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Thursday, March 16, 2006

Health 'Experts' Gang Up On Atkins Diet

I've noticed a trend since I started blogging about livin' la vida low-carb in April 2005. While there are negative articles against the Atkins diet and other low-carb programs here and there throughout the year, it seems the media and the so-called health "experts" like to orchestrate a huge negative splash against low-carb every six months in an attempt to discredit this wonderfully healthy and effective way of eating. Too bad for them I'm gonna call their bluff on it!

In August 2005 you will recall following the Atkins bankruptcy announcement that the press had a field day firing away at low-carb. They declared "the end of low-carb" and urged readers to just move on. There was just one problem: PEOPLE WERE STILL LOSING WEIGHT AND GETTING HEALTHY ON LOW-CARB!

So here we are in March 2006 and those wascally wittle weasels in the media are at it once again with all-too-eager "experts" to provide them with a quote or two expressing their great concern over the safety of the Atkins diet. Read all about it in this Forbes article.

If this stuff wasn't so ridiculous, it might be worth a pretty good discussion. But you will bust out laughing after reading about what the ruckus is about this time.

It seems there's this clinical assistant professor of medicien at New York University Medical School named Dr. Klaus-Dieter Lessnau who points to ONE case study of a 40-year-old obese woman who allegedly experienced health complications in 2004 during her experience on the Atkins diet.

Let's put this in perspective for you. Of the millions and millions of people who have gone on a low-carb diet, they have found ONE person (or two if you count that eager opportunist Jody Gorran!) who had trouble with it. Did you get that? ONE! UNO! BLIP! It comes out to about 0.0000000000000000000001 percent of the entire pool of people who have ever been on a low-carb diet!

Why are there HUGE headlines claiming "Atkins Diet Safety Questioned," "Atkins Diet Not Safe," "Low-Carb Unhealthy," etc. today over ONE person claiming it caused her trouble? Am I the only one who finds this just a wee bit suspicious?

Now, I'm not so naive to think there aren't other cases of people who MAY have experienced health problems while being on the Atkins diet (although it is unclear even in this case study whether the low-carb diet is what caused the problems or not). But to make a blanket statement about EVERYONE who is on the low-carb lifestyle based on this one case study is preposterous.

Using that logic, I suppose we can say that ALL journalists are guilty of plagiarism and just make up their news. What do I base this on? Well if you use Jayson Blair as your case study, there's no other conclusion to draw. Since Blair was deceitful and manipulative with the facts, then I suppose every single reporter in the entire world must be, right?

What's the difference between what I just did to journalists and what these journalists criticizing the Atkins diet are doing with low-carb? The answer is NOTHING! And therein lies the problem that people like me and other low-carb supporters have with the irresponsible journalism in reporting about livin' la vida low-carb.

This "new research" from Lessnau appears in the March 18, 2006 issue of the medical journal The Lancet.

According to Dr. Lessnau, this patient he studied had ketones build up in her blood as is commonplace when you restrict your carbohydrates intake. The process of ketosis, which causes the body to emit ketone bodies, is what makes the body burn fat and help people lose weight. Apparently for this patient, she experienced something called ketoacidosis and was hospitalized for it because it caused her to have breathing problems. This condition is treatable.

Concluding that this problem is much more commonplace that people think, Dr. Lessnau said it must be "not well-diagnosed or may be underreported."

"The Atkins diet is not a safe diet in everybody," Dr. Lessnau said. "It can cause potentially life-threatening problems."

With all due respect, Dr. Lessnau, the Atkins diet is COMPLETELY safe for the majority of people who try it. There is no denying that very clear fact. I will grant you leverage that there are some people who MAY not do well on the Atkins diet for a variety of reasons, but that doesn't mean we should throw the baby out with the bath water and discourage EVERYONE to avoid low-carb! Most people respond VERY WELL to low-carb by losing a whole lotta weight and restore their health.

Had it not been for the low-carb lifestyle, I would probably be a dead man today lying in an extra extra extra extra extra large casket six feet beneath the ground! Just two years ago I was walking around as a 410-pound ticking timebomb just waiting to explode. I had tried and failed on diet after diet, but Atkins saved me. Today, over 180 pounds lost and healthier than I've ever been in my entire life. I wouldn't think of any other way to eat than low-carb.

People are listening to people like Dr. Lessnau and thinking they need to move on to another weight loss plan instead of low-carb. All I can say is don't let his scaremongering cause you to wander around in the diet wilderness indefinitely for years on end trying to find a way to get your weight problem under control when the answer is sitting there right under your nose just waiting for you to try it. Low-carb works and I'm living proof. Are you gonna miss out on YOUR miracle all on account of ONE case study of someone who got sick while on low-carb?

Dr. Lessnau had some of his "expert" health colleagues join him in this anti-Atkins bash party, too.

Temple University's obesity "expert" Gary D. Foster said any weight loss program should be slow and methodical under a doctor's care.

"Losing weight quickly brings its own set of problems," he said. "We have known for a long time that losing weight quickly is a bad idea medically."

Is 180 pounds in one year consider "quickly," Mr. Foster? Perhaps, but it was necessary for my dire situation.

But University of Minnesota assistant professor Dr. Lyn Steffen had a few more choice words for livin' la vida low-carb.


Low-carb is "not a diet for life," Dr. Steffen asserts

Dr. Steffen is of the opinion that any diet that people choose to help them lose weight should be "sensible" and "healthy" as part of an active lifestyle. I agree, Dr. Steffen which is why I chose the low-carb life.

"My recommendation is to develop healthy eating habits for life," Steffen said. "The low-carbohydrate diet is not a diet for life."

What do you based your opinion about low-carb not being an excellent way to permanently maintain your weight, Dr. Steffen? I have personally been eating this way for over two years and my health has never been better. I know people who have been low-carbing for over a decade and yet their health is as strong as ever.

In fact, one senior citizen friend I know who lost well over 100 pounds on low-carb a few years back was recently told by his doctor that he's got the heart of a young person. Does he just have good genetics or could the Atkins diet have something to do with that, Dr. Steffen?

You can ask Dr. Steffen what she means by her comments against low-carb living by e-mailing her at steffen@epi.umn.edu.

Dr. Steffen is not the only one hurling stones at the Atkins diet, though. Check out the comments from Yale Medical School professor Dr. David L. Katz, who just happened to pen one of the biggest fad diet books you'll ever read called The Flavor Point Diet.


Dr. Katz says Atkins diet must "prove" it is health

"The Atkins diet is at odds with a strong foundation of knowledge about the fundamentals of healthful eating and sustainable weight loss," Dr. Katz asserts. "But the burden of proof has always been the other way around: diets at odds with conventional dietary wisdom must prove themselves healthful. In my opinion, the Atkins diet never did, and never will, meet this test."

Um, I can prove it, Dr. Katz. Do you want to see the pictures of that morbidly obese man I used to be and compare them with who I am today? Can I show you my medical history dealing with cholesterol, blood pressure, and breathing problems because of my weight and now I don't have to worry about ANY of those conditions as a result of being on a low-carb diet? The list goes on and on, my friend, and I'm happy to oblige you with the information upon request.

Let's e-mail Dr. Katz, too, asking him these questions and more at david.katz@yale.edu.

What we have here is a red herring. These self-proclaimed health "experts" along with their willing accomplices in the media want you to think the low-carb diets such as Atkins are unhealthy so the focus can be taken away from the legitimate failure of the low-fat diet as evidenced by the recent 8-year study released last month in the Journal of the American Medical Association.

These people can't stand the fact that people are finding success on any other way of eating other than the same old low-fat/low-calorie/portion control diets they've been pushing on us for decades. But people are discovering the monopoly of information the government and those in authority over health in the United States is wrong and they are getting educated for themselves about the alternatives that are available to them.

If you are one of those seekers, let me welcome you to the best thing you could ever do to improve your health. Putting up with negative headlines and information about livin' la vida low-carb is something us low-carbers have grown accustomed to. We don't let those things get us down because we have seen the success for ourselves.

Let the naysayers do and say what they want, but they will NEVER convince me that the low-carb lifestyle is anything but the healthy, delicious and nutritious approach to losing weight, keeping it off forever, and making me a vibrant and athletic man. That's what makes me "Livin' La Vida Low-Carb Man" and I'm proud to say I support the Atkins/low-carb diet 100%!

How about telling Dr. Klaus-Dieter Lessnau what you think about his case study where he concludes the Atkins diet is not recommended by e-mailing him at KLessnau@pol.net?

He can't possibly expect us to believe all this hoopla he stirred up in the media was over just ONE patient? Can you imagine what would have happened in the media if he had, say, 100 patients who had problems? THEN, he might have had a leg to stand on. Instead, he's just another "expert" trying to gang up on the Atkins diet!

3-18-06 UPDATE: My friend Andrew DiMino from CarbSmart.com was quoted about this study in the OC Register today:

"The core group of people who live the low-carb lifestyle are not going to be swayed by the latest word, whether it's good today or bad tomorrow," DiMino said.

True! But unfortunately studies like this aren't about those of us who are already low-carbing as much as they are about trying to discourage others who need to lose weight away from the healthy benefits of livin' la vida low-carb.

Take part in my CHALLENGE to Dr. Klaus D. Lessnau this week! Urge him to send his evidence that this is a widespread problem with the Atkins diet. If he can't, then demand he apologize for LYING about the Atkins diet!

12 Comments:

Blogger Newbirth said...

You posted twice, but this is more complete. Blogger is having problems tonight. I can't update anything on my blog. :(

Anyway, I see you saw the same story as me (same topic, different source). I was going to point you to it if you didn't.

3/16/2006 11:37 PM  
Blogger Newbirth said...

Oh yeah, ketosis is what happens on Atkins. Ketoacidosis is what happens to diabetics who's blood sugar is out of control. I wonder if this woman was TRULY following Atkins. I'm suspicious that she said she was, but really wasn't. People like that give Atkins a bad name.

3/16/2006 11:40 PM  
Blogger Jimmy Moore said...

THANKS, Victoria! I've got it fixed now. You KNOW I couldn't pass this one up!

3/16/2006 11:40 PM  
Blogger Newbirth said...

It's not your fault. Blogger is spazzed out tonight. I finally gave up. I'll try posting tomorrow and hope it's working better.

At least the article you referenced gave a counterpoint. The one I read was a total smear piece.

3/17/2006 12:48 AM  
Blogger Blaise said...

On the woman who suffered ketoacidosis after
being on an Atkins-like diet(I will take
her/their word for it) :

Did that doctor test her kidney function?

Atkins, in almost all his books, warned people not
to use Atkins (at least on the more intense "induction"
and OWL = "on-going weight loss" phases) if they have
poor kidney function. He points out the fact that
when you are burning fat instead of glucose you create
ketones in the blood, and you have to have good kidney
function to clear these by-products of fat breakdown
from the blood.

Another point:

Most doctors (with the typical one-day-of-nutirition-training
in over 6 years of medical education) seem rail on about
"mere anecdotal evidence" when you tell them a medical-anecdote
based on one case --- such as the 400 pound man who loses 180 pounds.

Sounds to me like this woman --- who was hospitalized with
ketoacidosis after (allegedly) being on an Atkins-like diet ---
is a "mere anecdote". The good doctor should not be making
sweeping statements based on that one "anecdote".

He needs to perform a double-blind study with a randomly
selected population of about 2,000 women --- and closely monitor
their diets, like they would in studying mice in cages (to make
sure they are really following almost identical diets).

Without a CONTROLLED study --- which I am sure he would demand
as proof of effectiveness of the Atkins method ---
I think the good doctor Lessnau has not a leg to stand on.

---

By the way, speaking of controlled studies of Atkins, the new
book "Atkins Essentials" includes about 20 recent references
(articles in peer-reviewed, mainstream medical journals) on
the effectiveness of low-carb diets --- like Atkins, The Zone,
and others.

These many controlled studies (besides "anecdotes" like
Jimmy Moore's and mine and Regina Wilshire's and many others
that can be found via Google blog search on "low carb triglycerides")
give essentially incontrovertible proof of the effectiveness
(and 99-plus% safety) of the method.

(The publishing of that book, by the way, gives some
justification of the Jimmy Moore blogs in mid-2005 pointing out
that the Atkins organization would go on beyond their bankruptcy,
which apparently was precipitated by their unwise pushing of
more PROCESSED "foods" onto the food market.)

In conclusion, I would like to point out that there seems to be
a lot of "fad diet" misinformation being generated on low-carb
diets, from people with various agendas.

All this misinformation is reminiscent of some of the agencies
of the U.S. federal government who seem to think it is a good
thing to spread disinformation in countries in an attempt to
achieve some sort of political goal.

Much of the misinformation is probably being spread by
1) reporters who get a kick out of de-bunking anything and everything,
and
2) by dieticians who were trained in nursing school to promote
"low-fat" diets --- and never heard of a "low carb" diet until
after they got out of nursing school.

On the other hand, there are probably others (probably in the
sugar industry, the candy industry, the soft drink industry, etc.)
who think it is in their best interest to spread "dis-information"
on "low carb" diets --- because they are essentially "low sugar" diets.

They spread this "dis-information" in spite of the fact that
it is leading to the weakness of this country --- via the
ill-health of younger and younger segments of our society ---
via obesity and type 2 diabetes.

It used to be called "adult onset" type 2 diabetes.
But now they drop the term "adult onset" because it is seen
in teens and even pre-teens.

We are probably doomed to continue hearing all this
dis-information --- because sugar-money will keep on talking
--- until about 100 years from now, when people will be
looking back at this time and thinking "what were people
thinking --- eating all those sugarS --- high fructose
corn syrup, sucrose, dextrose, maltodextrin, etc. etc."

"Not to mention all those starches, even after they found
out that starches cause a glucose spike in the blood almost
as fast as pure sugar."

Thank god there is a limit to how much sugar will dissolve
in water --- so that all those super-sweet soft drinks are
limited to being about 14% sugar --- whereas junky breakfast
cereals get above 50% sugar.

By the way, most commercial ketchups are 25% sugar. So
this Reagan-vegetable is more sugary than soft drinks.

Until there is a great enlightening, we will have to
give thanks for modest blessings --- like the limitS
to dissolving sugarS in water.

3/17/2006 5:14 AM  
Blogger Science4u1959 said...

Dr. Lessnau did a tightly-controlled, randomized clinical study on ONE person?

That's by definition impossible. Thus, this wasn't a scientific study at all. His patient probably already had all kinds of health problems and likely a plethora of medications.

That fact alone results in so many cofounding intervention factors that any such conclusion is completely unwarranted and totally unscientific. Hence, this entire "study" is worthless and nothing but propaganda for retarded, braindead and especially lazy reporters that will say anything and do anything for cheap publicity and boosting newspaper sales. A total waste of perfectly good trees, that's all that dr. Lessnau has achieved.

Another black page in the already rather mottled book of science.

3/17/2006 10:20 AM  
Blogger melissa said...

There was a 10 second blip about this on my morning news show here in San Diego. My boyfriend and I were like...uhm

3/17/2006 11:37 AM  
Blogger Klaus said...

Hi there:

My name is Klaus D. Lessnau, MD. As you know, we published the case of one patient who developed severe ketoacidosis while meticulously adhering to the Atkins' diet. I believe that it is important to read all the details of the report in the medical journal "Lancet". This was a patient who needed admission to the intensive care unit. Generally speaking, you do not want to start a diet and end up in the intensive care unit. Please ask your doctor if there is any alternative explanation of this severe metabolic acidosis. I would be happy to know if there is any other cause that could explain such a severe disease. We could not explain it by any other disease.

We do not know how common this event is. We do not know how often this happens. However, it does make sense to alert other doctors about this possible complication. Therefore I believe that it makes sense to alert other doctors about this possible complication. It also makes sense to alert people on the Atkins' diet to know that it is useful to see their doctor if the develop shortness of breath.

Please let me know if you have a better idea how to explain this severe metabolic acidosis.

Thank you very much and all the best.

With best regards

Klaus D. Lessnau, MD FCCP

3/17/2006 8:32 PM  
Blogger aj said...

I am type 2 diabetic, and my grown son was a type 1 diabetic since he was 4 years old, so I am familiar with ketoacidosis. This is a condition brought on by extremely high blood glucose, usually from undoagnosed diabetes or not taking one's medicine and/or ignoring the strict diet one with diabetes should follow (low carb). I can see how someone, a diabetic, could accumilate very high glocose readings even if they were following the Atkins diet, but not taking their medicine. This seems the only possible way such a high blood glucose could occur. Ketoacidocis is the result of too much glucose in the bloodstream, while ketosis is produced by reducing glucose in the bloodstream by eating low carb. They are direct opposites. This lady was not following Atkins or was a diabetic not taking medicine. The words are similar, but have opposite meanings. Unfortunately, unfamiliar readers will confuse the two and draw the wrong conclusions. Perhaps this was the goal of the writer! Many doctors are just ignorant of the benefits of low carb living, and seem bent on holding on to their old opinions rather than doing meaningful and unbiased research.

3/18/2006 12:56 PM  
Blogger Newbirth said...

Thanks, AJ. My dad is type 2 diabetic and I am on Atkins to improve my health (which I have), lose the excess weight (I am at the lowest weight of my entire adult life!), and hopefully prevent type 2 from happening to me since I do take after dad's side of the family. Dad is killing himself by following a high carb diet. He feels he can eating anything as long as he takes his insulin shots. With a fasting blood glucose of 175 I don't think it's working. But he thinks 175 is an okay reading. :-p (100 is the baseline for sugar metabolism problems here - anything above is a real problem.)

Anyway, sorry about the rant. Dr. Lessnau - did you check the patient for kidney problems? Is she diabetic? What other medications is she on? With a BMI of over 40 I can't believe she was in good health to start with.

Try doing a good, randomized, CONTROLLED study of 1000 of so people and see how they fare on Atkins.

3/19/2006 10:44 PM  
Blogger Steve Phinney said...

For starters, I applaud Dr. Lessnau for bringing this interesting case up for discussion. That said, however, Dr. Lessnau seems a bit too eager to blame carbohydrate restriction for his patient's metabolic acidosis. With apologies for my rather formal style, here's why I think he shot from the hip.

In the Lancet case report, Chen and Lessnau (see ref 1 below) suggest that a carbohydrate-restricted diet can induce ketoacidosis in a non-diabetic patient, but the data presented do not support this conclusion.

First: the reported anion gap of 26 represents a 12 mM anion excess above the upper limit of normal. The serum beta-hydroxybutyrate (the dominant circulating ketone moiety in humans), reported at 390 ug/mL, translates to a concentration of 3.7 mM. That is, the ketones in this case (both beta-hydroxybutyrate and acetoacetate) account for only about a third of the apparent anion excess. Thus the ketonemia in this case represents only a minor fraction of the anion excess, and thus is not the primary factor in the reported metabolic acidosis.

Second: the normal physiologic state of nutritional ketosis, also called starvation ketosis, is associated with serum ketones in the 1-5 mM range (as in this case), and this is not normally associated with metabolic acidosis (see refs 2,3,4). So given that nutritional ketosis does not cause acidosis despite up to 5 millimolar ketones, how is it credible to blame 4 millimoles of ketones for a 12 millimolar of excess anions in this case?

Third: in their case report, Dr. Lessnau states that they provided the patient with dextrose at the rate of only 38 g/d (5% dextrose at 30 ml/hr). This is not enough carbohydrate to reverse nutritional ketosis, and yet the patient improved. If the ketogenic state was the cause of her problem, why did it improve on a homeopathic dose of glucose?

Fourth: Yes, a barcarbonate of 8 and an anion gap of 26 are worrisome, and any ER doc would admit this patient for evaluation and rehydration. However most of us would save the term "severe acidosis" for anion gaps greater than 30 and blood pH values under 7.1. Calling an arterial blood pH of 7.19 "severe acidosis" is a bit of hyperbole.

Fifth: patients with pancreatitis can have an elevate lipase but normal serum amylase (see ref 5). Given her elevated lipase, white blood cell count of 13x10.ninth, and gastrointestinal symptoms, why was this not just a case of mild pancreatitis? We all know that CT scans of the abdomen in someone with a BMI of 41 are notoriously difficult to interpret for soft-tissue injury.

Sixth: I agree with Science4u1959 in questioning the frequency of events such as this case during low carbohydrate dieting. As an academic physician with 30 years of experience in adult weight management, I have not seen a similar case in over 3000 patients followed closely during a very low calorie ketogenic diet. Given this experience, I think that it is likely that the current case represents association without causality. Not having this experience, it is unfortunate that Dr. Lessnau chose to conclude causality rather than raising it as a hypothesis.

Stephen D. Phinney, MD, PhD
Professor emeritus, UC Davis
Elk Grove, CA, USA


References

1. Chen TY, Smith W, Rosenstock JL, Lessnau KD. A life-threatening complication of Atkins diet. The Lancet 2006;367:958.
2. Cahill GF. Starvation in man. N Engl J Med 1970; 282:668-675.
3. Phinney SD, Horton ES, Sims EAH, Hanson JS, Danforth E, LaGrange BM. Capacity of moderate exercise in obese subjects after adaptation to a hypocaloric, ketogenic diet. J Clin Invest. 1980;66:1152-1161.
4. Phinney SD, Bistrian BR, Wolfe RR, Blackburn GL. The human metabolic response to chronic ketosis without caloric restriction: physical and biochemical adaptation. Metabolism 1983; 32:757–768.
5. Sharma P, Lim S, James D, Orchard RT, Horne M, Seymour CA. Pancreatitis may occur with a normal amylase concentration in hypertriglyceridaemia
BMJ 1996;313:1265.

3/20/2006 12:10 PM  
Blogger Science4u1959 said...

Dr. Phinney, thank you for this brilliant rebuttal. I am very happy to see that there are experienced professionals out there that dare to stand up for the truth. Needless to say, I completely agree with your post.

3/21/2006 1:18 AM  

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