The Atkins diet was manufactured by Dr. Robert Atkins in the 1960s and became widely known in the 1970s with the release of some books describing Atkins’s theories. Lately, the Atkins franchise and the Atkins symbol have already been utilized on a number of products. The theory is based on the concepts that the main reason behind obesity is the use of refined carbohydrates, such as sugar, flour, and corn syrups, and that the consumption of dietary fat does not necessarily contribute to obesity. In this diet, the restriction of carbohydrates induces a state of ketosis where the human body begins to breakdown fat stores instead of using glucose supply for energy. Atkins described four phases of his diet: induction, ongoing weight loss, premaintenance, and lifetime maintenance. In the induction phase, carbohydrate intake is strictly restricted to 20 net grams daily (“net” carbohydrates are called those that subscribe to sugar levels, which excludes fiber and sugar alcohols). In the ongoing weight loss phase, a rise in carbohydrate intake is allowed, but nonetheless below a level that enables continued weight loss. Carbohydrate intake is further increased in the premaintenance phase, which can be above an even that induces ketosis.

The lifetime maintenance phase stresses long-term adherence to these principles of carbohydrate restriction and a go back to earlier, more restrictive phases if weight gain occurs. Among the largest randomized trials, conducted by Gardner et al90 at Stanford University, has found the diet to cause a greater weight loss over an amount of 12 months as in contrast to other popular diets. Low-carbohydrate ketogenic diets, including the Atkins diet, have already been shown to have a greater improvement on subjective symptoms, including mood changes and the impression of hunger, as weighed against low-fat diets.91 A study conducted by the Centers for Disease Control and Prevention implies that the dietary plan is relatively well tolerated, with approximately 40% of male users and 30% of female users reporting long-term utilization of the diet (longer than12 months).92 A study by Dansinger et al93 at Tufts–New England Medical Center showed a mean weight loss of 2.1 kg in patients adhering to the Atkins diet over a 1-year period, with 53% of patients remaining compliant throughout that time. Animal studies have demonstrated significant changes in metabolism caused by a ketogenic diet, correlating changes in gene expression to weight reduction, improved glucose tolerance, and increased energy expenditure.94 Concerns have been raised over possible detrimental consequences of the diet on overall nutritional balance and health with prolonged use. Some studies have suggested a growth in mortality in patients adhering to this diet.95–97 Particular concern has been expressed over increases in cardiovascular risk and mortality that could be attributable to the fat intake and carbohydrate restriction.95,96 Studies by Rankin and Turpyn98 have described a positive correlation between increasing C-reactive protein levels and a low-carbohydrate, high-fat diet, that will be indicative of a systemic inflammatory state. Effects on neurotransmitter metabolism have now been postulated, as a ketogenic diet has been proven to be beneficial in seizure prophylaxis in epileptic children.99 Despite such metabolic changes, there remains a paucity of data to support maintenance of weight reduction for more than 12 months from a low-carbohydrate, ketogenic diet.

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