I have been traveling a bit, the joys of moving, and have had a little more time for some recreational reading. So I decided to read The New Atkins for a New You by Westman, Phinney, & Volek. This book was at the top of my “I should read” list. It was at the top of my list for two reasons. First, I think the three authors have done some great research and second, I have not read an Atkins book yet. For some reason, over all the years in the nutrition and fitness field, I have not actually read the Atkins book. I had a pretty good understanding of what was being presented, but thought it would be a good idea to really know what was being said in the book. I realize this is an updated version and the first one not authored by Dr. Atkins himself, so I also read the most recent edition of Dr. Atkins New Diet Revolution. This was helpful for comparison and context aspects. Therefore, this review will actually look at both books. Here is my overall conclusion of the New Atkins for a New You; If you have never read an Atkins book then it is a good one to read, due to the changes of some content and the updated scientific support. However, if you have read a recent edition of Atkins, like the 1999 revised and updated edition that I also read, then I don’t think there is much you will learn from the newest book. Finally, even though I think the authors present a lot of good, evidence-based recommendations and I give the book a generally positive recommendation I did find that I disagreed with a few things and found that a few things were presented in a manner that I thought was odd. For those of you interested in the details please keep reading.
As I suggested in the opening paragraph, I think this addition of Atkins book presents the ideas regarding a low carbohydrate (CHO) diet well. The book clearly lays out the 4 phases of Atkins, offers many meal plans and recipes as well as supporting many of their statements with the many current studies on low CHO eating. Additionally, the final two chapters on Metabolic Syndrome and Diabetes are very good. These are the reasons why I think the book is worth reading, particularly if you have never read an Atkins book before. But there are a few things that made me scratch my head in bewilderment.
The first thing; Why no mention of ketosis? The first phase, Induction, of the Atkins diet, with its recommended 20 grams or less of net carbs, is most certainly going to induce some level of ketosis. Comparatively, the latest version of Atkins by Dr. Atkins discusses ketosis often and recommends the use of keto-sticks to monitor the level of ketosis. However, in this edition of Atkins, the new authors avoided the use of ketosis, except for one page near the end of the book (p.287) and have seemed to rename it the Atkins Edge. I would assume the change is due to the fact that ketosis is often thought of as a bad thing. I don’t think what they did was bad, but it is not how I would present the material. Again, not really a negative but just an observation on how the material was presented.
The next aspect has to do with the statements like “Eating the Atkins way (which includes two snacks a day) means you need never go hungry” (p.6, emphasis added). The suggestion that you will never be hungry as long as you stick to Atkins is repeated throughout the book. But, will you really NEVER be hungry? Do you have to force yourself to eat? This is certainly not the first time I have read this type of statement in the low-carb world. My problem with this statement is that it is a bit of an exaggeration. I think a more likely occurrence when following a ketogenic or low carb diet is a reduction in your overall appetite and likely the feeling of fullness from a meal will last longer, relative to a non-ketogenic or higher carb diet. However, the reduction of appetite is likely due to ketones and the amount of protein when following a very low CHO diet. When following a low CHO, but non-ketogic diet, the reduction is appetite seems to be likely due to the increase in protein intake and not necessarily from a change in CHO intake (Soenen et al). A final thing related to this aspect is food cravings. The authors state “Do you seek comfort in carbs?” (p.30) and relate cravings for high CHO foods, feeling tired, irritable, headachy, or unable to deal with stress or to focus in the afternoon or other times with a drop in blood sugar due to eating a higher CHO diet/meal. As with appetite, I don’t think there is good evidence that eating CHO foods, say 30-40% of calories from medium to lower GI carb foods, will likely cause these problems or that eating a low CHO diet will allow you to avoid these feelings.
A nice difference between The New Atkins and the older Atkins book is there is virtually no mention of the metabolic advantage. Additionally, the authors state that carb intake is very important but so is calorie intake. For example, the authors state
“…but if you’re trying to lose weight, you clearly must reduce your energy intake – in the form of taking in fewer calories” (p.29).
However, they repeatedly state that there is typically no need to count calories, but you must count carbs. I agree that just counting calories takes the focus off of where the calories are coming from. But, you still must COUNT the carbs, which entails doing basically the same thing as counting calories. You need to read labels, and weight or measure the food so that you get the correct amount of carbs and if calories do matter, as they did state, it is likely that you need to count the amount of protein and fat that you are ingesting also. So yes, you may not be counting calories, but if you are counting carb, fat, and protein intakes, then you are really doing the same thing as counting calories. My point with this aspect, is I feel that saying that you don’t need to count calories is a benefit to doing Atkins is really misleading, because instead of counting calories you are counting all the stuff that results in the amount of calories you are ingesting. In the end you are still counting shit.
The authors state that “along with protein, fat helps increase satiety. And because fat carries flavor, it makes food more satisfying…Bottom line: eat fats in place of carbs, and you’re less apt to overeat.” (pp.49-50). So fats are more satiating than carbs and because fat makes food taste better you will eat less? I think there is something wrong with these conclusions. Regrettably the authors did not have any references for these statements (it is possible that the subject came up at another point where they did reference the statements, but I don’t recall seeing that but I may have missed it) so I couldn’t check on where they were getting this. So I pulled up some papers to look at a few topics.
First, dietary fat and satiety. The evidence generally points to fat being the least satiating macronutrient (Kirkmyer et al; Rolls). The reasons for the usually occurrence of a reduction of ad libitum intake on lower CHO diets are many, higher protein intakes seems to be the top candidate (Johnstone et al; Soenen et al), but it is not likely due to the high fat (>40%) intakes which is the level of fat intake for all of the phases of Atkins.
Second, the influence of food palatability and food intake. The general view is that if a food taste really good you are more likely to eat more of it (Sorenson et al; Yeomans et al). I am not sure how making a food taste better, due to fat or anything else, is a good way to naturally eat less of something.
The following statement by the authors didn’t make sense to me, “Consuming enough protein combined with significant weight-bearing (resistance) activity, such as walking up and down stairs or lifting weights, can help preserve and tone your muscles during weight loss” (p.41, emphasis added). I totally agree with the “enough protein and weight training thing”, but I was surprised to see walking up and down stairs being equated with weight training. Also find the use of the phrase “tone your muscles” a bit funny.
The final thing that caught my eye had to do with meal frequency. Here are a few things they said regarding meal frequency;
“Don’t skip meals or go more than six waking hours without eating” (p.94)
“Snacks are an important part of Atkins Diet. A midmorning and mid afternoon snacks should help keep your energy on a level plane and head off fatigue, jitters, inability to concentrate, ravenous cravings for inappropriate food, or overeating at your next meal.” (p.101)
“Strange as it sounds, eating too little or skipping meals can slow down your metabolism.” (p.107)
As with the statements made about fat and satiety, there are no references to support these statements. The main argument being made by these statements deals with meal frequency and metabolic rate. This has been extensively studied and the general conclusion is there is NO metabolic difference, over a day, between a low and high frequency of meals (Smeets et al; Verboeket-van de Venne et al). So, there is no metabolic difference (number of calories burned) between low and high frequency meal patterns. There is no “slow down” in metabolic rate for the day. What matters are the total amount of calories ingested for the day, actually over a couple of days, and possibly the amount of protein ingested. That leads to one additional aspect they referred to, “eating too little” and a reduction of metabolic rate. First, what is eating “too little”? Is this a 1,000 calories a day or 500 a day? Can you really eat too little, when it comes to a weight loss diet? In a physiological sense, a very low calorie (about 600 to 900 calories/day), can elicit a fast rate of weight loss (Sweeney et al; Donnelly et al; Huerta et al). However, it is the psychological side, i.e., the ability to stick to it that can be very hard. But, will it lead to an inability to lose weight? I don’t think so. The thing is, as soon as calorie intake is reduced from a usual intake, there is likely to be a reduction in metabolic rate, usually referred to as adaptive thermogenesis (Major et al). The authors give the following recommendations for calorie intake; “Women should shoot for a range of 1,500 to 1,800 calories a day, while men should aim for 1,800 to 2,200” (p.107). Following those recommendations, the authors state “Eat less if you’re not losing weight” (p.107). Are these not relatively low calorie intakes? I think so. I don’t think this is bad, but I do want to point out that a relatively low calorie intake is recommended and even lower intakes are recommended it the beginning range is not working. A related side not to this topic is what Dr. Atkins said in his latest version of Atkins. For those that are “metabolic resistant”, people who can’t seem to lose weight no matter what, can do the diet based on the work of Kekwick and Benoit. This diet, a fat fast, “contained 1,000 calories, 90% of them as fat! The other 100 calories consisted of approximately 15 gms of protein and 10 gms of carbohydrate.” (p.239) This low intake of calories can apparently produce “amazing results” (p.239) Dr. Atkins states that is should only be followed for 5 days and only be followed by those that are really metabolic resistant. A 1,000 calorie intake can produce amazing results. Okay, I can see that because the person is not taking in very many calories. However, the work done by Kekwick and by Benoit seems to have some pretty big flaws, which has been thoroughly review by Anthony Colpo, here and here. However, the overall point is that very low calorie intakes will elicit rapid weight loss (Sweeney et al; Donnelly et al; Huerta et al). The amount of metabolic rate reduction will usually change, in a parallel fashion, with the amount of reduction of overall calorie intake (Mayer et al). However, some people do have a stronger response to a reduction of calorie intake. This adaptive thermogenesis response can be greater for some people and the variability of responses is based on a number of factors (Major et al).
One more thing connected to this discussion is the “starvation” comments, which the authors state a few times, such as “Don’t starve yourself” (p.94) in the Induction Guidelines. What does starving yourself mean? I will leave this as is for now, as I am working on a paper that will look at the “starvation mode” thing in detail. Check back soon for a detailed discussion of that topic.
Again, overall, this book clearly lays out how to do a ketogenic and non-ketogenic low carb diet. The authors give some good evidence for many of their contentions regarding the benefits of a low carb diet. But, as pointed out above, I think there are a few aspects that are misleading or incorrect. But you need to judge for yourself who is right. If you have not read an Atkins book then this is a good one to read. If you have already read the latest version of the Atkins book by Dr. Atkins you will probably not gain much by reading this version.
References
Donnelly, J. et al (1991). Effects of very low calorie diet and physical training regimens on body composition and resting metabolic rate in obese females. Am J Clin Nutr; 54: 56-61.
Huerta, S. et al (2009). Feasibility of a supervised inpatient low-calorie diet program for massive weight loss prior to RYGB in superobese patients. Obesity Surg; DOI 10.1007/s11695-009-0001-x.
Johnstone, A. et al (2008). Effects of a high-protein ketogenic diet on hunger, appetite, and weight loss in obese men feeding ab libitum. Am J Clin Nutr; 87: 44-55.
Major, GC. et al (2007). Clinical significance of adaptive thermogenesis. Inter J Obesity; 31: 204-212.
Rolls, B. (2000). The role of energy density in the overconsumption of fat. J Nutr; 130: 268s-271s.
Soenen, S. et al (2008). Proteins and satiety: Implication for weight management. Curr Opin Nutr Metab Care; 11(6): 747-751.
Sorenson, LB. et al (2003). Effect of sensory perception of foods on appetite and food intake: a review of studies on humans. Inter J Obesity; 27: 1152-1166.
Sweeney, ME. et al (1993). Severe vs moderate energy restriction with and without exercise in the treatments of obesity: efficacy of weight loss. Am J Clin Nutr; 57: 127-134.
Yeomans, M. et al (2004). Palatability: response to nutritional need or need-free stimulation of appetite. Br J Nutr; 92: Suppl 1. S3-S14.