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Atkin's/Keto Diets

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• Diets / Atkin's diet / Zone diet / Mediterranean diet / Ornish diet
• nutrition / carbohydrates / fats / protein
• Axokine / leptin / obesity / weight control / ghrelin / peripheral hormone peptide YY (PYY 3-36) / PGC-1beta / oleylethanolamide (OEA) / Xenical (orlistat) / Meridia® (sibutramine) / Topamax® (topiramate) / Wellbutrin®/Zyban® (bupropion) / Glucophage (metformin) / Acomplia (rimonabant)

News & Research:

• Popular keto and paleo diets aren’t helping your heart, report says - Washington Post, 4/27/23 - "Ketogenic and paleo diets may be trendy, but they won’t do your heart any favors ... The authors said one of the purposes of their report was to counter widespread misinformation about nutrition promoted by diet books, blogs and people on TikTok, Instagram and Twitter — where posts promoting keto and paleo eating plans have surged in recent years ... The amount of misinformation that has flourished on social media sites has reached “critical levels"
• Report: Keto diet could increase risk of heart disease, cardiac events - 10News.com, 3/7/23 - "Our study found that regular consumption of a self-reported diet low in carbohydrates and high in fat was associated with increased levels of LDL cholesterol— or “bad” cholesterol—and a higher risk of heart disease"
• High-Protein Diets, Like the Popular Dr. Dukan Diet, Increase the Risk of Developing Kidney Disease in Rats, Study Suggests - Science Daily, 1/21/14 - "researchers studied 20 Wistar rats, divided into two groups of 10. The first group were fed a high-protein diet of commercial hydrolysed protein supplements with a 45% protein level. The control group were fed a normal protein diet. The experiment lasted 12 weeks, which is the equivalent of 9 years in human terms ... the rats on a high-protein diet lost up to 10% of their body weight over the 12 weeks with no improvement in their plasma lipid profile. Moreover, urinary citrate in these rats was 88% lower and urinary pH was 15% more acidic. In the animals fed a high-protein diet, kidney weight increased by 22%, glomerular area -- the network of capillaries that filter blood in the kidneys -- by 13%, and the mesangium -- a collagen structure surrounded by these capillaries -- by 32% ... Eating large amounts of fruit and vegetables reduces the risk of kidney stones forming -- probably due to their high potassium and magnesium content, which compensates for the acidity of the high-protein diet"
• High intakes of protein and processed meat associate with increased incidence of type 2 diabetes - Br J Nutr. 2012 Aug 1:1-11 - "Dietary data were collected with a modified diet history method, including registration of cooked meals. During 12 years of follow-up, 1709 incident type 2 diabetes cases were identified. High protein intake was associated with increased risk of type 2 diabetes (hazard ratio (HR) 1.27 for highest compared with lowest quintile; 95 % CI 1.08, 1.49; P for trend = 0.01). When protein consumption increased by 5 % of energy at the expense of carbohydrates (HR 1.20; 95 % CI 1.09, 1.33) or fat (HR 1.21; 95 % CI 1.09, 1.33), increased diabetes risk was observed. Intakes in the highest quintiles of processed meat (HR 1.16; 95 % CI 1.00, 1.36; P for trend = 0.01) and eggs (HR 1.21; 95 % CI 1.04, 1.41; P for trend = 0.02) were associated with increased risk. Intake of fibre-rich bread and cereals was inversely associated with type 2 diabetes (HR 0.84; 95 % CI 0.73, 0.98; P for trend = 0.004). In conclusion, results from the present large population-based prospective study indicate that high protein intake is associated with increased risk of type 2 diabetes. Replacing protein with carbohydrates may be favourable, especially if fibre-rich breads and cereals are chosen as carbohydrate sources"
• Significant cardiovascular risk with Atkins-style diets, experts warn - Science Daily, 6/27/12 - "Although the actual numbers are small (an extra 4-5 cases of cardiovascular disease per 10,000 women per year) the authors say that this is a 28% increase in the number of cases and that these results are worrying in a population of young women who may be exposed to these dietary patterns and face the excess risk for many years ... authors carried out a study on just under 44,000 Swedish women aged between 30 and 49 years from 1991-92 (with an average follow-up of 15 years) ... After adjusting for other cardiovascular risk factors, there was still a significant 5% increase in the likelihood of a cardiovascular event or death with every two point increase in the LCHP score. The 5% increase resulted from a daily decrease of 20g of carbohydrates (equivalent to a small bread roll) and a daily increase of 5g of protein (equivalent to one boiled egg)"
• High-Protein Diet Raises Type 2 Diabetes Risk - Medscape, 9/13/11 - "The study consisted of 27,140 individuals 45 to 74 years of age who participated in the Malmö Diet and Cancer study ... the researchers found a 37% increased risk for type 2 diabetes associated with high protein intake (hazard ratio [HR], 1.37; 95% confidence interval [CI], 1.17 to 1.61; P for trend < .001]. High intake of processed meat was also associated with an elevated risk for diabetes (HR, 1.17; 95% CI, 1.00 to 1.36; P for trend = .005) ... The intake of breads and cereals rich in fiber was associated with a lower risk of developing diabetes (HR, 0.95; 95% CI, 0.92 to 0.98; P for trend = .005)"
• Animal-Based Low-Carbohydrate Diet Linked to Higher All-Cause Mortality - Medscape, 9/7/10 - "In a pooled analysis comparing the lowest vs the highest deciles, overall low-carbohydrate score was associated with a slight increase in overall mortality rates (hazard ratio [HR], 1.12; 95% confidence interval [CI], 1.01 - 1.24; P for trend = .136). Higher animal-based low-carbohydrate score was associated with higher all-cause mortality rates (pooled HR, 1.23; 95% CI, 1.11 - 1.37; P for trend = .051), cardiovascular deaths (HR, 1.14; 95% CI, 1.01 - 1.29; P for trend = .029), and cancer-related deaths (corresponding HR, 1.28; 95% CI, 1.02 - 1.60; P for trend = .089) ... In contrast, higher vegetable-based low-carbohydrate score was linked to reduced all-cause mortality rates (HR, 0.80; 95% CI, 0.75 - 0.85; P for trend ≤ .001) and cardiovascular deaths (HR, 0.77; 95% CI, 0.68 - 0.87; P for trend < .001)"
• High-protein diets may cause bone loss in older women, study - Nutra USA, 7/8/10 - "Study 1 ... on average, all women lost around 19 pounds, but those who ate the higher-protein, meat-containing diet also lost bone mineral density by about 1.4 percent ... Study 2 ... All women lost weight, but the groups that consumed the higher-protein meat-containing diets again also lost bone mineral density by up to 1.4 percent compared to the control group ... In the first study, all the participants con&shy;sumed calcium supplements to achieve calcium intakes of 2,000mg per day. In the second study, about half of the participants con&shy;sumed calcium supplements ... However, in neither case were the supplements found to impact the loss of bone density"
• Eat less, live longer? - New Scientist, 6/3/10 - "One piece of evidence for this idea comes from studies in fruit flies and rodents. If these animals are fed special diets with less amino acids - the building blocks of proteins - they can eat as many calories as they want and still live longer ... The protein theory is bad news for people on low-carbohydrate weight-loss plans like the Atkins diet. "I'd be wary of diets that put a heavy emphasis on protein," says Piper. "It's hard to see how that could be healthy." Fontana goes one step further, saying that high-protein diets could risk accelerated ageing and cancer ... There may be another reason for vegans to celebrate. Studies on flies and rodents suggest that cutting intake of one particular amino acid, called methionine, lengthens life to a similar degree as calorie restriction. Proteins in meat and other animal products have high levels of methionine, so a vegan diet would score well by that measure, too"
• Low-Carb Diet Lowers Blood Pressure - WebMD, 1/25/10
• 'Anti-Atkins' Low Protein Diet Extends Lifespan In Flies - Science Daily, 10/1/09 - Science Daily, 10/1/09 - "Flies fed an "anti-Atkins" low protein diet live longer because their mitochondria function better"
• Low-carb Diets Linked To Atherosclerosis And Impaired Blood Vessel Growth - Science Daily, 8/25/09 - "Even as low-carbohydrate/high-protein diets have proven successful at helping individuals rapidly lose weight, little is known about the diets' long-term effects on vascular health ... mice placed on a 12-week low carbohydrate/high-protein diet showed a significant increase in atherosclerosis, a buildup of plaque in the heart's arteries and a leading cause of heart attack and stroke ... our research suggests that, at least in animals, these diets could be having adverse cardiovascular effects that are not reflected in simple serum markers"
• Recipe for Diabetes: Too Much Protein, Fat - WebMD, 4/7/09 - "A high-fat diet may lead to insulin resistance, a major step on the path to type 2 diabetes. But cutting back on fat may not help those who continue to eat too much protein"
• Atkins-Like Diet Worse for Cholesterol Compared to South Beach, Ornish Diets, Study Says - WebMD, 4/1/09 - "While on the low-carb, high-fat diet, LDL cholesterol levels increased slightly, compared to decreases of about 12% and 17% respectively, during the South Beach and Ornish phases of the study ... After a month on the Atkins-like diet, study participants showed less blood vessel flexibility than they did after a month on the Ornish diet ... CRP levels remained in the normal range with all three diets, but levels went down slightly while participants were on the South Beach and Ornish diets and they went up slightly on the high-fat, low-carb diet"
• Low-carb Diets Can Affect Dieters' Cognition Skills - Science Daily, 12/11/08 - "A new study from the psychology department at Tufts University shows that when dieters eliminate carbohydrates from their meals, they performed more poorly on memory-based tasks than when they reduce calories, but maintain carbohydrates. When carbohydrates were reintroduced, cognition skills returned to normal"
• Ornish: Why Atkins Still Doesn't Beat Low-Fat Diet -  Newsweek, 7/16/08 - "A new study comparing the Atkins diet, a Mediterranean diet and a low-fat diet published on July 17 in The New England Journal of Medicine (NEJM), is likely to inspire headlines saying that the Atkins diet is better for your waistline and your health than a low-fat diet ... I believe this study is extremely flawed. Here's why: ... funded in part by the Atkins Foundation ... quality of data in this study ..."
• Most Effective Weight Loss Diet Revealed, According To New Study - Science Daily, 1/11/08 - "a high protein, low carbohydrate diet is most effective at reducing hunger and promoting weight loss, at least in the short term"
• Researchers Nix Low-carb Diet - Science Daily, 12/17/07 - "The term used to describe diets that produce this biological effect is ketogenic; hence, Atkins is a ketogenic, low-carbohydrate (KLC) diet, and the Zone diet is considered a nonketogenic, low-carbohydrate (NLC) diet ... the ketogenic diet may increase bone loss because of an increase in acid in the body and not enough intake of alkalizing minerals, such as potassium, to neutralize this effect. In addition, a higher percentage of calcium was found in the urine of those on the KLC diet, leading the researchers to believe that the bones are “leaching” calcium ... the reduction in fat loss and weight loss was about the same for both diets over a six-week trial. In addition, body mass index was significantly lower after six weeks in both diet groups. However, those following the KLC diet experienced a greater increase in LDL cholesterol than those following the NLC diet"
• Very Low Carbohydrate Diets May Disrupt Long-term Gut Health - Science Daily, 6/19/07
• Atkins Diet Tops Others in Study - washingtonpost.com, 3/6/07 - "The study by Stanford University researchers compared the Atkins approach to three others: the standard low-fat, reduced calorie regimen long recommended by physicians and weight loss experts; the Zone, a reduced carbohydrate approach developed by author Barry Sears; and the very low-fat, high-carbohydrate regimen created by physician Dean Ornish ... For all practical purposes the programs all worked about the same ... The extra four pounds lost by the Atkins group are not very meaningful"
• Atkins beats other diet plans in study - USA Today, 3/6/07
• Study reignites low-carb high-protein debate - Nutra USA, 9/28/06
• Low Carbohydrate Diet Did Not Increase Bone Loss, Study Finds - Science Daily, 5/24/06
• Study highlights possible health risk with Atkins diet - USA Today, 3/16/06
• Low carb lives on – at least for scientists - Nutra USA, 1/19/06
• Low carb diets 'cut heart energy' - BBC News, 11/14/05 - "the energy stored in the heart was reduced by an average of 16% among those who followed a high fat, low carbohydrate diet ... One of the participants even noticed he could not manage his daily run while on the diet"
• How Atkins works - possible mechanism discovered - Nutra USA, 11/9/05
• A Critical Appraisal of the Atkins Diet - Dr. Murray's Natural Facts
• New Study Shows How Very Low-carb Diets Take Off The Pounds - Science Daily, 4/7/05 - "We proved that people lose weight on the Atkins diet because they eat less (consume fewer calories), not because they get bored with the diet or lose body water or because the carbohydrate calories are treated differently by the body than fat or protein calories"
• Why Do Low-Carb Diets Cause Weight Loss? - WebMD, 3/14/05 - "participants in a new study lost weight when they restricted carbohydrates simply because -- drum roll, please -- they ate fewer calories"
• Counting calories on your mobile phone - MSNBC, 12/10/04
• Low-Carb Diets: Better for Men Than Women? - WebMD, 11/16/04
• Very Low-carbohydrate Diets Work For Men And Upper Body Fat - Science Daily, 11/15/04
• Low-Carb Diets Work, but Safety Still an Issue - WebMD, 9/2/04 - "What we are more concerned about is that people on low-carbohydrate diets begin to complain about side effects: headache, muscle weakness, and cramps and diarrhea. This is consistent with carbohydrate deficiency"
• Was Atkins Right? New Study Provides Support For Those Who Advocate A High Protein Diet For Weight Loss And Better Health - Science Daily, 7/20/04
• Is the Low-Carb Craze Waning? - WebMD, 7/15/04 - "People have the perception that low-carb diets are not healthy ... Of all the most popular diet approaches, the one consumers seem to like best is Weight Watchers"
• High Protein Diet May Be Bad For Women Trying To Conceive - Science Daily, 6/29/04
• Low carb diet dangerous for health, says consumer group - Nutra USA, 6/22/04 - "losing weight by an extremely low-carb diet can lead to serious health problems such as kidney stress, liver disorders and gout"
• What’s the Best Diet? - Dr. Weil, 6/11/04
• Is Low-Carb Eating Increasing Scurvy? - WebMD, 6/10/04 - "Because scurvy is rarely suspected, people with the symptoms -- fatigue, limping, bleeding gums, or swollen extremities -- may not be tested for vitamin C deficiency"
• Whey protein better than meat for reducing body weight - Nutra USA, 6/7/04 - "Increasing the dietary density of whey protein, but not of red meat, reduced body weight gain by 4 per cent, they add, while whey protein also reduced plasma insulin concentration by 40 per cent and increased insulin sensitivity, compared to meat protein" - See iHerb whey protein products.
• Man sues Atkins over clogged arteries - MSNBC, 5/28/04
• Low-Carb, Low-Fat Diets Get Similar Results - WebMD, 5/17/04 - "six months into a low-carb program, the dramatic weight loss ends abruptly"
• Low Carb Nation - Time Magazine Cover Story, 5/3/04 - "The bigger issue is the long-term health effects of protein-heavy diets. Very little data is available, but many researchers are worried that such diets can lead to kidney and liver problems. Research also suggests that too much protein can leach calcium out of the body, increasing the risk of osteoporosis"
• High protein diet weakens immunity system? - Nutra USA, 3/9/04
• More Carbs, More Exercise = More Weight Loss - WebMD, 3/5/04 - "The thinnest people eat the most carbs ... Without exception, a high-complex-carbohydrate, high-vegetable-protein diet is associated with low body mass ... High-protein diets were associated with higher body weight"
• Low carbs cause mood 'lows' - Nutra USA, 3/2/04 - "a lack of carbohydrates will reduce levels of the mood-regulating hormone seratonin"
• Low-Carb Diets Likely to Lead to High Calories - Medscape, 2/24/04
• Atkins Food Pyramid Aims to Clear Confusion - WebMD, 2/17/04
• Are Low-Carb Diets Unhealthy for Kids? - WebMD, 2/13/04
• The Facts on Low-Carb Diets and Heart Disease - WebMD, 2/11/04 - "the lack of long-term data on low-carb diets severely limits their ability to evaluate their safety and effectiveness in promoting weight loss as well as reducing the risk of heart disease"
• Doctor Atkins was obese, had heart disease - USA Today, 2/10/04 - "Dr. Robert Atkins, whose popular diet stresses protein-rich meat and cheese over carbohydrates, weighed 258 pounds at his death and had a history of heart disease ... Before his death, he had suffered a heart attack, congestive heart failure and hypertension"
• Atkins Diet Goes on a Diet - WebMD, 1/21/04
• Four Popular Diets All Good for Weight Loss But Not Equal for Reducing Heart Disease Risk - Doctor's Guide, 11/10/03 - "Patients were evenly assigned to the Atkins diet (low carbohydrates), Zone (moderate carbohydrates), Ornish (low-fat vegetarian), or Weight Watchers (moderate fat) ... the heart disease risk score is based on the HDL/LDL ratio, and the "Ornish diet does not increase HDL, while the other diets do achieve significant increases in HDL,"" - I put the results in table form:

• 4 Popular Diets Heart Healthy - WebMD, 11/10/03 - "the heart disease risk score is based on the ratio between LDL cholesterol and HDL "good" cholesterol ... The Atkins and Zone diets increased HDL by 15%, while Weight Watchers posted an 18.5% gain. But the Ornish diet increased HDL by just 2.2%"
• Atkins Center Closes After Founder Dies - Intelihealth, 10/23/03
• Low-Carb Diets Are Working, Study Says - Intelihealth, 10/14/03 - Yeah, but they still aren't addressing dehydration, fiber and the amount of water that fiber holds in the gut. - Ben
• Low-Carb, More Calories, Lose Weight? - WebMD, 10/14/03
• Low-Carb Backlash? - CBS News, 8/25/03
• Low-carb 'lifestyle' goes mainstream - USA Today, 8/18/03
• High-Fat Diet, Breast Cancer Linked - CBS News, 7/17/03 - "those who average more than 90 grams of fat a day have roughly double the risk of those who eat just 37 grams" - That's another area that hasn't been fully researched regarding the Atkin's diet.
• Fatty Diet Raises Diabetes Risk - WebMD, 6/20/03 - "surveys of people with diabetes have suggested a link between the amount of saturated fat in a person's diet and diabetes risk, but until now that link has not been confirmed by biological evidence ... they looked at the levels of fatty acids in the blood, which reflects how much saturated fat a person generally eats over time, and compared it to the risk of developing type 2 diabetes among a group of 2,909 adults aged 45-64 ... During nine years of follow-up, 252 of the men and women developed type 2 diabetes ... As the level of fatty acids increased, the likelihood that the person developed type 2 diabetes also increased" - This is something else the Atkin's studies should be looking at.  This study was nine years.  I believe the longest Atkin's study was one year. - Ben
• Weight Loss Benefits Of Low-Carbohydrate Diet May Be Temporary - Doctor's Guide, 5/29/03 - "At 3 months, the subjects on the low-carbohydrate diet had lost more weight than subjects on the conventional diet ... Similar results were seen at 6 months ... However, the difference at 12 months was not significant ... Throughout the study, high-density lipoprotein cholesterol and triglyceride levels were improved among subjects on the low-carbohydrate diet, but total and low-density lipoprotein cholesterol concentrations were similar between the groups at 3 months ... The lack of a statistically significant difference (in weight loss) between the groups at one year is most likely due to greater weight regain in the low-carbohydrate group and the small sample size ... They note that adherence was poor and attrition was high in both groups" - [Abstract] - Some thoughts:
  • I graphed it out below. The results would be the opposite if you project the momentum of the last six months of the graph out to 15 months.
  • I feel they should have addressed dehydration caused by high protein diets, as many critics claim and the percent of weight that would have accounted for.
  • They should have addressed the weight of the fiber and the water that fiber holds in the gut of the carb people.  For example, apples weight six times as much per calorie as steak.  So a pound of steak would have the same calories as 6 pounds of apples. That’s a 5 pound difference on the scale (or 2.5% body weight for a 200 pound person) for the same amount of calories until those apples leave your system. The difference would be even greater for fat as with the a low-carbohydrate, high-protein, high-fat diet vs. a low-calorie, high-carbohydrate, low-fat (conventional) diets used in this study.
  • Total body water is easy to measure with a body composition analyzer.  It's hard to believe it was out of the budget of this study.  Without knowing the total body water difference from baseline between the two groups the numbers are meaningless.  There seems to be so many flaws that I tried to find who funded the study but neither the abstract nor the media articles say.  I emailed the head of the study, Dr. Foster and he admitted that no body composition was taken but said that they were going to use DEXA in a future trial.  If the primary purpose of the study was to determine what weight loss regiment was more effective but the measurement of that effectiveness was meaningless without knowing the total body water, then why did they even have the study?
  • High-carb has been known for some time to lower HDL (the good cholesterol).  Why not just go with a balanced diet, i.e., a low calorie, medium-carbohydrate, medium fat, medium protein diet? It seems so obvious.
  • I was reading up on DEXA and body composition in general.  It's an interesting area and I started a web page on it..  For example:
    • The DEXA Van - arizona.edu - "A woman doesn’t just lose bone, she tends to lose muscle at the same time, and then she’s more at risk for falling. If you lose muscle, that lowers your metabolic rate, and you can gain weight. So losing muscle can contribute to diabetes. All three are related."

• Carbs vs Fats - Time, 9/2/03
• What if It's All Been a Big Fat Lie? - New York Times, 7/7/02

Abstracts:

• A diet with 35 % of energy from protein leads to kidney damage in female Sprague-Dawley rats - Br J Nutr. 2011 May 3:1-8 - "High-protein (HP) diets for weight loss remain popular despite questions surrounding overall safety. In a recent study using the pig model, we showed that long-term intakes from whole proteins at 35 % energy (en %) cause moderate renal histological damage. To examine whether this observation may be species specific or more generalisable, the effect of this diet in rats was examined ... Rats consuming the HP diet had 17 % higher kidney weights (P < 0.0001), three times higher proteinuria (P < 0.0001) and 27 % higher creatinine clearance (P = 0.0012) compared with those consuming the NP diet. Consistent with this, HP-fed rats had larger glomeruli (P < 0.0001) and more glomerulosclerosis (P = 0.0003) compared with NP-fed rats. The HP diet also resulted in altered levels of free monocyte chemoattractant protein-1 (P < 0.0001). The histological changes are consistent with those observed in the pig model. In contrast to the pig model, the elevated proteinuria and creatinine clearance observed in the rat model are also usually observed with HP consumption in human subjects. These results indicate that the rat is a useful model for HP effects on the kidney and, along with previous results using the pig model, suggest that long-term intake of high levels of protein may be detrimental to renal health"
• Long-Term High Intake of Whole Proteins Results in Renal Damage in Pigs - J Nutr. 2010 Jul 28 - "These findings suggest that long-term intakes of protein at the upper limit of the AMDR from whole protein sources may compromise renal health"
• A Prospective Study of the Modified Atkins Diet for Intractable Epilepsy in Adults - Epilepsia. 2007 Oct 5 - "A modified Atkins diet appears to demonstrate preliminary efficacy for adults with intractable epilepsy, especially in those who lost weight. Considering the rapid response in those who improved, but somewhat high discontinuation rate, a 2-month trial period may be adequate to assess for efficacy"
• A low-carbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia: a randomized, controlled trial - Ann Intern Med. 2004 May 18;140(10):769-77 - "Compared with a low-fat diet, a low-carbohydrate diet program had better participant retention and greater weight loss. During active weight loss, serum triglyceride levels decreased more and high-density lipoprotein cholesterol level increased more with the low-carbohydrate diet than with the low-fat diet"