The Atkins Diet, formally called the Atkins Nutritional Approach, is a popular low-carbohydrate eating plan developed in the 1960s by cardiologist Robert C. Atkins. It proposes that obesity and related health problems, such as type 2 diabetes and heart disease, are linked to the typical low-fat, high-carb American diet. The diet limits carbs and encourages eating more protein and fat. The Atkins Diet has several phases for weight loss and maintenance, starting with a very low-carbohydrate eating plan.
Atkins Diet Phases
The Atkins Diet has four phases:
- Phase 1: Induction. This strict phase cuts out almost all carbohydrates, limiting intake to around 10% of daily calories. Protein sources such as fish and shellfish, poultry, meat, eggs, and cheese are emphasized at every meal, while most fruits, sugary baked goods, breads, pastas, grains, nuts, or alcohol are restricted. Drinking at least eight glasses of water a day is recommended.
- Phase 2: Balancing. In this phase, a minimum of 12 to 15 grams of net carbs is consumed as foundation vegetables. Foods with added sugar are avoided. Some carbs that are high in nutrients, such as more vegetables and berries, nuts, and seeds, can be slowly added back in as weight loss continues.
- Phase 3: Pre-maintenance. The range of foods is slowly increased, including fruits, starchy vegetables, and whole grains. About 10 grams of carbs can be added to the diet each week, but intake must be cut back if weight loss stops.
- Phase 4: Lifetime maintenance. This phase is reached when the goal weight is achieved.
The Rationale Behind Low-Carbohydrate Diets for Diabetes
The Atkins Diabetes Revolution plan is similar to the Atkins weight loss strategy. For diabetes, carbohydrates are only reintroduced if glycemic control is acceptable. The Atkins Diabetes plan adds a Glycemic Ranking (AGR), derived from the glycemic index, glycemic load and net carbs. Preference is given to whole fruits and berries, while juices and dried fruits are low on the list.
The concept of a low carbohydrate diet and glycemic control has a pathophysiological merit. Dietary carbohydrates are the principal source for the initial rise of glucose in diabetic populations, who generally have a defect in the first phase insulin secretion that is responsible for handling the glucose load. Postprandial hyperglycemia is a risk factor for cardiovascular disease in diabetic patients, and controlling it can provide cardiovascular benefits and contribute to the overall decrease of hemoglobin A1c, which has been shown to reduce microvascular disease in both type 1 and type 2 diabetes.
The initial blood glucose rise associated with a high carbohydrate load, in the presence of absolute/relative insulin deficiency, leads to a significant rise in triglycerides and free fatty acids, which perpetuate the cycle of insulin resistance. From a metabolic standpoint, a low carbohydrate diet makes physiological sense.
Read also: Understanding the Atkins Diet
How Effective is the Atkins Diet for Diabetes?
Low-carb diets are popular because research shows they can rapidly reduce weight within six to 12 months. Diets that restrict carbs increase fat and protein, and one theory is that this leads to a feeling of fullness, which helps reduce hunger.
The Atkins Diet claims that its approach to carbs will burn off your body's fat stores, control your blood sugar, and help you achieve optimal health. Once you're at your goal weight, the Atkins Diet also explains it will help you find your personal carbohydrate balance.
Most people can lose weight on almost any diet plan that restricts calories, at least in the short term. Over the long term, though, studies show that low-carb diets like the Atkins Diet are no more effective for weight loss than are standard weight-loss diets. Because carbs usually provide over half of calories consumed, the main reason for weight loss on the Atkins Diet is lower overall calorie intake from eating less carbs. You may shed pounds because your food choices are limited, and you eat less since the extra protein and fat keep you feeling full longer.
Clinical studies have shown that the Atkins Diet can help reverse Type 2 diabetes by controlling symptoms of metabolic syndrome, which includes conditions such as abdominal obesity, high triglycerides, low HDL, high blood pressure and glucose intolerance. Subjects who followed an Atkins-type diet were able to reduce their blood sugar levels and improve their lipid profiles; half of them were able to normalize their blood sugar levels completely and stop their anti-diabetic and blood sugar medications.
A study published this year links increased sugar consumption with increased rates of diabetes. For every 12 ounces of sugar-sweetened beverage introduced per person per day in a county’s food system, the rate of diabetes goes up 1 percent.
Read also: Delicious Atkins Dinners
Potential Benefits of Low-Carb Diets
- Weight Loss: Weight loss by itself is beneficial in terms of improving insulin sensitivity and correcting the abnormalities associated with the metabolic syndrome and insulin resistance. Weight loss has a much greater effect on the prevention of type 2 diabetes in pre-diabetic patients than pharmacological interventions.
- Improved Blood Glucose Control: For a person with type 2 diabetes, a low-carb diet can dramatically improve blood glucose control and blood lipids. These findings are important because they give diabetics a way to decrease their weight as well as treat their diabetes.
- Reduced Triglycerides and Increased HDL: Studies have shown a substantial decrease of triglycerides in patients on low carbohydrate diet with a simultaneous increase in high-density lipoprotein (HDL) over 6 month to 1 year period.
Potential Risks and Considerations
Some very low-carb diets also restrict carbs so much that they cause you not to have enough nutrients or fiber. This can cause such health problems as constipation, diarrhea and nausea. It's also possible that restricting carbohydrates to less than 20 grams a day - the level recommended for phase 1 of the diet - can result in ketosis. Ketosis occurs when you don't have enough carbohydrates that are broken down into sugar (glucose) for energy, so your body breaks down stored fat. This causes ketones to build up in your body.
The Atkins Diet recommends that you talk to your health care provider before starting the diet if you take diuretics, insulin or oral diabetes medications. Also, people with severe kidney disease shouldn't follow the diet.
It's impossible to tell how much low-carb participants' weight loss counted toward better blood sugar control. Losing fat helps reduce insulin resistance. Forcing your body to rely on energy sources other than carbohydrates cuts your appetite. Also, when you eat higher levels of carbs, your pancreas has to produce higher amounts of insulin.
Recent Research and Alternative Perspectives
New research finds that animal-based, low-carbohydrate eating was associated with a higher Type 2 diabetes risk, whereas plant-based, low-carb eating was associated with a lower diabetes risk. The preliminary data shows that people in the lowest-carb group who got more of their protein and fat from plant-based sources had a 6% lower Type 2 diabetes risk - and if their eating further minimized sugar and other refined carbohydrates, they had a 15% lower risk.
Whether a person's diet was considered low-carb was not defined by the exact quantity of carbohydrates they ate each day. The lowest-carb group in the study got about 40% of daily energy from carbohydrates.
Read also: Atkins Diet for Vegetarians
It's worth noting that not everyone with prediabetes will be willing or able to cut their carbohydrate intake to the extreme levels undertaken by study participants. But cutting even some carbs might lead to blood sugar and weight control benefits.
A Comparative Study of Different Diets for Type 2 Diabetes
A study included 81 type 2 diabetic patients, all treated with Metformin 500 mg twice daily, with Body mass index (BMI) more than 25 kg/m2. They were randomized to one of three dietary interventions:
- High protein diet (Zone diet)
- High fat diet (Modified Atkins)
- Conventional high carbohydrates diet with consideration of being on a caloric deficit diet of 500 kcal per day.
Significant weight loss and reduction of BMI, reduction of waist circumference, significant fat mass reduction, significant muscle mass reduction, improvement of the insulin resistance, LDL and triglyceride reduction was achieved by the three dietary plans, with no significant difference between them. There was also significant improvement in HbA1c in all dietary plans; however Modified Atkins diet showed more significant improvement.
All three dietary plans show benefit and improve the anthropometric and metabolic outcomes of type 2 diabetic patients.