Tufts University School of Nutrition

Is It Possible to Follow the Atkins Diet Healthfully?
Tufts Health and Nutrition Letter 21 (2003):1.
Is It Possible to Follow the Atkins Diet Healthfully?

The content of our Tufts Health and Nutrition Letter is based substantially from the research and expertise of the Gerald J. & Dorothy R. Friedman School of Nutrition Science and Policy, the only graduate and professional school of nutrition in North America.

ONE OF THE vice presidents of Tufts posed the following questions. Is it possible to do the Atkins diet healthfully? And if not, is there a way to tweak the low-carbohydrate plan tomake it more nutritious for those people who want to try it to lose weight?

With Dr. Atkins’ New Diet Revolution on the New York Times bestseller list for six and a half years straight with no sign of its sales letting up, we thought the answers to those questions would be more than timely. So we ploughed through the book-again-to see whether there was anyway to reconcile Dr. Atkins’s weight-loss instructions with the principles of good nutrition accepted by the health-promoting community at large.

The most logical way to approach the project, it seemed, was to devise menus based on Dr. Atkins’s advice for the four phases of his plan-Induction, Ongoing Weight Loss,Pre-Maintenance, and Maintenance-and then see where adjustments could be made. It was not easy. As anyone with even a passing familiarity of the Atkins diet knows, there are no caloric restrictions, so deciding on amounts of various foods to include in the menus is something of an arbitrary decision. And the sample menus included in the back of Dr. Atkins’s book are of no help because they don’t jibe with the instructions in the text. For instance, the text says that by the time someone is upto the Maintenance phase, he or she may be able to enjoy up to three”deviations” a week, a deviation being anything from a serving offruit tG»a couple of slices of wholewheat bread to a baked potato. (All get most of their calories from carbohydrates.) But the “Typical Maintenance Menu” almost 100 pages later shows at least four or five deviations on a single day: half a cantaloupe, French onion soup (which tends to come with a thick slice of bread floating at the top), half a smallbaked potato, veal chops that are lightly breaded (the breading is made from carbohydrates), and a “generous cup” of fruit compote.

In the end, we decided to construct menus for the four phases that contained 1,800 calories each. That seemed like a reasonable calorie allotment for most people wantingto lose weight, including women, as long as they consistently logged a half hour to an hour of exercise each day.

Then we got stuck. The book is adamant in its instructions to avoid certain foods. The first phase-the 14-day Induction Diet that people are supposed to start with-contains “no fruit, bread, grains, starchy vegetables,or dairy products other than cheese,cream, or butter.” That means no milk or yogurt, no whole-wheat breads or cereals. And that, in turn, means no easy sources of calcium or viramin D or whole-wheat phytochemicals that researchers are discovering may play a role in warding off illnesses such as heart disease and diabetes. Dr. Atkins does say to take a multivitamin, but the formula he recommends contains no calcium and too little vitamin D to meet anyone’s needs. And it doesn’t have any of the fiber or other chemicals contained in whole wheat.

The next phase, Ongoing WeightLoss, or OWL, is more lenient, but readers are still warned that fruit-eating will “always” be “somewhat risky.” And Pre-Maintenance, the last two or three months “to shed thelast 10 pounds” before transitioningto Maintenance, includes only one to two “deviations” a week.

Then, too, all four phases, devised here according to the letter of Dr.Atkins’s instructions, are extremelyhigh in saturated fat and dietary cholesterol, large amounts of which are not consistent with heart health.

Granted, we could have taken a stab at tweaking the menu for each phase-limiting some of the foods high in saturated fat, like creamy dressings, whipped cream, cream cheese, bacon, and butter and replacing the calories from those items with calories from fruits, whole grains, and low- and nonfat dairy products. But then it wouldn’thave resembled the Atkins plan anymore. It would have begun to morph from the unnecessarily restrictive and nutritionally deficient diet that it is into one that more resembles a plain old healthful diet. And you already know what that looks like: a few servings ofwhole-grain foods each day, such as whole-grain breads and cereals; at least three servings of fruit and two of vegetables; a couple of servings of high-calcium dairy foods; smallish portions of meat, poultry, and fish; and sparing additions of cooking oil, mayonnaise,and other fats.

So, as to whether it’s possible to follow the Ackins diet healthfully or tweak it to make it safe and healthful,the answers are no and no. To be sure,Americans do eat too many calories inthe way of refined or processed (as opposed to whole-wheat) carbohydrates, which means too much cake, candy, pastries, muffins, ice cream,pasta, oversized bagels, soda pop, white bread, pizza, sweetened cereal, and French fries. And inappropriately large (and frequent) servings of all those foods are most definitely contributing to our expanding girth. But you don’t need a 300-page diet book to advise you on making adjustments. Just eat smaller portions less often-and cut down on the junk.