Although pregnant and breastfeeding women may be at most risk, “The [Atkins] diet is potentially dangerous to everyone,” warned the Chair of the Medical Society of New York County’s Public Health Committee.[171] In all of the editions of his Diet Revolution, Atkins cited the “pioneering” work of “brilliant” researcher Gaston Pawan.[172] When Atkins was brought before the Senate investigation on fad diets, the Chair of the Senate Subcommittee read a statement submitted by Dr. Pawan himself who supported the AMA’s condemnation of the Atkins diet and explained that he used very high fat diets only for “specific experimental purposes” (emphasis in original.) in hospital settings and would never “recommend a very high fat diet indiscriminately to obese subjects for obvious reasons.”[173]
The symptoms of ketosis include general tiredness, abrupt or gradually increasing weakness, dizziness, headaches, confusion, abdominal pain, irritability, nausea and vomiting, sleep problems and bad breath.[174] One study found that all those subjected to carb-free diets complained of fatigue after just two days. “[T]his complaint was characterized by a feeling of physical lack of energy… The subjects all felt that they did not have sufficient energy to continue normal activity after the third day. This fatigue promptly disappeared after the addition of carbohydrates to the diet.”[175] From a review published in a German medical journal, “[lightheadedness], fatigue, and nausea are frequent, despite what Dr. Atkins claims.”[176]
In World War II, the Canadian Army had an illuminating experience with ketogenic diets. For emergency rations, infantry troops had pemmican, which is basically a carbohydrate-free mixture of beef jerky and suet (animal fat). The performance of the infantrymen forced to live off pemmican deteriorated so rapidly that they were incapacitated in a matter of days. As reported in the journal War Medicine in 1945, “On the morning of the fourth day of the diet, physical examination revealed a group of listless, dehydrated men with drawn faces and sunken eyeballs, whose breath smelled strongly of acetone.”[177] A ketogenic diet, concluded one medical review, “can be associated with significant toxicity.”[178]
Danish obesity expert professor Arne Astrup, M.D., of the Centre of Advanced Food Research in Copenhagen published a September 2004 review of the Atkins Diet[515] in The Lancet, one of the most prestigious medical journals in the world.[516] Long term Atkins adherents “start to suffer headaches, muscle cramps and diarrhea,” Astrup concluded. “This is consistent with a carbohydrate deficiency. They simply do not get enough carbohydrate to supply the tissues with blood sugar. That is why the organs start to malfunction.”[517]
In a study funded by Atkins himself, most of the people who could stick with the diet reported headaches and halitosis (bad breath). Ten percent suffered hair loss. While most people lost weight–at least in the short-term–70% of the patients in the study also lost the ability to have a normal bowel movement.[511]