Atkins Diet: When fried eggs and bacon are part of the menu...

It has been advertised extensively and is revolutionary, since it urges us to consume eggs and bacon or fried omelette with cheese in order to lose weight! We are talking about the legendary Atkins Diet: a controversial weight loss program that first appeared in 1972. Even certain Hollywood stars have claimed to follow it from time to time; and how could they resist, since this diet promises weight loss without hunger or deprivation!

Apart from promising weight loss, the Atkins Diet has a holistic approach to therapeutics in general. In his book, Dr. Atkins himself presented it as a unique program for the treatment of other health problems apart from obesity, such as headaches, nutritional intolerance and allergies, blood sugar disorders and metabolism problems. Modern research suggests that Atkins’s claims are not only well-founded but that it is possible for diets of this kind (of high protein intake and low in carbohydrates) to contribute to the prevention and treatment of certain afflictions, such as childhood epilepsy, acne, polycystic ovary syndrome, possibly even some forms of cancer. It is interesting to note that all this is presented at the same time when other – equally well-founded scientific and clinical – research presents meat eating and high fat intake as the cause of cardio-vascular disease, hypertension, kidney and liver function disorders, even as the contributing factor in the growth of certain types of cancers. You can find more information about both types of research in the bibliography I have provided in the Appendix of this article.

There were times when the scientific community was truly divided regarding the Atkins Diet. However, it is certain that the diet has loyal fans across the world; people who followed its dictates, won the battle against obesity and are adamant about its beneficiary and impressive results. Likewise, the diet has sworn enemies who present strong counter-arguments about how harmful it can be for human health.

The Atkins Diet philosophy

The central idea of this slimming program is that people become overweight because they consume too much carbohydrates. The priority of human metabolism in order to produce energy is to “burn” carbohydrates first, proteins next and, finally, fat. Therefore, according to the Atkins Diet, by including very small quantities of carbohydrates in one’s diet and, simultaneously, eating large portions of proteins and fats, the body is coerced into burning the stored fat, thus losing its extra weight. We describe this condition by saying that the organism is in ketosis; ergo we name the Atkins Diet ketonic or biochemical or chemical diet.

More specifically, when the organism is in a stable condition and we do not wish for weight loss, in a medium approach and in the context of a balanced diet, approximately 55% of the overall energy we receive through food daily should come from carbohydrates, 15% from proteins and the remaining 30% from fats. In the Atkins Diet, the contribution of proteins to the diet becomes approximately 27%, carbohydrates fall to a mere 5% and fats rise to an impressive 68%! This extremely reduced daily carbohydrate intake is based on Dr. Atkins’s belief that obesity is based on metabolic causes and that the essential “root of evil” is the hyper-secretion of insulin from the organism. In extent, the great increase of carbohydrates – especially of white sugar – is primarily responsible for the increased secretion of insulin and, consequently, for diabetes, weight increase, obesity and many other chronic diseases. Therefore, according to this line of thought, in the Atkins Diet, the person is consuming merely 20g of carbohydrates daily (a quantity that is the equivalent of consuming one slice of bread) and, in this manner, the organism is forced to use proteins and fats for the produce of energy it needs. Let us note here that, in the Appendix, there is a brief overview regarding carbohydrates, proteins and fats.

The Atkins Diet basic rules

In its modern version, the Atkins Diet is governed by certain basic rules:

Atkins is a diet that does not want us to starve; yet we will have to satisfy our hunger mostly through the consumption of animal protein – instead of carbohydrates. Thus, the average person will need to eat approximately 150g of protein per meal, while men with a large frame can consume up to 200g per meal.
The amount of carbohydrates we consume per meal should also be measured; in particular those whose consumption raises sugar level in the blood – for instance, the sugar in our coffee, or the sugar contained in fruits or desserts.
For the benefit of our health, it is necessary to include in our diet omega-3 and omega-6 fatty acids. This, of course, is necessary as a rule whether we are following a specific weight loss program or not. This type of good fat can be found in fish.
We should reduce our consumption of foods and drinks that contain a lot of calories without offering us good nutritional value, such as alcohol and fizzy drinks.

What happens to our body when we follow the Atkins Diet

In order for our organism to be able to fulfill its required functions, it needs energy. Therefore, normally, all the foods we consume – through a chain of biochemical reactions that take place in our cells – are converted primarily into glucose; and glucose is turned into energy. If a person follows the Atkins Diet, they will have to exclude carbohydrates from their dietary schedule, thus forcing their organism to use stored fat for the produce of energy. As an extra (brief) piece of information, I will note here that the above mentioned process takes place primarily in the liver; ergo we say that the organism is in a condition of “ketosis”. So, with the Atkins Diet, body fat is “burned”, since it is used as fuel and, at the same time, diuresis increases; this causes further weight loss due to the loss of liquid from the body. Simultaneously, the proteins and fats that the person receives through their meals delay the digestive process, which decreases the feeling of hunger and the appetite; thus, in the end, the person consumes smaller amounts of food.

The Atkins Diet phases

The Atkins Diet includes three phases of body weight loss and a final (fourth) phase, during which we are trying to maintain the body weight we have achieved in the previous three. Each of these phases could become the topic of an entire article – possibly articles. However, in this article, we will offer an initial approach in the context of providing general – yet as well-founded as possible – information on the issue.

Phase I: Induction or Activation

This is the initial phase of the diet, which contributes to the person’s overcoming most obstacles that make the slimming process difficult. Thanks to this phase, weight loss is achieved even in people with extremely high metabolic resistance.

Depending on the person’s metabolism and the weight they desire to lose, the Induction Phase can last from 2 weeks up to even a whole year. It is recommended that people stick to this phase until they lose up to 50% of the total weight they have set as their ultimate goal. However, fans of the method are fairly divided when it comes to this last part.

Ιn general, the rules that govern the method are simple; yet they should be followed to the letter and with no deviations because that could condemn the entire program to failure. However, not deviating is not particularly hard since, as mentioned earlier, the Atkins program includes endless tasteful dishes!

What to eat during the Induction Phase:

The copious consumption of meat, poultry, fish, seafood and eggs is allowed; eggs can be cooked in all forms possible – even fried. All fresh cheeses are also allowed but not their light versions; while cheese imitations are forbidden – apart from those based on soy or rice.
Vegetables in the form of salads should be restricted to a maximum of 2-3 tea cups daily and, preferably, salads should be accompanied by dressings such as cheese, yogurt, mushrooms and fried bacon. Oil, lemon and vinegar as toppings are also allowed, as long as vinegar is not balsamic.
Spices can be used in abundance when cooking, provided their mix does not contain sugar; as far as herbs are concerned, one should opt for: Cayenne pepper, basil, dill, garlic, ginger, oregano, rosemary and thyme.
Regarding fats and oils, animal butter, olive oil and all herbal oils are allowed; in contrast, one should avoid margarine and partially or fully hydrogenated herbal oils (such as sunflower oil, soybean oil, walnut oil, palm oil).
White sugar is entirely forbidden; aspartame as well; the same holds true for all sweeteners ending in -ose, such as glucose and fructose. The sole exception is sucralose – which is allowed. Other sweeteners allowed are manittol, maltitol, acesulfame-K.
Fruits, bread and amyloid vegetables are not allowed.
Since they combine proteins with carbohydrates, pulses are not allowed during this phase of the program.
Quitting coffee, tea and generally beverages that contain caffeine is probably one of the most difficult aspects when one is applying the Atkins Diet. Yet it is crucial to undergo the deprivation because it has been proved that caffeine reduces sugar levels in the blood and, as a result, creates a need for sugar consumption.

In both the official Atkins Diet site and the book, you can find a list with the foods you are allowed to consume in all phases of the program.

Induction Phase basic rules:

One should get accustomed to eating very generously combinations of proteins and fats.
It is important to consume three full meals or six smaller meals daily; also, one should not remain unfed for a period longer than 6 hours.
The maximum amount of carbohydrates one should consume is 20g daily.
One should regularly consult the list of “allowed foods” provided by Dr. Atkins and not deviate from it.
As time passes and as long as one is in the Induction Phase, their appetite will decrease. Therefore, they should adjust the amount of food they consume so that they are not hungry or feel supersaturated.
One should carefully read the labels of any packed foods they are about to consume so that they are aware of the amount of carbohydrates they contain.
One may eat out with friends as often as they wish. The only thing they should pay attention to is the fact that, quite often, restaurant prepared meals contain hidden carbohydrates. For instance, chefs usually add flour or sugar in sauces, which are both forbidden in the Atkins program.
Drinking at least 8 glasses of water daily is essential for the proper hydration of the organism.
The usage of pharmaceutical concoctions against constipation or for organism detox is not indicated.
The intake of vitamins in the form of pills, as well as pharmaceutical concoctions that contain minerals and trace elements, are allowed; the only exception is those that contain iron.

Possible problems:

Since, during the Induction Phase of the Atkins Diet, the person does not consume sugar or caffeine, it is quite possible to experience certain unpleasant symptoms from this withdrawal, such as: headaches, diarrhea, nausea, confusion, muscle pain. These symptoms are rather common; in fact, they have been characterized by the term “Atkins Induction Phase flu”. One should be very careful when operating machinery and while driving. However, such symptoms are entirely temporary and soon both the person’s mental clarity and energy will be restored.

Phase II: Ongoing weight loss

This is the stage when the organism loses weight at a normal rate, while the rhythm of slimming is slowed intentionally so as to set the foundations for the person’s permanent weight stabilization. Here, the burning of fat continues, while the option of choice among a quite larger variety of healthy foods (that, in Phase I were entirely “prohibited”) is provided.

What to eat during Phase II:

The greatest secret for the successful application of Phase II of the Atkins Diet is to measure the grams of carbohydrates one consumes on a daily basis. This way, they will be able to determine a limit of carbohydrates quantity they can daily consume without gaining weight. This limit is called “critical carbohydrate level for losing” and it is different for every human being.`

In order to determine this limit in practice, once Phase I of the Atkins Diet has been concluded, a person starts adding 5g of carbohydrates to their diet each week, observing if they continue to lose weight or not. In case they observe that they have gained weight or do not continue to lose weight, then they should stop adding carbohydrates to their diet. So, the amount of carbohydrates one should consume is the one they recorded on the last week they kept losing weight. This is the person’s magic number regarding the quantity of carbohydrates they should consume in order to lose weight; and it is different for each one of us. Moreover, it is important to be observant so that, should the person detect that any chosen food causes them to gain weight, they should remove it from their daily diet. As an indication, 5g of carbohydrates can be translated into:

a medium sized tomato
1/2 cup of strawberries
8 stalks of asparagus
1/4 cup of melon
30g of walnuts
1/2 avocado
1 cup of broccoli
14 almonds or walnuts
1/4 cup lemon juice
140g cottage cheese

It is worth noting that, in Phase II, drinks such as whiskey or vodka are allowed as long as they are not mixed with juices or fizzy drinks.

Phase III: Pre-maintenance

This is essentially a transitory step that contributes to the person’s smooth rehabilitation into healthy dietary models, with the parallel stabilization of their new weight. So, here, one stops consuming gradually more and more carbohydrates, where the organism stops the lipolysis process, and returns normally to the glycolysis process, which means that weight loss slows down and stabilization begins. A person cannot skip this phase and pass straight to that of Maintenance (Phase IV). Pre-maintenance is extremely important for health, as well as for the result of the Atkins Diet in the long run.

What to eat during Phase III:

This is where one should determine the limit of carbohydrates they should consume, in the same manner they did during Phase II. Consequently, each week, a person should increase their daily carbohydrate consumption by 10g. If, at any given week, after an increase in carbohydrate level, they observe an increase in body weight, then they should return to the previous carbohydrate amount, with which no increase in weight occurred.

During the application of Phases II and III of the Atkins Diet, it is very important not to rush to easy conclusions regarding the critical level of carbohydrate consumption. Actually, it takes weeks before one can establish this level and this is so because, apart from nutrition, the decrease of body weight or its stabilization (no weight loss) depends on other conditions of life, as well as on the type of carbohydrates a person chooses to consume from the list Dr. Atkins provides in his book. For example, a period of increased stress at work or menstruation in women may cause fluid retention and misguide people in their efforts to determine their ideal carbohydrate quantity. Meanwhile, it is good for people to learn to observe what consequences any given food has on their body weight; therefore, it is necessary to add new foods to their diet at a slow rhythm, in order to record how their metabolism reacts to them.

Useful information regarding Phase III

The Phase of weight Pre-maintenance is the period when a person has come to know their metabolism fairly well. They are learning which foods “fatten” them and which do not. The rules of this phase do not have to be followed religiously, which translates to the fact that one can increase their carbohydrate level by 20g for a given week, for instance, without endangering the overall success of the slimming program.

Let us note, however, that Phase III of the Atkins Diet is the most difficult of all because it is the phase when a person learns to control the amounts of food to eat so as not to gain weight; at the same time, in this phase, the process of lipolysis is decreasing more and more, while that of glycolysis is increasing. In essence, this fact translates into one experiencing an intense sense of hunger – something that does not happen in the two previous phases of the program.

A small secret to help reduce the sense of hunger is to choose consuming carbohydrates low in glycemic index, such as pulses and wholegrain cereals.

Phase IV: Lifetime Maintenance of body weight

This is the fourth and last phase of the Atkins Diet, which secures the maintenance of weight after the slimming process and the lifetime stabilization of the organism to this weight. Dr. Atkins always links a person’s metabolic resistance, meaning the ease with which they lose weight, to the quantity of carbohydrates they consume. In brief:

Maximum weight loss is achieved when consuming less than 15g of carbohydrates daily.
Medium weight loss occurs by the introduction of 15-40g of carbohydrates to the daily diet.
Decreased or no weight loss happens through the daily consumption of more than 40g of carbohydrates.

What all this means is that, in practice, a person can consume a larger quantity and variety of foods than in the previous phases of the diet but in no case can they go back to their previous dietary customs. A person’s course through the diet’s previous stages has given them the chance to know their metabolism better so as to choose to consume the carbohydrates that “fatten” them less – with the sole exception of white processed sugar, which is always forbidden.

Phase IV basic rules:

In case a person discovers that they have gained weight during the Phase of Lifetime Maintenance, they can once again apply the Induction Phase; however, it is not good to transition often from one phase to the other because, this way, the diet loses its effectiveness. From then onward, in the Maintenance Phase, it is good to keep in mind the following rules:

In the human organism, especially in women, there is a normal fluctuation of 1-2 kilos, which is mostly due to hormones. This fluctuation, when transient, is not deemed an essential alteration in body weight.
In the Atkins Diet (and this is true for any other diet one chooses to follow), the rule of “change of dietary thinking” applies. This means that, even if a person successfully loses their excess weight, should they go back to their old bad dietary habits, they will soon gain weight again – quite possibly more than that they lost with the diet program they applied.

The effectiveness of the Atkins Diet

The Atkins Diet is what we call the “dream diet” of the average modern person since, when followed to the letter, it delivers what it promises: very quick weight loss through the burning of fat and, at the same time, loss of appetite. Actual cases of people who lost up to 4 kilos in the first week have been recorded.

The diet’s effectiveness – as mentioned above – is owed to two basic biochemical processes: on one hand, lipolysis and, on the other hand (and secondarily), ketosis. In the first process, the organism converts the already existing fat into glycerol and various fatty acids, which in turn are converted into sub-products of fat burning – such as ketones. Actually, ketones have a very distinct smell; and their trace in both breath and urine is the most important proof that the diet is working and that the person following it is in the process of burning their body’s natural fat.

The advantages of the Atkins Diet

An important advantage of the Atkins Diet is that it does not create withdrawal syndromes like many of the other existing diets; plus, it does not allow for the sense of hunger. Dr. Atkins himself notes that it is not possible for him to accept the sense of hunger as a way of life; therefore, the diet he proposes is full of foods such as fried eggs and bacon, omelettes, meat with sauce, etc. This is, in fact, a very significant advantage for someone who chooses to follow this dietary program; especially if you stop to think how difficult it is to follow a deprivation diet, while living in a world where we are literally “bombarded” by desirable dishes on every corner – for every taste and every single hour of the day. Indubitably, a person is bound to easily stop following a deprivation diet, due to the fatigue that the sense of hunger causes. Moreover, a deprivation diet may lead one to isolation, given the fact that they cannot follow their friends – and their dietary choices – to the restaurant. And, in the end, once the deprivation diet is concluded and the person is free of its limitations, it is highly possible that they will exhibit polyphagia episodes and to soon return to their initial weight – if not reach a greater one.

On the other hand, due to the saturation of hunger (if nothing else), a dietary program of the Atkins type secures for the person the necessary energy for bodily exercise. Therefore, the effectiveness of the program is further reinforced by the increasing weight loss, but also with the replacement of part of the body’s fat tissue with muscle; while, simultaneously, the person’s appearance is improved by the so-called “inch reduction” in the body.

One of the most important things we should all bear in mind is that weight loss is the “easy” part of a diet. Actually, since there is no pathological factor present in the organism (such as, for instance, hypothyroidism), anyone can lose their excess weight. The “difficult” part of any diet is to manage to stabilize the organism to its new weight; in other words, as time passes, not to regain the lost weight. The fact is that the Atkins Diet includes an equally easy (with regard to that of losing weight) way to maintain one’s body weight, since the difference in calories acquired during the slimming phase is very small compared to those received during the maintenance phase.

Applying the Atkins Diet pushes the organism into reducing the hyper-secretion of the hormone insulin, which is one of the basic factors implicated with obesity. Thus, on the one hand, the loss of weight acts on the result of the hormone’s action and, at the same time, on the very cause of obesity. In brief, let me note that insulin is a hormone of the human organism, which is produced by the so-called B-cells of the pancreas. In specific, it is produced in a special part of the pancreas that consists of cell groups, the islets of Langerhans. Insulin plays an important part in the metabolism of carbohydrates, while it is also implicated in the maintenance of adequate energy stores and the metabolism of fat so that the correct materialization of basic (for life) human functions is possible.

Dr. Atkins himself claims that his dietary program contributes to the person’s good health; this is due to the fact that, when applied correctly, it can actually reverse the organic and pathological consequences that derive from the dysfunctional metabolism of sugar and insulin. For Atkins, the complete replacement of carbohydrates in processed form (such as, for instance, white sugar) can be a source of life, revitalization, youth and well-being; a fact that can be proved by the definite improvement of the clinical condition of people who suffered from hypertension or diabetes and followed the program. At the same time, the sense of fatigue is reduced, while there have been recordings of other beneficiary effects on human health, such as the lessening of nerves, depression, lack of focus, vertigo, aches in joints and muscles, even relief from PMS syndrome, swelling and liquid retention. Contemporary research offers clear indications that ketonic diets (such as Atkins – especially its improved modern version), apart from weight loss, could very well help in the prevention and/or symptomatic treatment of diseases of nervous system, such as epilepsy or Parkinson’s disease – even diseases of the cardio-vascular system.

The disadvantages of the Atkins Diet

Legendary across the globe, the Atkins Diet has quite a few negative elements to exhibit, primarily for the health of the individual who chooses to follow it – and that’s just the start. So, let us first note that, due to the abstinence from fruits and vegetables that it dictates, the diet can result in insufficiency of metals and traces, as well as vitamin deficiency. It has been often observed that those who applied the Atkins Diet suffered severe problems of osteoporosis due to lack of calcium; while the lack in vegetal fibres can lead to problems with the normal function of the intestine. In general, statistics show a lot of cases of extreme dehydration of the organism, lack of mental clarity and natural energy, as well as disorders of the nervous system due to the application of the diet.

The sense of fatigue and bodily weakness are constant in many cases – and not just during the Induction Phase. According to Dr. Atkins, these symptoms are present only in the first days of the application of the program due to the quitting of sugar and coffee; however, statistics contradict this allegation.

The Atkins Diet is based on extreme meat eating, which, according to statistics is more and more linked to carcinogenesis as well as kidney failure. The amount of protein dictated by the diet is double the amount suggested daily, a fact that, in the long run, may seriously encumber kidney function and worsen the state of health of those suffering from arthritis.

After completing the method (especially if it has not been applied correctly), it is possible to suffer from changes in the metabolism – whatever this practically entails for each individual’s health. It is also highly possible that a person will not manage to follow this dietary program correctly, no matter how others try to describe it in an article or a book. And this can happen because the suggested diet is not easily applicable in a realistic context (at least not safely) over a prolonged period of time. On the other hand, the Atkins Diet rules have to be followed religiously. Any deviation, no matter how small, is capable of upsetting the program’s effectiveness. Therefore, the majority of people who start the diet are further down the course forced, either by mistake of fatigue, to stop it.

People who really love foods with carbohydrates will face extreme difficulty in applying the Atkins Diet. Especially in Greece, where diet includes bread and fruits almost on a daily basis, it is particularly hard to eject from our daily diet these (otherwise very healthy) options. Obviously, it is equally difficult to abstain from pasta and potatoes. But, even if you don’t love bread or pasta that much, fully subtracting carbohydrates from your diet on an everyday basis is truly difficult – if not impossible. There is a multitude of “hidden” carbohydrates in the foods we consume; and only a specialized scientist of the nutritional field with excellent knowledge of chemistry could apply the method with precision. The average person, who has no knowledge of the subject, can easily err – even if they follow the diet book’s instructions religiously; the outcome is that they will fail, despair, not lose the weight they wish and, above all, disrupt their metabolism. A solution for the person, who is not knowledgeable on food chemistry, would be to address a specialized scientist; one who will direct them with scientific precision as to what they should eat.

Basically, the effectiveness of applying the method is achieved when a person follows the Atkins Diet after studying the book in depth or with the help of an expert and under the condition that they cook at home. This way they will have more chances of eliminating carbohydrates from their plate. This is hardly possible when eating restaurant prepared meals because no one is in a position to fully check all the ingredients used in the preparation of a sauce, for instance. The danger of hidden carbohydrates in a plate is highly likely and this endangers the diet’s effectiveness. Due to the particularity and restrictions of the program, the person who chooses to follow it ends up risking being alienated from their social environment by not attending festivities or gatherings.

The process of ketosis causes very intense stench in breath, perspiration and urine. The usage of deodorants or chewing gum is inevitable, if the person does not wish to be socially alienated.

Finally, once the program is completed and the individual starts gradually re-including carbohydrates to their diet, it is still possible to gain back the weight they lost – even if the applied the method correctly. This may happen because there is always the possibility of a metabolic disorder, which leads to the conversion of caloric intake into fat that the organism stores.

Starting the Atkins Diet

When we start dieting with the intention to lose the extra weight and improve the condition of our body, we are, in essence, embracing a new dietary way of life. And this happens because a comprehensive dieting program, when it is a correct one, lasts for a substantial length of time, during which we establish specific dietary habits and incorporate them in our everyday routine. This holds true for all diet programs – not just for the Atkins Diet, which is the topic of this article. Therefore, it is good for the sustenance of our good health, as much as it is for the effectiveness of our effort, to conscientiously follow the weight loss program that we have chosen or the health scientist of our trust has suggested us, always bearing in mind the basic rules we should follow.

From then onward, in order to start the Atkins Diet, please bear in mind the following:

The best course of action is to address a specialized health scientist, in order to ensure not only effectiveness for the effort but safety and a scientific approach; this way, you will not risk the emergence of a new or implications of an already existing health problem.
In co-operation with your doctor or pharmacist, you should take into account all the medication you are already receiving. The Atkins Diet is not compatible with the majority of diuretics, anti-hypertensive and anti-diabetic medication. Getting advice from a health scientist you trust should not be overlooked.
You should undergo a series of medical screenings (such as blood screens, glucose tolerance test, thyroid, kidney, liver and heart check-ups) in order to ensure that you are actually in a position to enter the process of this particular weight loss program.

Let us note that individuals suffering from chronic kidney disease, pregnant and lactating women should not under any circumstances try the Atkins Diet.

Epilogue

The Atkins Diet is as famous as it is the source of contradiction worldwide. Both its defenders and those arguing against it have strong arguments to put forth, based on extensive and reliable scientific research – like those provided in the Appendix of this article. The correct application of the diet indubitably leads to loss of weight; in fact, there is a lot of research explaining that this type of diet may be much more effective than low-fat diets. On the other hand, health scientists are concerned about the safety and the long-term effectiveness of the program, as the production of ketones is a pathological condition, which can possibly prove life-threatening and cause serious health problems. The World Health Organization clearly suggests that, for the maintenance of good health and a balanced diet, our daily energy must derive from the following combination: 15% protein, 55% carbohydrates and 30% fat. The Atkins Diet effectively suggests 27% protein, 5% carbohydrates and 68% fat; and, despite the fact that, over the years, an improved version has been proposed – one that raised the variety of foods it allows – the percentage of fat (saturated fat, actually) it dictates still remains extremely high.

In any case, if you love a good kebab and this article got you drooling over losing your extra weight, the best course of action is to start the Atkins diet only after you have visited your GP and they have agreed – as well as under the scientific guidance of a trusted dietician. It is certainly safer and much more effective.

Christina Bakopoulou

Pharmacist

Appendix

There will be other articles following this that will discuss proteins, carbohydrates and fats separately, as well as each group’s importance for our health. For now, we will just provide some brief information in order for you to be able to comprehend the Atkins Diet.

Proteins: Complex macro-molecules with a multi-dimensional structure. This structure consists of amino-acid sequences linked together by peptide bonds. Each protein has a specific amino-acid sequence that is defined by one single gene; this is its genetic code, the known to us all DNA. In all cells – even the most “simple” ones – hundreds of different proteins can be traced; each protein has a different part to play in securing the structure and normal function of the cell. On the nutritional level, excellent protein sources for humans are meat, poultry, fish, nuts, eggs and dairy.

Carbohydrates: This is a group of organic substances with a particular chemical structure. The structural units that form a carbohydrate are called sugars. Thus, according to the number of sugars that form a carbohydrate, the latter is categorized as a monosaccharide, a disaccharide or a polysaccharide. Carbohydrates are the most basic source of energy for the human organism and are of vital importance for its normal function. The most known monosaccharides are glucose and fructose, while common sugar is a disaccharide. Other important sources of carbohydrates in nutrition are amyloid foods like potatoes and rice, bread, cereals, pasta, fruits and vegetables.

Fats: This is a group of organic compounds – in specific, esters. Depending on the natural condition in which they can be found in normal circumstances, fats are divided into two basic categories. Therefore, when a fat has liquid form (under normal circumstances) we call it oil; when it has solid form we call it fat. Fats are substances of a specific yet complex nature. Some fats are basic structural elements of the human body, are produced by our very organism and are necessary for life. Other, equally important, are a source of energy – actually, in a “condensed form” – or serve basic cell functions. Some of them cannot be produced by the human organism and so must be received through nutrition. Good sources of fat are meat, poultry, fish, dairy (not its light versions), nuts and certain vegetables, like avocado.

Bibliography

Paoli A., “Ketogenic diet for obesity: friend or foe?” [Pubmed]
«Η νέα δίαιτα Atkins για μια νέα ζωή» E. C. Westman, S.D. Phinney, Dr. J.S. Volek. Εκδόσεις Διόπτρα.
Atkins R.C.The High Calorie Way to Stay Thin Forever. McKay Co.; New York, NY, USA: 1972. Dr. Atkins’ Diet Revolution.
Paoli A., Rubini A., Volek J.S., Grimaldi K.A., Beyond weight loss: a review of therapeutic uses of very-low-carbonhydrates (ketogenic) diets
Astrup A, Larson T και Harper A (2004) Atkins and other low-carbohydrate diets: hoax or an effective tool for weight loss? The Lancet 364:897-899.
Krebs HA. The regulation of the release of ketone bodies by the liver.Adv Enzyme Regul.1966;4:339–354. [Pubmed]
Veldhorst MA, Westerterp-Plantenga MS, Westerterp KR. Gluconeogenesis and energy expenditure after a high-protein, carbohydrate-free diet.Am J Clin Nutr. 2009;90:519–526. [Pubmed]
Freedman MR, King J, Kennedy E. Popular diets: A scientific review.Obes Res. 2001;9 (Suppl 1:1S–40S. [Pubmed]
Veech RL. The therapeutic implications of ketone bodies: The effects of ketone bodies in pathological conditions: ketosis, ketogenic diet, redox states, insulin resistance, and mitochondrial metabolism. Prostaglandins Leukot Essent Fatty Acids.2004;70:309–319. [Pubmed]
Danial N.N., PhD., Hartman A.L., MD., Stafstrom C.E., MD, PhD., Thio L.L., MD., PhD., How does the ketogenic diet works? Four potential mechanisms
Olshansky S.J., Passaro D.J., Hershow R.C., Layden J., Carnes B.A., Brody J., Hayflick L., Butler R.N., Allison D.B., Ludwig D.S. A potential decline in life expectancy in the United States in the 21st century.[Pubmed]
Dansinger ML et al. (2005) Comparison of the Atkins, Ornish, Weight Watchers, and Zone Diets for Weight Loss and Heart Disease Risk Reduction. A Randomized Trial. Journal of the American Medical Association 293:43-53.
Brehm BJ, Seeley RJ, Daniels SR, D’Alessio DA. A randomized trial comparing a very low carbohydrate diet and a calorie-restricted low fat diet on body weight and cardiovascular risk factors in healthy women.J Clin Endocrinol Metab.2003;88:1617–1623. [Pubmed]
Shai I, Schwarzfuchs D, Henkin Y, Shahar DR, Witkow S, Greenberg I, et al. Weight loss with a low-carbohydrate, mediterranean, or low-fat diet.N Engl J Med.2008;359:229–241. [Pubmed]
Fine EJ, Feinman RD. Thermodynamics of weight loss diets.Nutr Metab (Lond)2004;1:15. [Pubmed]
Halton TL, Hu FB. The effects of high protein diets on thermogenesis, satiety and weight loss: a critical review.J Am Coll Nutr.2004;23:373–385. [Pubmed]
Paoli A, Grimaldi K, Bianco A, Lodi A, Cenci L, Parmagnani A.Medium term effects of a ketogenic diet and a mediterranean diet on resting energy expenditure and respiratory ratioBMC Proceedings20126(Suppl 3): P37
Sumithran P, Prendergast LA, Delbridge E, Purcell K, Shulkes A, Kriketos A, et al.Ketosis and appetite-mediating nutrients and hormones after weight lossEur J Clin Nutr 2013;. e-pub ahead of print 1 May 2013; [Pubmed]
Veldhorst M, Smeets A, Soenen S, Hochstenbach-Waelen A, Hursel R, Diepvens K, et al. Protein-induced satiety: effects and mechanisms of different proteins.Physiol Behav.2008;94:300–307. [Pubmed]
Johnstone AM, Horgan GW, Murison SD, Bremner DM, Lobley GE. Effects of a high-protein ketogenic diet on hunger, appetite, and weight loss in obese men feeding ad libitum.Am J Clin Nutr.2008;87:44–55.[Pubmed]
Nordmann AJ, Nordmann A, Briel M, Keller U, Yancy WS, Jr, Brehm BJ, et al. Effects of low-carbohydrate vs low-fat diets on weight loss and cardiovascular risk factors: a meta-analysis of randomized controlled trials.Arch Intern Med.2006;166:285–293. [Pubmed]
Blackburn GL, Phillips JC, Morreale S.Physician’s guide to popular low-carbohydrate weight-loss dietsCleve Clin J Med 200168761–766.766768–9, 773–4. [Pubmed]
Volek JS, Phinney SD, Forsythe CE, Quann EE, Wood RJ, Puglisi MJ, et al. Carbohydrate restriction has a more favorable impact on the metabolic syndrome than a low fat diet.2009;44:297–309. [Pubmed]
Sharman MJ, Kraemer WJ, Love DM, Avery NG, Gomez AL, Scheett TP, et al. A ketogenic diet favorably affects serum biomarkers for cardiovascular disease in normal-weight men.J Nutr.2002;132:1879–1885.[Pubmed]
Volek JS, Sharman MJ, Forsythe CE. Modification of lipoproteins by very low-carbohydrate diets.J Nutr.2005;135:1339–1342. [Pubmed]
Jornayvaz FR, Samuel VT, Shulman GI. The role of muscle insulin resistance in the pathogenesis of atherogenic dyslipidemia and nonalcoholic fatty liver disease associated with the metabolic syndrome.Annu Rev Nutr.2010;30:273–290.[Pubmed]
Hellerstein MK. De novo lipogenesis in humans: Metabolic and regulatory aspects.Eur J Clin Nutr.1999;53[Pubmed]
Bistrian BR, Blackburn GL, Flatt JP, Sizer J, Scrimshaw NS, Sherman M. Nitrogen metabolism and insulin requirements in obese diabetic adults on a protein-sparing modified fast.1976;25:494–504.[Pubmed]
Gumbiner B, Wendel JA, McDermott MP. Effects of diet composition and ketosis on glycemia during very-low-energy-diet therapy in obese patients with non-insulin-dependent diabetes mellitus.Am J Clin Nutr.1996;63:110–115. [Pubmed]
Boden G, Sargrad K, Homko C, Mozzoli M, Stein TP. Effect of a low-carbohydrate diet on appetite, blood glucose levels, and insulin resistance in obese patients with type 2 diabetes.Ann Intern Med.2005;142:403–411.[Pubmed]
Dashti HM, Al-Zaid NS, Mathew TC, Al-Mousawi M, Talib H, Asfar SK, et al. Long term effects of ketogenic diet in obese subjects with high cholesterol level.Mol Cell Biochem.2006;286:1–9 [Pubmed]
Yancy WS, Jr, Foy M, Chalecki AM, Vernon MC, Westman EC. A low-carbohydrate, ketogenic diet to treat type 2 diabetes.Nutr Metab (Lond)2005;2:34. [Pubmed]
Nielsen JV, Joensson EA. Low-carbohydrate diet in type 2 diabetes: Stable improvement of bodyweight and glycemic control during 44 months follow-up.Nutr Metab (Lond)2008;5:14 [Pubmed]
Basu S, Yoffe P, Hills N, Lustig RH. The relationship of sugar to population-level diabetes prevalence: An econometric analysis of repeated cross-sectional data.PLoS One.2013;8:e57873. [Pubmed]
Hartman AL, Gasior M, Vining EP, Rogawski MA. The neuropharmacology of the ketogenic diet.Pediatr Neurol.2007;36:281–292.[Pubmed]
Paoli A, Cenci L, Fancelli M, Parmagnani A, Fratter A, Cucchi A, et al. Ketogenic diet and phytoextracts comparison of the efficacy of mediterranean, zone and tisanoreica diet on some health risk factors.Agro Food Ind Hi-Tech.2010;21:24.Paoli A, Canato M, Toniolo L, Bargossi AM, Neri M, Mediati M, et al. The ketogenic diet: an underappreciated therapeutic option. Clin Ter. 2011;162:e145–e153. [Pubmed]
Kessler SK, Neal EG, Camfield CS, Kossoff EH. Dietary therapies for epilepsy: future research.Epilepsy Behav.2011;22:17–22.[Pubmed]
Fukao T, Lopaschuk GD, Mitchell GA. Pathways and control of ketone body metabolism: on the fringe of lipid biochemistry.Prostaglandins Leukot Essent Fatty Acids.2004;70:243–251. [Pubmed]
Foster GD κ.ά. (2003) A randomized trial of a low-carbohydrate diet for obesity. New England Journal of Medicine 348:2082-2090.
Thompson W.G., Cook D.A., Clark M.M., Bardia A., Levine J.A. Treatment of obesity.Mayo Clin. Proc.2007;82:93–101.
Stern L et al. (2004) The effects of low carbohydrate versus conventional weight loss diets in severely obese adults: one year follow up of a randomised trial. Annals of Internal Medicine 140:778-785.
Nordmann A.J., Nordmann A., Briel M., Keller U., Yancy W.S., Jr., Brehm B.J., Bucher H.C. Effects of low-carbohydratevs. low-fat diets on weight loss and cardiovascular risk factors: A meta-analysis of randomized controlled trials. Intern. Med. 2006;166:285–293. doi: 10.1001/archinte.166.3.285 [Pubmed]
Bueno N.B., de Melo I.S., de Oliveira S.L., da Rocha Ataide T. Very-low-carbohydrate ketogenic diet v. Low-fat diet for long-term weight loss: A meta-analysis of randomised controlled trials.[Pubmed]
World Health Organization Obesity and Overweight, Factsheet No. 311, Updated March 2013. [(Accessed on 24 January 2014)].
Paoli A., Rubini A., Volek J.S., Grimaldi K.A. Beyond weight loss: A review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets.[Pubmed]
Brehm B.J., Seeley R.J., Daniels S.R., D’Alessio D.A. A randomized trial comparing a very low carbohydrate diet and a calorie-restricted low fat diet on body weight and cardiovascular risk factors in healthy women.[Pubmed]
Chahoud G., Aude Y.W., Mehta J.L. Dietary recommendations in the prevention and treatment of coronary heart disease: Do we have the ideal diet yet?[Pubmed]
Al-Khalifa A., Mathew T.C., Al-Zaid N.S., Mathew E., Dashti H.M. Therapeutic role of low-carbohydrate ketogenic diet in diabetes.2009;25:1177–1185. [Pubmed]
Koh-Banerjee P., Wang Y., Hu F.B., Spiegelman D., Willett W.C., Rimm E.B. Changes in bodyweight and body fat distribution as risk factors for clinical diabetes in US men. J. Epidemiol.2004;159:1150–1159. [Pubmed]
Drewnowski A., Krahn D.D., Demitrack M.A., Nairn K., Gosnell B.A. Taste responses and preferences for sweet high-fat foods: Evidence for opioid involvement. Behav.1992;51:371–379. [Pubmed]
Veech R.L. The therapeutic implications of ketone bodies: The effects of ketone bodies in pathological conditions: Ketosis, ketogenic diet, redox states, insulin resistance, and mitochondrial metabolism. Prostaglandins Leukot. Essent. Fatty Acids.2004;70:309–319. [Pubmed]
Kossoff E.H., Zupec-Kania B.A., Rho J.M. Ketogenic diets: An update for child neurologists. Child Neurol.2009;24:979–988. [Pubmed]
Krebs H.A. The regulation of the release of ketone bodies by the liver. Enzyme Regul.1966;4:339–354. [Pubmed]
Owen OE, Morgan AP, Kemp HG, Sullivan JM, Herrera MG, Cahill GF., Jr Brain metabolism during fasting.J Clin Invest.1967;46:1589–1595. [Pubmed]
Hartman A.L., Gasior M., Vining E.P., Rogawski M.A. The neuropharmacology of the ketogenic diet. Neurol.2007;36:281–292. doi: 10.1016/j.pediatrneurol.2007.02.008.[Pubmed]
Dashti H.M., Mathew T.C., Khadada M., Al-Mousawi M., Talib H., Asfar S.K., Behbahani A.I., Al-Zaid N.S. Beneficial effects of ketogenic diet in obese diabetic subjects. Cell. Biochem.2007;302:249–256. [Pubmed]
Paoli A., Grimaldi K., Bianco A., Lodi A., Cenci L., Parmagnani A. Medium term effects of a ketogenic diet and a mediterranean diet on resting energy expenditure and respiratory ratio.BMC Proc.2012;6
Bortz W.M., Paul P., Haff A.C., Holmes W.L. Glycerol turnover and oxidation in man. Clin. Invest.1972;51:1537–1546. [Pubmed]
Fukao T., Lopaschuk G.D., Mitchell G.A. Pathways and control of ketone body metabolism: On the fringe of lipid biochemistry.Prostaglandins Leukot. Essent. Fatty Acids.2004;70:243–251. [Pubmed]
Vazquez J.A., Kazi U. Lipolysis and gluconeogenesis from glycerol during weight reduction with very-low-calorie diets.1994;43:1293–1299. [Pubmed]
Felig P., Owen O.E., Wahren J., Cahill G.F., Jr. Amino acid metabolism during prolonged starvation. Clin. Invest.1969;48:584–594. [Pubmed]
Fine E.J., Feinman R.D. Thermodynamics of weight loss diets. Metab.2004;1 [Pubmed]
Veldhorst M.A., Westerterp-Plantenga M.S., Westerterp K.R. Gluconeogenesis and energy expenditure after a high-protein, carbohydrate-free diet. J. Clin. Nutr.2009;90:519–526. [Pubmed]
Sharman M.J., Kraemer W.J., Love D.M., Avery N.G., Gomez A.L., Scheett T.P., Volek J.S. A ketogenic diet favorably affects serum biomarkers for cardiovascular disease in normal-weight men. Nutr.2002;132:1879–1885. [Pubmed]
Paoli A., Grimaldi K., Toniolo L., Canato M., Bianco A., Fratter A. Nutrition and acne: Therapeutic potential of ketogenic diets.Skin Pharmacol. Physiol.2012;25:111–117. [Pubmed]
Leino R.L., Gerhart D.Z., Duelli R., Enerson B.E., Drewes L.R. Diet-induced ketosis increases monocarboxylate transporter (MCT1) levels in rat brain. Int.2001;38:519–527. [Pubmed]
Feinman R.D., Fine E.J. Nonequilibrium thermodynamics and energy efficiency in weight loss diets. Biol. Med. Model.2007;4[Pubmed]
Brinkworth G.D., Noakes M., Clifton P.M., Buckley J.D. Effects of a low carbohydrate weight loss diet on exercise capacity and tolerance in obese subjects.2009;17:1916–1923. [Pubmed]
Sumithran P., Prendergast L.A., Delbridge E., Purcell K., Shulkes A., Kriketos A., Proietto J. Ketosis and appetite-mediating nutrients and hormones after weight loss. J. Clin. Nutr.2013;67:759–764. [Pubmed]
Johnstone A.M., Horgan G.W., Murison S.D., Bremner D.M., Lobley G.E. Effects of a high-protein ketogenic diet on hunger, appetite, and weight loss in obese men feeding ad libitum. J. Clin. Nutr.2008;87:44–55.[Pubmed]
Volek J.S., Phinney S.D., Forsythe C.E., Quann E.E., Wood R.J., Puglisi M.J., Kraemer W.J., Bibus D.M., Fernandez M.L., Feinman R.D. Carbohydrate restriction has a more favorable impact on the metabolic syndrome than a low fat diet.2009;44:297–309. [Pubmed]
Paoli A., Moro T., Marcolin G., Neri M., Bianco A., Palma A., Grimaldi K. High-intensity interval resistance training (HIRT) influences resting energy expenditure and respiratory ratio in non-dieting individuals. Transl. Med.2012;10:237. [Pubmed]
Freedman M.R., King J., Kennedy E. Popular diets: A scientific review. Res.2001;9:S1–S40. [Pubmed]
Lefevre F., Aronson N. Ketogenic diet for the treatment of refractory epilepsy in children: A systematic review of efficacy. [Pubmed]
Owen O.E. Ketone bodies as a fuel for the brain during starvation. Mol. Biol. Educ.2005;33:246–251.
Owen O.E., Felig P., Morgan A.P., Wahren J., Cahill G.F., Jr. Liver and kidney metabolism during prolonged starvation. Clin. Invest.1969;48:574–583. doi: 10.1172/JCI106016. [Pubmed]
Owen O.E., Morgan A.P., Kemp H.G., Sullivan J.M., Herrera M.G., Cahill G.F., Jr. Brain metabolism during fasting. Clin. Invest.1967;46:1589–1595. [Pubmed]
Manninen A.H. Metabolic effects of the very-low-carbohydrate diets: Misunderstood “villains” of human metabolism. Int. Soc. Sport. Nutr.2004;1:7–11. [Pubmed]
Laeger T., Metges C.C., Kuhla B. Role of beta-hydroxybutyric acid in the central regulation of energy balance.2010;54:450–455. [Pubmed]
Seyfried T.N., Mukherjee P. Targeting energy metabolism in brain cancer: Review and hypothesis. Metab.2005;2 [Pubmed]
Cahill G.F., Jr. Fuel metabolism in starvation. Rev. Nutr.2006;26:1–22. [Pubmed]
Paoli A., Cenci L., Fancelli M., Parmagnani A., Fratter A., Cucchi A., Bianco A. Ketogenic diet and phytoextracts comparison of the efficacy of mediterranean, zone and tisanoreica diet on some health risk factors.Agro Food Ind. Hi-Tech.2010;21:24–29.
Westerterp-Plantenga M.S., Nieuwenhuizen A., Tome D., Soenen S., Westerterp K.R. Dietary protein, weight loss, and weight maintenance. Rev. Nutr.2009;29:21–41. [Pubmed]
Tagliabue A., Bertoli S., Trentani C., Borrelli P., Veggiotti P. Effects of the ketogenic diet on nutritional status, resting energy expenditure, and substrate oxidation in patients with medically refractory epilepsy: A 6-month prospective observational study. Nutr.2012;31:246–249. [Pubmed]
Davidson T.L., Hargrave S.L., Swithers S.E., Sample C.H., Fu X., Kinzig K.P., Zheng W. Inter-relationships among diet, obesity and hippocampal-dependent cognitive function.2013;253:110–122. [Pubmed]
Yancy W.S., Jr., Almirall D., Maciejewski M.L., Kolotkin R.L., McDuffie J.R., Westman E.C. Effects of two weight-loss diets on health-related quality of life. Life Res.2009;18:281–289. [Pubmed]
Vining E.P., Freeman J.M., Ballaban-Gil K., Camfield C.S., Camfield P.R., Holmes G.L., Shinnar S., Shuman R., Trevathan E., Wheless J.W. A multicenter study of the efficacy of the ketogenic diet. Neurol.1998;55:1433–1437. [Pubmed]
Freedland S.J., Mavropoulos J., Wang A., Darshan M., Demark-Wahnefried W., Aronson W.J., Cohen P., Hwang D., Peterson B., Fields T., et al. Carbohydrate restriction, prostate cancer growth, and the insulin-like growth factor axis.2008;68:11–19. [Pubmed]
McLaughlin T., Allison G., Abbasi F., Lamendola C., Reaven G. Prevalence of insulin resistance and associated cardiovascular disease risk factors among normal weight, overweight, and obese individuals. 2004;53:495–499. [Pubmed]
Rabinowitz D., Zierler K.L. Forearm metabolism in obesity and its response to intra-arterial insulin. Characterization of insulin resistance and evidence for adaptive hyperinsulinism. Clin. Invest.1962;41:2173–2181. [Pubmed]
McDaniel S.S., Rensing N.R., Thio L.L., Yamada K.A., Wong M. The ketogenic diet inhibits the mammalian target of rapamycin (mTOR) pathway.2011;52 [Pubmed]
Srivastava S., Kashiwaya Y., King M.T., Baxa U., Tam J., Niu G., Chen X., Clarke K., Veech R.L. Mitochondrial biogenesis and increased uncoupling protein 1 in brown adipose tissue of mice fed a ketone ester diet.FASEB J.2012;26:2351–2362. [Pubmed]
Sandri M. Signaling in muscle atrophy and hypertrophy.2008;23:160–170. [Pubmed]
Jeffery R.W. Does weight cycling present a health risk? J. Clin. Nutr.1996;63:S452–S455 [Pubmed]
Sandri M., Barberi L., Bijlsma A.Y., Blaauw B., Dyar K.A., Milan G., Mammucari C., Meskers C.G., Pallafacchina G., Paoli A., et al. Signalling pathways regulating muscle mass in ageing skeletal muscle. The role of the IGF1-Akt-mTOR-FoxO pathway.2013;14:303–323. [Pubmed]
Demetrius L. Aging in mouse and human systems: A comparative study. N. Y. Acad. Sci.2006;1067:66–82.[Pubmed]
Janda M., Zeidler D., Bohm G., Schoberberger R. An instrument to measure adherence to weight loss programs: The compliance praxis survey-diet (COMPASS-diet)2013;5:3828–3838. [Pubmed]
Sumithran P., Proietto J. The defence of body weight: A physiological basis for weight regain after weight loss. Sci.2013;124:231–241. [Pubmed]
Wing R.R., Hill J.O. Successful weight loss maintenance. Rev. Nutr.2001;21:323–341. [Pubmed]
Thomas P.R.Weighing the Options: Criteria for Evaluating Weight-Management Programs.National Academies Press; Washington, DC, USA: 1995.
Paoli A., Bianco A., Grimaldi K.A., Lodi A., Bosco G. Long term successful weight loss with a combination biphasic ketogenic mediterranean diet and mediterranean diet maintenance protocol.2013;5:5205–5217. [Pubmed]
Volek J.S., Sharman M.J., Forsythe C.E. Modification of lipoproteins by very low-carbohydrate diets. Nutr.2005;135:1339–1342. [Pubmed]
Welle S., Nair K.S. Relationship of resting metabolic rate to body composition and protein turnover. J. Physiol.1990;258:990–998.[Pubmed]
Eisenstein J., Roberts S.B., Dallal G., Saltzman E. High-protein weight-loss diets: Are they safe and do they work? A review of the experimental and epidemiologic data. Rev.2002;60:189–200. [Pubmed]
Praga M. Synergy of low nephron number and obesity: A new focus on hyperfiltration nephropathy. Dial. Transplant.2005;20:2594–2597. [Pubmed]
Westerterp-Plantenga M.S. How are normal, high- or low-protein diets defined? J. Nutr.2007;97:217–218. [Pubmed]
Poplawski M.M., Mastaitis J.W., Isoda F., Grosjean F., Zheng F., Mobbs C.V. Reversal of diabetic nephropathy by a ketogenic diet.PLoS One.2011;6 [Pubmed]
Paoli A., Cenci L., Grimaldi K.A. Effect of ketogenic mediterranean diet with phytoextracts and low carbohydrates/high-protein meals on weight, cardiovascular risk factors, body composition and diet compliance in Italian council employees. J.2011;10 [Pubmed]
Paoli A., Grimaldi K., D’Agostino D., Cenci L., Moro T., Bianco A., Palma A. Ketogenic diet does not affect strength performance in elite artistic gymnasts. Int. Soc. Sports Nutr.2012;9 [Pubmed]
Paoli A., Canato M., Toniolo L., Bargossi A.M., Neri M., Mediati M., Alesso D., Sanna G., Grimaldi K.A., Fazzari A.L., et al. The ketogenic diet: An underappreciated therapeutic option? Ter.2011;162:145–153.[Pubmed]
Noto H., Goto A., Tsujimoto T., Noda M. Low-carbohydrate diets and all-cause mortality: A systematic review and meta-analysis of observational studies.PLoS One.2013;8 [Pubmed]
Larsen T.M., Dalskov S.M., van Baak M., Jebb S.A., Papadaki A., Pfeiffer A.F., Martinez J.A., Handjieva-Darlenska T., Kunesova M., Pihlsgard M., et al. Diets with high or low protein content and glycemic index for weight-loss maintenance. Engl. J. Med.2010;363:2102–2113. [Pubmed]
Bielohuby M., Sisley S., Sandoval D., Herbach N., Zengin A., Fischereder M., Menhofer D., Stoehr B.J., Stemmer K., Wanke R., et al. Impaired glucose tolerance in rats fed low-carbohydrate, high-fat diets. J. Physiol. Endocrinol. Metab.2013;305:1059–1070. [Pubmed]
Bielohuby M., Sawitzky M., Stoehr B.J., Stock P., Menhofer D., Ebensing S., Bjerre M., Frystyk J., Binder G., Strasburger C., et al. Lack of dietary carbohydrates induces hepatic growth hormone (GH) resistance in rats.2011;152:1948–1960. [Pubmed]
Ellenbroek J.H., van Dijck L., Tons H.A., Rabelink T.J., Carlotti F., Ballieux B.E., de Koning E.J. Long-term ketogenic diet causes glucose intolerance and reduced beta and alpha cell mass but no weight loss in mice. J. Physiol. Endocrinol. Metab.2014 [Pubmed]
Bielohuby M., Menhofer D., Kirchner H., Stoehr B.J., Muller T.D., Stock P., Hempel M., Stemmer K., Pfluger P.T., Kienzle E., et al. Induction of ketosis in rats fed low-carbohydrate, high-fat diets depends on the relative abundance of dietary fat and protein. J. Physiol. Endocrinol. Metab.2011;300:65–76. [Pubmed]
Bielohuby M., Matsuura M., Herbach N., Kienzle E., Slawik M., Hoeflich A., Bidlingmaier M. Short-term exposure to low-carbohydrate, high-fat diets induces low bone mineral density and reduces bone formation in rats. Bone Miner. Res.2010;25:275–284. [Pubmed]
Gower B.A., Casazza K. Divergent effects of obesity on bone health. Clin. Densitom.2013;16:450–454. [Pubmed]
Clifton P. Effects of a high protein diet on body weight and comorbidities associated with obesity. J. Nutr.2012;108:S122–S129. [Pubmed]
Tang M., O’Connor L.E., Campbell W.W. Diet-induced weight loss: The effect of dietary protein on bone. Acad. Nutr. Diet.2014;114:72–85. [Pubmed]
Carter J.D., Vasey F.B., Valeriano J. The effect of a low-carbohydrate diet on bone turnover. Int.2006;17:1398–1403. [Pubmed]
Levy RG, Cooper PN, Giri P. Ketogenic diet and other dietary treatments for epilepsy.Cochrane Database Syst Rev.2012;3:CD001903. [Pubmed]
Stafstrom CE, Rho JM. The ketogenic diet as a treatment paradigm for diverse neurological disorders.Front Pharmacol.2012;3:59.[Pubmed]
Kossoff EH, Zupec-Kania BA, Amark PE, et al. Optimal clinical management of children receiving the ketogenic diet: recommendations of the International Ketogenic Diet Study Group.2009;50(2):304–317.[Pubmed]
Poplawski MM, Mastaitis JW, Isoda F, et al. Reversal of diabetic nephropathy by a ketogenic diet.PLoS One.2011;6(4):e18604. [Pubmed]
Ma W, Berg J, Yellen G. Ketogenic diet metabolites reduce firing in central neurons by opening K(ATP) channels.J Neurosci.2007;27(14):3618–3625 [Pubmed]
Huang YZ, McNamara JO. Inhibiting glycolysis to reduce seizures: how it might work.Nat Neurosci.2006;9(11):1351–1352.[Pubmed]
Pan YZ, Devinney MJ, Rutecki PA, Sutula TP. Effect of glycolytic metabolism on synaptic currents in CA3 pyramidal neurons.Soc Neurosci Abstr.2009 10/16.
Milder J, Patel M. Modulation of oxidative stress and mitochondrial function by the ketogenic diet.Epilepsy Res.2012;100(3):295–303.[Pubmed]
McDaniel SS, Rensing NR, Thio LL, et al. The ketogenic diet inhibits the mammalian target of rapamycin (mTOR) pathway.2011;52(3):e7–11. [Pubmed]
Hartman AL, Lyle M, Rogawski MA, Gasior M. Efficacy of the ketogenic diet in the 6-Hz seizure test.2008;49(2):334–339.[Pubmed]
Gilbert DL, Pyzik PL, Freeman JM. The ketogenic diet: seizure control correlates better with serum beta-hydroxybutyrate than with urine ketones.J Child Neurol.2000;15(12):787–790. [Pubmed]
Ross DL, Swaiman KF, Torres F, Hansen J. Early biochemical and EEG correlates of the ketogenic diet in children with atypical absence epilepsy.Pediatr Neurol.1985;1(2):104–108. [Pubmed]
Fraser DD, Whiting S, Andrew RD, et al. Elevated polyunsaturated fatty acids in blood serum obtained from children on the ketogenic diet.2003;60(6):1026–1029. [Pubmed]
Neal EG, Chaffe H, Schwartz RH, et al. A randomized trial of classical and medium-chain triglyceride ketogenic diets in the treatment of childhood epilepsy.2009;50(5):1109–1117. [Pubmed]
Kang HC, Lee HS, You SJ, et al. Use of a modified Atkins diet in intractable childhood epilepsy.2007;48(1):182–186.[Pubmed]
Kossoff EH, McGrogan JR, Bluml RM, et al. A modified Atkins diet is effective for the treatment of intractable pediatric epilepsy.2006;47(2):421–424. [Pubmed]
van Delft R, Lambrechts D, Verschuure P, et al. Blood beta-hydroxybutyrate correlates better with seizure reduction due to ketogenic diet than do ketones in the urine.2010;19(1):36–39. [Pubmed]
Bough KJ, Valiyil R, Han FT, Eagles DA. Seizure resistance is dependent upon age and calorie restriction in rats fed a ketogenic diet.Epilepsy Res.1999;35(1):21–28. [Pubmed]
Likhodii SS, Musa K, Mendonca A, et al. Dietary fat, ketosis, and seizure resistance in rats on the ketogenic diet.2000;41(11):1400–1410. [Pubmed]
Nylen K, Likhodii S, Abdelmalik PA, et al. A comparison of the ability of a 4: 1 ketogenic diet and a 6.3: 1 ketogenic diet to elevate seizure thresholds in adult and young rats.2005;46(8):1198–1204 [Pubmed]
Likhodii SS, Serbanescu I, Cortez MA, et al. Anticonvulsant properties of acetone, a brain ketone elevated by the ketogenic diet.Ann Neurol.2003;54(2):219–226. [Pubmed]
Cahill GF., Jr Fuel metabolism in starvation.Annu Rev Nutr.2006;26:1–22. [Pubmed]
Westerterp-Plantenga MS, Nieuwenhuizen A, Tome D, Soenen S, Westerterp KR. Dietary protein, weight loss, and weight maintenance.Annu Rev Nutr.2009;29:21–41. [Pubmed]
Feinman RD, Fine EJ. Nonequilibrium thermodynamics and energy efficiency in weight loss diets.Theor Biol Med Model.2007;4:27.[Pubmed]
Gardner CD, Kiazand A, Alhassan S, Kim S, Stafford RS, Balise RR, et al. Comparison of the atkins, zone, ornish, and LEARN diets for change in weight and related risk factors among overweight premenopausal women: The A TO Z weight loss study: a randomized trial.2007;297:969–977. [Pubmed]
Paoli A, Grimaldi K, Toniolo L, Canato M, Bianco A, Fratter A. Nutrition and acne: therapeutic potential of ketogenic diets.Skin Pharmacol Physiol.2012;25:111–117. [Pubmed]
Smith RN, Mann NJ, Braue A, Makelainen H, Varigos GA. The effect of a high-protein, low glycemic-load diet versus a conventional, high glycemic-load diet on biochemical parameters associated with acne vulgaris: A randomized, investigator-masked, controlled trial.J Am Acad Dermatol.2007;57:247–256. [Pubmed]
Smith R, Mann N. Acne in adolescence: a role for nutrition.Nutr Diet.2007;64:S147–S149.
Cordain L. Implications for the role of diet in acne.Semin Cutan Med Surg.2005;24:84–91. [Pubmed]
Giovannucci E, Harlan DM, Archer MC, Bergenstal RM, Gapstur SM, Habel LA, et al. Diabetes and cancer: a consensus report.CA Cancer J Clin.2010;60:207–221. [Pubmed]
Warburg O, Wind F, Negelein E. The metabolism of tumors in the body.J Gen Physiol.1927;8:519–530. [Pubmed]
Hanahan D, Weinberg RA. Hallmarks of cancer: the next generation.2011;144:646–674 [Pubmed]
Klement RJ, Kammerer U. Is there a role for carbohydrate restriction in the treatment and prevention of cancer.Nutr Metab (Lond)2011;8:75. [Pubmed]
Tisdale MJ, Brennan RA, Fearon KC. Reduction of weight loss and tumour size in a cachexia model by a high fat diet.Br J Cancer.1987;56:39–43. [Pubmed]
Beck SA, Tisdale MJ. Effect of insulin on weight loss and tumour growth in a cachexia model.Br J Cancer.1989;59:677–681. [Pubmed]
Ho VW, Leung K, Hsu A, Luk B, Lai J, Shen SY, et al. A low carbohydrate, high protein diet slows tumor growth and prevents cancer initiation.Cancer Res.2011;71:4484–4493. [Pubmed]
Otto C, Kaemmerer U, Illert B, Muehling B, Pfetzer N, Wittig R, et al. Growth of human gastric cancer cells in nude mice is delayed by a ketogenic diet supplemented with omega-3 fatty acids and medium-chain triglycerides.BMC Cancer.2008;8:122. [Pubmed]
Seyfried BT, Kiebish M, Marsh J, Mukherjee P. Targeting energy metabolism in brain cancer through calorie restriction and the ketogenic diet.J Cancer Res Ther.2009;5 (Suppl 1:S7–S15. [Pubmed]
Zhou W, Mukherjee P, Kiebish MA, Markis WT, Mantis JG, Seyfried TN. The calorically restricted ketogenic diet, an effective alternative therapy for malignant brain cancer.Nutr Metab (Lond)2007;4:5.[Pubmed]
Nebeling LC, Lerner E. Implementing a ketogenic diet based on medium-chain triglyceride oil in pediatric patients with cancer.J Am Diet Assoc.1995;95:693–697. [Pubmed]
Nebeling LC, Miraldi F, Shurin SB, Lerner E. Effects of a ketogenic diet on tumor metabolism and nutritional status in pediatric oncology patients: Two case reports.J Am Coll Nutr.1995;14:202–208 [Pubmed]
Fine EJ, Segal-Isaacson CJ, Feinman RD, Herszkopf S, Romano MC, Tomuta N, et al. Targeting insulin inhibition as a metabolic therapy in advanced cancer: a pilot safety and feasibility dietary trial in 10 patients.2012;28:1028–1035. [Pubmed]
Mavropoulos JC, Yancy WS, Hepburn J, Westman EC. The effects of a low-carbohydrate, ketogenic diet on the polycystic ovary syndrome: a pilot study.Nutr Metab (Lond)2005;2:35. [Pubmed]
Poplawski MM, Mastaitis JW, Isoda F, Grosjean F, Zheng F, Mobbs CV. Reversal of diabetic nephropathy by a ketogenic diet.PLoS One.2011;6:e18604. [Pubmed]
Jia Y, Hwang SY, House JD, Ogborn MR, Weiler HA, O K, et al. Long-term high intake of whole proteins results in renal damage in pigs.J Nutr.2010;140:1646–1652. [Pubmed]
Wakefield AP, House JD, Ogborn MR, Weiler HA, Aukema HM. A diet with 35% of energy from protein leads to kidney damage in female sprague-dawley rats.Br J Nutr. pp. 1–8. [Pubmed]
Skov AR, Haulrik N, Toubro S, Molgaard C, Astrup A. Effect of protein intake on bone mineralization during weight loss: A 6-month trial.Obes Res.2002;10:432–438. [Pubmed]
Martin WF, Armstrong LE, Rodriguez NR. Dietary protein intake and renal function.Nutr Metab (Lond)2005;2:25 [Pubmed]
Welle S, Nair KS. Relationship of resting metabolic rate to body composition and protein turnover.Am J Physiol.1990;258:E990–E998. [Pubmed]
Praga M. Synergy of low nephron number and obesity: A new focus on hyperfiltration nephropathy.Nephrol Dial Transplant.2005;20:2594–2597.[Pubmed]
Eisenstein J, Roberts SB, Dallal G, Saltzman E. High-protein weight-loss diets: are they safe and do they work? A review of the experimental and epidemiologic data.Nutr Rev.2002;60:189–200 [Pubmed]
Westerterp-Plantenga MS. How are normal, high- or low-protein diets defined.Br J Nutr.2007;97:217–218.[Pubmed]