Apparently the Atkins diet does work

[Hellbound]

Evidence that the two were related?

Atkins does say in The Book that high protien consumption is bad if your kidney function is already impaired. But no studies have connected a low-carb diet to impairing healthy kidneys.

did

Let me rephrase, as I wasn't quite clear.

His function was at about 50% before starting the diet.

He degraded over a few weeks since starting it.

Clear now?

 

[Badly Shaved Monkey]

Temporary de-railing...

...and IIRC is down to around 50% function in each...

Could someone please tell me what "IIRC" stands for? Thanks.

 

[Lisa Simpson]

If
I
Recall or Remember
Correctly

 

[Fade]

An example of bad veggies and fruits are potatoes and bannanas.

Any diet that tells you not to eat these things is deeply, deeply flawed. Bananas and Potatoes are two of the most nutritionally complete foods there are. It's like saying avoid things like Oatmeal!

 

[Badly Shaved Monkey]

According to Atkins (I've got The Book in hand), ketoacidosis and ketosis are different things. Ketoacidosis is related to diabetes and involves out-of-control blood sugar; Atkins sought a state of ketosis/lypolysis, where ketones in the urine resulted from metabolism of fats.

Can't go into more detail now - gotta go. It's on page 95 of the paperback edition of the New Diet Revolution. I'd like to see more info about what Atkins claims in that - Atkins certainly had something to sell, and so relying on him for primary information is risky.

did

No, that's just being too clever by half and trying to pretend that something pathological is normal.

Ketosis is abnormal in people. An uncontrolled, but not especially sick diabetic is ketotic who can probably be managed as an out-patient. My Dad's been an insulin-dependent diabetic for 40 years and if he really messes up his regime, usually through too much travel and irregular eating he may get a little ketotic and just manages himself through it. Ketoacidosis is the next stage, which is just what it says: ketosis complicated by acidosis. You are then a really sick diabetic and are unlikely to survive without hospital management.

In other words they are stages in pathology. Both are abnormal.

As far as I can see the debate on the Atkins diet has been mostly cast in the wrong terms. The advocates seem to defend it against an unmade accusation that it doesn't work, presumably because in the public mind and in the advocates' minds in particular, it just seems weird to think you can lose weight on a high-fat and high-protein diet. Well, that just goes to show how little the general public understand of basic physiology. While it may not have been intuitively obvious that the diet would cause weight loss, using fat to mess about with satiety as a means to reducing overall calorie intake does not conflict with any basic concepts in nutrition. Not is basic physiological knowledge contradicted once we know that you pee out calories as unmetabolised ketones.

This whole debate is predicated on the public notion that there could be some special way to lose weight without eating fewer calories. If people lost weight on the Atkins diet then they had to be metabolising fewer calories, the only interesting question was why.

A sub-debate is that the diet would raise blood cholesterol or bad lipoprotein or something. Again this is an unmade accusation that the advocates defend against. I have seen numerous claims that people on the diet have reduced cholesterol. Whether these anecdotes represent the truth for the population as a whole, I do not know and have not bothered to investigate, but really I don't much care, because the real problem is the one we started with, making yourself ketotic is a really weird and abnormal thing to do and the fact that the promoters of the diet try to pretend it has nothing to do with the abnormalities of an uncontrolled diabetic should ring alarm bells in the quack-aware.

I can see making yourself ketotic is a neat trick to induce weight loss but I find it very difficult to believe that something so wholly unphysiological does not carry long term risks even if we have not found them yet.


The interesting science is to be found in the field of satiety, lipostasis and 'set-points' for body weight.

 

[Jeff R]

Any diet that tells you not to eat these things is deeply, deeply flawed. Bananas and Potatoes are two of the most nutritionally complete foods there are. It's like saying avoid things like Oatmeal!

I hate bananas, so any diet that prohibits them is OK with me.

 

[Rolfe]

According to Atkins (I've got The Book in hand), ketoacidosis and ketosis are different things....

Er, no.

Actually, I started that post originally by saying the difference between starvation ketosis (anyone familiar with Every Good Boy Deserves Favour - "Daddy, why does your breath smell of aeroplane glue?") and diabetic ketosis is.... and then changed it because thinking about it for approximately three seconds straightened me up on the fact that they are basically the same thing, it's only that in diabetes the lack of insulin prevents the glucose from getting into the cell and it builds up in the blood, while in starvation you simply don't consume enough glucose (precursors). The net result is the same - the lack of oxaloacetate then stops the Krebs cycle, and fat catabolism diverts to a ketone endpoint, thus utilising only a proportion (sorry, not going to work it out tonight) of the energy available had the whole thing gone right down to CO<SUB>2</SUB>.

OK, the body is resilient. You'll recover from the ketotic state. But it's still pathological and nobody with any sense would go there voluntarily. It's a dirty trick to play on your metabolism for a purpose that can be achieved more healthily by simply - wait for it - eating less and exercising more.

Oops, I just noticed BSM got there first.

Well, what he said.

And has anyone figured if there's any way to ensure protein consumption is heavy on the ketogenic amino acids and light on the glucogenic? That would be even more subtle, but I suspect impractical. Oh, it's rational, and perfectly explicable, and it will work for those with the willpower not to consume even the tiniest scrap of carbohydrate that will let the good old Krebs cycle start rollin' along again.

It's still nuts. Respect your citric acid cycle, do not put a spoke in its wheel.

Rolfe.

 

[bjornart]

Here's a bit from the Horizon program on Ketosis and losing calories through Ketones.

NARRATOR: What Dr Atkins argued is that ketosis was another reason why his dieters could eat to their hearts content. Ketones are in fact calories, and you could literally flush them unused down the toilet.

---

Prof JOSEPH DONNELLY: The concept is very interesting, it’s very controversial, in science it’s very nice to be there. It’s nice to do something that isn’t boring, there are millions of people interested in Atkins, really right, wrong or indifferent. So we’re very interested and eager to see the results.

NARRATOR: For two weeks one of the twins was put on the high fat, high protein Atkins diet. While the other was put on the conventional low fat diet. They were then locked inside this sealed chamber. By measuring how much oxygen they breathed in and out the computers could calculate how quickly their bodies were burning fuel. The hope was that this would begin to answer whether more calories are worked off on the Atkins diet by breaking down fats and proteins. Donnelly also tested Dr Atkins’s theory of calories lost as ketones down the toilet. The twins had to donate their bodily fluids for the duration of their internment.

Prof JOSEPH DONNELLY: We’ve collected a litre and a half of urine at each collection period. They’ll be analysed for urinary ketones and then we will know how many calories are lost in the urine.

NARRATOR: If Dr Atkins’s theories were right the twin on the Atkins diet should be losing significantly more calories than the twin on low fat. In the morning the twins were released and the results were in. To prove you burn off significantly more calories breaking down the Atkins diet researchers expected the twin on Atkins to have lost at least a hundred calories more than the twin on low fat. And the Atkins dieter did lose some more calories this way, but a total of just twenty two.

Prof JOSEPH DONNELLY: Twenty two calories is too small to suggest that there really is anything going on.

NARRATOR: In other words burning fats and proteins appeared to take up hardly any more energy than burning carbohydrates. It seemed Dr Atkins’s theory that you lose calories when breaking down his diet might be wrong. Next the researchers looked to see whether any calories were lost as ketones in the urine. The twin on the Atkins diet had lost less than a single calorie more than his brother on low fat.

 

[Badly Shaved Monkey]

Here's a bit from the Horizon program on Ketosis and losing calories through Ketones.

Thanks, I'd forgotten that had been on that programme showing a real but insignificant effect.

One of the classic errors of the public's view of scientific data, I also find in vet students I have taught is that statistical significance is not the same as biological signifiance, or, nearly conversely, that while a lack of statistical significance rules out biological significance it is only within limits dictated by the parameters of the test.

 

[Rolfe]

Next the researchers looked to see whether any calories were lost as ketones in the urine. The twin on the Atkins diet had lost less than a single calorie more than his brother on low fat.

That's interesting. It rather confirms what I was thinking in practical terms.

The theory is fine. And if you really can completely starve your citric acid cycle it will work. But how realistic a goal is this when you're not actually starving (as the hunger-striker in Every Good Boy Deserves Favour was)? Eat fats, OK, these won't help the citric acid cycle go round. But the diet also allows a lot of protein, and that seems to me to be a weak spot.

Proteins are digested to amino acids, and any amino acids not required as they are for reconstitution into new proteins are deaminated, and their carbon skeletons go into the fuel pathways. (Deamination produces waste nitrogen, which is excreted as urea, and it is this factor which is the main concern as far as people with renal or hepatic problems are concerned, as far as I can make out.) Reaches once more for the bible, Stryer.... The carbon skeletons are degraded to various intermediaries in the citric acid cycle, or to acetyl co-enzyme A or acetoacetyl co-enzyme A. These last are not citric acid cycle intermediaries, and therefore do not promote the continuation of the cycle.

Only leucine is purely ketogenic, that is it is only degraded to acetyl co-enzyme A or acetoacetyl co-enzyme A. Isoleucine, lysine, phenylalanine, tryptophan and tyrosine are both ketogenic and glucogenic (their carbon skeletons split, some going one way, some the other). The other 14 amino acids are purely glucogenic.

So obviously you can't really get away from feeding the citric acid cycle quite a bit with the breakdown products of all the protein you're consuming. And so long as it has glucogenic amino acids in it (inevitable), there is likely to be enough in the way of oxaloacetate in the system to allow a fair whack of the products of fatty acid oxidation to get in there.

This was what I was thinking in my last post when I mentioned the glucogenic amino acids, and Bjornart's point seems to me to confirm that in practice the citric acid cycle is getting along a lot better than Atkins would like. This is probably why, unless people are simply cheating.

Let's face it, even a very little bit of acetone smells quite a lot.

Rolfe.

 

[HarryKeogh]

Any diet that tells you not to eat these things is deeply, deeply flawed. Bananas and Potatoes are two of the most nutritionally complete foods there are. It's like saying avoid things like Oatmeal!

Potatoes? aside from the energy provided by the high calories; nutritionally theyre pretty worthless.

but tasty. especially fried and salted.

as for my take on the Atkins thing, up until recently I was a staunch advocate of it. Personal experimentation tells me that the ony reason it worked for me was because the fatty foods curbed my hunger longer than carb-laden ones. So now I don't follow Atkins but I rarely eat pasta, potatoes, bread. Theyre empty calories. I eat my veggies (except most of the very starchy ones) though.

 

[Rolfe]

aside from the energy provided by the high calories; nutritionally theyre pretty worthless.

I rarely eat pasta, potatoes, bread. Theyre empty calories.

Mmm, but the main reason we eat is to provide ourselves with energy. The main "worth" in nutrition is calories. Yes, we need other things too, but this a bit like scorning putting petrol in the tank of a car because all it does is fuel the engine. You need oil and new tyres and brake pads and all sorts as well, but still, the main thing you need to supply the car with is petrol. In the same way, the main thing we need to supply our bodies with is calories.

Define "empty calories". Do you mean foods with low vitamins, minerals and protein? Indeed, not a good idea to let yourself go short of these things, but they're needed in relatively small quantities compared to the basic fuel of calories, so some foods which are mainly calorie-suppliers are not out of place as part of a balanced diet.

Badly Shaved Monkey seemed to have some interesting details on the hunger-suppressing properties of fatty foods, maybe he could expand after the beer has run out? It certainly may be the case that this is the main reason a diet like the Atkins works, if indeed it works.

Rolfe.

 

[bjornart]

Well, I have to post quotes from the Horizon program again, the tests refered to there seem to indicate fat content increases appetite rather than inhibiting it.

NARRATOR: This may be the secret to the Atkins diet. It works by controlling appetite. But what is it about the diet that kills hunger? Dr Atkins believed that it was due to cutting carbohydrates, but as yet evidence for this theory is so far inconclusive. There may be another reason. The Atkins diet is famous for its fat. Dr Atkins said you could eat as much of it as you like. Is it possible that fat could be suppressing appetite? To find out Susan Jebb and her team decided to run an experiment. All the meals in the study looked exactly the same, but there was a big difference. Half the food had liberal quantities of fat secretly added to it.

Dr SUSAN JEBB: We used things like spaghetti bolognaise or mousses so that you could because easily disguise the fat content of the food.

NARRATOR: None of the volunteers knew which type of food they were getting. But half of them were eating low fat meals, and half were eating high fat meals.

Dr SUSAN JEBB: What we told them is they could eat as much or as little as they wanted and they simply just had to ask when they wanted more food.

NARRATOR: If fat was the magic ingredient that switches appetite off, then the men eating the high fat food would fewer calories than normal to feel full. After four hundred and eighty six meals the results were clear. The fat was having the exact opposite effect. The men on the high fat food needed more calories to satisfy their appetite. They were actually overeating.

Dr SUSAN JEBB: What we conclude from that is that fat doesn’t make people feel full. It doesn’t trigger the sense of fullness and satiety that we believe is fundamental to appetite control.

On the other hand, studies show protein inhibits appetite:

NARRATOR: So fat wasn’t the reason for the Atkins diet success. This just added to the mystery. There had to be another to explain why the Atkins diet made people eat less. The answer may have come from Denmark. This supermarket in Copenhagen is like no other in the world. It was built by Arne Astrup, a professor in human nutrition.

Prof ARNE ASTRUP: All the food items have a bar code on it, not for, not for pricing but for all the nutrition information with the calories, protein and carbohydrate.

NARRATOR: In this supermarket the check out assistant’s not all she seems. She’s a scientist, and everything in the shop is free.

Prof ARNE ASTRUP: When we announced actually in the television our University here was bombarded and the switchboard broke totally down and there were almost a thousand people who wanted to participate.

NARRATOR: Professor Astrup was running a study to discover the secret of appetite control. To do this he chose sixty shoppers and split them in to two groups. One group shopped for high carbohydrate food, the other group shopped for food high in protein, similar to the Atkins diet but low in fat.

Prof ARNE ASTRUP: One group should eat a lot of, of lean meat from shell fish, fish, poultry and lean meat, and dairy products. And the other group should eat a lot of bread, pasta, rice, fruit and vegetables.

NARRATOR: Both groups were told they could eat as much as they wanted. They should eat to satisfy their appetite just as Dr Atkins advised on his diet. The study ran for a whole year and the results were spectacular.

Prof ARNE ASTRUP: One of the groups was losing much more than the other group. I say it was four or five kilo more.

NARRATOR: When they looked more closely it was clear which group had lost so much weight. it was the group eating a diet high in protein. And the shopping lists revealed why.

Prof ARNE ASTRUP: We could see from the data that the reason why the high protein group had lost more weight was because they had actually consumed fewer calories throughout the study, despite the fact that they had just as the same free access to all the foods they really want to, to eat.

 

[Jeff R]

On the other hand, studies show protein inhibits appetite:

Another way to look at the results from that study is that eating lots of protein normalizes appetite while eating lots of carbohydrates abnormally increases appetite. That's certainly the view that low carb proponents would take.

 

[Fade]

Potatoes? aside from the energy provided by the high calories; nutritionally theyre pretty worthless.

This is just ignorant.

There are many, many types of potatos. Some are more complete, some are less so, but almost all potatoes contain these in varying amounts:

Protein
Calcium
Iron
Potassium
Vitamin-C
Thiamin
Riboflavin
Niacin
Vitamin B-6

And trace amounts of vitamin-E


Potatoes are not empty. It would be possible to subsist on Potatoes and Whole Milk entirely.

 

[Charles Livingston]

Regarding potatoes and bannanas:

yes, potatoes and bananas may (I'm quite sure with bannanas but dont know about pototatoes) have many nutrients, but they are rapidly digested and delivered to the bloodstream, and therefore quickly raise blood sugar levels, etc. That's the only reason they are bad, they spike your blood sugar levels and therefore do all sorts of crazy things with insulin etc. that can cause weight gain and other problems. I believe high fat meals also raise blood sugar levels. You can get nutrients from other fruits and vegetables without these drawbacks. Additinally, when these types of carbs are eaten with certain fats (like butter for example) they cause you to release a hormone (LPL I think) that stimullates fat storage. Atkins and other low carb diets basically work on the reduced calorie formula, as has been stated above. Similarly, most low-glycemic diets basically work on the same principle cause lower glycemic foods generally dont induce cravings that cause you to overeat. However, although for the most part a calorie is a calorie, some calories may cause your body to react in different ways, such that you can lose weight eating the same amount of calories you were when you were gaining/maintaining if you generally eat a lower glycemic diet and dont combine highly glycemic foods with bad fats that cause the release of LPL. To me, none of this is really news, havent weight lifters and diabetics been eating this way for a long time?

Also, some perpspective is needed. although bannanas are highly glycemic compared to other fruits, I would bet they are still better than eating pure table sugar. However, a plain baked potatoe is worse then pure table sugar at least regarding how fast it is digested and released into your bloodstream.

Now I'm no doctor or nutritionist, this is just what i have gathered from reading the south beach diet and most importantly a book from the glycemic research institute, which goes into way more detail than the SBD book. Anyone who knows more about this is free to elaborate or correct me.

 

[Rolfe]

The interesting science is to be found in the field of satiety, lipostasis and 'set-points' for body weight.

This was the bit of BSM's post I'd be interested in hearing more about. All this has been discovered relatively recently and I'm not very familiar with the area.

Come in, BSM, I for one am listening.

Rolfe.

 

[alfaniner]

Since most of these crazy diets seem to come from California, I'm thinking of creating one of my own, called the Super-Cali-magi-mystic-ketoacidosis diet.

 

[Rolfe]

That's the only reason they are bad, they spike your blood sugar levels and therefore do all sorts of crazy things with insulin etc. that can cause weight gain and other problems.....

I can see the rationale for avoiding things that cause an exaggerated spike in blood glucose (note, exaggerated, because pretty much anything will cause a measurable increase in glucose actually). It's not so much the spike that's undesirable, it's the fact that it stimulates an exaggerated insulin response, which shoves the glucose back down equally fast, and then causes it to overshoot a bit. So you actually get a mild hypoglycaemic episode before the system self-corrects. You're likely to feel hungry at that point, and it's not actually a very pleasant sort of feeling. Meagre and hollow, but crisp?

But I doubt very much if it results in any measurable weight gain over and above the same number of calories being taken in in a slower-assimilated format. Yes, high insulin does cause weight gain, but I'd need a bit of evidence that the sort of spike we're talking about here is enough to cause a measurable effect. It's more likely to be that you then eat something else when the hypo hits.

I don't think it's a nice way to be, but on the other hand I don't necessarily think it does any measurable actual lasting harm. The body is awfully good at coping with a pretty wide range of ways food gets presented to it, and a hit of sugar isn't actually poisonous.

Rolfe.

 

[Charles Livingston]

I can see the rationale for avoiding things that cause an exaggerated spike in blood glucose (note, exaggerated, because pretty much anything will cause a measurable increase in glucose actually). It's not so much the spike that's undesirable, it's the fact that it stimulates an exaggerated insulin response, which shoves the glucose back down equally fast, and then causes it to overshoot a bit. So you actually get a mild hypoglycaemic episode before the system self-corrects. You're likely to feel hungry at that point, and it's not actually a very pleasant sort of feeling. Meagre and hollow, but crisp?

But I doubt very much if it results in any measurable weight gain over and above the same number of calories being taken in in a slower-assimilated format. Yes, high insulin does cause weight gain, but I'd need a bit of evidence that the sort of spike we're talking about here is enough to cause a measurable effect. It's more likely to be that you then eat something else when the hypo hits.

I don't think it's a nice way to be, but on the other hand I don't necessarily think it does any measurable actual lasting harm. The body is awfully good at coping with a pretty wide range of ways food gets presented to it, and a hit of sugar isn't actually poisonous.

Rolfe.

If you read what I posted carefully you will see that I agree with you for the most part, the reason you gain weight from the spike is that you overeat (take in more calories) from the cravings. However, you can gain weight even without ingesting more calories if you combine the high glycemic carbs with bad fats because LPL is released which tells your body to store instead of consume (I assume it must adjust your metabolism?). If you are really interested, I can link the glycemic research institutes site where you can find their book. I dont know anything about them so they could be full of it but the book is very technical and the information they present seems legit to a layperson like me, but of course its only one side of the story and they could be making it up. What do I know. Teh book also has a good chapter on why high-protein diets like atkins are unhealthy and how they can actually cause you to gain weight over the long term, something about how they teach your body to be more efficient at storing fat. Again, I am not knowledgeable enough to give the theory a decent review, but it was an interesting theory at least. They also claim that excess protein often gets stored as fat, but i have heard atkins somewhere say that excess protein gets flushed out and thus are 'empty calories'.

Regarding your excellent elaboration of the effects of blood sugar spikes, I completely agree. I didnt see the need to elaborate what the spike in blood sugar does but in hindsight it is helpful. I can tend to blabber on and on and the "etc." was my way of cutting myself short. Anyway, thanks for the reply, I would be interested to hear if the whole LPL things is legit.

Anecdotally, I did atkins last year and lost weight but it came back in a hailstorm when I stopped. This year I did low-glycemic and generally only consumed slightly less calories than on no diet and lost 20lbs in 2 months that has stayed off, albeit while I continually eat low glycemic. Since I usually eat only one meal a day on no diet, part of the loss is likely due to eating many small meals taht, although add up to almost or as many cals as the no diet one meal, boost my metabolism througout the day. IE, the cravings werent really an issue for me cause I didnt feed them, but there are other issues that could explain the weight loss above and beyond the LPL deal.