Popular but often faulted, Atkins diet made its mark

Many nutrition experts see the recent bankruptcy filing by Atkins Nutritionals Inc. as the proper outcome for a diet that seemed to encourage virtually unlimited consumption of steak, cream and pork rinds. After all, the eating plan was often at odds with the large body of nutritional research showing the benefits of a diet rich in fruit, vegetables, whole grains, lean protein and a moderate or low percentage of fat.

But some also see value in the popularity of the weight-loss method, created by Dr. Robert C. Atkins, even if they don’t agree with it.

“The good that Atkins did is that he made people more mindful about the importance of limiting refined carbohydrates like sugar and white flour,” said cardiologist Dean Ornish, a proponent of a very low-fat, high-carbohydrate approach to losing weight and lowering the risk of heart disease. “The bad is that he taught people that in the short run, you can sell a lot of books and make a lot of money telling them what they want to hear.”

Atkins “taught the scientific community a good lesson,” said Gary Foster, clinical director of the Weight and Eating Disorders Program at the University of Pennsylvania. “Don’t be so quick to judge new approaches.”

The bestselling success of Atkins diet books was a cultural phenomenon that researchers couldn’t ignore. “We can’t test every fad diet,” Foster said. “So why did we test this one? Because 10 million people had bought the book.”

In studying Atkins, researchers found some surprises. “It’s clear that the Atkins diet does better in the short term and doesn’t do any worse in the long run in terms of weight control,” said Walter Willett, professor of nutrition at the Harvard School of Public Health. “That was so contrary to the general nutritional dogma that it really did shake things up a bit.”

Also unexpected: Participants’ blood fat levels either were the same as or slightly better than those of people who followed a conventional low-fat weight regimen for a year. “Who would have predicted that?” said Foster, author of the study, which was published in the New England Journal of Medicine. “Certainly, it wouldn’t have been me.”

The long-term health effects of limiting fruit, vegetables, whole grains, fiber and such popular dairy products as milk, yogurt and cheese are not known. Those questions may be answered by a two-year, federally funded study of 300 people on a very low-carbohydrate diet. “Whether anyone will care about the results, I don’t know,” said Foster, who heads this study as well. “But we’re going to continue.”

Here’s what else leading nutrition experts said the Atkins experience has shown:

* Quick weight loss doesn’t last. Severe restriction of carbohydrates depletes the body of glycogen, a substance that helps retain water. The quick weight loss on Atkins is initially due to loss of water, not fat.

* Protein is important. Studies show that protein increases satiety -- the feeling of fullness. When University of Cincinnati School of Nursing researchers put overweight women on an Atkins diet, their hunger decreased and they lost weight. Initially, the pounds came off faster than for women on a conventional low-fat diet. But by six months there was no statistical difference between the two groups. Women on the Atkins diet “had protein with breakfast, protein with lunch and protein with dinner,” said Bonnie Brehm, lead author of the study. “I was amazed at how satisfied they were, and they didn’t crave snacks.”

* Taste counts. The Atkins diet launched numerous new lines of low-carbohydrate products from many food manufacturers. “Two years ago they filled half a grocery wall. Now they’re just a stand-alone unit because they didn’t taste very good and they were expensive,” Brehm said.

* Diets don’t work. It takes consistent lifestyle changes to lose weight and maintain it. “Americans tried [Atkins],” Brehm said. “It worked for a while and then it didn’t continue to work, so they abandoned it.... The message is moderation, moderation, moderation.”

* Too many processed, sugary carbohydrates are unhealthy. “Atkins was good in pointing out that refined grains can be a problem, but bad in making any carbohydrate out to be a toxin,” said Michael Jacobson, executive director of the Center for Science in the Public Interest.