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There are no long-term follow-up studies to prove the Atkins' Diet is a safe and effective weight loss program. The Dr. Atkins' New Diet Revolution contains only a handful of case studies of individuals on the diet, even though Dr. Atkins claims he has thousands of success stories. Where is the research from the past 20+ years that shows the diet is effective? Where are the studies that show there is a group of "diet-related disorders" that can be cured by his diet?
In contrast to being a proposed cure for many health problems, the diet may have a negative impact on health. The Atkins' Diet is made up of a very high proportion of fat and protein foods (which contain fat and saturated fat). Causative factors that underlie mild hypercholesterolemia include diets high in saturated fat and dietary cholesterol. Saturated fats specifically elevate concentration of LDL cholesterol. Overwhelming evidence indicates that elevated concentrations of LDL promote atherogenesis and therefore increase the risk for coronary heart disease. An increased amount of dietary cholesterol in the diet also raises LDL cholesterol in many people. Reduction in intakes of saturated fat and cholesterol over the last three decades in the U.S. has increased the proportion of the U.S. population with desirable cholesterol levels. 4
The American Heart Association and the National Cholesterol Education Program recommend a diet with total fat < 30% of total calories, saturated fat < 10% of total calories, monounsaturated fat10-15% of total calories, polyunsaturated fat <10% of total calories, carbohydrate 55% of total calories, protein 15% of total calories, and cholesterol < 300 milligrams per day. These recommendations are based on evidence showing that modification of specific risk factors (elevated LDL cholesterol) will decrease incidence of CHD.
A diet high in fat and meat may increase the risk for certain types of cancer. Evidence strongly supports an association between animal fat consumption and risk of prostate cancer. Furthermore, a large body of evidence indicates that a higher consumption of grains, fruits and vegetables is associated with a reduced risk of cancer. 4 Grains, fruits and vegetables contain important micronutrients and phytochemicals such as antioxidants, B vitamins and fiber, which appear to have protective roles against cancer. The American Cancer Society recommends "an overall dietary pattern that includes a high proportion of plant foods (fruits, vegetables, grains, beans) and limited amounts of meats, dairy and other high-fat foods." However, on Dr. Atkins' Diet only a very limited amount of these foods could be eaten without exceeding his recommendations for carbohydrate intake.
The Atkins' Diet may have other health implications. Excessive protein intake may influence the development of osteoporosis. An increase in protein intake causes an increase in the loss of calcium in the urine. High protein intake has been proposed as a reason for the high incidence of osteoporosis in some populations despite moderate to high levels of calcium intake.4, 8 Long-term high protein intake may also affect kidney function. Some studies have suggested that long-term excessive protein intake can speed the age-associated process of renal glomerular sclerosis.8 High uric acid production, which occurs as a result of elevated ketones may exacerbate gout.2
Dr. Atkins warns pregnant women to avoid the induction phase but does not mention a safety issue for the other phases although he expects that the state of ketosis be maintained throughout the ongoing weight loss phase. He issues the same "crucial warning" for people with severe kidney disease in regards to the induction phase. Both warnings appear on page 108 so you'd have to have read that far to be forewarned! Pregnant women should avoid the diet because chronic ketosis could adversely affect the fetus. Weight loss of any kind during pregnancy is contraindicated and could also affect the health of a growing fetus.
A ketogenic diet may also cause short-term side effects. These might include fatigue and insufficient energy to perform normal activities. Such fatigue is alleviated after carbohydrate consumption is resumed. Other side effects of the ketogenic diet might include nausea and hypotension.2
A high-fat, high-protein, low-carbohydrate diet should definitely be avoided by individuals with pre-existing kidney disease, liver disease, type I lipoproteinemia, and chylomicronemia.8
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