ATKINS NUTRITIONAL APPROACH

1
ATKINS NUTRITIONAL APPROACH

• From weight loss to lifestyle
• Jacqueline A. Eberstein, R.N.

2
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.

3
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.

4
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.

5
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.

6
Levels of ketones

• Dietary ketosis vs. diabetic
  hyperketoacidosis
• Fed state 0.1 mmol/L
• Overnight fast 0.3 mmol/L
• Ketogenic diet 1-3 mmol/L
• 21 day fast 10 mmol/L
• Uncontrolled diabetes more than 25 mmol/L
  

7
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.

8
Four phases of the ANA

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

9
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.

10
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.

11
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.

12
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.

13
Nutrient analysis 0f 20 gram, 2000 calorie menu
based on RDI
14
Nutrient analysis of 20 gram, 2000 calorie menu
based on RDI
15
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.

16
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

17
Ketones vary

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

18
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

19
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.

20
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.

21
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.

22
What is Success?

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