I am a nutrionist and a pharmacist. I am always asked by my patients to recommend a good diet. Many who come to see me are on Atkins, and its imitators like South Beach. It is very disturbing since I had a patient who got 2 gout attacks this month from Atkins. I told him that he ate too much protein. I am truly surprised that in 2010, the public wants to follow these fad diets.
I bought this new Atkins book just to review it. I am aurprised that respected dotors do not know too much protein is bad for thyroid. This new diet still recommends artificial sweeteners which research shows they are worse than pure sugar. The authors recommend ham, bacon which are linked to many types of cancer.
I know opponents of low-fat diets will say, but sugar is really bad and I lost weight. Get real. It is a not about weight loss, it is about preserving your health before getting cancer.
I love this post. It sounds so much like Dick Cheney. You MUST be afraid. So afraid you don't think. First, if Margaret actually read chapter 4, she'd know that this book advocates only about as much protein as the average American currently eats. Second, if Margaret, as a health care professional, was actually in touch with the current medial literature, she'd know that inflammation is now tightly correlated to the underlying cause of most of the common cancers afflicting our population. And the Atkins diet has been shown in repeated randomized controlled trials to reduce inflammation (see for example, Forsythe C, et al, Lipids, 2008). If a low carb diet caused an epidemic of cancer, why didn't the Inuit in the Arctic and Native American's on the Great Plains (who lived on the buffalo and nothing but the buffalo) die out thousands of years before Europeans arrived on these shores? Maybe they all died of cancer shortly after giving birth. But if you have read George Catlin's 1844 saga of his 10 years among pre-contact Native Americans west of the Mississippi, you'll not be surprised to hear that many of them lived well beyond our current national average. And maybe you'll actually read this book. The 'New Atkins' is all about fresh vegetables and whole foods. Yes you can eat bacon and ham, but with so many other delicious choices, why would you limit yourself to these foods? Third, dietary carbohydrates are the primary driver of inflammation in people with insulin resistance - about a third of our adult population. And pure sugar is the worst offender. So, Margaret, should we write off this third of our population because they made a bad choice of their parents? After all, the propensity to develop metabolic syndrome and type-2 diabetes (disease conditions characterized by insulin resistance) are inherited traits. Fourth, if you have read the book, you might discover that the 'New Atkins' is not just about weight loss (although many people can now do this with little hunger or cravings). It's about a sustainable pattern of eating that controls hypertension, diabetes, and dangerous blood lipids without expensive drugs (which have their own dangerous side-effects). It's about being satisfied with your diet, and not having to always be hungry or struggling with cravings. Gout on Atkins? We've known about this for 50 years. About 0.5% of the population is at risk for gout, and as a physician, I am concerned about these individuals. So if your patient sees his or her doctor (as recommended) and starts on allopurinol a week before starting the Atkins Diet, you as a pharmacist get to sell that person a drug and nothing bad is going to happen. Meanwhile the other 99.5% of the population does not need to be made to fear a healthful dietary alternative. Fear not. Steve
I do not disagree with you that too much insulin from bad carbs is bad, but you are obviously behind on the latest research on processed meats. Fear not!!! I have attached a recent study for you so that you educate yourself since you say you 're a doctor. You endanger your naive patients when you tell them big words like inflammation. Shame on those doctors to promote processed meats, aspartame, and splenda for the misinformed. Fear not! Read the study doctor and educate yourself so that you can change your tune, and start saying to your patients "save your life and stay away from Atkins."
Processed meat and mortality
Rashmi Sinha, PhD; Amanda J. Cross, PhD; Barry I. Graubard, PhD; Michael F. Leitzmann, MD, DrPH; Arthur Schatzkin, MD, DrPH
Arch Intern Med. 2009;169(6):562-571.
Background High intakes of red or processed meat may increase the risk of mortality. Our objective was to determine the relations of red, white, and processed meat intakes to risk for total and cause-specific mortality.
Methods The study population included the National Institutes of Health-AARP (formerly known as the American Association of Retired Persons) Diet and Health Study cohort of half a million people aged 50 to 71 years at baseline. Meat intake was estimated from a food frequency questionnaire administered at baseline. Cox proportional hazards regression models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) within quintiles of meat intake. The covariates included in the models were age, education, marital status, family history of cancer (yes/no) (cancer mortality only), race, body mass index, 31-level smoking history, physical activity, energy intake, alcohol intake, vitamin supplement use, fruit consumption, vegetable consumption, and menopausal hormone therapy among women. Main outcome measures included total mortality and deaths due to cancer, cardiovascular disease, injuries and sudden deaths, and all other causes.
Results There were 47 976 male deaths and 23 276 female deaths during 10 years of follow-up. Men and women in the highest vs lowest quintile of red (HR, 1.31 [95% CI, 1.27-1.35], and HR, 1.36 [95% CI, 1.30-1.43], respectively) and processed meat (HR, 1.16 [95% CI, 1.12-1.20], and HR, 1.25 [95% CI, 1.20-1.31], respectively) intakes had elevated risks for overall mortality. Regarding cause-specific mortality, men and women had elevated risks for cancer mortality for red (HR, 1.22 [95% CI, 1.16-1.29], and HR, 1.20 [95% CI, 1.12-1.30], respectively) and processed meat (HR, 1.12 [95% CI, 1.06-1.19], and HR, 1.11 [95% CI 1.04-1.19], respectively) intakes. Furthermore, cardiovascular disease risk was elevated for men and women in the highest quintile of red (HR, 1.27 [95% CI, 1.20-1.35], and HR, 1.50 [95% CI, 1.37-1.65], respectively) and processed meat (HR, 1.09 [95% CI, 1.03-1.15], and HR, 1.38 [95% CI, 1.26-1.51], respectively) intakes. When comparing the highest with the lowest quintile of white meat intake, there was an inverse association for total mortality and cancer mortality, as well as all other deaths for both men and women.
Conclusion Red and processed meat intakes were associated with modest increases in total mortality, cancer mortality, and cardiovascular disease mortality.
Author Affiliations: Nutritional Epidemiology Branch (Drs Sinha, Cross, Leitzmann, and Schatzkin) and Biostatistics Branch (Dr Graubard), Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Rockville, Maryland.
Dear Julie and Steve , Julie, I read the 'the Perfect 10 diet, " and I agree with you it is a very different diet, it is about real food.
Steve, I also got the new Atkins book thinking they changed their tune, but they also recommend the same junk and fake foods, artificial sweeteners which are bad for leptin should count as 1 gram of carbs. What junk science is that! Fake sweeteners are totally unrecognizable to our body. Processed meats are linked to cancer. Atkins bars are full of chemicals. Read its labels and see if you can recognize any of the ingredients. It is a shame, they are preying on the naive.
Steve as a doctor, don't defend low-carb diets because you just say big words like inflammation. I still have not heard your reply about the study. Do you still think Atkins does not cause cancer?? The study also said a lot of red meat causes heart disease. I hope you didn't miss that part too. This means Atkins increases risk for both cancer and heart disease. Balanced approach with no sugar, bad carbs, and chemicals is the way to eat and get rid of inflammation as well.
Margaret, I am sure you have good intentions, but you quote only one study vs. the over 50 studies quoted in this book. As Steve mentioned, the protein intake advocated in Atkins does not exceed the protein intake of the average American. What Atkins does is to advocate removal of the things that make us sicker, such as over-processed foods. Take it as an elimination diet which takes away the bad and leaves the good we eat.
BTW, cancer is caused by a multitude of factors, including genetics and exposure to offending substances. You should know that, being a dietitian and all. So now we should blame all cancer on Atkins? Work the numbers and percentages. How many people are on Atkins in America vs. how many Americans have cancer? If Atkins was the culprit, we have found the cure ... start stuffing yourselves with refined carbohydrates, everyone! You should submit your theory for publication....not!
Also, inflammation is not a"big word" as you repeatedly say. It is a pretty common, middle-intelligence word. If you consider it a big word, I am beginning to wonder ... you have a Master's, right? And for you this is a big word? I am speechless.
Dear R Hall, The link of nitrities to cancer is very well establisehed in the literature. Atkins is old news. The study I quoted is not a single study, it is a metanalysis or compilation of studies. Telling people to eat bacon, sausage, ham for breakfast is nothing but a recipe for cancer. You talk about processed food being out on Atkins. Have you even read the Atkins book? It tells readers to have artificial sweeteres and count them as 1 gram of carbs!! Have you even read the ingredients on Atkins bar? It has soy protein islate, and sugar alcohols. Do you call that real food? Atkins of for fools who just want to lose weight and do not care about the negative effect of chemicals or increased cancer risk.
The biggest cause of cancer in the American diet, even more so than consumption of highly processed sugar and grains, is the consumption of highly processed oils like corn, soybean, canola, etc. Our bodies can't metabolize these rancid oils; instead our bodies deposit them into our cell membranes, reducing the membrane's ability to do their jobs properly. They act similarly to trans fats in the cell membranes. In addition, you can eat a low carbohydrate diet without eating processed junk, and anyone who has seen the movie "Food, Inc." knows that industrial meat, eggs, and dairy should be avoided as much as possible. Grass-fed meat and raw, properly produced dairy are health-promoting foods and have a better omega 6/omega 3 fatty acid profile than industrial meat as well as the junk industrial oils found in most processed foods. Processed foods, even low carb shakes and bars, should be avoided as much as possible. The authors are merely offering alternatives for people who choose those convenience foods, however, the authors are serious researchers who have been in the forefront of the latest research concerning insulin resistance and inflammation. In addition, anyone offering advice on these matters should at least read "Good Calories, Bad Calories" by Gary Taubes for a comprehensive look at the history of the research of the past hundred years of low carb. This rabbit hole is much deeper than you think! And no, I am not a doctor or nutritionist, but I have had success with lowcarb controlling my weight and type 2 diabetes, and my cholesterol profile is very healthy; I eat lots of butter and coconut oil - healthy saturated fats that do not promote fat accumulation or heart disease.
The biggest cause of cancer in the American diet is highly processed oils like corn, soybean, canola, etc. Our bodies can't metabolize these rancid oils; instead our bodies deposit them into our cell membranes, reducing the membrane's ability to do their jobs properly. You can eat a low carbohydrate diet without eating processed junk, and anyone who has seen the movie "Food, Inc." knows that industrial meat, eggs, and dairy should be avoided as much as possible. Grass-fed meat and dairy are health-promoting foods and have a better omega 6/omega 3 fatty acid profile than industrial meat as well as the junk industrial oils found in most processed foods. Processed foods, even low carb shakes and bars, should be avoided as much as possible. The authors are merely offering alternatives for people who choose those convenience foods, however, the authors are serious researchers who have been in the forefront of the latest research concerning insulin resistance and inflammation. In addition, anyone offering advice on these matters should at least read "Good Calories, Bad Calories" by Gary Taubes for a comprehensive look at the history of the research of the past hundred years of low carb. This rabbit hole is much deeper than you think!
Frankly, I would never ask for dietary advice from a pharmacist.
People eat sausage. They eat bacon. That's just reality. Are these foods healthy? Not really, unless you make them yourself. Is a chicken healthy? Not if it was raised in a CAFO operation inhaling ammonia, under extreme stress from overcrowding, fed antibiotics, and processed in such a manner that 10 percent of its weight is fecal-contaminated water. Is fish healthy? Not if it's farm-raised feeding on grains in polluted water. Well, how about wild tuna? Too much mercury. Is beef healthy? Not if it's been consuming grains in a feedlot. Hey, just cooking meat damages the proteins.
Is soy healthy? No way. Most of it is genetically modified, highly processed, and contains numerous antinutrients. How about wheat? Sixty percent of the population is intolerant of gluten contained in wheat resulting in an epidemic of--here's that big word--inflammation! How about spinach? Too much oxalic acid. An apple? Bred for high sugar content and sprayed with toxins. Strawberries? Might as well spray RAID on your dessert. How about sugar? Highly processed food stripped of its nutrients and requires stored nutrients just for metabolization. Vegetable oils? Talk about inflammation from too many omega-6s!
Unless you want to go live in the wild and hunt your own meat and forage your own plants, most of what comes to us through our industrial food chain is nutrient-poor and toxin-rich. In other words, unhealthy.
And here you are pointing your finger at processed meats and sugar substitutes as if they constitute the entirety of the Atkins diet. The Atkins diet just replaces carbs with fats and a little more protein. That's it. But it's also rich in nutrient-dense foods.
How much processed meats are in a typical week? Let's look at week 1 of induction and see what meats are recommended: eggs, sausage, roast beef, salmon, ground beef, grilled chicken, pork chops, tuna, sardines, deli turkey, beef tenderloin, smoked salmon, ham, and bacon.
Every single one of those meats purchased from the typical grocery store is unhealthy, with the processed meats being the worst. But processed meats make up a small percentage of total intake.
Here are the ingredients in one day's induction menu:
Margaret--I have one the most careful and research-oriented internal medicine MDs I know. He is one of those rare brilliant doctors that did not succumb to the allure of surgical practice. His results are such that he always has a waiting list of patients begging for him to add them. When my blood lipids came back in the danger zone in my yearly physical, he gave me the choice of either low-fat or low-carb to reduce my weight and get my cholesterol numbers back in line. When I told him I'd prefer low-carb, his response was, "Good! You'll get your numbers under control a lot faster that way."
Like other posters here, I surmise that you haven't really read much of the book or the research cited therein, or you wouldn't be making the statements you made. Your patient didn't get a gout attack "from Atkins". In fact, a low-carb diet is a long-term cure for one of the key risk-factors in gout: metabolic syndrome. I suspect you could benefit your patients by digging beneath the surface and updating your knowledge base with the newest research. An open mind is a key element in foreward progress...you owe it to your patients to read the studies referenced in the book.
Just a reminder, folks. The voting buttons want to know if you think a post adds to the discussion, not if you agree with the writer. Every issue has multiple sides, and it's important to keep an open mind. I don't agree with Margaret, but I think her posts DO add to the discussion.
So what is the primary cause of gaining weight? INSULIN If you don't create insulin, you don't store fat. You truly know NOTHING about the biochemistry involved if you say that it isn't healthy. And yes, if you already have gout, you have to SLOW DOWN the rate of weight loss on Atkins. This is quite clearly spelled out in the new book.
Joanne, I believe people are voting that Margaret is not adding to the discussion because she is either ignorant or misinformed about what she is writing about. She is also using argument from authority with her statement that she is both a nutritionist and pharmacist, while showing little ability to think rationally in her responses. Her "diagnosis" that two of her "patients" got gout from Atkins is laughable. There are many different factors which can raise uric acid levels, so how was she able to determine that Atkins was the cause?
Similarly her idiotic and presumptuous inclusion of a study showing that red and processed meat consumption is associated with a modest increase in mortality ignores the fact that the Atkins diet and most low carb diets I'm aware of do not recommend higher levels of protein than what most Americans already eat. Atkins recommends consuming a level of protein for a given body weight. No where does it require red or processed meat consumption.
I just came across this study titled: Comparison of the Atkins, Zone, Ornish, and LEARN diets for change in weight and related risk factors among overweight premenopausal women: the A TO Z Weight Loss Study: a randomized trial. http://www.ncbi.nlm.nih.gov/pubmed/17341711
OBJECTIVE: To compare 4 weight-loss diets representing a spectrum of low to high carbohydrate intake for effects on weight loss and related metabolic variables.
CONCLUSIONS: In this study, premenopausal overweight and obese women assigned to follow the Atkins diet, which had the lowest carbohydrate intake, lost more weight at 12 months than women assigned to follow the Zone diet, and had experienced comparable or more favorable metabolic effects than those assigned to the Zone, Ornish, or LEARN diets [corrected] While questions remain about long-term effects and mechanisms, a low-carbohydrate, high-protein, high-fat diet may be considered a feasible alternative recommendation for weight loss.
Not only did these women lose more weight on the Atkins diet, but their metabolic markers improved more than the other diets.
Joanne, I just read this study. It is very interesting. I already decided to go the low carb route...or TRY it....before I read the study, but it was reassuring. I was a vegetarian, then vegan, then vegetarian, then vegan, but I could not seem to feel good on it, though I did in my younger days...you know, BC (before children).
Margaret, I understand that purines can be found in many meats, and I understand that your patient had gout, but I was also given the understand that meat does not cause gout, but that if a patient has gout they should watch their consumption of certain meats. That seems to be a difference to me.
Tigre8, I just read Why WE Get Fat and What We Can Do About It by Taubes. Very good. Thought provoking. I am reading his Good Calories/Bad Calories next. I would like to find the studies he mentions and read for myself....even though I know I won't understand all of the big words.8-)