7 Is There a Metabolic Advantage?You Be the Judge.
I can't wait to get you started doin8 Alkins. But before I do, I want to increase your enthusiasm to a fever pitch. Are you ready to lose more weight and more fat—-and keep it off, permanently—than you've succeeded in doing on any weight loss and weight maintenance plan you've ever tried?
If so, let me introduce you to your ally, mentioned briefly in Chapter 2 and expanded upon here: the metabolic advantage.
You'll recall that I said the metabolic advantage would enable you to lose weight on Atkins eating more calories than on its low-fat counterpart Burning fat takes more energy so you expend more calories when you follow a controlled carbohydrate nutritional approach.
But let me tell you that this enormous dietary bonus is, today, years after it was first studied and a decade after the first edition of this book, still an area of some controversy. In this case it seems appropriate to let you be the judge. The published scientific evidence of the metabolic advantage is so impressive and my own decades of clinical observations so confirming of the conclusions those researchers reached that I'm confident of the outcome. After you read this overview of the actual scientific evidence that underlies the metabolic advantage, you'll have the power of knowledge. high-carbohydrate 1,000-calorie regimen took off very little weight.2 They then showed that their subjects did not lose at all on a so-called "balanced" diet of 2,000 calories. But, when their diet contained primarily fat and very little carbohydrate, these same obese subjects could lose, even when they ate as many ns 2,600 calories a day. The difference in weight loss between the two programs comes close to being one-haft pound per day. Despite the Middlesex doctors' impeccable reputations, the majority of their colleagues remaned skeptical, given their "calorie-is-n-calorie" mind set. They set out to disprove this intellectual bomb that Kekwick and Pawan had dropped on them.
Among other things, critics claimed that the impressive results of a low-carbohydrate diet were merely water loss. However, Kekwick and Pawan did water-balance studies that showed water loss to be only a small part of the total weight lost. Kekwick and Pawan then embarked on a two year study of mice in a metabolic chamber. By measuring the loss of carbon in the feces and urine, they were able to show that the mice on the high-fat diet excreted considerable unused calories in the form of ketone bodies, as well as citric, lactic and pyruvic acids. At the end of the study period, they analyzed the fat content of the animals' bodies and found significantly less fat on the mice that had been fed a high-fat, Low-carbohydrate diet.
Perhaps the most provocative aspect of Kekwick and Pawan's work is that during the time they were proving the metabolic advantage of a low-carbohydrate diet, they detocted and extracted n substance from the urine of people on the regimen. When that substance was injected into mice, it caused the same metabolic results they had observed in the mice on low-carbohydrate diets, indicating that fat was "melting" off their bodies. The carcass fat decreased dramatically, the ketone and free fatty-acid levels rose and, most significantly, the excretion of unused calories via urine and feces rose from a normal ten percent to thirty-six percent. They named this substance fat-mobilizing substance
Kekwick and Pawan attributed hormonal to FMS. Unfortunately, their findings on FAdS have never been investigated by scientists. But I am hopeful that research WIll be underwritten that will seek to duplicate and investigate further this phenomenon. I intend to do my port, through the newly formed Dr. Robert C. Atkins Foundation, which will sponsor further research on the metabolic advantage and other nspects of controlled carbohydrate nutrition.
Now let's look at some other research that supports the fatburning theory, this time from the Oakland Naval Hospital. Impressed with the Kekwick and Pawan success, Frederick Benoit and his associates decided to compare a l,O00calorie, lO-grams-of-carbohydrate, high-fat diet with fasting (the same principle that Kekwick and Pawan found most effective), using seven men weighing between 230 and 290 pounds. They used state-of-the-art body composition technology. After ten days, the fasting subjects lost 21 pounds on average, but most of that was lean body weight; only 7.5 pounds was body fat. However, on the controlled carbohydrate regimen over the same period of time, 14 of the 14.5 pounds lost was body fat. Think of it. By eating foods low in carhohydrate and high in dietary fat, subjects burned their fat stores almost twice ns fast ns when they ate nothing at all!
Benoit's other exciting discovery was that on a fatburning regimen, subjects maintained their potassium levels, while subjects who fasted experienced major potassium losses. (Potassium depletion can cause heart arrhythmia, which, in severe cases, can be fatal.)
Still not convinced? Try this one. Charlotte Young, professor of clinical nutrition at Cornell University, compared the results of overweight young men placed on three diets, all providing 1,800 calories, but with varying degrees of carbohydrate restriction.4 The regimens contained 30, 60, and 104 grams of carbohydrate, and subjects followed them for nine weeks. Young and her colleagues calculated body fat through a widely accepted technique involving immersion underwater. Those on 104 grams of carbs lost slightly better than 2 pounds of fat per week, oust of 2.73 pounds of total weight loss—-not bad for 1,800 calories. Those on 60 grams of carbs lost nearly 2.5 pounds of fat per week, out of 3 pounds of actual weight lose better.
But those on 30 grams of carbs, the only situation that produced lipolysis and the secondary process of ketosis, lost 3.73 pounds of fat per week—approximately one hundred percent of their total weight loss. These results are a perfect example of the benefits the metabolic advantage provides. That's what has enabled most of my patients to succeed. And it will make you a success, too.
Before we leave Charlotte Young, I've got good news for those of you who have been trying to lose weight on low-fat plans, most of which typically comprise sixty percent or more carbohydrate. Dr. Young's most liberal regimen contained only thirty-five percent carbohydrate. She discovered that the more carbs consumed, the less body fat was lost. In treating many thousands of weight loss patients, I have observed the same thing. And virtually every other scientist who has actually studied controlled carbohydrate nutrition has confinned that the more carbohydrate consumed, the less the amount of body fat lost. And that may be one of the major reasons yon are straggling with your weight and getting nowhere.
Several other studies have shown that you can consume more calories and lose mere weight than on low-fat programs. For example, Uli'ich Rabast and associates at the University of Wurzburg studied forty-five hospitalized patients for five weeks,s Once again the controlled carbohydrate approach to weight loss demonstrated a significant metabolic advantage: This time an extra 9.24 pounds were lost on the low-carbohydrate version of a 1,000-calorie-a-day diet in contrast to the 1,000-calorie-a-day, Low-fat diet. Moreover, capful water-balance studies demonstrated that the proportion oft hose extra pounds that could be attributed to water loss was insignificant.This trend continued in other trials, even when calories consumed were greater 1,000.
The Beat Goes On
The massive revived of interest in controlled carbohydrate approaches to weight management that flowered in the 1990s has provoked exciting new research. And the results have only fueled the fire. The metabolic advantage is very real.
Five studies are worth noting. The relevance of the first four of these is limited by the fact that the cmrbohydrnte content of the "low" carbohydrate diet being studied was still a good deal higher than you would experience during the first weight loss phase of Atkins. Therefore the metabolic advantage was relatively small, though it still existed. One study done in Glasgow described overweight women who after three months had lost 14.5 pounds on a thirty-five-percent carbohydrate diet of 1,200 calories and 12.3 pounds on a fifty-eight-percent carbohydrate diet of 1,200 calories. That's fairly slow weight loss and pretty strict caloric deprivation. The advantage went to the lower-carbohydrate diet as always, but the lesson is that stricter carbohydrate control makes for an even more successful weight loss plan.
Three other recent examples also didn't go low enough in carbe and thus had limited metabolic advantage, but two facts should be noted: First, in all cases, the lowercarbohydrate group did lose more weight than the highercarbohydrate group. Studies that 'show the opposite are, believe me, more rare than pink elephants in the streets of Boise. Second, in two of the studies cardiovnsofinr risk factot's improved significantly—-but only in the subjects who were on a lower-carbohydrate intake. The folks who got put on a high-carbohydrate diet showed no significant improvements in these health indicators.
That leaves one last study, which was really a blowout. Published in the Journal of Adolescent Health in 2000, it reported on a group of obese adopts put on a contwlled carbothydrate diet with no restriction on ealories for three months and meticulously monitored throughout that period. By design, the regimen was based on the Atkins approach. The group was compared with a control group put on a low-fat diet.
The results? Well, naturally, the adolescents lost significantly more weight on the controlled carbohydrate diet than on the low-fat diet. The written records indicated that at the end of the trial, the adolescents in the controlled carbohydrate group had averaged 1,830 calories daily, while the adolescents in the low-fat group had consumed 1,100 calories. The controlled carbohydrate group averaged 21.7 pounds lost, compared to 9.1 pounds for the low-fat group, and a significant improvement in body mass index (BMI), compared with the low-fat dieters.
As studies like this become increasingly common, opposition to a controlled carbohydrate nutritional approach should fall away even more quickly than has already been the case in recent years.
The Metabolic Advantage in Action
Perhaps you will now understand how Harry Kronberg, the patient I mentioned in Chapter 3, was able to lose fifty pounds in three months on an eating plan containing an abundance of nutrient-dense, high-calorie foods: And he did so, even though in the previous three years on a moderately low-fat balanced diet he had gained 70. This does not contradict reason; instead, it is an outstanding example of metabolic advantage.
When you study both of Harry's menus, you'll see that when doing Atkins, he ate an average of only 200 calories less than he ate on his low-fat diet, but he has gone from gaining an average of O.5 pound a week to shedding almost 4 pounds.
The metabolic advantage is there. It can't be disguised, evaded, put down to water weight or wished away.
Harry Kronberg's Before and After Menus
A Typical Pre-Atkins Day
Breakfast Calories
Cheese Danish 308
Coffee (decaf with half 'n' half) 2
Lunch
French Fries (31/2 oz) 175
Pastrami/Corned Beef (4 oz cooked) 410
Rye Bread (2 slices) 140 Pretzels (3 oz) 220
Snacks
Nestle Crunch Bar (1 oz) 138
Orange 71
Dinner
Kippered Herring (4 oz) 217
Vegetables (1 cup cabbage) 24
Small Green & Tomato Salad 80
Crackers (4 rye thins) 52
Diet Soda 0
Vanilla Ice Cream (1 cup) 290
Total 2.1271
A TypicalAtkins Day Breakfast
Calories Tuna Salad (1 cup) 240
1/2 Grapefruit 41
Decaf Coffee (with half 'n' half) 2
Lunch
Grilled Chicken (light meat, 6 oz) 280
Small Green & Tomato Salad 80
Salad Dressing (1 oz) 170
Dinner
Rib Steak (6 oz) 490
Summer Squash (1/2 cup) 19
Small Green & Tomato Salad 80
Salad Dressing (1 oz) 170
Seltzer 0
Snacks
Almonds (1 oz) 176
Sugar-free Coleslaw 174
Cucumber (1/2 medium) 8
Total 1930
Now it's your mm. Do you want an edge, a bonus and the odds on your side? You could bet the ranch on it. May the Edge be with you.
KEY POINTS!
·Only by doing Atkins can you lose weight eating the same number of calories on which you used to gain weight.
·Burning body fat has a metabolic advantage over socalled "balanced" or "low-fat" diets.
·The breakthrough concept of fat-mob'dization was first discovered over forty years ago.
·Numerous studies have reinforced the metabolic advantage of burning fat for energy.
A FREQUENTLY ASKED QUESTION:
Why have you never published your findings on the variom benefits of the Atkins Nutritiousl Approach in a scientific journal?
I am a full-time practitioner and not a researcher, As a physician I am responsible for the health of my patients and would never use some of them as a control group in the interest of research.
But I have taken a series of important steps to share the benefits of the Atkins Nutritional Approach with the medical community throughout the world. Working with a number of leading academic and research institutions, I have developed a series of Continuing Medical Education courses for health professionals. These courses explore the available research and clinical relevance of controlled carbohydrate nutrition. Additionally, the Dr. Robert C. Atkins Foundation sponsors further research in all aspects of controlled carbohydrate nutrition. The Foundation is funded through Atkins Nutritionals Inc., our food products and nutritional supplements company. AN, as l call it, has the added benefit of helping to supply the demand we now see of people seeking controlled carbohydrate foods. All of our products are developed to support the Atkins Nutritional Principles. Interestingly, our products have encouraged other food companies to develop additional new products.
TIPS:
·Count carbs, not calories.
·Spread your carbohydrate intake thronghout the day to avoid blood-sugar spikes.