www.power-surge.com/transcripts/atkins.htm
[513] Maclean's 23 August 2004.
[514] Omaha World Herald (Nebraska) 28 July 2004.
[515] The Lancet 364(9437) 4 September 2004.
[516] BBC News 6 October 2003.
[517] The Independent (London) 3 September 2004.
[518] The Billings Gazette 18 August 2004.
[519] Asia Pacific Journal of Clinical Nutrition 12(2003):397.
[520] Nutrition, Metabolism and Cardiovascular Disease 14(2004):61.
[521] Angiology 51(2000):817.
[522] New England Journal of Medicine 340(1999):1994.
[523] Preventive Cardiology 5(2002):110.
[524] BBC News 23 February 2004.
[525] The Lancet 364(2004):897.
[526] Journal of the American Dietetic Association 104(2004):537.
[527] Journal of the American Medical Association 285(2001):2486.
[528] Archives of Internal Medicine 164(2004):181.
[529] Journal of the American College of Cardiology 43(2004):2142.
[530] Trans Fats Heat Up. http://atkins.com/Archive/2003/7/31-167227.html
[531] Top 10 Foods With Trans Fats. http://my.webmd.com/content/article/70/81100.htm
[532] Dr. Atkins: Pioneer and Innovator. http://atkins.com/Archive/2004/6/30-185426.html
[533] Dr. Atkins: Pioneer, Innovator (Part 2) http://atkins.com/Archive/2004/8/10-529410.html
[534] New York State Journal of Medicine 85(1985):451.
[535] Proceedings of the Nutrition Society 62(2003):867.
[536] Diabetes and Metabolism 26(2000):45.
[537]
“How will doing Atkins help to lower my cholesterol? “
http://atkins.com/helpatkins/newfaq/answers/HowWillDoingAtkinsHelpToLowerMyCholesterol.html
[538]
Wachtell, Lipton, Rosen & Katz; Booker, L.T "Philip Morris
Companies Inc. and Philip Morris Incorporated, Plaintiffs vs American
Broadcasting Companies, Inc., Forrest Sawyer, John Martin, Walt
Bogdanich, and John/Jane Doe(s) I-IV, Defendants" 20 Mar 1994 Bates:
2022813330-2022813359.
[539] Recorded personal communication with John McDougall, M.D. on KRSO radio, Santa Rosa, CA.
[540] Atkins, RC. Dr. Atkins Diet Revolution. David McKay Company, Inc., 1972.
[541] The Associated Press 11 June 1981.
[542] Kurzweil, R The 10% Solution for a Healthy Life. Three Rivers Press (CA), 1995.
[543]
Lovendale, M The Pritikin-Atkins Debate (1979): Introduction and the
Science of Nutrition http://www.preventivecare.com/media.htm (where you
can also listen to the famous 1979 Pritikin v Atkins debate in
streaming audio).
[544] "Re: Smoking and Pollution Pupil's Booklet" 12 Feb 1992 Bates: 2500119513-2500119514.
[545] Journal of the American Medical Association 289(2003):1837.
[546] Journal of Comparative Psychology 2(1922):371.
[547] Psychopharmacology 83(1984):93.
[548] Life Sciences 46(1990):1523.
[549] Life Sciences 43(1988):277.
[550] Behavioral and Neural Biology 53(1990):269.
[551] Lancet 8670(1989):1046.
[552] Biomedicine and Pharmacotherapy 43(1989):19.
[553] Life Sciences 44(1989):1521.
[554] Digestive Diseases and Sciences 35(1990):827.
[555] British Journal of Psychiatry 154(1989):797.
[556] Progress in Clinical and Biological Research 317(1989):189.
[557] Chest 87(1985):11.
[558] Psychopharmacology 108(1992):393.
[559] Psychopharmacology 108(1992):437.
[560] Addiction 88(1993):589.
[561] Pharmacology, Biochemistry and Behavior 38(1991):281.
[562] Progress in Drug Research 33(1989):9.
[563] Addictive Behaviors 9(1984):265.
[564] Psychopharmacology 108(1992):432.
[565] Psychopharmacology 104(1991):113.
[566] Psychopharmacology 108(1992):485.
[567] Psychopharmacology 108(1992):443.
[568] British Journal of Addiction 87(1992):1313,
[569] Pharmacology, Biochemistry and Behavior 42(1992):301.
[570] British Journal of Addiction 86(1991):571.
[571] Journal of Smoking Related Disorders 3(1992):43.
[572] Medical Hypotheses 52(1999):101.
[573] Proceedings of the National Academy of Sciences of the United States of America 100(2003):8182.
[574] Clinical Gastroenterology & Hepatology 2(2004):41.
[575] Journal of Family Practice 46(1998):460.
[576]
Warburton, DM and AC Walters Attentional Processing, in Ney, T and A
Gale (Eds) Smoking and Human Behavior (New York, Wiley), 1989.
[577] British Medical Journal 293(1986):359.
[578] International Journal of Gynecology 27(1988):57.
[579] American Journal of Obstetrics and Gynecology 144(1982):655.
[580] Chest 122(2002):227.
[581] Journal of Pediatrics 140(2002):125.
[582] Journal of the American Academy of Dermatology 45(2001):965.
[583] Archives of Internal Medicine 161(2001):2502.
[584] Arthritis & Rheumatism 44(2001):2456.
[585] Drugs 61(2001):777.
[586] Archives of Dermatology 136(2000):1442.
[587] Journal of Clinical Oncology 18(2000):3453.
[588] AIDS 14(2000):1859.
[589] Drugs 60(2000):273.
[590] British Medical Journal 307(1993):939.
[591] Pediatric Infectious Disease Journal 15(1996):465.
[592] British Medical Journal 313(1996):377.
[593] Archives of Dermatology 132(1996):1392.
[594] Journal of the American Medical Association 278(1997):1135.
[595] Archives of Dermatology 134(1998):1045.
[596] New England Journal of Medicine 341(1999):1606.
[597] Journal of Clinical Oncology 22(2004):2477.
[598] Mayo Clinic Proceedings 79(2004):875.
[599] British Journal of Haematology 125(2004):149.
[600] Gut 53(2004):609.
[601] Archives of Dermatology 140(2004):277.
[602] Journal of Pediatrics 143(2003):692.
[603] British Journal of Haematology 123(2003):436.
[604] Journal of Clinical Oncology 21(2003):3770.
[605] Archives of Internal Medicine 163(2003):1487.
[606] Journal of Clinical Oncology 21(2003):2211.
[607] British Journal of Haematology 121(2003):191.
[608] Mayo Clinic Proceedings 78(2003):34.
[609] Circulation Research 91(2002):988.
[610] American Heart Journal 144(2002):847.
[611] Neurology 60(2003):130.
[612] Journal of Clinical Oncology 21(2003):16.
[613] Journal of Infectious Diseases 180(1999):61.
[614] British Medical Bulletin 52(1996):58.
[615]
Tobacco Industry Research Committee. "A Scientific Perspective on the
Cigarette Controversy."
http://tobaccodocuments.org/ctr/CTRMN003338-3357.html
[616] http://www.asbestos-institute.ca/main.html
[617] "Environmental Working Group Arsenic in Pressure Treated Lumber" http://www.ewg.org/issues/arsenic/index.php
[618] "Wood Preservative Science Council" http://www.woodpreservativescience.org/reports.shtml
[619] "U.S Environmental Protection Agency. Guidance for Uses of Chromated Copper Arsenate" 6 June 2004.
[620] Center for Media and Democracy "American Council on Science and Health" http://www.prwatch.org/improp/acsh.html
[621] "American Council on Science and Health" http://www.acsh.org/publications/pubID.154/pub_detail.asp
[622] Journal of the American Medical Association 289(2003):1837.
[623] Journal of the American Medical Association 289(2003):1837.
[624] Journal of the American Dietetic Association 101(2001):411.
[625] Journal of the American College of Nutrition 22(2003):9.
[626] Asia Pacific Journal of Clinical Nutrition 6(1997):122.
[627] BBC News 23 February 2004.
[628] The Lancet 364(2004):897.
[629] Written Statement of Stuart Trager, M.D Atkins Nutritionals, Inc. to the House Government Reform Committee 3 June 2004.
[630] WJLA-TV ABC News 22 June 2004.
[631] Atkins Nutritionals, Inc. News Release November 2004 http://atkins.com/Archive/2003/11/22-889227.html
[632] CNN Larry King Live 16 February 2004.
[633] PR Newswire 21 March 2004.
[634] Atkins Nutritionals, Inc. News Release http://atkins.com/Archive/2004/5/27-421771.html
[635] Atkins Nutritionals, Inc. News Release 28 June 2004.
[636] Atkins Nutritionals, Inc. News Release 25 June 2004.
[637] "Research Supporting Atkins" http://atkins.com/science/researchsupportingatkins.html
[638] Circulation 104(2001):1869.
[639] The Philadelphia Inquirer 6 August 2004.
[640] CNN. Larry King Live 16 February 2004.
[641] Journal of the American College of Cardiology 43(2004):725.
[642] "Research Supporting Atkins" http://atkins.com/science/researchsupportingatkins.html
[643]
Boden, G., Sargrad, K., Homoko, C., et al., "Effects of the Atkins Diet
in Type 2 Diabetes: Metabolic Balance Studies," 64th session of the
American Diabetes Association, #321-OR, June 8, 2004.
[644]
Dansinger, M.L., Gleason, J L., Griffith, J.L., et al., " One Year
Effectiveness of the Atkins, Ornish, Weight Watchers, and Zone Diets in
Decreasing Body Weight and Heart Disease Risk," Presented at the
American Heart Association Scientific Sessions November 12,2003 in
Orlando, Florida.
[645] Israel Medical Association Journal 6(2004):314.
[646]
Greene, P., Willett, W., Devecis, J., et al., "Pilot 12-Week Feeding
Weight-Loss Comparison: Low-Fat vs Low-Carbohydrate (Ketogenic) Diets,"
Abstract Presented at The North American Association for the Study of
Obesity Annual Meeting 2003, Obesity Research, 11S, 2003, page 95OR.
[647]
Greene, P.J., Devecis, J., Willett, W.C., "Effects of Low-Fat Vs
Ultra-Low-Carbohydrate Weight-Loss Diets: A 12-Week Pilot Feeding
Study," abstract presented at Nutrition Week 2004, February 9-12, 2004,
in Las Vegas, Nevada.
[648] Nickols-Richardson, S.M., Volpe, J.J.,
Coleman, M.D., "Premenopausal Women Following a
Low-Carbohydrate/High-Protein Diet Experience Greater Weight Loss and
Less Hunger Compared to a High-Carbohydrate/Low-Fat Diet," Abstract
Presented at FASEB Meeting on Experimental Biology: Translating the
Genome, April 17-21, 2004, in Washington, D.C.
[649] O'Brien, K.D.,
Brehm, B.J., Seeley, R.J., "Greater Reduction in Inflammatory Markers
With a Low-carbohydrate Diet than with a Calorically Matched Low Fat
Diet," Presented at American Heart Association's Scientific Sessions
2002 on Tuesday, November 19, 2002, Abstract ID: 117597.
[650]
Stadler, D.D., Burden, V., Connor, W., et al., "Impact of 42-Day Atkins
Diet and Energy-Matched Low-Fat Diet on Weight and Anthropometric
Indices," FASEB Journal, 17(4-5), Abstract of the 12th Annual FASEB
Meeting on Experimental Biology: Translating the Genome; Abstract#
453.3, San Diego, CA, April 11-15, 2003.
[651] Journal of General Internal Medicine 19(2004):110S.
[652] Journal of General Internal Medicine 19(2004):111S.
[653] New England Journal of Medicine 303(1980):277.
[654] Tobacco Control 2(1993):103.
[655] American Journal of Neuroradiology 20(1999):1173.
[656] Journal of the American Medical Association 263(1990):1401.
[657] New England Journal of Medicine 303(1980):255.
[658] Anesthesia and Analgesia 61(1982):448.
[659] Physical Therapy 70(1990):277.
[660] Archives of Internal Medicine 136(1976):1232.
[661] Archives of Internal Medicine 136(1976):1232.
[662] Physical Therapy 70(1990):277.
[663] American Journal of Neuroradiology 20(1999):1173.
[664] Journal of Pediatric Surgery 22(1987):11,
[665] Ophthalmology 98(1991):553.
[666] New England Journal of Medicine 3030(1980):277.
[667] Journal of the American Medical Association 277(1997):927.
[668] American Journal of Neuroradiology 20(1999):1173.
[669] Atkins Nutritionals, Inc. "Research Supporting Atkins" http://atkins.com/science/researchsupportingatkins.html
[670] Countway Library Collections Overview http://www.countway.med.harvard.edu/countway/collections.shtml
[671] Mary Ann Liebert, Inc. publishers Customer Service Personal Communication 3pm 13 August 2004
[672]
University of Alabama at Birmingham Lister Hill Library of the Health
Sciences http://www.uab.edu/lister/ and University of South Alabama
Biomedical Library http://southmed.usouthal.edu/library/index.html
[673] List of Journals Indexed in Index Medicus, 2004 ftp://nlmpubs.nlm.nih.gov/online/journals/ljiweb.pdf
[674] "Indexed Biomedical Journals" http://www.lib.uiowa.edu/hardin/serials.html
[675] Business Wire, Jan 29, 2004.
[676] The International Network of Cholesterol Skeptics "List of members" http://www.thincs.org/members.htm
[677] The International Network of Cholesterol Skeptics news release 5 September 2002.
[678] Postgraduate Medicine 87(1990):13.
[679]"Metabolic Syndrome and Related Disorders" http://www.liebertpub.com/eboard.aspx?pub_id=115
[680] Kingsbrook Conference on Nutritional and Metabolic
Aspects of Low-carbohydrate Diets 18-19 June 2004 http://www.downstate.edu/kingsbrook/default.html
[681] PR Newswire 10 March 2004.
[682] "What is the cost of these programs?" http://atkinsathome.com/faq.asp
[683] Associated Press 20 April 2004.
[684]"Metabolic Syndrome and Related Disorders Honors Dr. Atkins" http://atkins.com/Archive/2004/4/16-589668.html
[685] Metabolic Syndrome and Related Disorders 1(2003):179.
[686] Metabolic Syndrome and Related Disorders 1(2003):181.
[687] Metabolic Syndrome and Related Disorders 1(2003):183.
[688] Business Wire 29 Jan 2004.
[689] Metabolic Syndrome and Related Disorders 1(2003):179.
[690] Metabolic Syndrome and Related Disorders 1(2004):183.
[691]
Greene, P., Willett, W., Devecis, J., et al., "Pilot 12-Week Feeding
Weight-Loss Comparison: Low-Fat vs Low-Carbohydrate (Ketogenic) Diets,"
Abstract Presented at The North American Association for the Study of
Obesity Annual Meeting 2003, Obesity Research, 11S, 2003, page 95OR.
[692]
Greene, P.J., Devecis, J., Willett, W.C., "Effects of Low-Fat Vs
Ultra-Low-Carbohydrate Weight-Loss Diets: A 12-Week Pilot Feeding
Study," abstract presented at Nutrition Week 2004, February 9-12, 2004,
in Las Vegas, Nevada.
[693] Metabolic Syndrome and Related Disorders 1(2003):227.
[694] Journal of Nutrition 134(2004):880.
[695] Journal of Nutrition 132(2002:1879.
[696]
Sharman, M.J., Volek, J.S., "Weight Loss Leads to Reductions in
Inflammatory Biomarkers after a Very Low-Carbohydrate and Low-Fat Diet
in Overweight Men," Clinical Science (London), 2004.
[697] Journal of Pediatrics 142(2003):253.
[698] Metabolic Syndrome and Related Disorders 1(2003):233.
[699] Journal of the American College of Nutrition 19(2000):383.
[700] Journal of the American College of Nutrition 23(2004):177.
[701] Metabolism 51(2002):864.
[702] Journal of Nutrition 133(2003):2756.
[703] Cleveland Clinic Journal of Medicine 69(2002):849.
[704] Current Atherosclerosis Reports 5(2003):476.
[705] American Journal of Medicine 113(2002:30.
[706] Journal of General Internal Medicine 19(2004):111S.
[707] Annals of Internal Medicine 140(2004:769.
[708] Alternative Therapies in Health and Medicine 7(2001):16.
[709] Neurology 61(2003):1789.
[710] Metabolic Syndrome and Related Disorders 1(2003):239.
[711] Metabolic Syndrome and Related Disorders 1(2003):221.
[712]
Boden, G., Sargrad, K., Homoko, C., et al., "Effects of the Atkins Diet
in Type 2 Diabetes: Metabolic Balance Studies," 64th session of the
American Diabetes Association, #321-OR, June 8, 2004.
[713] Israel Medical Association Journal 6(2004):314.
[714] Journal of the American College of Nutrition 17(1998):595.
[715] Endocrinology Practice 8(2002):177.
[716]
O'Brien, K.D., Brehm, B.J., Seeley, R.J., "Greater Reduction in
Inflammatory Markers With a Low-carbohydrate Diet than with a
Calorically Matched Low Fat Diet," Presented at American Heart
Association's Scientific Sessions 2002 on Tuesday, November 19, 2002,
Abstract ID: 117597.
[717] Psychopharmacology 171(2003):36.
[718] National Philanthropic Trust news release 25 May 2004.
[719] BusinessWeek Online 18 June 2004.
[720] Rampton, S and J Stauber. Trust Us, We're Experts. New York: Penquin Putnam, 2002.
[721] British Journal of Industrial Medicine 45(1988):624.
[722] Tobacco Control 2(1993):103.
[723] Rampton, S and J Stauber. Trust Us, We're Experts. New York: Penguin Putnam, 2002.
[724]
Judge J Robert Elliot, case no 4:95-cv-36 (JRE), the Bush Ranch Inc.,
et al V E.I du Pont de Nemours and Co., 21 August 1995:40.
[725]
Fagin, D., Lavelle, M & The Center For Public Integrity. Toxic
Deception: How the chemical industry manipulates science, bends the law
and endangers your health, Common Courage Press, Monroe, Maine, 1999:51.
[726] Rampton, S and J Stauber. Trust Us, We're Experts. New York: Penquin Putnam, 2002.
[727] New England Journal of Medicine 324(1991):1362.
[728] Journal of the American Medical Association 279(1998):1566.
[729] CNN 8 May 1998.
[730] Postgraduate Medicine 104(1998) December.
[731] Postgraduate Medicine 104(1998) December.
[732] Journal of the American Medical Association 279(1998):1566.
[733] Journal of Health Politics, Policy and Law 21(1996):515.
[734] Journal of Health Politics, Policy and Law 21(1996):515.
[735] Tobacco Control 2(1993):103.
[736] Atkins Nutritionals, Inc. news release November 2001.
[737] American Journal of Public Health 91(2001) November.
[738] "Atkins Physicians Council" http://atkins.com/about/atkins-physicians-council.html
[739] British Medical Journal 316(1998):1555.
[740] http://atkinsfoundation.org/grants.asp
[741] American Journal of Public Health 91(2001) September.
[742] J Epidemiol Community Health 55(2001):588.
[743] Tobacco Control 12(2003):iii38.
[744] Tobacco Control 2(1993):103.
[745] Who Says There Are No Studies? http://atkins.com/Archive/2002/11/21-533336.html
[746] British Medical Journal 324(2002):8.
[747] The Lancet 355(2000):1197.
[748] Journal of General Internal Medicine 12(1986):155.
[749] Archives of Internal Medicine 154(1994):157.
[750] Canadian Medical Association Journal168(2003):1267.
[751] New England Journal of Medicine 342(2000):1539.
[752] Journal of the American Medical Association 290(2003):113.
[753] New England Journal of Medicine 342(2003):1539.
[754] Journal of the American Medical Association 282(1999):1453.
[755] Psychopharmacology 171(2003):36.
[756] Archives of Internal Medicine 154(1994):157.
[757] The New England Journal of Medicine 348(2003):2074.
[758] "Praise the Lard." Sunday Telegraph(London) 25 May 2003.
[759] "Let's Set the Record Straight" http://atkins.com/Archive/2003/5/29-77313.html
[760] Morbidity and Mortality Weekly Report 6 February 2004.
[761] The New England Journal of Medicine 348(2003):2074.
[762] Annals of Internal Medicine 140(2004):778.
[763]
Commentary: "The following information was written by Atkins
professionals".http://atkins.com/Archive/2004/5/19-393409.html
[764] Annals of Internal Medicine 140(10), 2004, pages 778-785.
[765] Preventive Cardiology 5(2002):110.
[766] Journal of the American Dietetic Association 104(2004):537.
[767]
Dansinger, M.L., Gleason, J. L., Griffith, J.L., et al., "One Year
Effectiveness of the Atkins, Ornish, Weight Watchers, and Zone Diets in
Decreasing Body Weight and Heart Disease Risk," Presented at the
American Heart Association Scientific Sessions November 12, 2003 in
Orlando, Florida.
[768] "Research Supporting Atkins" http://atkins.com/science/researchsupportingatkins.html
[769] Metabolic Syndrome and Related Disorders 1(2003):221.
[770] 64th session of the American Diabetes Association, #321-OR, June 8, 2004.
[771] Israel Medical Association Journal 6(2004):314.
[772] Obesity Research 11S(2003):95OR.
[773]
Greene, P.J., Devecis, J., Willett, W.C., "Effects of Low-Fat Vs
Ultra-Low-Carbohydrate Weight-Loss Diets: A 12-Week Pilot Feeding
Study," abstract presented at Nutrition Week 2004, February 9-12, 2004,
in Las Vegas, Nevada.
[774] Journal of the American College of Nutrition 17(1998):595.
[775] Journal of Clinical Endocrinology and Metabolism 89(2004):2717.
[776]
Nickols-Richardson, S.M., Volpe, J.J., Coleman, M.D., "Premenopausal
Women Following a Low-Carbohydrate/High-Protein Diet Experience Greater
Weight Loss and Less Hunger Compared to a High-Carbohydrate/Low-Fat
Diet," Abstract Presented at FASEB Meeting on Experimental Biology:
Translating the Genome, April 17-21, 2004, in Washington, D.C.
[777] Journal of Nutrition 134(2004):880.
[778] Journal of Nutrition 132(2002):1879.
[779] Journal of Pediatrics 142(2003):253.
[780]
Stadler, D.D., Burden, V., Connor, W., et al., "Impact of 42-Day Atkins
Diet and Energy-Matched Low-Fat Diet on Weight and Anthropometric
Indices," FASEB Journal, 17(4-5), Abstract of the 12th Annual FASEB
Meeting on Experimental Biology: Translating the Genome; Abstract#
453.3, San Diego, CA, April 11-15, 2003.
[781] Journal of the American College of Nutrition 19(2000):383.
[782] Journal of the American College of Nutrition 23(2004):177.
[783] Metabolism 51(2002):864.
[784] The Journal of Nutrition 133(2003):2756.
[785] Journal of General Internal Medicine 19(2004):110S.
[786] Metabolic Syndrome and Related Disorders 1(2003):239.
[787] 64th session of the American Diabetes Association, #321-OR, June 8, 2004.
[788] Obesity Research 11S(2003):95OR.
[789]
Greene, P.J., Devecis, J., Willett, W.C., "Effects of Low-Fat Vs
Ultra-Low-Carbohydrate Weight-Loss Diets: A 12-Week Pilot Feeding
Study," abstract presented at Nutrition Week 2004, February 9-12, 2004,
in Las Vegas, Nevada.
[790] Neurology 61(2003):1789.
[791] Journal of Clinical Endocrinology and Metabolism 89(2004):2717.
[792]
Nickols-Richardson, S.M., Volpe, J.J., Coleman, M.D., "Premenopausal
Women Following a Low-Carbohydrate/High-Protein Diet Experience Greater
Weight Loss and Less Hunger Compared to a High-Carbohydrate/Low-Fat
Diet," Abstract Presented at FASEB Meeting on Experimental Biology:
Translating the Genome, April 17-21, 2004, in Washington, D.C.
[793] Journal of Nutrition 134(2004):880.
[794] Journal of Nutrition 132(2002):1879.
[795]
Stadler, D.D., Burdn, V., Connor, W., et al., "Impact of 42-Day Atkins
Diet and Energy-Matched Low-Fat Diet on Weight and Anthropometric
Indices," FASEB Journal, 17(4-5), Abstract of the 12th Annual FASEB
Meeting on Experimental Biology: Translating the Genome; Abstract#
453.3, San Diego, CA, April 11-15, 2003.
[796] Metabolic Syndrome and Related Disorders 1(2003):233.
[797] Journal of the American College of Nutrition 19(2000):383.
[798] Journal of the American College of Nutrition 23(2004):177.
[799] Metabolism 51(2002):864.
[800] The Journal of Nutrition 133(2003):2756.
[801] Journal of General Internal Medicine 19(2004):111S.
[802] Alternative Therapies in Health and Medicine 7( 2001):116.
[803] Metabolic Syndrome and Related Disorders 1(2003):239.
[804] 64th session of the American Diabetes Association, #321-OR, 8 June 2004.
[805] Mayo Clinic Proceedings 78(2003):1331-1336.
[806] Metabolic Syndrome and Related Disorders 1(2003): 227-232.
[807] Neurology 61(2003):1789-1791.
[808] Metabolic Syndrome and Related Disorders 1(2003):233-237.
[809] Journal of the American College of Nutrition 19(2000):383-391.
[810] American Journal of Medicine 113(2002):30-36.
[811] Journal of General Internal Medicine 19(2004):111S.
[812] Journal of General Internal Medicine 19(2004):110S.
[813] Metabolic Syndrome and Related Disorders 1(2003):239-243.
[814] Alternative Therapies in Health and Medicine 7(2001):116.
[815] The Journal of Clinical Endocrinology and Metabolism 88(2003):1617.
[816] Israel Medical Association Journal 6(2004):314.
[817] Obesity Research 11S(2003):95OR.
[818]
Greene, P.J., Devecis, J., Willett, W.C., "Effects of Low-Fat Vs
Ultra-Low-Carbohydrate Weight-Loss Diets: A 12-Week Pilot Feeding
Study," abstract presented at Nutrition Week 2004, February 9-12, 2004,
in Las Vegas, Nevada.
[819] O'Brien, K.D., Brehm, B.J., Seeley,
R.J., "Greater Reduction in Inflammatory Markers With a
Low-carbohydrate Diet than with a Calorically Matched Low Fat Diet,"
Presented at American Heart Association's Scientific Sessions 2002 on
Tuesday, November 19, 2002, Abstract ID: 117597.
[820] The New England Journal of Medicine 348(2003):2074.
[821] Annals of Internal Medicine 140(2004):778.
[822] Annals of Internal Medicine 140(2004):769.
[823] Journal of the American Dietetic Association 101(2001):41.
[824] Journal of the American Dietetic Association 101(2001):41.
[825] Braunwald E, ed Harrison's Advances in Cardiology New York: McGraw Hill; 2002.
[826]
Dansinger, M.L., Gleason, J. L., Griffith, J.L., et al., "One Year
Effectiveness of the Atkins, Ornish, Weight Watchers, and Zone Diets in
Decreasing Body Weight and Heart Disease Risk," Presented at the
American Heart Association Scientific Sessions November 12, 2003 in
Orlando, Florida.
[827] New England Journal of Medicine 348(2003):2082.
[828] Annals of Internal Medicine 140(2004):778.
[829] Preventive Cardiology 5(2002):110.
[830] Time Magazine 7 June 2004.
[831] Annual Review of Nutrition 21(2001):323.
[832] Reason, March 2003.
[833]
Norton, H.W., Univ, I.L "Letters to the Editors American Scientist Vol
47 [That Smoking Causes Lung Cancer Is A Mere Opinion] " Mar 1957
(est.) Bates: HT0004104-HT0004106.
[834] Ahrensfeld, Thomas F "Memo for file" 07 Nov 1962 Bates: 1005148463.
[835] Lee, Peter N "Smoking during pregnancy and congenital limb deficiency" 1994 Bates: 500802154-500802157.
[836]"References 1 - 529" http://atkinsexposed.org/atkins/58/References_1_-_529.htm
[837] Atkins Nutritionals, Inc. news release January 2004.
[838]
Atkins Nutritionals, Inc. "Frequently Asked Questions"
http://atkins.com/helpatkins/newfaq/answers/WhyDidDrAtkinsReviseHisNewDietRevolutionDoes.html
Accessed 9 August 2004.
[839] Expert Opinions http://www.atkinsexposed.org/atkins/22/Opinions.htm
[840] The New York Weekly 26 March 1973.
[841] Journal of the American Medical Association 289(2003):1773.]
[842] Business Week 9 August 2004.
[843] http://www.atkinsdietalert.org/advisory.html
[844] Tufts University Health and Nutrition Letter December 2003.
[845] Journal of the American College of Nutrition 19(2000):578.
[846] Journal of the American College of Cardiology 43(2004):725.
[847]
American Gastroenterological Association. Medical position statement:
impact of dietary fiber on colon cancer occurrence. American College of
Gastroenterology Gastroenterology 2000 Jun;118(6):1233-4.
[848] U.S
Food and Drug Administration Center for Food Safety and Applied
Nutrition Guidance on How to Understand and Use the Nutrition Facts
Panel on Food Labels Updated July 2003,
http://vm.cfsan.fda.gov/...dms/foodlab.html
[849] Institute of
Medicine "Dietary reference intakes: Energy, carbohydrate, fiber, fat,
fatty acids, cholesterol, protein, and amino acids," September 2002,
National Academy Press, Washington D.C.
[850] Atkins, RC Dr. Atkins New Diet Revolution 3rd edition M Evans and Company, Inc. 2002.
[851] Journal of the American College of Nutrition 19(2000):578.
[852] National Institutes of Health publication 01-3305, May 2001.
[853] Most Weight Loss, LDL Reduction on Ornish Diet http://aolsvc.health.webmd.aol.com/content/Article/77/90389.htm
[854]
Dansinger, M.L., Gleason, J L., Griffith, J.L., et al., " One Year
Effectiveness of the Atkins, Ornish, Weight Watchers, and Zone Diets in
Decreasing Body Weight and Heart Disease Risk,"Presented at the
American Heart Association Scientific Sessions November 12,2003 in
Orlando, Florida.
[855] Journal of the American Medical Association 280(1998):2001.
[856] Angiology 51(2000):817.
[857]
Dansinger, M.L., Gleason, J L., Griffith, J.L., et al., " One Year
Effectiveness of the Atkins, Ornish, Weight Watchers, and Zone Diets in
Decreasing Body Weight and Heart Disease Risk,"Presented at the
American Heart Association Scientific Sessions November 12,2003 in
Orlando, Florida.
[858] Dansinger, M.L., Gleason, J. L., Griffith,
J.L., et al., "One Year Effectiveness of the Atkins, Ornish, Weight
Watchers, and Zone Diets in Decreasing Body Weight and Heart Disease
Risk," Presented at the American Heart Association Scientific Sessions
November 12, 2003 in Orlando, Florida.
[859] New England Journal of Medicine 348(2003):2082.
[860] Annals of Internal Medicine 140(2004):778.
[861] Preventive Cardiology 5(2002):110.
[862] Journal of the American Dietetic Association 104(2004):537.
[863] Preventive Cardiology 5(2002):110.
[864] Journal of the American Medical Association 280(1998):2001.
[865] Angiology 51(2000):817.
[866] The Lancet 364(9437) 4 September 2004.
[867] The Independent (London) 3 September 2004.
[868] Journal of the American College of Nutrition 19(2000):578.
[869] Annals of Internal Medicine 140(2004):769.
[870] Gastroenterology 118(2000):1233.
[871] "Report Prepared by Legal Counsel to Tobacco Companies" Blilely RJR Document 503674990-5067.
[872] Shape Up America! news release 29 December 2003.
[873]
American Cancer Society. Weighing In on Low-carb Diets. 2004.
http://www.cancer.org/docroot/SPC/content/SPC_1_A_Low_Carb_Diet_to_Prevent_Cancer.asp
[874] Charity Wire 13 May 2003.
[875]
American Institute for Cancer Research/ World Cancer Research Fund
Expert Report, Food, Nutrition and the Prevention of Cancer: a global
perspective, 1997.
[876] World Health Organization. World Health
Assembly Raises Global Public Health to New Level.
http://www.who.int/mediacentre/releases/2004/wha4/en/
[877] World
Health Organization. Frequently Asked Questions About the WHO Global
Strategy on Diet, Physical Activity and Health.
http://www.who.int/dietphysicalactivity/faq/en/
[878] "Live Chat - Dr. Atkins on Diet and Cancer" 2 August 2001 http://atkins.com/Archive/2001/12/27-219167.html
[879] "New Thinking on Colorectal Cancer Part 2" http://atkins.com/Archive/2002/3/19-622090.html
[880] American Cancer Society Guidelines on Diet and Cancer Prevention 9 October 1997.
[881] New England Journal of Medicine 323(1990):1664.
[882] Cancer Research 54(1994):2390.
[883] Nutrition Action Healthletter, January/February 2004:1.
[884] American Journal of Medicine 113(2002):63S.
[885] American Journal of Medicine 113(2002):5S.
[886]
September 19, 2004 Medline search of ((colorectal cancer.mp or
Colorectal Neoplasms/) and (Meat/ or red meat.mp.)) limited to "review
articles" published in 2003 or 2004.
[887] Public Health Nutrition 7(2004):187.
[888] ]"Food and Breast Cancer: What's the Connection? Part 2" http://atkins.com/Archive/2002/2/14-761333.html
[889] "Food and Breast Cancer: What's the Connection? Part 2" http://atkins.com/Archive/2002/2/14-761333.html
[890]
U.S Department of Agriculture, Agricultural Research Service 2004 USDA
National Nutrient Database for Standard Reference, Release 17 Nutrient
Data Laboratory Home Page, http://www.nal.usda.gov/fnic/foodcomp
[891] American Journal of Clinical Nutrition 19(2000):578.
[892] "Food and Breast Cancer: What's the Connection?" http://atkins.com/Archive/2002/2/7-197330.html
[893] Proceedings of the Nutrition Society 56(1997):369.
[894] "Say What? Minding the Media" http://atkins.com/Archive/2003/7/22-983171.html
[895] Journal of the National Cancer Institute 95(2003):1079.
[896] Charity Wire 13 May 2003.
[897]
American Institute for Cancer Research/ World Cancer Research Fund
Expert Report, Food, Nutrition and the Prevention of Cancer: a global
perspective, 1997.
[898] European Journal of Medical Research 8(2003):373.
[899] British Journal of Cancer 89(2003):1672.
[900] Journal of the National Cancer Institute 82(1990):561.
[901] International Journal of Cancer 111(2004):584.
[902] "Live Chat - Dr. Atkins on Diet and Cancer" 2 August 2001 http://atkins.com/Archive/2001/12/27-219167.html
[903] The Lancet 362(2003):212.
[904] Journal of Urology 159(1998):1271.
[905] Cancer Causes & Control 4(1993):239.
[906] Journal Of The National Cancer Institute 85(1993):1906.
[907] American Journal of Epidemiology 155(2002):783.
[908] FDA Consumer magazine September-October 2003 Issue
Pub No FDA04-1329C
[909]
Fat and Fatty Acid Content of Selected Foods Containing Trans-Fatty
Acids U.S Department of Agriculture, Agricultural Research Service 2004
USDA National Nutrient Database for Standard Reference.
[910] Fat
and Fatty Acid Content of Selected Foods Containing Trans-Fatty Acids
U.S Department of Agriculture, Agricultural Research Service 2004 USDA
National Nutrient Database for Standard Reference.
[911] "Trans
Fatty Acids" General Conference Nutrition Council Position Statement
Andrews University Nutrition Department 7 March 2002.
[912] Men's Journal September 2003.
[913]
Fat and Fatty Acid Content of Selected Foods Containing Trans-Fatty
Acids U.S Department of Agriculture, Agricultural Research Service 2004
USDA National Nutrient Database for Standard Reference.
[914] Fred Hutchinson Cancer Research Center News 7 May 1998
[915]
National Academy of Sciences Institute of Medicine Dietary Reference
Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol,
Protein, and Amino Acids (Macronutrients) (2002)
[916] Reuters 10 July 2002.
[917]
National Academy of Sciences Institute of Medicine Dietary Reference
Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol,
Protein, and Amino Acids (Macronutrients) (2002)
[918] "Trans Fats Heat Up" http://atkins.com/Archive/2003/7/31-167227.html
[919] Atkins, RC. Dr. Atkins Diet Revolution. David McKay Company, Inc., 1972.
[920] "Top 10 Foods With Trans Fats" http://my.webmd.com/content/article/70/81100.htm
[921] " Dr. Atkins: Pioneer and Innovator" http://atkins.com/Archive/2004/6/30-185426.html
[922] " Dr. Atkins: Pioneer, Innovator (Part 2) " http://atkins.com/Archive/2004/8/10-529410.html
[923] Journal of the National Cancer Institute 95(2003):1079.
[924] International Journal of Cancer 111(2004):584.
[925] The Lancet 362(2003):212.
[926]
FASEB Journal, 17(4-5), Abstract of the 12th Annual FASEB Meeting on
Experimental Biology: Translating the Genome; Abstract#3321 San Diego,
CA, April 11-15, 2003.
[927] "Live Chat - Dr. Atkins on Diet and Cancer" 2 August 2001 http://atkins.com/Archive/2001/12/27-219167.html
[928] American Journal of Epidemiology 146(1997):832.
[929] Nutrition & Cancer 42(2002):10.
[930] Japanese Journal of Cancer & Chemotherapy] 28(2001):159.
[931] Cancer Research 61(2001): 5415.
[932] American Journal of Epidemiology 137(1993):155.
[933] Journal of the National Cancer Institute 86(1994):1131.
[934] Annals of Oncology 14(2003):907.
[935] Onkologie 24(2001):546.
[936] International Journal of Cancer 58(1994):644.
[937] American Journal of Gastroenterology 94(1999):1373.
[938]
"Doesn't a high-fat diet increase cancer risk? "
http://atkins.com/helpatkins/newfaq/answers/DoesnTAHighFatDietIncreaseCancerRisk.html
[939]
"Doesn't a high-fat diet increase cancer risk?
"http://atkins.com/helpatkins/newfaq/answers/DoesnTAHighFatDietIncreaseCancerRisk.html
[940]
"This is the outcome of the European Conference on Nutrition and Cancer
held in Lyon, France on 21-24 June..." World Health Organization
International Agency for Research on Cancer Nutrition and Lifestyle:
Opportunities for Cancer Prevention IARC Scientific Publications No
156, 2002.
[941] "Live Chat - Dr. Atkins on Diet and Cancer" http://atkins.com/Archive/2001/12/27-219167.html
[942]
Riboli, E., "Meat, Processed Meat and Colorectal Cancer," June 21-24,
2001, Abstract of the European Conference on Nutrition and Cancer,
International Agency for Research on Cancer and Europe Against Cancer
Programme of the European Commission, Abstract #0.08, Lyon, France.
[943] Health & Medicine Week 23 July 2001.
[944]
Riboli, E., "Meat, Processed Meat and Colorectal Cancer," June 21-24,
2001, Abstract of the European Conference on Nutrition and Cancer,
International Agency for Research on Cancer and Europe Against Cancer
Programme of the European Commission, Abstract #0.08, Lyon, France.
[945] Health & Medicine Week 23 July 2001.
[946]
U.S Department of Agriculture, Agricultural Research Service 2004 USDA
National Nutrient Database for Standard Reference, Release 17 Nutrient
Data Laboratory Home Page, http://www.nal.usda.gov/fnic/foodcomp
[947]
Norat, T., et al "Meat Consumption and Colorectal Cancer Risk."
Abstract for the European Conference on Nutrition and Cancer,
International Agency for Research on Cancer and Europe Against Cancer
Programme of the European Commission, Abstract # 8.14, Lyon, France.)
[948] Public Health Nutrition 7(2004):187.
[949]
U.S Department of Agriculture, Agricultural Research Service 2004 USDA
National Nutrient Database for Standard Reference, Release 17 Nutrient
Data Laboratory Home Page, http://www.nal.usda.gov/fnic/foodcomp
[950]
World Health Organization International Agency for Research on Cancer
Nutrition and Lifestyle: Opportunities for Cancer Prevention IARC
Scientific Publications No 156, 2002:552.
[951] South Coast Today 24 June 2001.
[952]
World Health Organization International Agency for Research on Cancer
Nutrition and Lifestyle: Opportunities for Cancer Prevention IARC
Scientific Publications No 156, 2002:93.
[953] World Health
Organization International Agency for Research on Cancer Nutrition and
Lifestyle: Opportunities for Cancer Prevention IARC Scientific
Publications No 156, 2002:351.
[954] Cancer Causes and Control 7(1996):178.
[955] British Medical Journal 313(1996):775.
[956] Tufts Health and Nutrition Letter December 2003.
[957] "Talking About Atkins to Your Doctor"http://atkins.com/Archive/2002/6/17-1515.html
[958] Proceedings of the Nutrition Society 62(2003):867.
[959]
World Health Organization and the Food and Agriculture Organization of
the United Nations "Human Vitamin and Mineral Requirements." Report of
a joint FAO/WHO expert consultation Rome, 2002.
[960] 145.6 grams of
protein (Journal of the American College of Nutrition 19(2000):578)
minus 5 grams of plant protein contained in 3 cups of salad (U.S
Department of Agriculture, Agricultural Research Service 2004 USDA
National Nutrient Database for Standard Reference, Release 17 Nutrient
Data Laboratory Home Page, http://www.nal.usda.gov/fnic/foodcomp).
[961] American Journal Epidemiology 143(1996):472.
[962] American Journal Epidemiology 143(1996):472.
[963] American Journal of Clinical Nutrition 73(2001):118.
[964] American Journal of Epidemiology 145(1997):117.
[965]
"A Controlled Carbohydrate Diet Does Not Negatively Affect Normal
Calcium and Bone Metabolism"
http://atkins.com/science/principles/goodhealth/principleAcontrolledcarbohydratedietcalciumandbone.html
[966] Proceedings of the Nutrition Society 62(2003):867.
[967] Journal of Bone and Mineral Research 15(2000):2504.
[968] American Journal of Clinical Nutrition 69(1999):147.
[969] Clinics in Geriatric Medicine 19(2003):321.
[970] American Journal of Epidemiology 145(1997):117.
[971] http://www.atkinsdietalert.org/advisory.html
[972] "Debunking the Myths > Fact vs Fallacy, Part 4" http://atkins.com/Archive/2001/12/18-578467.html
[973] "Debunking the Myths > Fact vs Fallacy, Part 4" http://atkins.com/Archive/2001/12/18-578467.html
[974] http://www.atkinsdietalert.org/advisory.html
[975]
U.S Food and Drug Administration Center for Food Safety and Applied
Nutrition Guidance on How to Understand and Use the Nutrition Facts
Panel on Food Labels Updated July 2003
http://vm.cfsan.fda.gov/...dms/foodlab.html
[976] Tufts University Health and Nutrition Letter December 2003.
[977] New England Journal of Medicine 307(1982):652.
[978] "Debunking the Myths > Fact vs Fallacy, Part 4" http://atkins.com/Archive/2001/12/18-578467.html
[979] Journal of the American College of Cardiology 43(2004):725.
[980]
FASEB Journal, 17(4-5), Abstract of the 12th Annual FASEB Meeting on
Experimental Biology: Translating the Genome; Abstract#3321 San Diego,
CA, April 11-15, 2003.
[981] World Health Organization and the Food
and Agriculture Organization of the United Nations "Human Vitamin and
Mineral Requirements." Report of a joint FAO/WHO expert consultation
Rome, 2002.
[982] Journal of the American College of nutrition 19(2000):578.
[983] Angiology 51(2000):817.
[984] Boston Herald 12 October 1999.
[985] "Are Triglycerides as Great a Heart Risk as High Cholesterol? " http://atkins.com/Archive/2002/6/19-692311.html
[986] Circulation 2004;110:227-239.
[987] National Institutes of Health publication 01-3305, May 2001.
[988] http://www.nhlbi.nih.gov/about/ncep/index.htm
[989] Journal of the American Medical Association 285(2001):2486.
[990] American Heart Journal 144(2002):S33.
[991] American Heart Journal 140(2000):232.
[992] Cleveland Clinic Journal of Medicine 69(2002):849.
[993] Angiology 51(2000):817.
[994] Cleveland Clinic Journal of Medicine 69(2002):855.
[995] "Talking About Atkins to Your Doctor "http://atkins.com/Archive/2002/6/17-1515.html
[996] Arteriosclerosis 9(1989):176.
[997] Arteriosclerosis, Thrombosis and Vascular Biology 22(2002):1168.
[998] Harvard School of public Health Department of Nutrition Frank Sacks http://www.hsph.harvard.edu/faculty/FrankSacks.html
[999] Journal of the American Medical Association 285(2001):2486.
[1000] Journal of Endocrinology and Metabolism 10(2003):4525.
[1001] American Journal of Cardiology 94(2004):320.
[1002] Journal of Endocrinology and Metabolism 10(2003):4525.
[1003] American Journal of Clinical Nutrition 69(1999):411.
[1004] Annals of Internal Medicine 151(1991):1389.
[1005] Arteriosclerosis, Thrombosis and Vascular Biology 16(1996):2002.
[1006] Cleveland Clinic Journal of Medicine 69(2002):849.
[1007] Angiology 51(2000):817.
[1008] Atkins, R.C "The Cholesterol Drug Bonanza" http://atkins.com/Archive/2002/9/23-518825.html
[1009] American Journal of Medicine 113(2002):30.
[1010] Angiology 51(2000):817.
[1011] Atkins, R.C "The Cholesterol Drug Bonanza" http://atkins.com/Archive/2002/9/23-518825.html
[1012] Journal of the American Medical Association 285(2001):2486.
[1013] National Institutes of Health publication 01-3305, May 2001.
[1014] Journal of the American College of Cardiology 43(2004):725.
[1015] Journal of the American Medical Association 285(2001):2486.
[1016] Circulation 89(1994):1329.
[1017]
Expert Panel on Detection, Evaluation, and Treatment of High Blood
Cholesterol in Adults, National Cholesterol Education Program. Second
report of the Expert Panel on Detection, Evaluation, and Treatment of
High Blood Cholesterol in Adults (Adult Treatment Panel II).
Circulation. 1994;89:1329-1445.
[1018] AJ CARD 89(11) 1 June 2002 pp 1286-1290.
[1019] Pharmacotherapy 23(2003):26S.
[1020] "William C Roberts, M.D." http://www.baylor.edu/biomedical_studies/index.php?id=19528
[1021] The American Journal of Cardiology 83(1999):816.
[1022]
Based on Lock DR, et al 1982 Sep;31(9):917-21, Roshanai F, Sanders TA
Hum Nutr Appl Nutr 1984 Oct;38(5):345-54, Fisher M, et al Arch Intern
Med 1986 Jun;146(6):1193-7, Thorogood M, et al Britain.Br Med J (Clin
Res Ed) 1987 Aug 8;295(6594):351-3, Thorogood M, et al British Medical
Journal 1990 May 19;300(6735):1297-301, Sanders TA, Roshanai F Eur J
Clin Nutr 1992 Nov;46(11):823-31, Thomas EL, Frost G, Barnard ML, et al
Lipids 1996 Feb;31(2):145-51,Toohey ML, et al J Am Coll Nutr 1998
Oct;17(5):425-34, Li D, et al Eur J Clin Nutr 1999 Aug;53(8):612-9,
Krajcovicova-Kudlackova M, et al Scand J Clin Lab Invest 2000
Dec;60(8):657-64, Fokkema MR, et al Prostaglandins Leukot Essent Fatty
Acids 2000 Nov;63(5):287-92 Compiled by Jack Norris in Making Sense of
Nutrition Research, March 2003.
[1023] Archives of Internal Medicine 164(2004):181.
[1024] Sun Herald 3 September 2004.
[1025] Journal of the American Dietetics Association 77(1980):264.
[1026] American Journal of Clinical Nutrition 30(1977):160.
[1027] Nutrition and Metabolism 17(1974):360.
[1028] Journal of Pediatrics 142(2003):352.
[1029] New England Journal of Medicine 348(2003):2082.
[1030] New England Journal of Medicine 348(2003):2074.
[1031] Annals of Internal Medicine 140(2004):778.
[1032] Obesity Research 9(2001):1s.
[1033] Journal of Nutrition. 132(2002):1879.
[1034] Journal of Pediatrics 142(2003):253.
[1035] Journal of Clinical Endocrinology and Metabolism 88(2003):1617.
[1036] Annals of Internal Medicine 140(2004):769
[1037] Journal of Nutrition 134(2004):880.
[1038] Journal of Nutrition 133(2003):2756.
[1039] American Journal of Medicine 113(2002):30.
[1040] Archives of Internal Medicine 151(1991):1389.
[1041] Journal of the American Medical Association 290(2003):502.
[1042] Angiology 51(2000):817.
[1043]
"Yahoo Chat - Dr. Atkins on Lowering Cardiac Risk Factors" 16 August
2001 http://atkins.com/Archive/2001/12/27-836486.html
[1044] Circulation 110(2004):227.
[1045]
National Heart, Lung, and Blood Institute. National Cholesterol
Education Program. Coordinating Committee Membership Roster
http://www.nhlbi.nih.gov/about/ncep/ncep_ros.htm
[1046] Pharmacotherapy 23(2003):26S.
[1047] Pharmacotherapy 23(2003):26S.
[1048] American Journal of Medicine 113(2002):30.
[1049] National Institutes of Health publication 01-3305 May 2001.
[1050] Journal of the American Medical Association 285(2001):2486.
[1051] Journal of the American Medical Association 285(2001):2486.
[1052] Federal Document Clearing House Congressional Testimony 3 June 2004.
[1053] Journal of Nutrition. 132(2002):1879.
[1054] Journal of Pediatrics 142(2003):253.
[1055] Journal of Pediatrics 142(2003):352.
[1056] New England Journal of Medicine 348(2003):2074.
[1057] Annals of Internal Medicine 140(2004):778.
[1058] New England Journal of Medicine 348(2003):2082.
[1059] Journal of Clinical Endocrinology and Metabolism 88(2003):1617.
[1060] Annals of Internal Medicine 140(2004):769.
[1061] Journal of Nutrition 134(2004):880
[1062] Journal of the American College of Nutrition 23(2004):177.
[1063] Journal of Nutrition 2003 Sep;133(9):2756-61.
[1064] American Journal of Clinical Nutrition 63(1996):174.
[1065] Journal of the American Dietetics Association 77(1980):264.
[1066] American Journal of Clinical Nutrition 30(1977):160.
[1067] Journal of Clinical Investigation 85(1990):144.
[1068] Journal of the American Dietetic Association 104(2004):537.
[1069] Pharmacotherapy 23(2003):26S.
[1070] Angiology 51(2000):817.
[1071]
"I am just starting Atkins but my physician says I should be on
cholesterol-lowering medication. What should I do?"
http://atkins.com/helpatkins/newfaq/answers/IAmJustStartingAtkinsButMyPhysicianSaysIShould.html
[1072] "Meaningful Tests: Blood Lipids" http://atkins.com/Archive/2002/5/14-516408.html
[1073] New England Journal of Medicine 350(2004):2042.
[1074] British Medical Journal 325(2002):1202.
[1075] American Journal of Psychiatry 159(2002):2099.
[1076] New England Journal of Medicine 350(2004):2042.
[1077] Archives of Neurology 57(2000):1422.
[1078] "Homocysteine: An Idea Whose Time Has Come" http://atkins.com/Archive/2002/9/25-87674.html
[1079] Mayo Clinic Proceedings 78(2003):1331.
[1080] Circulation 99(1999):178.
[1081] "Meaningful Tests: Blood Lipids" http://atkins.com/Archive/2002/5/14-516408.html
[1082] "Elevated Homocysteine Levels and Increased Risk of Cervical Cancer" http://atkins.com/Archive/2002/8/23-936833.html
[1083] Mayo Clinic Proceedings 78(2003):1331.
[1084] Journal of the American Dietetic Association 104(2004):537.
[1085] Preventive Cardiology 5(2002):110.
[1086] Preventive Medicine 30(2000):225.
[1087] Mayo Clinic Proceedings 78(2003):1331.
[1088] Journal of the American Dietetic Association 104(2004):537.
[1089]
"I am just starting Atkins but my physician says I should be on
cholesterol-lowering medication. What should I do?"
http://atkins.com/helpatkins/newfaq/answers/IAmJustStartingAtkinsButMyPhysicianSaysIShould.html
[1090] "Meaningful Tests: Blood Lipids" http://atkins.com/Archive/2002/5/14-516408.html
[1091] Journal of the American Medical Association 290(2003):932.
[1092] Metabolism: Clinical and Experimental 53(2004):984.
[1093] Journal of Nutrition 133(2003):2756.
[1094] Mayo Clinic Proceedings 78(2003):1331.
[1095] Journal of the American College of Nutrition 23(2004):177.
[1096] Mayo Clinic Proceedings 78(2003):1331.
[1097]
O'Brien, K.D., Brehm, B.J., Seeley, R.J., "Greater Reduction in
Inflammatory Markers With a Low-carbohydrate Diet than with a
Calorically Matched Low Fat Diet," Presented at American Heart
Association's Scientific Sessions 2002 on Tuesday, November 19, 2002,
Abstract ID: 117597.
[1098] FASEB Journal 17(2003):abstract No 698.5.
[1099] "Most Weight Loss, LDL Reduction on Ornish Diet" http://aolsvc.health.webmd.aol.com/content/Article/77/90389.htm
[1100] ]"Most Weight Loss, LDL Reduction on Ornish Diet" http://aolsvc.health.webmd.aol.com/content/Article/77/90389.htm
[1101] Metabolism 53(2004):377.
[1102] Journal of the American Medical Association 290(2003):502-510.
[1103] Journal of the American Medical Association 290(2003):932.
[1104] Journal of the American Dietetic Association 104(2004):537.
[1105] Journal of the American College of Cardiology 43(2004):2142.
[1106] Journal of the American Medical Association 290(2003):932.
[1107] "Meaningful Tests: Blood Lipids" http://atkins.com/Archive/2002/5/14-516408.html
[1108] Journal of the American Dietetic Association 104(2004):537.
[1109] Journal of the American College of Cardiology 43(2004):2142.
[1110] The New York Times 18 January 2004.
[1111]
World Cancer Research Fund/American Institute for Cancer Research.
Food, Nutrition, and the Prevention of Cancer: a global perspective.
World Cancer Research Fund/American Institute for Cancer Research, 1997.
[1112] Journal of the National Cancer Institute 95(2003):1079.
[1113]
Report of a Joint WHO/FAO Expert Consultation. Diet, Nutrition and the
Prevention of Chronic Diseases. WHO Technical Report Series 916, 2003.
[1114] Medscape Medical News 21 January 2004.
[1115] Circulation 98(1998):935.
[1116] Public Health nutrition 7(2004):167.
[1117]
FASEB Journal, 17(4-5), Abstract of the 12th Annual FASEB Meeting on
Experimental Biology: Translating the Genome; Abstract#3321 San Diego,
CA, April 11-15, 2003.
[1118] Washington Post 14 April 1973.
[1119] American Journal of Public Health 79(1989):1668.
[1120] American Journal of Public Health 81(1991):791.
[1121] Pioneer Press 3 March 1998.
[1122] Southern Medical Journal 95(2002):1047.
[1123] Motion to Dismiss CASE NO.: 502004-CC-006591-MB in the County Civil Court for Palm Beach County, Florida 24 June 2004.
[1124] Centers for Disease Control Tobacco Information and Protection Source http://www.cdc.gov/tobacco/issue.htm
[1125]
R Kluger, Ashes to Ashes - America's Hundred-Year Cigarette War, the
Public Health, and the Unabashed Triumph of Philip Morris, Alfred A
Knopf, New York, 1996:130.
[1126] United States National Library of
Medicine database accessed 5 September 2004 through Ovid Medline
searching Cholesterol, Dietary/ae [Adverse Effects] or meat/ae [Adverse
Effects].
[1127] "Reading the Nutrition Facts Label" http://atkins.com/Archive/2003/11/17-700880.html
[1128] "Big Fat Lies" http://atkins.com/Archive/2001/12/21-587266.html
[1129] American Journal of Clinical Nutrition 70(1999):951.
[1130] American Journal of Clinical Nutrition 70(1999):1001.
[1131] "Debunking the Myths > Fact vs Fallacy, Part 5" http://atkins.com/Archive/2001/12/18-292461.html
[1132] "A Timeline of Milestones from The Framingham Heart Study" http://www.framingham.com/heart/timeline.htm
[1133] "The Framingham Heart Study" http://www.framingham.com/heart/backgrnd.htm
[1134] "PBS Scientific American Frontiers Affairs of the Heart" 23 January 2001 http://www.pbs.org/saf/1104/index.html
[1135] Personal Communication to JoAnn Farb January 24, 2000 9:20 AM.
[1136] "PBS Scientific American Frontiers Affairs of the Heart" 23 January 2001 http://www.pbs.org/saf/1104/index.html
[1137] Royal Courts of Justice QUEEN'S BENCH DIVISION No 1990-M-NO.S724 Witness Statement 27 July 1993.
[1138] "The Truth About Fat" http://atkins.com/Archive/2004/2/3-915798.html
[1139] "Fun Facts" http://www.candyusa.org/Classroom/Facts/default.asp
[1140] "Candy Myths" http://www.candyusa.org/Media/Nutrition/candy_myths.asp
[1141] "Research Shows "Chocolate Does Not Raise Cholesterol" http://www.candyusa.org/Media/Nutrition/chocolate_cholesterol.asp
[1142] "Cholesterol" http://www.hersheys.com/nutrition_consumer/cholesterol.shtml
[1143] "Stearic Acid in Chocolate and Its Neutral Effect on Cholesterol" http://www.chocolateinfo.com/sr/sr_article_11.jsp
[1144] "Nutrition" http://www.beefitswhatsfordinner.com/askexpert/nutrition.asp
[1145] Journal of the American College of Nutrition 60 (1994):986S.
[1146] Preventive Medicine 24(1995):308.
[1147] American Journal of Clinical Nutrition 70(1999):1001.
[1148] American Journal of Clinical Nutrition 70(1999):951.
[1149] "Atkins Killed Our Daughter" 23 August 2003 http://www.atkinsexposed.org/atkins/65/Atkins_Killed_Our_Daughter.htm
[1150]
JODY GORRAN, Plaintiff, v. ATKINS NUTRITIONALS, INC. and PAUL D. WOLFF,
Solely in his Representative Capacity as Co-Executor of the Estate of
Robert C. Atkins, M.D., Defendants.
[1151] Doesn't doing Atkins
increase the risk of osteoporosis by flushing calcium from the body?
http://atkins.com/helpatkins/newfaq/answers/DoesnTDoingAtkinsIncreaseTheRiskOfOsteoporosis.html
[1152] New England Journal of Medicine 340(1999):1994.
[1153] Copley News Service 22 September 2004.
[1154] Newsday (New York) 14 September 2004.
[1155] American Broadcasting Companies, inc. Good Morning America 24 September 2004.
[1156] Toronto Star 22 September 2004.
[1157] Boston Globe 17 August 2004.
[1158] Mincin, K. "High-Protein Diet is Risky." Well Being Journal 13(2004):1,34-36.
[1159] Hall, C. "Atkins dieters 'at risk of sharp rise in cholesterol'" The Daily Telegraph 4 September 2003:13.
[1160]
Bray GA, Nielsen SJ, and BM Popkin. "“Consumption of high-fructose corn
syrup in beverages may play a role in the epidemic of obesity."
American Journal of Clinical Nutrition 79(2004):537-543.
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