Overview of the Atkins Diet
The Atkins diet, developed by Dr. Robert Atkins in the 1960s, is a classic low-carb weight loss plan that has evolved. Initially allowing unlimited fat consumption, it now places a more balanced emphasis on fat intake and encourages the inclusion of vegetables. The Atkins diet restricts simple carbohydrates while prioritizing protein sources.
The Phases of the Atkins Diet
The Atkins diet consists of several phases, each with varying net carb restrictions and food choices. The ketogenic diet is a high-fat, very low carb diet that can be hard to stick to.
Phase 1: Induction
During the two-week induction phase, you limit net carbs to 20 grams per day from low-carb vegetables like leafy greens. This phase helps kick-start weight loss and transition your body into a fat-burning state. Many people lose weight quickly, especially in the beginning but it can be difficult to maintain which is why keeping a food journey or keeping track of calories might help you stay consistent.
Phase 2: Balancing
In the second phase, you can add nuts, more low-carb vegetables, and small amounts of fruit to your diet. This phase allows for continued weight loss while gradually reintroducing carbohydrates.
Phase 3: Fine-tuning
During the third phase, you'll increase your carb intake, finding your "personal carb balance" through trial and error, up to 100 grams of net carbs per day. At least one-fifth of these carbs must come from low-carb vegetables. This phase helps you maintain your goal weight while enjoying a wider variety of foods.
Food You Can Eat and Restrictions
The Atkins diet allows a range of foods, with specific allowances and restrictions depending on the phase.
- Meat (excluding nitrate-processed meats and bacon in excess)
- Low-carb vegetables (spinach, kale, broccoli, asparagus, other dark leafy greens)
- Full-fat dairy
- Nuts and seeds
- Olive oil and vegetable/nut oils
- Artificial sweeteners (in moderation)
As you progress through the phases and increase your carb intake, you can also eat:
- High-carb vegetables (carrots, root vegetables)
- High-carb fruits (bananas, apples, oranges, pears, grapes)
- Starches (potatoes, sweet potatoes, winter squash)
- Legumes (beans, lentils, chickpeas)
- Still or sparkling water
- Diet soda
- Green and herbal tea
- Limited alcohol (primarily spirits or dry wines)
Foods to Avoid
- Sugar-sweetened foods and beverages
The Latest Research
It is challenging to find many health professionals who believe that a diet devoid of whole grains or fruits and with limited vegetables is beneficial for heart health. Evidence suggests that high-protein diets may increase the risk of heart disease and congestive heart failure.
In 2018, researchers analyzed data from approximately 2,400 men aged 42 to 60, collected between 1984 and 1989. These men were asked to record their food intake for four days and were followed for 22 years. During this period, 334 of them developed heart failure. The higher their protein intake, the greater their risk of heart failure. Men who consumed the most animal protein had a 43% higher risk of heart failure than those who consumed the least. Those who consumed the most dairy protein had a 49% higher risk. However, individuals with the most plant protein only had a 17% higher chance. Protein from eggs and fish was not associated with an increased risk. In a 2020 review of 12 randomized studies, a low-carbohydrate diet was linked to decreased triglycerides, blood pressure, and total cholesterol (although LDL cholesterol increased, and fasting glucose did not change significantly). However, weight loss often reduces blood lipids, blood pressure, and glucose levels that contribute to developing cardiac conditions. This makes it difficult to accurately determine which improvements in heart health are due to the weight loss itself or the diet responsible for the weight loss.
Numerous research studies have established a connection between saturated fat intake and inflammation throughout the body, raising concerns as the Atkins diet contains higher levels of saturated fat than most reputable scientists recommend. Even a short period of three weeks on a high saturated fat diet may adversely affect working memory due to an inflammatory response in the brain.
An anti-inflammatory diet consists of fruits, vegetables, whole grains, healthy fats, and a variety of spices and herbs. This diet is more closely aligned with the DASH, Pritikin, or Mediterranean diets, which differ significantly from the Atkins plan. By incorporating leafy greens, salmon, or other fatty fish (such as tuna), olive oil, and herbs and spices, it may be possible to mitigate the inflammatory effects of the Atkins diet.
Research consistently demonstrates that losing weight is a valuable pursuit for individuals with diabetes aiming to improve their health. However, the best approach to weight loss is less clear-cut. It's also essential to consider that the elevated LDL cholesterol caused by the Atkins diet could be particularly harmful to those with diabetes.
In a 2021 review published in Current Diabetes Reports, 585 publications were screened, and 14 were ultimately included. Ten of those 14 studies positively impacted HbA1c, although the results ranged from a reduction of 0.6% after three weeks to 0.9% after four months or 1.3% after 32 weeks. In another study, three months on a ketogenic diet led to an average drop in HbA1c from 8.9% to 5.6%. In yet another study, after 24 weeks, HbA1c dropped from 7.8% to 6.3%.
However, in many studies, the long-term decrease in A1c is similar to the decline seen among followers of high-carbohydrate, low-fat diets. This suggests that, like with heart disease, the weight loss method may not be as crucial as the weight loss itself.
In a 2020 study, total protein intake and protein intake specifically from dairy products were associated with decreased depressive symptoms among 6,887 American adults. However, protein intake from red meat, poultry, fish, grain products, and legumes was insignificant. In a study conducted at Johns Hopkins, 27 adults with an average age of 71 participated in a 12-week diet study, with only 14 completing the study. Nine participants were put on a modified Atkins diet with a carbohydrate restriction of 20 grams or less, while the other five followed a diet similar to the Mediterranean diet. Although the individuals on the modified Atkins diet never reached the goal of 20 grams of carbohydrates per day, they consumed around 39 grams by week six. At the beginning of the study, each participant provided urine samples, which were repeated every three weeks to measure ketone levels. More than half of the participants on the modified Atkins diet entered a state of ketosis. All participants completed the same panel of cognitive tests at the program's start. They were also given neuropsychological memory tests before starting their diets and then again after six and twelve weeks on the diet. The six-week tests showed significant improvement in memory measures among those participants with the highest ketone levels and the lowest carbohydrate intake. Those on the modified Atkins plan also improved their short-term memory/recall test scores by about 15% of the total score, while those who didn't follow the Atkins plan experienced a slight decrease in their score during the same period.
- Brehm, B. J., Seeley, R. J., Daniels, S. R., & D'Alessio, D. A. (2003). A randomized trial comparing a very low carbohydrate diet and a calorie-restricted low fat diet on body weight and cardiovascular risk factors in healthy women. The Journal of Clinical Endocrinology & Metabolism, 88(4), 1617-1623. Link: https://academic.oup.com/jcem/article/88/4/1617/2845298
- Foster, G. D., Wyatt, H. R., Hill, J. O., McGuckin, B. G., Brill, C., Mohammed, B. S., ... & Klein, S. (2003). A randomized trial of a low-carbohydrate diet for obesity. New England Journal of Medicine, 348(21), 2082-2090. Link: https://www.nejm.org/doi/full/10.1056/nejmoa022207
- Shai, I., Schwarzfuchs, D., Henkin, Y., Shahar, D. R., Witkow, S., Greenberg, I., ... & Tangi-Rozental, O. (2008). Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. New England Journal of Medicine, 359(3), 229-241. Link: https://www.nejm.org/doi/full/10.1056/NEJMoa0708681
- Volek, J. S., Sharman, M. J., Gómez, A. L., Judelson, D. A., Rubin, M. R., Watson, G., ... & Kraemer, W. J. (2004). Comparison of energy-restricted very low-carbohydrate and low-fat diets on weight loss and body composition in overweight men and women. Nutrition & Metabolism, 1(1), 13. Link: https://nutritionandmetabolism.biomedcentral.com/articles/10.1186/1743-7075-1-13
Rating and Review
Atkins Diet: A Good Choice?
Ease and Sustainability
- Randomized controlled trials show that some, but not all people benefit from low-carb diets
- Unprocessed and minimally processed foods are emphasized, especially in the higher-carb phases
- Meeting fiber recommendations and nutrient needs is possible on the higher-carb phases
- Potentially more sustainable than the ketogenic diet
- The induction phase may cause side effects such as headaches, fatigue, dizziness, and constipation
- Reliance on animal-based protein sources may lead to a higher saturated fat intake than is optimal for health
- Higher protein consumption than necessary for health and satiety may be unsuitable for certain individuals
- The Atkins diet is less balanced than some other low-carb plans
- The Atkins program promotes its bars, shakes, and other products, which are ultra-processed, even if they’re low-carb
- Cooking three meals a day from scratch can be challenging for most people, necessitating carb counting to follow the diet correctly