ATKINS NUTRITIONAL APPROACH

From weight loss to lifestyle

Jacqueline A. Eberstein, R.N.

Rationale: Atkins Lifestyle

Stored fat is the bodys backup fuel source. The body cannot store more than a 2 day supply of carbohydrate. In the absence of significant dietary carbohydrate and adequate protein, fat becomes the primary fuel. The steady burning of fat produces more energy while dramatically decreasing appetite.

From glucose burning to fat burning metabolism

The lipolytic pathway is the second of two primary pathways for energy The body can readily produce the enzymes involved in fat mobilization (lipolysis). When fat is burned for energy ketones are produced. When fat is being mobilized, it neither accumulates nor deposits.

The truth about ketones

Ketones are produced on any weight loss plan where fat is burned. When controlling carbs the presence of ketones is a positive sign and should NOT be confused with ketoacidosis. Acidosis does not result from controlling carbs. Ketoacidosis is a concern in people primarily with uncontrolled type 1 diabetes or alcoholism.

Ketones

Doctors are scared of ketosisBut ketosis is the normal physiological state of man. Rather than being poison, which is how the press often refers to ketones, they make the body run more efficiently and provide a back-up fuel source for the brain. Richard Veech, NIH researcher Veech calls ketones magic and has shown that both the heart and brain run 25% more efficiently on ketones than on blood sugar.

Levels of ketones
Dietary ketosis vs. diabetic hyperketoacidosis

Fed state: Overnight fast: Ketogenic diet: 21 day fast: Uncontrolled diabetes:

0.1 mmol/L 0.3 mmol/L 1-3 mmol/L 10 mmol/L more than 25 mmol/L

Ketones as a fuel source

Results in a decrease in appetite. Insulin is not involved in ketone production. Lowered insulin requirements decrease: triglycerides, blood pressure, adrenaline, cortisol, PCOS and cancer death rates.

Four phases of the ANA

Phase 1 Induction Phase 2 Ongoing weight loss Phase 3 Pre-Maintenance Phase 4 Lifetime Maintenance

The ideal controlled carb nutritional approach: therapeutic principles

Every person has a level of carb intake below which weight loss is automatic and a level below which weight maintenance is automatic. Find the Critical Carbohydrate Level for Losing (CCLL) and stay at or below this level until goal weight is reached. Once at goal, stay at or slightly below your Atkins Carbohydrate Equilibrium (ACE). The amount of carbs you can eat without losing or gaining weight. Select the most nutrient-dense carbs, fats and proteins within established levels.

Phase 1: Induction

Ingest about 20 grams of Net Carbs with an adequate protein and fat intake. Do not overeat. Generally expect a 4 to 16 pound weight loss in 2 weeks. Most people begin here and follow for 2 weeks. May follow longer if there is a lot of weight to lose. Do not stay on Induction until at goal. Move on. Drink 64 ounces of water during the day. Be sure to eat 3 to 4 cups of salad and vegetables daily from the approved list. Read labels- avoid many commercially prepared products. Avoid or limit caffeine, trans fats AKA partially hydrogenated oils and margarine. Use Splenda and limit all sweeteners to 3 packets daily.

Induction contd
Unlimited to satiety: Protein-chicken, turkey, beef, lamb, fish, shellfish, pork, veal, eggs, etc. Fat-oils, butter

Limited: Carbohydrate-cheese (hard and fresh) 3 to 4 ounces, vegetables 3 to 4 cups, olives 10, avocado-1/2, cream up to 4 ounces, lemon/lime juice- 3 tablespoons. After 2 weeks can add 1 ounce of walnuts, almonds, pecans, Brazils, macadamias, sunflower or pumpkin seeds.

Induction contd
Omit: Beverages with caffeine and alcohol Medications with sugar such as lozenges, cough syrups etc. All foods with added forms of sugar and trans fats.

Nutrient analysis 0f 20 gram, 2000 calorie menu based on RDI

500 450 400 350 300 250 200 150 100 50 0 Vita-Nutrients Vitamin A Vitamin C Vitamin D Vitamin E Thiamin Riboflavin Niacin Pyridoxine Folate Cobalamin Pantothenic Acid Vitamin K

Nutrient analysis of 20 gram, 2000 calorie menu based on RDI

400 350 300 250 200 150 100 50 0 Vita-Nutrients Sodium Potassium Calcium Iron Phosphorus Magnesium Zinc Copper Manganese Selenium Chromium Molybdenum

Symptoms On The Induction Plan

Withdrawal from carbs can trigger headaches, moodiness, irritability and fatigue. Usually begins within 12 to 24 hours of starting Induction. If there is a history of migraines, the withdrawal may trigger a migraine. Carb cravings may continue for 4 or 5 days, rarely up to a week.

Carb Addicts

During the transition phase (the first 4 or 5 days) maintain an adequate protein and fat intake. Snack as needed and dont miss meals. In rare, severe cases when you cant go cold turkey, remove a carb food group every 3 days until you get to Induction. days 1-3 eliminate only sugars days 4-6 eliminate flour containing foods days 7-10 eliminate fruit and juice days 11-13 eliminate starches and legumes

Ketones vary
Time of day Sex Age Activity level Hormone status-ketones can decrease before the menses. Medications Finger stick method is best

The Carb Ladder

As the program progresses, moving from one phase to another add back carbs in this order: Salad and vegetables Nuts and seeds Soft fruits i.e. berries Other fruits i.e. melon, pineapple Starch vegetables and legumes Whole grains- unrefined

Ongoing Weight Loss- OWL

Each week add 5 grams of extra carbs per day following selections from the carb ladder. Continue to add each week as long as weight and/or inches are lost. If cravings or increased hunger occur, stop the latest addition and allow yourself to re-stabilize. You are determining your CCLL-critical carb level for losing. The maximum amount of carbs that can be consumed while still losing weight. The level is an individual one. Varies due to age, sex, amount of muscle mass, activity level etc. Plan on losing more slowly- about 1 to 2 pounds a week on average. Stay on OWL until within 5 to 10 pounds of goal weight.

Pre-Maintenance

About 40 to 90 grams of carbs Allow 2 months to lose the last few pounds Important phase that helps to instill permanent dietary behavior changes Add 10 grams daily of extra carbs each week as long as less than 1 pound of weight is lost Follow the carb ladder for choices Usually when higher glycemic fruits, legumes, starches and unrefined whole grains are added.

Lifetime Maintenance

Once you have reached pre-maintenance and you have not lost any weight for at least 4 weeks you have found your ACE-Atkins Carbohydrate Equilibrium. The amount of carbs you can consume without gaining to losing weight. To maintain goal weight, stay at your ACE. Maintain your goal weight within 3 to 5 pounds. Never allow yourself to gain more than 5 pounds without taking action. Average grams of Net Crab is 40 to 120 grams a day. Engage in regular exercise; those who exercise regularly usually have a higher ACE. Your ACE can change over time. Readjust your diet to adapt to a higher or lower ACE.

What is Success?

control of eating increased sense of well-being decreased risk factors for disease loss of size management of weight