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Archive for Wednesday, November 5, 2003

Atkins debate

High-protein, low-carbohydrate diet helping trim area residents’ waistlines

November 5, 2003

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Christina Neavitt had enough.

The Lecompton resident was tired of being overweight, and she decided to do something about it.

Neavitt, 41, decided to consult with her family practice physician, Mary Vernon, M.D., who specializes in bariatric medicine, the medically supervised treatment of obesity and its associated conditions.

"I told her that I just couldn't do it any more -- be that heavy. I was wanting to get control of my health and my weight. I wanted to be able to run around with my kids," Neavitt said.

Vernon, on staff at the Lawrence Family Practice Center, 4951 W. 18th St., suggested her patient give the Atkins Diet -- the popular low-carbohydrate, high-protein regimen -- a try.

"I started the program in August of 2002, and I've stuck to it religiously. I weighed 272 pounds. Now I'm weighing 165," Neavitt said.

"My cholesterol has gone down considerably, and I don't have blood pressure problems. I've got a lot more energy, and I feel a lot better, of course."

The changes in the life of this mother of four have been dramatic.

"I went from a size 28 jean to a size 12 jean. I had a tummy tuck done to get rid of the overhang in my belly area -- I did that at the end of June. From my top weight, I've lost 122 pounds, 107 of that since August 2002," she said.

Neavitt is one of many Lawrence residents who have gone on the Atkins Diet in recent years.

Though not everyone who adopts the restricted-carbohydrate style of eating has experienced the kind of weight loss Neavitt has, many people in town have enjoyed success in shedding 10, 15, 20 pounds or more in a short time.

There is much debate about the Atkins Diet among health experts.

Some criticize it as drastic, nutritionally unbalanced and potentially having negative long-term effects. Others swear by it, calling it a safe, remarkably effective way for people to lose weight and improve overall health.

Neavitt, meanwhile, is sold on Atkins.

"I'm still in that awe state when I look in the mirror and don't realize it's me. It's a nice feeling," she said.

Found no drawbacks





Vernon is one of the nation's leading experts on the Atkins Diet.

She is one of only three doctors across the country who serve on the Atkins Physicians Council, which provides expertise and guidance for the educational information products and programs undertaken by Atkins Nutritionals Inc.

Vernon, vice president of the American Society of Bariatric Physicians, medically supervises many patients in the Lawrence area who are on the Atkins Diet. She also is a national expert in the controlled-carbohydrate approach to the treatment of disease.

She explained how the diet works.

"The Atkins approach initially decreases the carbohydrates in your diet to those that are present in somewhere between three to five servings of leafy green vegetables. In a simplistic way, you are then allowed to eat the amount of protein that you need to feel full. There's no restriction on fat, although, in general, Dr. Atkins advised people to eat foods with as few additives, and with the fat that we could call healthy fat, if that choice was available," Vernon said.

"The reason that particular approach is very effective is that if you don't put anything into your mouth that can be turned into sugar, then your body has no choice. To maintain its energy requirements, it has to turn toward your stored fats. Dr. Atkins believed each person has a specific level that's probably pretty individual to them, of how much they can eat of the carbohydrate-type foods and not turn off their fat burning, or just maintain their weight. He called it the critical carbohydrate level."







The Atkins Diet restricts carbohydrate intake and permits the dieter to freely consume foods high in protein and fat.According to "Dr. Atkins' New Diet Revolution," these are foods that you may eat liberally on the Atkins Diet: fish, fowl, shellfish, meat and eggs. You also may eat dairy products, such as cheese and heavy cream. Those on the diet may consume a variety of salad vegetables, as well as other lower-carbohydrate vegetables, such as broccoli and cauliflower.The Atkins Diet -- at least in the early, "induction" phase -- eliminates these foods: cereals, rice, wheat, bread, flour, candy, juice, fruit, potatoes, chips, fries and alcohol. After dieters have been on the program for a while, they may be able to slowly reintroduce some carbohydrates, including lower-carbohydrate fruits such as berries and melons.

Vernon has found the Atkins approach to be an extremely effective tool to help patients lose weight and control their metabolism.

What about possible drawbacks on the diet?

"I've not seen them. I have followed people in my practice for as long as three years, and I have not found a health problem that was related to the diet," she said.

Skeptics raise questions

Other health experts on nutrition and diet take a dimmer view of the Atkins approach.

"My opinion of this diet is that it is a jump start to weight loss, that it's best when limited to use for one week to a month, and that as with all of the extremely low-carbohydrate, high-protein diets, it's not to be used as a healthy eating style long term," said Adrienne Baxter, a registered dietitian and an instructor in the School of Allied Health at the Kansas University Medical Center in Kansas City, Kan.

"There's a number of medical effects that can be expected with this diet. Because of the use of meat, it raises the risk of colon and prostate cancer. It may tax the kidneys because it's very high in protein. It leaches calcium (from the body), and most Americans are getting insufficient calcium through dietary means already."

Ann Chapman, coordinator of nutrition services at KU's Watkins Student Health Center, expresses similar concerns.

"I can give you reasons why (the Atkins Diet) might not be the best idea. It can increase your cholesterol, it may impact adversely on blood pressure, it can increase the risk for gout and kidney stones. If it's followed on a long-term basis, it could increase risk for osteoporosis, because you excrete more calcium with a high-protein diet. If you're just going to follow it for three weeks or a month, that probably wouldn't be an issue," she said.

"Any time you read about a diet and it's recommended to you that you eliminate a whole food group, a red flashing light should go off. Each group gives unique contributions nutritionally. A diet that eliminates any food groups can't be balanced or healthy, certainly not for the long run."

Joseph Donnelly, director of the Center for Physical Activity and Weight Management in the Schiefelbusch Institute for Life Span Studies at KU, has studied obesity and its associated health problems since 1985.

He's unconvinced by the long-term prospects of the Atkins approach for those on the diet.

"We're a bit skeptical, but open-minded. One of the things about any low-carbohydrate diet is that they tend to be a bit extreme; they border on the elimination of an entire food group. They may be down in the five or 10 percent of calories from carbohydrates. When you eliminate food groups, you wonder how sustainable they are across time," he said.

Christina Neavitt, of Lecompton, holds a shirt she wore before she
went on the Atkins Diet and lost 107 pounds in 14 months. Neavitt
said the diet has helped improve her overall health.

Christina Neavitt, of Lecompton, holds a shirt she wore before she went on the Atkins Diet and lost 107 pounds in 14 months. Neavitt said the diet has helped improve her overall health.

Vernon provides medical management for some of Donnelly's research projects and is a collaborating investigator on other projects.

But the two experts don't necessarily see eye to eye on Atkins.

"There are no long-term studies on the safety of low-carbohydrate diets. There's no question that there are individuals who have used these diets for years and are fine. But that's not how we do science," Donnelly said.

"I think we disagree in terms of our current level of enthusiasm. Mary has practical, clinical experience using this diet and is pleased with it. But what she doesn't have -- what no one has -- is a whole bunch of literature that isn't clinical or anecdotal."

Adopting diet for life

Vernon, meanwhile, said that she can refute each and every point that skeptics of the Atkins Diet typically cite when defending the orthodox, low-fat approach to nutrition that holds sway among America's medical establishment.

"They don't know the science. They're saying what the standard concerns are, and they haven't had the opportunity to look at the scientific articles. I hope that's why that is," she said.

"It does not make your cholesterol go up. There's not been a study that demonstrates a statistically significant rise in cholesterol. As a matter of fact, it improves the triglyceride-to-HDL ratio, which is a major marker for cardiovascular disease risk. And it improves that at a level about 50 percent over baseline. This is not an insignificant finding. It's big."

Vernon said the Atkins Diet is an effective tool for decreasing blood pressure, and that most of her patients following the diet eventually come off their blood-pressure medications.

Nor, according to her, are whole food groups eliminated. Rather, the level of carbohydrates are dropped down to a level that suits an individual's metabolism. Later, more carbohydrates are slowly added back in until a state of balance is achieved.

What about the common criticism that the effects of the Atkins approach disappear when people go off the diet, causing their weight to rebound?

Dr. Mary Vernon, of the Lawrence Family Practice Center, displays a
PowerPoint presentation explaining the Atkins Diet, one which is
quickly becoming a popular method of weight loss. Vernon is one of
only three doctors nationwide who serves on the Atkins Physicians
Council. The council provides guidance for the educational
information products and programs undertaken by Atkins Nutritionals
Inc.

Dr. Mary Vernon, of the Lawrence Family Practice Center, displays a PowerPoint presentation explaining the Atkins Diet, one which is quickly becoming a popular method of weight loss. Vernon is one of only three doctors nationwide who serves on the Atkins Physicians Council. The council provides guidance for the educational information products and programs undertaken by Atkins Nutritionals Inc.

"It's just like if you quit taking your allergy medication; you'll start sneezing again. I have followed people for as long as three to five years, and the patients that continue to use this tool continue to maintain their progress. I can count five people that have lost 100 pounds or more and have kept it off on the Atkins diet," she said.

Kenna Frankenfeld is among them.

Frankenfeld, a 61-year-old Lawrence woman, has lost 107 pounds since starting the diet the Monday after Thanksgiving two years ago.

She had tried many diets before adopting the Atkins approach under Vernon's medical supervision.

"I am off of my blood-pressure medicine. I used to take two medicines for diabetes; I now take no medicines for it. My cholesterol and triglycerides are excellent. I think I'm Vernon's poster child for the blood test results," she said.

The Atkins approach has proved to be a revelation for her.

"Food used to just control my life. I'd spend the whole day thinking about how I'm going to eat my 1,000 calories, and I would still be hungry," she said.

"Now I'm not hungry, and so I don't think about food. Eating doesn't control my life anymore. I'll live this way the rest of my life, and I've never said that about a diet."

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