The Atkins diet was manufactured by Dr. Robert Atkins in the 1960s and became widely known in the 1970s with the release of a series of books describing Atkins’s theories. Recently, the Atkins franchise and the Atkins symbol have now been applied to many different products. The idea is based on the concepts that the key reason behind obesity may be the usage of refined carbohydrates, such as for example sugar, flour, and corn syrups, and that the usage of dietary fat does certainly not contribute to obesity. In this diet, the restriction of carbohydrates induces circumstances of ketosis by which the body begins to break up fat stores in place of using glucose supply for energy. Atkins described four phases of his diet: induction, ongoing weight reduction, premaintenance, and lifetime maintenance. In the induction phase, carbohydrate intake is strictly restricted to 20 net grams per day (“net” carbohydrates are called the ones that contribute to sugar levels, which excludes fiber and sugar alcohols). In the ongoing fat loss phase, an increase in carbohydrate intake is allowed, but nonetheless below a level which allows continued weight loss. Carbohydrate intake is further increased in the premaintenance phase, which may be above an even that induces ketosis.

The lifetime maintenance phase stresses long-term adherence to these principles of carbohydrate restriction and a come back to earlier, more restrictive phases if weight gain occurs. One of the largest randomized trials, conducted by Gardner et al90 at Stanford University, has found the dietary plan to result in a greater weight reduction over a period of 12 months as compared with other popular diets. Low-carbohydrate ketogenic diets, such as the Atkins diet, have been shown to truly have a greater improvement on subjective symptoms, including mood changes and the sensation of hunger, as weighed against low-fat diets.91 A study conducted by the Centers for Disease Control and Prevention shows that the dietary plan is relatively well tolerated, with approximately 40% of male users and 30% of female users reporting long-term use of the dietary plan (longer than12 months).92 A study by Dansinger et al93 at Tufts–New England Medical Center showed a mean fat loss of 2.1 kg in patients sticking with 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 the effect of a ketogenic diet, correlating changes in gene expression to fat loss, 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 an increase in mortality in patients adhering to the diet.95–97 Particular concern has been expressed over increases in cardiovascular risk and mortality that could be due to the fat intake and carbohydrate restriction.95,96 Studies by Rankin and Turpyn98 have described a confident correlation between increasing C-reactive protein levels and a low-carbohydrate, high-fat diet, that is indicative of a systemic inflammatory state. Effects on neurotransmitter metabolism have been postulated, as a ketogenic diet has been shown 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 loss for longer than 12 months from a low-carbohydrate, ketogenic diet.

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