ASK DR. ATKINS
The following information has been borrowed from the official
Atkins Center website. Please feel free to visit there for more information.
This is not meant to be a primer on the Atkins diet. You will
find here the "official" responses to many rumors and controversies that have
been in the press. You will also find lots of great advice for those who are
already convinced that this is a sound, healthy approach to weight loss.
Click on the Links Below
Back to the Top
On Low Carb Dieting
I've heard that Atkins is unhealthy and
unsafe. How do you respond?
There is a large body of scientific research showing that
a controlled carbohydrate nutritional approach, such as Atkins, can help people
significantly decrease their risk of developing heart disease, diabetes, and
obesity. Following Atkins correctly will lower clinical parameters in the
blood that are known to contribute to these conditions. We at the Atkins Health
and Medical Information Services continually explain the scientific rationale
of the benefits of the Atkins Nutritional Approach to health care professionals
at medical conferences, in articles, and in the media. Please browse our Web
site or read Dr.
Atkins New Diet Revolution for a more comprehensive discussion of the
safety and efficacy of Atkins.
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On Using the Word
I see you don't use the term "The Atkins
Diet" anymore. Why not?
The word diet has several meanings, the most basic
one referring to the food we regularly eat. But in our culture, the word has
become entwined with weight loss and implies a limited period during which
intake is limited in order to lose weight. No matter how successful they are
in losing weight, most people then go off their "diet" and return to their
normal way of eating - and then regain the weight they have lost.
In contrast, the Atkins Nutritional Approach refers to
a lifestyle and four graduated phases that encompass weight loss and weight
maintenance as well as overall health and well-being and the reduction of
risk factors for heart disease, diabetes and other illnesses. Depending upon
your weight and health, you can personalize the Atkins Nutritional Approach
to suit your individual needs and move from one phase of the program to another
as your needs change. In sum, Atkins is more than a diet - it is a healthful
approach to eating that will serve you for the rest of your life.
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On High Fat Intake
What is the Atkins position on studies
that state fat intake is detrimental to your health?
A diet high in both fats and carbohydrates can cause cardiovascular
problems. The Atkins Nutritional approach restricts carbohydrates, thereby
putting your body into lipolysis. In this metabolic state, the body burns
both the fat that you consume along with your stored body fat, and will not
allow plaque to clog your arteries. Natural dietary fats such as olives, avocados,
olive oil, butter and fat from red meat and poultry are not the culprits in
heart disease. Fats that should be avoided, however, are trans fats (food
labels refer to them as hydrogenated or partially hydrogenated oils). Found
in packaged products such as crackers, bread, margarine and commercially baked
desserts and snacks, these fats have been found to pose a serious risk of
cardiac disease, according to several studies.
Selected reference: New England Journal of Medicine 1997;
Why do you allow "fried foods"? They are
a known health risk.
Fried foods allow you to enjoy Atkins more and do not adversely
affect the metabolic state of lipolysis, or "fat burning." However, we do
agree that given a choice, broiling or roasting meat is preferable; both of
these two ways of cooking eliminate the "trans fats" that are created by the
ultra-high heat of frying.
I have elevated cholesterol and have been
told to watch my fat intake. How can the Atkins Nutritional Approach, which
is so high in fat, be safe for me?
It's only a diet high in fats and carbohydrates that can cause
cardiovascular problems. The Atkins Nutritional Approach restricts carbohydrates,
thereby putting your body into "ketosis." In this metabolic state, the body
burns both the fat that you consume and your stored body fat, and will not
allow plaque to clog your arteries.
Natural dietary fats such as olives, avocado, olive oil, butter
and fat from red meat and poultry are not the culprits in heart disease. There
are many studies that show that sugar is the real ingredient that triggers
heart problems. The fats that should be avoided, however, are trans fats (food
labels refer to them as hydrogenated or partially hydrogenated oils). Found
in packaged products such as crackers, bread, margarine and commercially baked
desserts and snacks, these fats have been found to pose a serious risk of
cardiac disease, according to several studies.
Selected reference: New England Journal of Medicine 1997; 337:
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On Using Supplements
Do you recommend a lot of supplements because
the Atkins Nutritional Approach is unbalanced and doesn't provide enough nutrition
on its own?
On the contrary, a computer analysis using the software program
most widely accepted by nutritionists shows that even a sample menu appropriate
for the Induction phase of Atkins -- the one that can certainly be considered
the most restrictive -- far exceeds the recommended daily intake requirements
set for adults for most vitamins, minerals and antioxidants. We and many
other nutrition-oriented doctors recommend additional supplements because
of our polluted environment, our own lifestyles, and the degraded quality
of the food supply. In an ideal world, we could depend on whole foods grown
organically in nutrient-rich soils, free from pesticides and pollution. However,
our depleted soils, the over-processing of foods and other chemical assaults
to the environment leach vital nutrients from foods. By the time a meal arrives
at our table, a lot of the nutrients have been lost. In addition, the chemical
overload from antibiotics and other drugs, cigarettes, pesticides and pollution,
as well as work-related stresses, all combine to strain our immune systems.
Supplemental nutrients help neutralize the harmful effects of these insults
to our bodies and prevent further breakdown of our health. Moreover, supplements
are even more important when your body is under stress from weight loss or
This 2,000-calorie daily menu is nutrient-rich and suitable
for the Induction phase of Atkins:
- Breakfast: Avocado, mozzarella and tomato
omelet and two slices of bacon.
- Lunch: Beef patty and a spinach, endive
and romaine salad garnished with mushrooms, onions, celery and Parmesan
- Dinner: Broiled salmon; asparagus and garlic
sautéed in safflower oil and topped with lemon juice and sesame seeds.
The recommended daily intake of vitamins and minerals
found in this menu include:
|Vitamin A: 164%
|| Potassium: 115%
|Vitamin C: 145%
|| Sodium: 64%
|Vitamin D: 339%
|Vitamin E: 102%
|Vitamin K: 558%
Every time I take supplements, I get sick
to my stomach.
Don't stop taking your nutrients; change the way you take them.
Your nausea almost certainly is an absorption problem. Supplements only occasionally
cause side effects. When they do, symptoms tend to appear before absorption
into the bloodstream. That's quite unlike drugs; the side effects of which
usually appear only after the medications are surging through your arteries.
The solution involves technique and timing. First, gather up
all the supplements you would normally take for the day, put them in a food
processor or blender, and pulverize them. Divide the powder in half or into
quarters. Take each portion over the course of the day during the middle of
your meals, not at the start. This is important, because you need some food
in your stomach to stir the flow of gastric juices and better digest the nutrients.
You can mix the powdered supplements with anything you'd like
-- you might stir it into a bowl of soup or mix it in a glass of water, for
example. We usually recommend adding it to the Atkins Shake Mix.
The technique works for most people we know who have complained
of stomach upset upon taking supplements. If it doesn't work for you, try
dividing the powder into even smaller portions.
There is also the possibility that a certain supplement brand
is behind your nausea. Through a process of elimination, you probably could
find out which one. If you do identify a certain supplement, don't eliminate
it from your program; switch to another manufacturer.
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On Counting Calories
Is it true that Atkins works because it's
a low-calorie diet?
Ask anyone doing Atkins and they will tell you this is completely
false. While some Atkins followers eat fewer calories than before, it's not
because Atkins is restrictive or unduly limiting of food intake (as is true
for every low-fat nutritional philosophy), it's because people are generally
less hungry and are less obsessed with food while doing Atkins. This occurs
for two reasons:
- Stable blood sugar throughout the day ensures that you
will have fewer food cravings or false hunger pains.
- The food you eat on Atkins (meat, fish, cheese, nuts, eggs,
low sugar/starch vegetables and fruit...etc.) is less processed and more
nutritious than you were previously eating. Give your body fewer empty calories,
providing it with more nutrient-dense alternatives, and your body will logically
be satisfied sooner and require less food.
For those who need further
convincing, try this 500 calorie test:
Day 1 breakfast: 500 low-fat calories, including
cereal (maybe one of the high-sugar versions endorsed by the American
Heart Association), skim milk, orange juice and a bagel.
Day 2 breakfast: 500 Atkins calories, including
a Cheese/broccoli omelet, bacon and/or sausage. (Make sure each breakfast
measures out to 500 calories.)
If you're like most people, the low-fat breakfast will
cause your body to scream for more food well before lunch, while the Atkins
breakfast will keep your mind off food so long you'll be shocked when lunch
time comes around.
I'm used to counting calories. How many
calories am I allowed during Induction?
There is no need to count calories. The Atkins Nutritional
Approach counts grams of carbohydrates instead of calories. At the beginning
of Induction, you are allowed 20 grams of carbohydrates, gradually adding
them in 5-gram increments as you progress from Ongoing Weight Loss to Pre-Maintenance,
and finally to the Lifetime Maintenance phase of Atkins. Although there is
no need to count calories, they do count. Gaining weight results from taking
in more calories than you expend through exercise, thermogenesis (the body's
own heat production), and other metabolic functions. Research has shown that
on a controlled carbohydrate program, more calories are burned than in a mixed
diet, so there is a certain metabolic advantage to the controlled carb approach.
But understand that this does not give you a license to gorge.
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Is it true that Advantage bars are higher
in carbs than it says on the label because the glycerine is not counted?
Our main concern for Atkins followers is the impact of carbohydrates
on blood sugar and insulin levels. Glycerine does not metabolize like a carbohydrate.
Instead, it actually has the same effect on blood sugar that protein does.
Therefore, it has not been included on the label.
I've read recently that Atkins does not report carbohydrates
correctly on its nutritional labeling on certain products. Is that true? If
so, why is this happening and what does Atkins intend to do about the situation?
Atkins products are specifically formulated to minimize the
impact of carbohydrates on a person's blood sugar level because elevated blood
sugar and the resulting excess insulin production can inhibit weight loss,
weight management and increase the risk of disease and illness. We accomplish
this in our product formulation by understanding that not all carbohydrates
behave the same way in a person's body. While most carbohydrates - sugar,
which imparts 4 calories per gram, is the best example - are digested by your
body and turned into blood sugar, other carbohydrates behave differently.
Some carbs are digested by your body but not turned into glucose. And, some
carbs - such as fiber - can impart as little as 0 calories per gram, are not
digested at all, and pass through your body as waste. In either of these last
two cases there is no noted impact on blood sugar levels. However, the FDA
and other health organizations have not yet focused on this important biochemical
difference and treat all carbohydrates as the same.
The nutritional information on Atkins food products is intended
to help consumers understand exactly how we formulate our products so that
the consumer has the knowledge necessary to follow a controlled carbohydrate
nutritional approach and eat healthy foods. Thus, for Atkins
Advantage™ Bars, the "net" carb count listed in the Total Carbohydrate
statement is completely accurate for Atkins followers, and the "gross" carb
count matters very little.
Example: Atkins Chocolate Mocha Crunch Advantage Bar
| Total Carbohydrate (as defined
by the FDA)
Non-Caloric and/or Non-blood sugar impacting Carbs
Net Carbohydrates of interest to consumers who do
(* Mainly from the soy nuggets, cocoa and residual
carbs found in the sources for the protein blend)
Millions of people have benefited and continue to benefit
from the Atkins Nutritional Approach™ and the products we have created to
support this approach. Healing and helping people is the cornerstone of the
mission of the company.
Atkins has been working very closely with the FDA in a spirit
of cooperation. Our goal has been to provide accurate information to Atkins
consumers and others for whom blood sugar levels are a real health issue.
Atkins believes consumers would benefit tremendously by understanding the
relative importance of the impact different types of carbohydrates have on
blood sugar and that this information should be presented right on the nutrition
We certainly understand and respect that the FDA has now
made the decision that requires all food products labels include all nutrients
defined as carbohydrates by the FDA - and that these nutrients be listed in
the Total Carb statement on the Nutrition Facts Panel.
Atkins will therefore update all its labels to comply with this
directive. This process is underway and can be seen on Atkins™
Ready-To-Drink Shakes, Atkins™ Shake Mixes, Atkins™
Quick & Easy Mixes and many other Atkins products.
It is presently being accomplished on Atkins
Advantage™ Bars, Atkins™ Breakfast Bars and Atkins
Endulge™ Bars. Current products with existing labels
will be sold through, and will then be replaced by product with the FDA-mandated
labels. Consumers should start seeing these new labels in early 2002.
The new labels will fully comply with the FDA ruling. And, our
labels will also become even clearer about the benefits of the Atkins Nutritional
Approach™ so that consumers who want to moderate their refined carbohydrate
intake will understand the health benefits of Atkins products.
Atkins Nutritionals will be issuing shortly a detailed guide
to carbohydrates that will help retailers better educate their consumers on
the wide variety of carbohydrates found in food products.
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At what age can a child start doing Atkins?
Babies, if showing signs of obesity, could be moved in the
direction of the Atkins Nutritional Approach as soon as the tendency is noted
(no sugar, less fruit and juice, and more protein). If this fails, the carbohydrates
should be increasingly restricted. Please do not do this without the guidance
of a knowledgeable pediatrician.
My 6-year-old is overweight. Can I put
him or her on Atkins?
We don't recommend Atkins for children under 12 without supervision
by a pediatrician. (Losing weight too quickly could stunt growth at this age.)
But remember, young children tend to eat like their parents do. That's why
it's important that the whole family eat healthy, balanced meals. We suggest
that you cut out sugar, processed food, junk food and other refined carbohydrates.
The single most important thing you can do for an overweight
child is wean him or her off sugar. Children can certainly eat Atkins
Shake Mix, Advantage Bars, and certain sugar substitutes. What usually
makes children overweight is a diet high in refined carbs, sugary treats and
sodas, and the trans fats (hydrogenated oils) found in manufactured foods.
If you put your entire family on a whole foods eating plan, your son or daughter
will probably lose weight. That means no bread, bagels, pasta, crackers, potato
chips, pretzels, soda, fruit juice or any food not in its natural state. Instead,
offer nuts, cheese, fruit, raisins and other healthy snacks. The earlier parents
instill good nutrition, the healthier their children will be as they get older.
If your son or daughter is a couch potato and eats a lot of
high-carb and junk foods, he or she is heading for a lifetime of weight and
health problems. Limit the amount of time kids spend in front of the television
or the computer. Encourage them to get involved with sports and plan regular
physical activities the family can enjoy together, such as hiking, biking
and swimming. Again, the sooner you instill the habit of exercise, the better.
The biggest problem for most overweight people is simply that they're inactive.
Our culture's bad diet wouldn't cause as many health problems if people were
Note: When you talk to your kids about eating habits,
it's important not to focus on weight or body fat. You don't want to set the
stage for a future eating disorder. Instead, talk to them about how healthy
eating will make them feel better.
Tip: Don't restock the fridge, empty the pantry, and insist
on a family hike all in one day. Make changes slowly, and you'll encounter
less resistance from the younger set.
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On Atkins for Teenagers
My teenager wants to do Atkins. Is it safe
for someone her age?
Yes, controlling carbohydrate intake is appropriate for adolescents
and children over the age of 12. (Younger children should follow the program
only under the advice and supervision of a physician.) There are, however,
certain things parents should be aware of when an adolescent restricts carbs
without expert supervision:
- Although appetite is usually decreased, teens should be
encouraged not to skip meals.
- Like adults, they should consume at least eight glasses
of water per day. If your child experiences constipation, add fiber, such
as wheat bran, psyllium husks or flaxseed, to his or her diet.
- Adolescents should take a multivitamin/mineral supplement
while restricting carbohydrates.
Recent research at Schneider Children's Hospital in New Hyde
Park, N.Y., confirms the effectiveness of a controlled carbohydrate program
for teens. Marc S. Jacobson, M.D., lead researcher and director of the Center
for Atherosclerosis Prevention at New York Hospital, reported that 22 adolescents
consuming a high-protein, high-fat carbohydrate-restricted diet were more
successful at losing weight than those consuming a low-fat, high-carbohydrate
one. Teens who restricted their carb intake also had improved cardiovascular
risk factors and other clinical health markers.
Participants were 12 to 18 years old and 20 to 100 pounds
overweight. Those following a controlled carb program lost 19 pounds in 12
weeks, while the low-fat group lost less than half that amount, 8.5 pounds.
The research showed that the controlled carb group also showed a greater decrease
in overall cholesterol levels, with triglycerides dropping 33 percent as compared
to a 17 percent drop for the low-fat group. Kidney and liver functions were
unaffected by the high-protein, high-fat diet. The high-protein group ate
66 percent more calories than the low-fat group (1,830 calories vs. 1,100
calories per day). After three months on a weight-loss regimen, the participants
followed a weight maintenance program that included additional carbohydrates.
Nutritionist Nancy Copperman, M.S., R.D., who designed both regimens, says
that six to 12 months later, most members of the controlled carbohydrate group
had maintained their weight loss.
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Can a vegetarian follow the Atkins Nutritional
Animal proteins are a vital component of Atkins. Atkins cannot
be done as successfully without them. They contain many essential fatty acids
that cannot be found in any other sources. There are patients at The Atkins
Center for Complementary Medicine, however, for whom we derived a modified
ovo-lacto vegetarian diet; they can eat eggs, cheese and tofu for their protein
(although it is usually necessary for a person to be able to also eat fish
for Atkins to be enjoyable). Atkins food products such as the
Advantage Bars and Atkins Shakes can also be used as occasional meal replacements.
A vegan cannot follow Atkins. A pure vegan diet could never
be low enough in carbohydrates, because there are no plants that are carbohydrate
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On Atkins for Slender
Can I join my partner on Atkins? My partner
is overweight, but I am slim. Will I lose weight or mess up my metabolism?
Atkins is recommended for more than weight
loss. It is your ticket to weight maintenance, good health and disease prevention.
Anyone can experience the health benefits associated with controlled carbohydrate
nutrition. Use your husband's Induction-level menu as a base, then add liberal
amounts of vegetables low in carbs and some higher-carb ones such as yams,
carrots and peas. Also add fruits such as melons and berries, as well as legumes
and whole grains. While consuming a regular amount of protein, add as much
of these foods as you wish at levels that allow you to maintain your normal
weight. Do, however, avoid empty carbs in the form of packaged or processed
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Do I need to exercise to lose weight on
Exercise will not only speed up your weight loss (or help
you maintain your weight) and enhance muscle tone, but also offers cardiovascular
conditioning that is essential for continued good health.
Many studies have shown that inactivity is the greatest
risk factor leading to heart disease, more so than the usual indicators such
as high cholesterol. Regular aerobic exercise strengthens the heart muscle
and widens the arteries called collaterals that supply extra oxygen-rich blood
to weaker areas of the heart. Patients treated in the cardiology division
of our clinical practice receive a prescription that includes a lifestyle
change in nutrition, supplementation and exercise. Select a form of exercise
that you enjoy, whether walking, running, swimming or bicycling. You actually
need to engage regularly in two kinds of exercise. Isometric, or dynamic,
exercise is aerobic, meaning it increases the heart rate and the blood pressure;
swimming or brisk walking are good examples. Isotonic, or static, exercise,
such as weight lifting, involves the muscles, but does not significantly increase
the heart rate.
How long does it take to see results from
Be patient. Two weeks is not enough time to effect changes
in your body from exercise. Some people, especially those who are flabby,
may even gain a little weight. That's because muscle mass increases as you
get stronger, and muscle weighs more than fat. As we start to age, from our
30s on, we begin to lose muscle mass. That's one reason your metabolic rate
slows down. The more muscle you have, the more oxygen you take in; oxygen
burns fat, so you in turn burn more fat. If you follow an exercise program
five days a week you should see results within a month.
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Exactly what is ketosis, and can it be
There are two fuels your body burns for energy.
Glucose, the primary fuel, comes from eating carbohydrates. When your body
runs out of glucose, it turns to its secondary fuel source: your own body
fat. When you reduce your intake of carbohydrates, your body must convert
fat into energy, and this metabolic state is called "ketosis." So being in
ketosis simply means living off your fat stores. Assuming you're overweight,
this process is not only safe - it's desirable!
One reason why people become overweight in
the first place is that their bodies have great difficulty in using this backup
fuel system. Almost 50 years ago, scientists demonstrated that obese and overweight
people differed dramatically from people of normal weight in that they were
very resistant to developing ketosis. The Atkins Nutritional Approach helps
your body activate its fat-burning system by restricting its primary source
of fuel - glucose.
Ketosis is absolutely safe, unless you happen
to have no excess body fat. So, why do so many people think ketosis is dangerous?
Perhaps because the term is often confused with another K-word. Ketoacidosis
is a potentially dangerous condition that occurs in a diabetic whose blood
sugar levels are out of control. Ketoacidosis is not experienced on Atkins.
We have diabetic patients at The Atkins Center for Complementary Medicine
in ketosis whose blood sugar is under control, and they are burning fat and
Anyone who is diabetic and wishes to do Atkins (or any weight-loss
program) should seek a physician's supervision.
Selected reference: Bloom, W., "Fasting Ketosis in Obese Men
and Women." J. Lab. & Clin. Med. 606, 1962; 784.
Why am I unable to get into ketosis even
with a very low amount of carbohydrates? What should I do?
You are either metabolically resistant to weight loss or else
you don't know all sources of the carbohydrates you may be eating. If you
are losing weight and doing well, there is no need to do anything differently.
If you are not doing well or losing weight, you may benefit from additional
nutritional supplementation Vita-Nutrients, including L-Carnitine, HCA and
chromium may prove helpful. To stimulate ketosis, the best diet is high in
fat (cream cheese, macadamias, deviled eggs, etc.), moderate amounts of protein
and a very low level of carbohydrates. You may also need to increase exercise
from three times per week, to four or five times per week. If all else fails,
you need to see a M.D. trained in the Atkins Nutritional Approach. To really
understand what is occurring in your body, we strongly suggest you read Dr.
Atkins New Diet Revolution
What shade of purple should my Lipolysis
Testing Strips be?
Lipolysis is an indicator of whether a person is adhering
to the Atkins Nutritional Approach. Ketones are formed when the body breaks
down fat. If you are restricting the amount of carbohydrates you eat, then
the body's preferred source of energy, fat, is used for metabolism.
There are many reasons why a person's lipolysis test strip
would be varying shades of purple. Each person's metabolism level is different
and therefore will turn the sticks a varying degree of purple. In addition,
the time of the day, whether or not you exercise, and what you had at your
last meal will all affect the ketone test strips. It also does not necessarily
matter whether you are turning the strips a dark or light color. The important
thing is you are in ketosis and are burning fat for energy. However, keep
in mind that every individual's metabolism is different, and as a result,
there are people who never even get into ketosis, yet lose all the weight
In summary, don't worry about the exact level of ketosis
you will find on the strip. The important thing is to worry about the restrictions
of the Atkins Nutritional Approach, how your clothes are fitting and what
the scale says. Because of this, we sometimes do not even use the strips,
nor do we encourage you to weigh yourself every day. This should be done once
per week. Don't make the common mistake of eating less fat to get into ketosis;
the opposite is actually true.
No matter what I do, I can't get into ketosis,
or the shade of purple on the sticks is very light. What am I doing wrong?
The first question to ask yourself is, "Am I seeing success
with Atkins?" (loss of weight/inches, improved mental/physical energy, etc.).
If you are, then don't focus on ketosis as a success gauge. If you are not
seeing success, please review the question on our Web site concerning slow
weight loss and plateaus for additional help.
In either case, please remember not to over test yourself.
We recommend that you test your ketosis level no more than once a week.
Since starting Atkins, I have bad breath.
Can I use Tic Tacs or other breath mints? Any other suggestions?
Lipolysis (the process during which your body primarily burns
fat as fuel rather than glucose), causes ketosis, which generates ketones,
the by-products of fat breakdown. During lipolysis, ketones are released in
your breath and your urine. While this can be annoying, the good news is that
ketone breath is chemical proof that you're burning stored body fat. The more
ketones you release, the more fat you've burned. Drinking plenty of water
helps dilute the concentration of ketones. Parsley, too, is a natural breath
freshener, as is oil of peppermint (drops are available at natural food stores.
(Read the label to ensure that it contains no sugar.) Chewing fresh parsley
or taking capsules such as Breath-a-Sure, which can be found in any health
food or drug store, will also help. As long as you drink enough water, the
bad breath caused by ketones usually lasts only a few weeks.
We discourage the use of breath mints while doing Atkins because
they may contain either sugar or artificial sweeteners. Even so-called "sugar-free"
products are often full of carbs. Check the number of grams of carbohydrates
on the label of any product before using it.
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Are there any medical conditions that can
interfere with a person's ability to do Atkins?
Yes, and they include far advanced kidney disease, gout, urate
kidney stones, or unmanageable constipation or allergy to the primary foods
on the Atkins Nutritional Approach, such as meat and cheese. The absence of
digestive enzymes needed to digest fat and protein also make the Atkins Nutritional
Approach difficult to handle, but this can usually be corrected. People who
are underweight or of normal weight should not use the Induction phase of
Atkins, but rather begin with the Ongoing Weight Loss (OWL), Pre-Maintenance
or Maintenance phase. For more information, read Dr.
Atkins New Diet Revolution.
What medical conditions should be monitored
by an M.D. during the Atkins Nutritional Approach?
All medical conditions requiring prescriptions, and even some
that don't -- like diet controlled diabetes mellitus -- need to be monitored
by a physician. This is necessary because the Atkins Nutritional Approach
and nutritional supplements improve so many conditions that the prescriptions
often become an overdose or unnecessarily strong.
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I know I'm allowed up to 20 grams of carbohydrates
a day during the two weeks of Induction. But if I stay under 20 grams of carbs
a day, why can't I have some in the form of a slice of whole grain bread or
even a peanut butter cup, which has 20 grams of carbs?
There are two reasons this approach won't work. For one, all
carbohydrates are not created equal. The Atkins Nutritional Approach is designed
to prevent blood sugar levels from spiking and causing the overproduction
of insulin - a hormone that helps convert carbohydrates to body fat. The first
carbohydrates you need to add back to your eating plan are more vegetables,
then seeds and nuts, then berries and then - if you are still losing - grains.
Even bread made from 100 percent whole-wheat flour contains enough refined
carbs to produce the insulin-raising, fat-storing effect in many people. Later,
if your weight loss is progressing well and you have increased your daily
carb intake, you may eat an occasional slice of whole grain bread. As for
the 20-gram peanut butter cup, it contains a lot of sugar - not to mention
artery-clogging hydrogenated fat - and sugar is the worst kind of carbohydrate.
Second, Atkins is not just about rapid weight loss - it's
about learning to eat only nutrient-dense carbohydrates for the rest of your
life. These are foods that are packed with the most antioxidant vitamins and
healthful phytochemicals relative to the amount of carbohydrates - so you're
getting the most bang for your carbohydrate buck. Once you've reached your
goal weight and established your personal carbohydrate level for maintenance,
you can enjoy whole-grain bread, fruit and even the occasional plate of french
fries. Unfortunately, that peanut butter cup just doesn't make the grade!
Can I eat Advantage Bars and Shakes during
the Induction phase?
An Advantage Bar can serve as either a snack or an occasional
meal replacement. Feel free to eat them during Induction as long as you continue
to lose weight. (We generally recommend no more than one bar a day during
Induction.) But keep in mind that neither the Atkins shakes nor the bars were
formulated to be total meal replacements. Atkins does not recommend the use
of meal replacements; instead, it is important to eat whole, unprocessed foods
to learn wholesome eating habits.
I have been experiencing dizziness since beginning
Atkins. Why and what should I do?
First, check with your physician to make sure you don't have
a medical condition. Once your doctor has ruled out any conditions that require
medical intervention, the possibility exists that you may be going through
carbohydrate withdrawal. When your body becomes accustomed to burning fat
for fuel, these symptoms should dissipate, usually within a week. You might
alleviate them by adding more vegetables that are low in carbohydrates, such
as leafy green vegetables. Then bring the quantities back down once your body
adjusts to the controlled carb routine. You may find it helpful to eat protein
snacks throughout the day, such as a slice of turkey or cream cheese in celery.
Try a few days of eating every 3-4 hours and make sure you drink plenty of
Protein Powders & Flours
What is the difference between soy powder,
soy protein isolate, soy flour, protein powder, and whey protein?
Soy (also called soya) powder (or soy protein isolate) and
soy flour are both made from the same source: the soy bean. The physical difference
between the two is that soy powder is ground finer than soy flour. You can
use both when doing Atkins. However, soy flour has more carbs, so you need
to keep this in mind when counting your carb intake. For best results, especially
during Induction, use Atkins Bake Mix, which has a very low carb count.
Protein powder is a pure source of protein, usually an egg
protein powder or vegetable-based protein powder that is very low in carbohydrate.
Keep in mind that many protein powders may contain certain fillers and hidden
sugars. Make sure you read the label to check carbohydrate and sugar amounts.
Whey Protein Isolate (WPI) is considered the highest quality
protein available in terms of the body's ability to utilize it. It is extremely
low in carbohydrate, high in protein, and contains virtually no fat. It has
also been shown to possess immune boosting capabilities by increasing the
body's cellular levels of glutathione, an important anti-oxidant. WPI is an
ingredient in the Atkins Bake Mix.
On Snacks for
What are some healthful snacks kids will
Try blueberries or other fresh fruit with whole-milk cottage
cheese or whipped cream. Serving fruit with a source of protein moderates
blood sugar swings. Or try a mix of nuts, seeds and raisins. Other ideas include:
whole grain bread or crackers with cheese or peanut butter; celery sticks
with peanut or another nut butter; popcorn made in an air popper and drizzled
with melted butter; deviled eggs; or rolled up slices of turkey or ham. Instead
of soda or fruit juice, offer kids flavored seltzers or iced herbal teas.
If they're hooked on fruit juice, offer the whole fruit instead - which causes
a less dramatic rise in blood sugar. In the winter, you can make hot chocolate
using Splenda instead of sugar. Also, keep a supply of Advantage
Bars handy for snacking, and make treats from Atkins
Shake Mix. For sweet snacks, we offer dessert recipes ranging from popsicles
to cupcakes, many of which are made with Atkins products such as the Bake
Mix, Syrups, and Shake
On Alcohol Consumption
Why can't I consume alcohol while doing
You should not drink alcohol during Induction, but you can
drink moderate amounts of alcohol during the Ongoing Weight Loss, Pre-Maintenance
and Lifetime Maintenance phases of the Atkins Nutritional Approach. When given
the choice, your body will burn alcohol for energy before it burns fat. But
alcohol does not act as a carbohydrate so it will not interfere with burning
fat in the same way that sugars and other carbohydrates do.
Alcohol consumption may also increase yeast-related symptoms,
such as bloating, gas and cravings for sweets, and can therefore interfere
with weight loss. Beer, which contains yeast, probably has the most yeast-forming
components of any alcohol. An occasional glass of wine or vodka is the best
choice. Scotch and other grain-based spirits are more likely to promote yeast
Note: Use only mixers that contain no sugar or fruit juices.
Even tonic water contains carbs and regular soda is made with sugar. Seltzer,
club soda, mineral water and non-aspartame diet sodas are better alternatives.
How many carbs does alcohol contain?
It varies by type of alcoholic drink. In the case of beer,
read the label. For wine and spirits, refer to a carb counter. Wine usually
contains about 2 grams of carbs per 3-ounce serving.
Is it OK to drink light beer, which is
lower in grams of carbohydrates?
If you have yeast-related problems, such as bloating, gas,
a coated tongue and cravings for sugar, you should eliminate beer or limit
your beer intake. Otherwise, after the Induction phase, you can drink light
beer as long as it does not make you gain weight or stall your weight-loss
What kind of sweeteners do you recommend?
A main goal of the Atkins Nutritional Approach is to stabilize
blood sugar (glucose) and insulin levels through the restriction of carbohydrates.
Sugar is a carbohydrate, so it is strictly limited. Controlling carb content
naturally curbs sugar cravings. However, if you still crave sweets, we suggest
you use a sugar substitute. The prudent, moderate use of artificial sweeteners
is usually acceptable. But be aware that not all sugar substitutes are created
equal. We recommend specific sweeteners that will not interfere with weight
loss. Some people experience negative reactions to certain sweeteners, and
the risk increases with the amount used. With all artificial sweeteners, the
less used, the better.
Our preference is sucralose, marketed under the name Splenda®.
Derived from sugar, it is non-caloric, contains less than 1 gram of carbs
per serving and it doesn't raise blood sugar. It has been used in other countries
since 1991 and has been tested for safety and efficacy. In 1998, the U.S.
Food and Drug Administration (FDA) approved sucralose for sale in the United
States after reviewing more than 100 studies conducted during the past 20
Atkins Nutritionals has since reformulated all of its products
using sucralose, including the Atkins
Shake Mixes, the Advantage Bars, and the Sugar
Free Syrups. Sucralose is approximately 600 times sweeter than sugar.
Unlike aspartame, it is inert in the body's digestive system, quickly passing
through without accumulating in tissues. In addition, it does not lose its
sweetness when heated, so it can be used in cooking and baking. (For more
information about Splenda, go to www.splenda.com.)
If Splenda is not available, saccharin is the next best thing.
The FDA recently removed saccharin from its list of carcinogens, basing its
decision upon a thorough review of the medical literature and the National
Institute of Environmental Health Sciences' statement that "there is no clear
association between saccharin and human cancer." It can be safely consumed
in moderate amounts -- no more than three packets a day. Sugar poses a greater
threat to good health than saccharin does. Saccharin is marketed as Sweet
Acesulfame potassium, also known as acesulfame K, another
non-caloric sweetener, is approximately 200 times sweeter than sugar. Because
it cannot be metabolized, it passes through the body without elevating blood
sugar. The U.S. Department of Agriculture (USDA) has authorized the use of
acesulfame K after evaluating numerous studies and determining its safety.
It is sold under the brand name Sunett™.
We do not recommend the use of aspartame -- sold under the
brand names of Equal® and NutraSweet® -- because of questions about its safety.
Note: During Induction, avoid sorbitol and mannitol (both
fermented sugars), and natural sweeteners such as fructose, lactose or maltose.
Tip: Sugar substitutes have a synergistic sweetness.
Mixing together tiny amounts of each mimics the sweetness of sugar better
than a larger amount of any single one.
I used artificial sweetener in a recipe
Bake Mix and the finished product tasted bitter. What did I do wrong?
Certain artificial sweeteners lose their effect when heated.
This is especially true of aspartame, which you should avoid in any case because
it can raise insulin levels and encourage fat storage. Try switching to a
heat-proof sweetener, such as Splenda®.
On Drinking Lots of
How much water should a person doing Atkins
A minimum of eight (8) glasses is the usual recommendation.
Coffee, tea and diet sodas do not apply to this minimum.
Why is caffeine unacceptable while doing Atkins?
Excess caffeine stimulates insulin production, which will
drop blood sugar levels and leave you hungry for sweets. I you're addicted
to caffeine, you must give it up. The best way to do this is to segue from
the high-octane stuff to decaf by gradually adding decaf to your full-force
brew until you are drinking straight decaf, which you can enjoy with cream.
Water-processed decaf is preferable because it was not produced using chemicals,
as some decafs are. Caffeine is found not just in coffee and tea but also
in chocolate and many soft drinks. Switch to decaffeinated coffee and tea,
experiment with flavorful herbal teas or stick to plain, pure water. You may
miss caffeine or even experience withdrawal symptoms at first, but we often
see weight loss start up again as soon as patients remove caffeine and aspartame
from their diet.
Can I drink flavored coffees?
Some flavored coffees contain hidden carbohydrates. Hazelnut,
almond or other nut- or grain-extracted flavors are fine, but do check labels
for the carb count. You can also add a low-carb syrup to decaf coffee if you're
looking for more flavor without added sugar. Some of these syrups are also
good in decaffeinated tea.
I just started Atkins and I have a severe
headache. What can I do to alleviate this symptom?
Don't worry; your headache will likely go away after the third
day. Sometimes people will get withdrawal headaches from all the caffeine
and all the sugar they are used to eating. Usually this resolves in the first
three days and then your body will be able to start on its new efficient fat
burning self. Make sure you are drinking enough water, as dehydration can
aggregate this condition. If these symptoms do not resolve, you should contact
your local physician. This usually convinces people of the addiction they
may have had to either caffeine or sugar or both.
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On Processed Meats
How can I find bacon, sausage and other
meats without nitrates and/or sugar?
Bacon and many other cured meats, including
ham are cured with sugar. However, most lose the sugar in the curing process
and the sugar does not become a factor when determining sugar and carbohydrate
contents. There are many name brands not cured with sugar that may be available
in your area. We would suggest contacting a local butcher who should be able
to provide you with the information you need.
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I really miss eating fruit. Which ones
are relatively low in carbs?
You should avoid fruit completely during Induction, because
for most people it interferes with lipolysis/ketosis. When you move to
Ongoing Weight Loss, you can try introducing berries, which are relatively
low in carbohydrates, as long as they don't slow or stop your weight loss.
Recent research shows blueberries are loaded with antioxidants and other phytochemical
nutrients. A quarter of a cup of strawberries, blueberries, raspberries or
blackberries contains approximately 5 grams of carbs (check a Carbohydrate
Gram Counter for exact numbers).
When you reach Pre-Maintenance, most people can also enjoy
low-glycemic fruits such as plums, nectarines, green apples, kiwi and cherries
in moderate amounts. Again, continue to count carbs and refer to a Carb Counter.
You can also eat up to one cup of berries each day. Have high-sugar citrus
fruits only occasionally - grapefruit is lowest - and bananas only once in
a while. Avoid fruit juices, which provide huge doses of sugar (a splash to
flavor seltzer is okay). Choose whole, fiber-rich fruit instead. As a general
rule, limit your fruit servings to two or a maximum of three a day. After
you have tested your tolerance to fruit sugar and are still able to gradually
lose or maintain your weight, depending upon your phase of the program, you
can try the higher glycemic fruits such as pears, mangos, pineapple and so
Eating fruit with nuts will slow down the release of the sugars
into the blood stream. Eating fruit with animal protein may cause flatulence
in some individuals.
Most nutritional recommendations lump together fruits and
vegetables. While there is no question that fruits are loaded with phytonutrients
and fiber, you cannot ignore the impact they have on blood sugar and insulin
levels. Ounce for ounce, veggies - and the greener the better - can offer
more of the same benefits with less of a blood sugar spike. Research has shown
that a diet that includes sufficient vegetables can reduce the risk of colon
and rectal cancer.
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Nuts have carbohydrates, but you include
them in the Atkins Nutritional Approach. Why? And when can I eat them?
Different nuts and seeds have different percentages of fats,
protein, and carbohydrates. We don't recommend eating them during the Induction
phase of Atkins, the initial period of greatest carbohydrate restriction and,
as a result, greatest weight loss. But you can certainly eat them during the
other phases, when you won't have to count carbs so closely because you'll
be nearing or have reached you desired weight.
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On Cheating & "Carb
After months of doing Atkins, I started
cheating and fell off the wagon. What's the best way to get back on?
When someone "cheats," they often experience carbohydrate
cravings caused by unstable blood sugar levels. The first thing you need to
do is get back on Induction for a week or so to get your blood sugar level
under control. When you are no longer craving foods high in carbohydrates
and your energy level feels stable, you can move beyond Induction again. Pay
careful attention to what happened that led you to "fall off the wagon" and
make sure not to let it happen again. But don't fall into the trap of being
too strict and denying yourself completely; this could lead to more cheating.
Giving yourself an occasional treat - within your carbohydrate threshold -
is part of the Atkins approach.
What is "carb creep" and how can I avoid
When you start adding carbohydrates back into
your meals as you move from Induction into the progressively less restrictive
phases of the Atkins Nutritional Approach, you may begin to lose track of
how many grams of carbs you're eating. When that happens, you are likely to
regain the pounds you lost. That is why it is very important to increase your
daily carb intake by only 5 grams each week and to introduce only one new
food at a time. That way, you'll also immediately notice if a new food is
causing you to experience cravings that lead to over-eating. Another way to
stay in control is to keep a food diary so you can spot troublesome foods
before they set up a pattern of cravings and gorging. For example, if you
find that after eating nuts you are hungry again in a few hours, cut out the
nuts and see if the hunger disappears.
I always eat too much during the holidays
and inevitably leave the table overstuffed. How can I avoid this situation?
Most of us spend hours at the dinner table during the holidays.
It's easy to overdo it, and combining protein and fats with too many carbohydrates
can lead to indigestion. The key to feeling well after holiday meals is to
create an eating strategy.
- Stick to fats and protein-rich foods: They are far more
satiating than carbohydrates, and can help you avoid overeating. Sugary
foods and other refined carbs are more apt to cause indigestion. So load
up on turkey - but pass on the stuffing; or if you simply can't resist it,
have a small portion. Instead, focus on the nutrient-dense carbs such as
leafy green veggies.
- Odd as it sounds, a good strategy is to eat a small meal
before attending holiday dinners or other parties. All too often, people
skip lunch because they know they will be sitting down to a big dinner.
But you're much better off having a meal or a filling snack so you can get
your blood sugar under control before you face an array of tempting carbohydrates.
And drink plenty of water: Not only will drinking water help you feel full,
it also helps you flush toxins from your body.
- Don't deny yourself completely: Giving yourself an occasional
treat - within your carbohydrate threshold - is part of the Atkins approach.
- If you do feel an attack of indigestion, avoid antacids
- they can interfere with protein digestion. Instead, try a digestive enzyme
formula, available in most health food stores. (Be sure you use one that
contains proteases and lipases.)
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I lost weight nicely on Induction and for
the first few months of the Ongoing Weight Loss phase, but now the scale just
won't budge. How do I get off this plateau?
First, before you assume there is a problem, ask yourself
some questions: Are you feeling better? Are your clothes fitting better? (You
may be losing inches, not pounds, because muscle weighs more than fat.) Are
you still losing, but at a slower rate? You may just need to go a bit longer,
making slight modifications.
However, if you are truly stalled, you can usually get yourself
off a plateau by going back to Induction, the strictest level of the plan.
This level of the Atkins program serves several purposes, one of which is
much like the way the starter in an old-fashioned automobile works. It gets
the weight-loss reaction started because it throws your body into ketosis,
making it burn fat for energy. You may need to be even stricter, consuming
only meat, fish, fowl and eggs. You need not do this very long, just enough
time to see your weight loss begin. Then, make sure you add new foods more
gradually than you did before. Another way to lose faster is to increase the
amount of fat and decrease protein.
I think I'm doing Atkins correctly, yet
I'm not losing weight or my weight loss has plateaued. What are some of the
factors that could make that happen?
First, recognize that there may not be a problem at all. Different
people will respond to Atkins differently; some consistently lose weight while
others do so in stages. Don't watch the scale and become overly concerned
with short-term results. Also, make sure your expectations of weight loss
are realistic. Atkins is designed to lead you to your natural ideal weight.
For many people, that may still be more than they wish to weigh. We strongly
recommend that you manage your expectations in a real and healthy way. Second,
remember that success on Atkins should always be measured by more than just
the scale. Consider the following questions and think about how they apply
to your experience on Atkins:
- Are you experiencing more energy and vitality throughout
- Are your clothes fitting you better? Are you experiencing
less between meal cravings and hunger?
- Have your blood tests improved? Are you still losing weight,
but just at a much slower pace?
- Have you lost inches in your body measurements?
If you answered "yes" to any of the above, then you have
the right plan for the rest of your life. Continue to stick with it, modifying
it as you go along to make it work for you, and you will continue to see suitable
health enhancing results. Given all of the above, there are a number
of key factors that may inhibit a person's ability to have success on a controlled
carb program like Atkins.
Listed below are the difficulties people experience most frequently:
Consuming Too Many Carbohydrates
It's amazing how frequently this is the source of most
people's problems. Some people can get away with higher carb consumption
and still experience success on Atkins, but many (especially those who are
overweight to begin with), need to be more vigilant in keeping carbs contolled.
Check to make sure you are completely aware
of all the sources of carbohydrates you may be eating. For example, lemon
juice, excess vegetables, and low fat substitute products can contain those
few carbs that could disrupt your success. Keep a complete food diary for
a few days to see exactly what you are consuming. You may be surprised!
Also, even if you think you've caught every carbohydrate, check
the ingredients on any processed food you are eating (if a serving size
contains less than 1 gram of carbs, it can be listed as 0 carbs. If you
are consuming a lot of this product, the hidden carbs can add up fast.
If you've done a full investigation and believe you've caught
all the carbs, try a week at a lower carb level (e.g. If you're on an Ongoing
Weight Loss Level, go back to Induction) to see if that might restart your
While it is true that calorie counting is not necessary
on Atkins, this is not a license to gorge yourself at every meal. The Atkins
Nutritional Approach is most effective when you eat until you are satisfied,
not until you can't eat another bite or you'll explode. Also, try eating
slower to allow your body to signal when it is full before you overeat.
Think about this over the next week and see if it helps you to start/restart
your weight loss.
Just as overeating can cause your body to resist weight
loss, so can undereating. If you're hungry, eat; if you're starving, you
should have eaten 30 minutes ago.
Trying To Do A "Low-Fat" Version of the
Atkins Nutritional Approach
Some people with very fast metabolisms can get away with
this and experience success on Atkins. However, for most, it will inhibit
your weight loss and keep you hungrier throughout the day and thus more
susceptible to sugar/carb cravings.
Nutritional Deficiencies Caused By Previous Diets
Many people who have been on a diet high in sugar and other
refined carbohydrates, as well as low in fat (which is almost everybody)
prior to beginning Atkins, will have nutritional deficiencies that may not
be fully addressed by the Atkins Nutritional Approach. Readers of Dr. Atkins'
books know that he is a firm believer in nutritional supplementation. His
key recommendations for everyone include a broad-based multi-vitamin program
(preferably not a "one-a-day", but one consumed through the day for optimal
absorption) and an essential fatty acid formula (which can boost your metabolism
and enhance fat burning). For additional supplementation, refer to Dr. Atkins'
books to develop a program that meets your specific needs.
Virtually all medications will inhibit weight loss to
some degree, with prescription medications being the most problematic. For
more information on this subject, please review the questions concerning
Yeast Overgrowth/Candida Condition
Re-read the yeast chapter in Dr.
Atkins New Diet Revolution, and go on a yeast/fermentation-free version
of Atkins (e.g. no cheese, vinegar, mushrooms, etc.) for two weeks to see
if that precipitates weight loss.
Re-read the chapter on food intolerances in Dr.
Atkins New Diet Revolution.
Lack of Exercise
While Atkins doesn't require you to kill yourself on the
treadmill or in an aerobic class everyday to see results, the importance
of regular exercise can't be overlooked. Make sure you are engaged in some
form of exercise at least three times a week, or as directed by your doctor.
If you can increase that to four or five times a week, all the better. You
will definitely see the results on Atkins if you increase your exercise
Lack of Proper Water Consumption
If you're not drinking enough water, your
body is operating inefficiently. An inefficient body will not respond as
well to weight loss efforts. Basically, by the time you feel thirsty, you
are already dehydrated. Do yourself and your body a favor and drink at least
8 glasses of water a day (preferably filtered), and more if possible. You
may go to the bathroom more, but your body will love you for it. Note: This
means water, not decaf coffee, tea, diet soda or anything else that may
include water but is not water.
Low Body Temperature
This would indicate a possible sluggish thyroid. Refer to
Atkins New Diet Revolution for how this can impact weight loss and how
you can test for this condition in your own home.
Consumption of Artificial Sweeteners
For many people, products such as aspartame and saccharin
are not a problem, especially when consumed at low to moderate levels (remember
that all sweetener packets contain a gram of carbs). However, some people
can experience a weight loss impasse from these products. For many Atkins
followers, these products have been a "necessary evil", since they are better
than giving into sugar cravings.
Our advice: If you are
having trouble losing weight on Atkins, refrain from these artificial sweeteners
for a week to see if it helps. Consider trying Stevia, a natural product
that people use as a sweetener. Sucralose, recently approved by the FDA
and used safely for years in countries throughout the world (many of which
ban the use of aspartame), may solve the problem for all Atkins followers.
We do not believe it will cause weight loss impasses for any Atkins followers,
and are now using it as the sweetener in all Advantage Bars, cheesecakes
and other Atkins food products.
If you have reviewed all of the above and are still having
problems, consider coming to The Atkins Center for Complementary Medicine
as a patient or schedule a Telephone Nutritional Consultation (TNC), For information
please call 1-888-ATKINS-8 and ask for the New Patients Department.
On Eating Away from
Do you have any tips for eating away from
Think "big picture." Don't use your trip as an excuse to go
off the program. Remember, if you continually take "detours" from your planned
route, you'll never reach your destination.
Take it with you. Pack some controlled-carb snack foods
like 1-ounce portions of cheese in plastic wrap. If you're traveling by car,
pack a cooler with cold cuts and cheese or salad. Or stow away a few Atkins
bars and some shake mix to use as meal replacements.
Eat first. Start out on the right foot by eating a
well-planned, satisfying meal before you depart.
Go a little nuts. Snack on nuts and seeds, which are
high in protein and fat. You'll feel more satisfied and in control of your
appetite after eating a handful. Go easy on these snack options if you are
in the Induction phase, particularly if you find it difficult to lose weight.
No skipping allowed. Tempted
to pass on lunch to make better time? Don't do it. Omitting a meal could make
you ravenous, out of control and more likely to grab anything edible.
Fly right. If you're on a flight where a meal will
be served, call ahead and ask what's on the menu. You can probably find a
seafood or chicken salad or another dish you can "remodel."
Drink up. Consume lots of water,
which will help you feel satisfyingly full. But stay away from caffeine and
diet sodas full of aspartame, which increase carbohydrate cravings.
Pack your pills. Once one element of your routine gets
upset, other good habits tend to slide as well. Even if you make some mistakes
with your food choices, staying on your supplements will help you focus on
getting back to eating properly.
Speed counts. If you do slip off the program for a
day or more, get back on ASAP. The longer you're derailed, the harder it may
be to get back on track.
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On Fast Food Restaurants
What can I eat in a fast food restaurant
when I'm in a hurry?
Sandwich Shops: Chicken or tuna
salad is a good choice. Just be sure to pick out any carrots. In sub shops,
bring on the turkey, roast beef, cheese and sausage, but try to steer clear
of salami, bologna and other meat products preserved with nitrates. Ask for
your selection on a plate instead of on a roll, and you're ready to rock.
Burger Chains: Sandwiches are usually a good bet. Yes,
even the bacon cheeseburger! Just toss the bun. Mayo and mustard are permissible
but beware of ketchup, which often contains a lot of sugar. Watch out too
for special sauces, as they also often have sugar in them. Tomato slices and
lettuce are fine. Steer clear of anything advertised as "low fat," a label
that often translates to "high carb."
Fried Chicken Places: Avoid anything barbecued or breaded.
Barbecue sauce is typically full of sugar and even if you remove the skin,
the sugar has probably seeped into the meat. Dry-rubbed meats are fine, as
are roasted chicken and allowed side dishes such as salad. If there's a grilled
chicken filet sandwich available, grab it! Discard the bun, and you've got
a pretty good selection. Or scrape the breading off a fried chicken breast
and dig in!
Salad Bars: Here you'll find
the choices you need for a nutritious meal. Use olive oil and regular red
or white wine vinegar instead of a prepared dressing. Commercial dressings
and balsamic vinegars often contain sugar. Baked stuffed potatoes are an absolute
Unless you're starving, avoid Mexican-style restaurants,
pizza parlors, doughnut shops and yogurt/ice cream parlors.
Back to the Top
Is it true that eating too much protein
can damage your kidneys?
Studies show that the glomerular filtration rate (GFR) goes
up with a high protein intake. The GFR is a measure of how efficiently the
kidneys are filtering protein and other byproducts of metabolism from the
blood. A high GFR may seem bad to some dietitians but, in fact, it is actually
a sign of excellent kidney function. It simply means the kidneys are capable
of doing a job beyond their usual requirements. Think of this analogy: Aerobic
exercise raises your heart rate, yet everyone acknowledges that, because aerobic
exercise raises the heart rate, it strengthens the heart. In our clinical
practice, we have seen thousands of patients over three decades, and we have
never seen a single case of a high-protein eating program causing kidney damage.
Can a person with kidney problems do Atkins?
If so, how is the Atkins Nutritional Approach adjusted?
The Atkins Nutritional Approach can be used safely by any kidney
patient whose creatinine level is under 3.0. However, monitoring creatine
levels every 2 weeks is required. Creatinine levels above 3 require a doctor's
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On Muscle Mass
Doesn't ketosis lead to loss of muscle
The notion that the Atkins Nutritional Approach -- high in
protein, which builds muscle, and fat, which is used for energy -- will force
your body to break down muscle is incorrect. Only dieters on very low calorie
diets can lose muscle mass, because they have an inadequate protein intake.
Atkins, however, is not calorie restricted (this isn't an invitation for gorging,
but a recommendation to eat until you are no longer hungry) and the high protein
intake required offsets any possible loss of body mass.
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I suspect I may have an underactive thyroid.
Could that be why it is so difficult for me to lose weight?
Your thyroid gland's main function is to regulate the speed
of your metabolism. So it is not difficult to understand that if it is underactive
- the medical word is hypothyroid - your slowed metabolism makes you more
resistant to weight loss.
Whenever a patient at The Atkins Center has real trouble
losing weight, the physicians always check for a sluggish thyroid gland. As
you age, it's not unusual for your thyroid to stop producing enough of the
hormones that control the speed of your metabolism. When that happens, your
whole body slows down; you gain weight and can't get it off. Hypothyroidism,
or underactive thyroid, is easy to diagnose, even though it doesn't always
show up on standard lab tests.
To ascertain whether you have hypothyroidism, your doctor
will do blood tests to evaluate your production of thyroid hormones T4 (also
known as thyroxine) and T3 (your body converts T4 to T3), as well as another
hormone called TSH. However, these clinical tests do not catch all cases.
First think about whether you are experiencing any of the signs of an underactive
thyroid. These include sensitivity to cold, weight gain, hair loss, sleep
disturbances, fatigue and lethargy, depression, dry skin, chronic constipation,
poor nails, poor memory and elevated cholesterol levels. If so, there is a
simple way - the Barnes technique of basal metabolism - to ascertain if you
Simply take your temperature orally four times a day (before
each meal and before you go to bed) for four days. Average your temperature
each day, and if it is consistently below 98 degrees Fahrenheit, you are likely
to have a sluggish thyroid. If it is significantly lower such as below 97.6,
you almost definitely have hypothyroidism, and you should bring this information
to the attention of your physician, who will likely prescribe thyroid hormone
replacement therapy. (Do be aware that not all doctors take basal metabolism
as seriously as they should.)
The treatment for hypothyroidism is straightforward. As Dr.
Atkins explains, "I use the therapeutic trial for thyroid. After examining
blood test results, I start patients with a very low dose of a prescription
thyroid hormone replacement and build up gradually and very carefully. In
most cases, when we reach the right dose patients start to feel dramatically
better. They have a much better sense of overall well-being, with much more
energy and vitality. Best of all, they start to lose weight again."
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On Yeast Overgrowth
Will a low carb approach help clear up
my yeast problem?
After years of eating a high-sugar diet, it's quite possible
that your digestive tract has an overgrowth of an organism known as Candida
albicans. When that happens, the beneficial bacteria in your intestines get
crowded out. Candida (also known as yeast) overgrowth also provokes food intolerances,
headaches and immune-system weakness, and keeps you from losing weight by
causing unstable blood sugar and major carbohydrate cravings.
Once your practitioner has diagnosed a yeast overgrowth, you'll
need to eliminate some foods from your diet until it clears up. Typically,
the first food to go is sugar. Candida thrives on sugar - so a sugar-free,
controlled carb approach will starve it out. It's also important to eliminate
yeast and fermented foods such as sourdough breads, pickles, beer, wine, vinegar
and many cheeses. Also omit nuts, which can contain mold.
What blood tests should my physician perform
to check for yeast infection?
The appropriate blood tests to check for yeast infections are
Candida Antibody lgG, lgM, and lgA.
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Could my medications be interfering with
my weight loss?
Weight-loss plateaus are often caused not by what you eat
but by prescription drugs. Drugs for high blood pressure, especially diuretics
and the drugs known as beta blockers, can make your body extremely resistant
to weight loss." As a cardiologist, I see a lot of patients who come to me
taking these drugs," says Patrick Fratellone, M.D., medical director of The
Atkins Center. "They can't lose weight while they're on them, but being overweight
is a big reason for their high blood pressure."
At The Center, the solution to this circular problem,
he explains, is to gradually taper patients off blood-pressure medications
and replace them with herbs and dietary supplements. As patients lose weight
and improve other aspects of their health, their blood pressure often returns
to normal, eliminating the need for any treatment. Always discuss any change
in medications with your health-care practitioner.
The same chicken and egg situation applies to patients
who are taking selective serotonin reuptake inhibitor (SSRI) antidepressants.
Common side effects of SSRIs, such as anxiety, sleeplessness, nervousness
and headaches, actually create carbohydrate cravings. For example, about 10
percent of people on Prozac® have appetite loss, but about a third experience
increased appetite. "It's surprising how quickly patients start to lose weight
when they stop these drugs," Dr. Fratellone notes.
Natural substitutes for SSRI drugs include the herbs St. John's
wort and kava kava or inositol hexanicotinate, a B vitamin. Dr. Fratellone
warns, however, against stopping antidepressants on your own - you need to
taper off these drugs slowly - and that there can be interactions with alternative
remedies. Don't forget to consult your doctor.
When it comes to the cholesterol-lowering statin drugs,
Dr. Fratellone is emphatic. "These drugs keep you from losing weight and they're
potentially dangerous as well. At The Atkins Center, we stop statin drugs
immediately. Our low-carbohydrate eating plan alone will improve blood lipids."
Are You a Diabetic? The most fattening of all the
hormones is insulin. Diabetics who have to inject insulin find it almost impossible
to lose weight. Oral drugs are almost as bad. According to Dr. Atkins, "The
majority of oral medications for diabetes have a weight-gain effect. Even
drugs that don't stimulate insulin have this effect. The one drug that does
help diabetics control their blood sugar and lose weight is metformin, marketed
under the brand name Glucophage®. I often prescribe this for my diabetic patients
when they start the Atkins program. Once they've been following it for a while,
their need for the drug almost invariably disappears."
After insulin, Dr. Atkins believes that hormone replacement
therapy (HRT) is a leading offender in terms of inhibited weight loss. Menopausal
women who take estrogen or estrogen/progesterone have a lot of trouble shedding
pounds. In fact, weight gain, water retention and skyrocketing triglyceride
levels are well-known side effects of HRT. "There are better, more natural
ways to treat menopause symptoms," Dr. Atkins says. "Folic acid in prescription-strength
doses, for example, helps minimize many symptoms, as do other nutrients, such
as boron, soy isoflavones and herbs such as agnus cactus and dong quai." Also
consume moderate amounts of soy products.
What medications interfere with or need
adjustment once you are committed to the Atkins Nutritional Approach?
Virtually all medications will inhibit weight loss. The most
incompatible medications are:
- Diuretics (water pills).
- Psychotropic drugs, including prozac, zoloft, lithium,
- Hormones and steroids, including estrogen (premarin), birth
control pills and prednisone.
- Arthritic drugs, especially NSAIDS (Non-Steroidal Anti-Inflammatory
- Cholesterol-lowering drugs.
- All anti-diabetic medications, including insulin with the
exception of glucophage.
- Seizure medications.
Doctors who work with the Atkins Nutritional Approach can
usually use it and certain supplements to help you get off most of the above
or taper you to minimal doses. Please DO NOT COME OFF MEDICATIONS BY YOURSELF
without medical supervision. Please read Dr.
Atkins Net Diet Revolution or Dr. Atkins Vita-Nutrient Solution for further
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On Food Allergies
What if I'm allergic to something that's
a mainstay of the Atkins nutritional plan?
Unsuspected food intolerances can be a major roadblock to
weight loss. Many patients at The Atkins Center, for example, turn out to
be allergic to wheat and wheat products. Other common allergens include soy,
milk, cheese and eggs. People with food intolerances often have gastrointestinal
problems, along with joint pain, anxiety or depression and other symptoms.
Your practitioner will use a process of elimination to uncover any food allergies.
It takes time, but it will be worth it when your weight loss picks up and
your overall health improves.
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On Carbs for Athletes
As a runner, I'm used to carb loading before
competitive events. Will following the Atkins Nutritional Approach impact
It is a misconception that carb-loading is the best way to
prepare yourself for endurance exercise. Although an overabundance of carbs
might give you an initial burst of energy, that surge can then lead to a sharp
drop in your blood sugar - and, therefore, fatigue - later in your workout.
This isn't to say that you should eliminate carbs, but endurance athletes
will do better by consuming moderate amounts of healthy, unrefined carbohydrates,
found in foods such as kale, spinach and broccoli, to ensure stable blood
sugar throughout a workout.
A 1994 study of well-trained cyclists demonstrated the principle
that a low-carb eating program contributes to improved endurance. Subjects
on a 7 percent carbohydrate program were able to pedal nearly twice as long
as those whose diet consisted of 74 percent carbs.
If you are contemplating switching to a lower-carb eating
plan, do so during training, never right before a race. It should take your
body about two weeks to adjust, so don't worry if you don't experience extra
energy immediately. The amount of carbohydrates you should consume also relates
to your percentage of body fat.
If you are an overweight runner, stay on the lowest level
of carb consumption that suits your needs while still allowing you to lose
weight. On the other hand, if your weight is normal, simply stick to vegetables,
whole grains, berries and other fruits low in sugar and other healthful complex
carbs, avoiding junk foods and sugar.
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On Attention Deficit Disorder
My child has ADD/ADHD. Can Atkins help?
Does it help with other diet-related conditions?
It's important to remember that diet impacts not only weight,
but also a number of other medical issues. There is a clear connection between
what kids eat and such conditions as attention deficit disorder (ADD), moodiness,
difficulty with learning, chronic ear infections, colic, and gastrointestinal
problems. These diet-related disorders are often signs of food sensitivities,
and the culprits are likely to be sugar and refined carbs. Children also may
often have sensitivities to milk or other dairy products. Yeast, wheat and
gluten are considered other common culprits.
You've probably heard that breakfast is vitally important
for kids. Consider that most children start their days off with a bowl of
sugary cereal and a glass of orange juice - perhaps some white toast with
jelly, too. With nothing but sugar and refined carbohydrates coursing through
their systems, it's no wonder so many have trouble sitting still and focusing.
The typical American, high-carb, junk-food-laden diet, which is leading to
greater numbers of obese people in this country every year, is putting our
children at serious risk. A controlled carbohydrate lifestyle can help
stabilize blood sugar, thereby increasing attention span and focus even when
weight loss is not an issue.
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On Giving Blood
What can I drink and eat after giving blood
instead of the usual OJ and cookies?
After donating blood, your fluid volume is reduced, which
can make you lightheaded or dizzy. You will be offered something to drink
to replace the fluid, which also decreases the volume of blood sugar available.
Instead of sugary fruit drinks, consume water or other non-carbohydrate beverages
and instead of a cookie, have a piece of cheese or a slice of turkey. If you
are beyond Induction, you can combine whole fruit with nuts. It's a good idea
to plan ahead and bring with you some of your allowable foods and beverages.
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Since I have been on Atkins, my cholesterol
has gone up. Why? What can I do about it?
First, look at what you've been eating. Have you been following
Atkins correctly? If you are just starting the Induction phase, be sure you
stay below 20 grams of carbohydrates a day as recommended. You may also want
to consider a couple of other things that could be happening.
First, the increase might be temporary. When a person loses
weight, cholesterol usually rises because the body must break down stored
fat for energy. Your total cholesterol should drop within two months. Look
at your HDL (known as "good" cholesterol) levels. A rise in total cholesterol
levels could even be a good thing, if it's all attributed to HDL cholesterol.
Total cholesterol may temporarily go up due to the rise in HDL. If you've
been following the Atkins Nutritional Approach for some time and your cholesterol
levels have not come down, something else is going on.
You may also need to look at a third component of your blood
tests: triglycerides. Cholesterol rises in some people when triglycerides
drop significantly. If that drop is greater than the LDL increase, your lipid
profile may, again, be improved.
High cholesterol that has a genetic component usually responds
to changes in diet, but may be difficult to address with diet alone. You may
still need to take supplements such as pantethine, essential oils, garlic
and fiber. For a detailed discussion of cholesterol-lowering nutrients, see
Dr. Atkins Vita-Nutrient Solutions. Exercise is also an important component,
as is cutting back on processed meats, such as bacon, sausage and cold cuts
and limiting intake of hard cheese.
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Constipation & Diarrhea
I never suffered from constipation until
I started doing Atkins. What should I do?
When you change your eating habits, you may experience constipation
until your body adapts. The Atkins Nutritional Approach contains enough vegetables,
which are rich in soluble fiber, to usually prevent constipation. But some
constipation is not uncommon during the first week of the Induction phase.
Be sure you are taking in at least 3 cups of salad vegetables and not using
your carb allotment on other foods. After the first few days, your body should
adjust and constipation shouldn't be a problem. And when you begin to add
more carbohydrates, your first choices should be more vegetables, followed
However, during Induction, there are several remedies. It is
critically important to drink eight or more glasses of water daily. Inadequate
hydration is the main reason for constipation. Most people, especially women,
don't drink enough water and are slightly dehydrated almost always. Exercise
also stimulates the bowel, so step up your activity level.
If you still find yourself constipated, increase your consumption
of insoluble fiber by sprinkling wheat bran on your salad or stirring a tablespoon
of psyllium husks into a glass of water each day. The amount needed to stay
regular varies from person to person. Start with a tablespoon and increase
the amount gradually until you achieve results.
I have been experiencing diarrhea since
beginning Atkins. Why is this happening and how can I control it?
It is not normal to experience diarrhea while doing Atkins.
Several things should be considered: Are you eating more dairy than you did
before? Are you allergic to any foods you are eating? Are you gorging yourself?
Try adding 1 tablespoon of unsweetened Metamucil or psyllium daily. It acts
as a sponge and forms a healthy stool. If you have been on a very low-fat
diet prior to starting Atkins, it could be an adjustment period. Try cutting
back on the amount of fat for a little while if that is the case. If the diarrhea
continues for any length of time you should see your doctor.
Why is the Atkins Nutritional Approach
so low in fiber? Will this be a risk for my colon?
The Atkins Nutritional Approach is low in fiber because most
fiber-containing foods are also high in carbohydrates. Don't forget to eat
salads as leafy greens provide an important source of fiber on Atkins. There
is a colon risk only if you get quite constipated. Use 2 tablespoons of psyllium
husks in 2 glasses of water every morning and/or 2 tablespoons of unprocessed
Miller's bran if this is a concern. If constipation persists, magnesium oxide
may be helpful as well as an herbal laxative tea.
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I've noticed that I have fewer asthma problems
when I adhere to a controlled carbohydrate nutritional approach. Is there
Yes, they are related. There is evidence that asthma attacks
can be linked to food allergies and mold and yeast exposure. While doing Atkins,
you eliminate a lot of common allergens such as grains and moldy substances
such as beans, fruit and bread. When you reduce the load of allergens to which
your immune system is exposed, you can reduce the incidence of asthma attacks.
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Can Type I and Type II Diabetics both do
For a type II diabetic, the Atkins Nutritional Approach is a
godsend. In fact, it is usually "curative", allowing for normal blood sugar
without medication. For type I, it usually helps reduce the insulin requirements,
but this can only be done if managed by a doctor extremely familiar with treating
type I with the Atkins Nutritional Approach.
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Can I follow the Atkins Nutritional Approach
while I'm pregnant?
Weight loss is not recommended while you are pregnant or breastfeeding,
so the Atkins weight-maintenance phase is ideal during this time. As with
all phases of the Atkins Nutritional Approach, build your diet around protein,
including meat, poultry and seafood, and healthy natural fats such as olive
and flaxseed oil and avocados. Eat plenty of vegetables and one serving of
fruit such as strawberries, blueberries or grapefruit daily. Instead of hydrogenated
oils, consume healthy fats, seeds and nuts. Cook meat well but don't burn
it -- heavily charred meats can be unhealthy. Be sure to drink plenty of water.
Try to walk 30 minutes a day at a comfortable pace. Avoid getting overheated
during exercise and be sure to get plenty of rest. And have fun, this is a
very special time!
Expect to gain at least 27 pounds over the full nine months
- which will include baby, placenta and fluid. The weight should all come
off a few weeks after delivery. Nursing your baby burns more calories and
contracts your uterus, so it's good for both of you.
When pregnant or nursing, supplement your diet with the following
- Atkins Basic #1 Multivitamin: 1 tablet x 3
- Atkins Essential Oils: 1 soft-gel tablet x 3
- Calcium: 1,000 mg
- Magnesium: 500 mg
- Zinc: 50 mg
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NutraSweet and Equal are registered trademarks of The
NutraSweet Company. Splenda is a trademark of McNeill PPC, Inc. Sweet 'n Low
is a registered trademark of Cumberland Packing. Prozac is a registered trademark
of Eli Lilly & Co. Glucophage is a registered trademark of Bristol-Meyers