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CNN Saturday Morning News
Analysis of Dr. Robert Atkin's Diet Program Changes
Aired February 01, 2003 - 08:29 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
HEIDI COLLINS, CNN ANCHOR: Do you need to lose a little weight? Maybe you're like 60 percent of Americans, who need to lose more than a little. Dr. Robert Atkins has been preaching his low carb, high fat diet to the pudgy masses for 30 years.
But, medical correspondent Elizabeth Cohen joins us now with our weekend House Call to explore what appears to be a little bit of a change in tune to this diet. People might be confused now about what's going on with this.
ELIZABETH COHEN, CNN CORRESPONDENT: Absolutely. So we're going to try to get rid of the confusion. I know when most people think of Atkins they think meat, meat, meat. That's why I'm going on the diet, right, so I can eat bacon...
COLLINS: Bacon, sausage...
COHEN: Exactly. So I can eat all of that. But now the Atkins folks are saying oh, no, that's not what we meant.
(BEGIN VIDEOTAPE)
COHEN (voice-over): Whenever you think of Dr. Robert Atkins and the Atkins diet, you think ah, freedom to eat meat as much as I want and still lose weight. Now, after 30 years as a diet author, Dr. Atkins says this is not what his diet is all about. Surprised? So were we when we heard this from Dr. Atkins' spokeswoman.
COLETTE HEIMOWITZ, ATKINS SPOKESWOMAN: My concern is that when you talk about Atkins, the images of steak and frying food is always in the media. And people might interpret that as well, I'll just cut back on brad and pasta and eat lots of steak and cheeseburgers, and that's not what the Atkins nutritional approach is all about.
COHEN: Really? Just two years ago, the same woman told us she loved red meat.
HEIMOWITZ: So it's safe to take in steak, and that's the beauty about the diet, you know, you can have your steak and not have to worry.
COHEN: This new Atkins P.R. video says the media distorted the Atkins diet and that Atkins really advocates eating fish and chicken and fruits and vegetables. Do you know anyone who went on Atkins so they could pig out on fish and broccoli? We don't. In fact, right here in Dr. Atkins's 1999 book, it says to eat bacon and ham for breakfast, for lunch a bacon cheeseburger, no bun, of course, and steak, roasts, chops or chicken or fish for dinner.
And so that left us confused. Why does it seem Atkins is suddenly de-emphasizing red meat, the thing everyone loves about his diet? A spokesman for Atkins simply says that over the past year or two, there's been an evolution in the diet revolution. But you have to ask, will people still want to go on Atkins if it means eating unlimited amounts of chicken?
(END VIDEOTAPE)
COHEN: Now, you'll notice we talked about Dr. Atkins's 1999 book, which said meat, meat, meat. Well, in his new book, which has just come out, there's recipes for things like chicken salad in an avocado shell or smoked salmon and cream cheese on low carb bread. So there seems to be a real change here.
We have two guests with us here today to talk about some of those changes.
From New York, we have nutritionist Colette Heimowitz. She is director of education and research at the Atkins Health and Medical Information Systems. And from San Francisco, we have nutritionist Judith Stern. She is professor of nutrition and internal medicine at the University of California at Davis and she is not a fan of the Atkins diet.
Colette, I have a question for you first.
What's going on? Why this change?
HEIMOWITZ: There are different phases of the Atkins diet. On the induction phase, you have the luxury to have meat two times a week if you choose to. It's not necessary for the success of the program. It depends on people's likes and dislikes.
When you're burning fat for fuel and carbohydrates are restricted to less than 40 grams, you burn fat for energy and fat poses no risk. In the new book, "Atkins For Life," it addresses maintenance where carbohydrates are increased. And the amount of carbohydrates will depend on the choices of fat in the menu. And we warn you cannot have a lot of fat and have a lot of carbohydrates. That's the combination that's dangerous.
COHEN: And, Colette, do you think that people have misunderstood to Atkins diet, that they think it's meat, meat, meat all the time, and that that's not the case?
HEIMOWITZ: Absolutely, and that's a real concern of mine, because research has shown that fat will increase cardiovascular risk in the presence of excessive carbohydrates, where they're 40 percent or more of the total calorie composition. But in emerging research and in the research in the literature, you find that when carbohydrates are restricted to less than 20 percent, like 10 percent of total calories, fat poses no risk. In fact, cardiovascular risk diminishes when carbohydrates are restricted because you're burning fat for fuel. COHEN: Judy Stern, tell me, what do you think about this evolution in the Atkins revolution?
JUDY STERN, UNIVERSITY OF CALIFORNIA, DAVIS: Well, Elizabeth, I'm always happen to see an evolution, but I think it's a little bit misleading. First of all, cardiovascular risk can decrease on any diet that's calorically restricted. It can be high carb, it can be low carb. And you lose weight because you eat less. It's not rocket science. But, in fact, if you're limited to 20 calorie, 20 grams of carb a day, guess what you can't have? An apple.
The other thing is you're supposed to have berries and fruit on the Atkins diet. You can't have a lot of strawberries. They're wonderful. I adore strawberries. These are California strawberries, by the way. So that your choices are very limited. You're not taking in very much fiber. And the diet is very dependent on supplements plus, my real concern is Atkins is saying that if you can follow this approach for a lifetime, and that's on the Web site, and when I went on the Web site to look at the good health reference list, it says none at this time.
So, in fact, we have no data for the long-term effect of staying on the Atkins diet. There are a few six month studies. The National Institutes of Health is doing a five year study. But that's not well under way. It's about a year into the five year study and we just don't know.
So if I were to hedge my bets, Elizabeth, and say do I want to have a long life and a happy, you know, and a healthy life, I'd put my bets on fruits and vegetables because that's what we know.
COHEN: Judy Stern, thank you.
We're going to have more of this debate on the Atkins diet from two people who feel very differently about it, as you can tell, when we come back.
COLLINS: They do.
COHEN: And phone calls and e-mails.
COLLINS: That's right. You know, I know a lot of people who have done this and they've been very successful at it. So I'm interested to know of those who've even had success at the old Atkins, if that's safe to say, you know, if they're going to change their eating habits or just going to stick to it, because it's worked.
COHEN: Right, exactly. So you're going to try something that might not necessarily work.
COLLINS: Yes, exactly.
COHEN: Absolutely.
COLLINS: All right, we're going to talk more about that when we come back. And you can certainly weigh in on our debate. So keep it here on CNN SATURDAY MORNING.
COMMERCIAL
COLLINS: Welcome back to weekend House Call.
We're talking about the popular but controversial Atkins diet with our medical correspondent Elizabeth Cohen.
And, hey, I went down and got some bacon during the break.
COHEN: There you go. Well, chew away. One of our guests will be happy with what you're doing, maybe not the other one.
COLLINS: Well, but, you know, I imagine that you can still eat the bacon. You just have to make sure you're really low on the carbs, right?
COHEN: Yes, really low on the carbs. And basically what we're seeing, what the Atkins people have told us is there has been, as they say, an evolution in the Atkins diet revolution. They used to say meat, meat, meat and now they're saying well, we didn't really mean that. We think actually that you ought to be getting your protein, also, a lot of it from fish and chicken.
So the question is will people still be as enthusiastic about the Atkins diet if it means fish and chicken and not just fun stuff like bacon that Heidi is chomping on over here?
We have an e-mail. We have a question here. "I have had great success on Atkins but worry about switching back to so-called normal eating. Will I gain what I lost? Are there other negatives?"
I know that's a question that many people have, once you go off the first part of Atkins, can you still keep that weight loss down later on?
Colette Heimowitz, a spokeswoman for Atkins, can you answer that question for us?
HEIMOWITZ: That is exactly why "Atkins For Life" was written, to show people how to progress through the phases, to add nutrient dense carbohydrates like berries. And if Judy read the book, she would see that berries is the first thing that we add back in. And calorie for calorie, vegetables are much more nutrient dense as far as antioxidants and phytochemicals and fiber. So vegetables are increased, berries are one of the first fruits that are added, seeds and nuts. So you learn how to choose the lowest carbohydrates, the highest nutrient dense choices, and you learn how to stay away from the refined flours, the refined sugars. And you appreciate fruit as a sweet rather than candy.
So it's very important to learn how to progress through the phases and how to still keep your risks down and achieve permanent weight control. COHEN: Now, Judy, I know that you have concerns that people might lose weight on Atkins but then their weight might go back up when they try to stay on it for life.
STERN: Right, Elizabeth.
First of all, the Atkins people have no data that you can stay on this for life, or even stay on this for two plus years. It just isn't published. But basically when we look at the National Weight Loss Registry, and that's a study supported by the National Institutes of Health of over 3,000 men and women who've permanently kept off weight, less than one percent, fewer than one percent do so on a high protein, higher fat diet.
They mostly are on a low fat diet. And so, in the absence of evidence, Colette, which you all don't have, I can't say this is something that you can go on for life. And I have one other...
HEIMOWITZ: I think...
STERN: Can I just make one other point, if that's OK?
HEIMOWITZ: Sure.
STERN: OK, I'm not against supplements. However, I don't think we know what duplicates things like what's in carrots, what's in peppers or what's in dark, green leafy vegetables. We do know fruits and vegetables decrease cancer risk. But when they did a study in Europe with beta carotene, because we all thought it was beta carotene and people at high risk for lung cancer...
COHEN: Judy, I'm going to bring in a phone call here.
STERN: OK, sorry.
COHEN: Because I think this phone call wants to address some of these concerns.
STERN: Great.
COHEN: Deb from Illinois, you have a question.
Go ahead, Deb.
DEB: Well, my first part of my question was is it for life? And you guys have touched upon that. The second part was would it be a great diet for a diabetic?
COHEN: Colette, why don't you go ahead and answer that.
HEIMOWITZ: Diabetics have high blood sugar. You know, that's how they're diagnosed as diabetes. Carbohydrates are the macronutrient that raises blood sugar. When you control carbohydrates, you control the amount of blood sugar the body produces. So absolutely, this is the type of the population that responds best to controlling carbohydrate consumption. Whether or not induction phase is appropriate is a question your health care professional needs to answer. But controlling carbohydrates is very important.
COHEN: And Troy from New York -- thank you, Colette.
Troy from New York...
STERN: But, Elizabeth...
COHEN: ... has a question about red meat.
Troy, go ahead.
TROY: I've been on the Atkins diet and lost 12 pounds in two weeks and I think it's very successful. I just took a trip to Paris and was able to eat there freely and have no problems and was able to follow the carbohydrate rules.
My question is whether or not it's possible to substitute other items for red meat, because I don't like red meat.
HEIMOWITZ: Absolutely. Absolutely. You can do this program without red meat. It's so important, all of the research, Judy, has shown better compliance because you can eat luxuriously on the induction phase, like steak. But it's not necessary. You could have fish and chicken and tofu and some cheese. We limit it to three ounces a day. As long as you're controlling carbohydrates, and that's the most important point. It's not about meat, it's about controlling carbohydrate consumption so that the body burns fat for fuel. That is our backup fuel system.
And you will live longer...
STERN: But Colette...
HEIMOWITZ: ... when your weight is lower.
STERN: Actually, Colette...
HEIMOWITZ: It includes vegetables.
STERN: ... just a minute, OK? You can lose weight on anything. What the Atkins diet does, it restricts whole classes of foods so you eat less.
HEIMOWITZ: You're wrong, Judy.
STERN: And just to comment...
HEIMOWITZ: We include vegetables.
STERN: No, no. Just...
HEIMOWITZ: We include strawberries.
STERN: No, no, 20 grams of carbs.
HEIMOWITZ: There are seeds and nuts...
STERN: Just a comment, OK...
HEIMOWITZ: For two weeks...
STERN: People with Type II diabetes who go on a Slim Fast plan that actually has a lot of carbohydrate do just as well. They control their diabetes. Their insulin levels are down and their insulin resistance are down.
HEIMOWITZ: When you go very low calorie...
COHEN: And ladies, this discussion is so fascinating and I'm sure our viewers find it fascinating, too.
But, unfortunately, Heidi, I'm told we have to go to a break, right?
COLLINS: Right. But I just wanted to point out really quickly that when Troy called, the first thing that caught my attention was he said he lost 12 pounds in two weeks. And nobody touched on that. That is an awful lot of weight to lose in a very short amount of time.
COHEN: Right.
COLLINS: You know, certainly I am not a doctor, but I would be curious to know if, in fact, that's even safe.
COHEN: Right.
COLLINS: He feels very happy about that, but that sounds a little fast to me.
COHEN: Right. Most people will tell you a pound or two a week. Six pounds is way too much.
COLLINS: Yes. Yes.
COHEN: That's what most people will tell you.
COLLINS: All right, we'll touch on that, hopefully, in just a little bit, too.
COHEN: OK.
COLLINS: So maybe with all of this talk of diets you are wondering if you should try to lose a few pounds. Well, to help you make a decision, you can go to our Web site to find your body mass index. A lot of this is based on your body mass index, this huge mathematical calculation. So you can learn how to do it on our Web site. Just go to cnn.com/health and use our BMI calculator.
And stay with us right here on House Call as we dish up more of the skinny on the Atkins diet. COMMERCIAL
COLLINS: Magic weight loss earrings?
COHEN: I bought them here yesterday.
COLLINS: You did? Wow, I'm interested in those.
All right, we are, of course, back with CNN's weekend House Call and medical correspondent Elizabeth Cohen talking about the Atkins diet today. Heated debate.
COHEN: Heated debate between a spokeswoman for Atkins and a critic of Atkins. And what you heard on our air just before the break was actually something that I think will shock a lot of Atkins dieters, which is that, as the spokeswoman for Atkins said, it is not about meat. That's not what we're telling people to do, eat meat, meat, meat. She says that the diet has been misunderstood.
Judy Stern, who is a professor at U.C. Davis in California -- Judy, I'd like you to weigh in on this a little bit. Were you surprised to hear that Atkins is sort of stepping away from the meat?
STERN: Well, it's about time they did because all the data and the evidence shows very high meat consumption with high saturated fatty acids increases heart disease risk. So thank you for changing your diet.
HEIMOWITZ: In the presence of carbohydrates.
COHEN: And we have...
STERN: And, pardon me?
HEIMOWITZ: In the presence of carbohydrates.
STERN: Oh, baloney.
HEIMOWITZ: That will do that.
STERN: You know, caloric restriction is what it's all about...
HEIMOWITZ: OK, Judy, let's talk evidence...
STERN: ... and give us maintenance, you know, you don't have the evidence.
HEIMOWITZ: Let's talk evidence. Good.
STERN: Let's talk evidence.
HEIMOWITZ: You haven't read what's been presented at conferences in the last two years. There's been six independent trials head to head with low fat and Atkins at the University of Connecticut, the University of Cincinnati, Duke University. And what they find is that on Atkins, the risk for cardiovascular disease is better when compared to low fat. Weight loss is better. Compliance is better. And they studied it for six months to a year on induction.
What "Atkins For Life" is telling people is that they need to add carbohydrates back in and teach them how to keep that weight off that they lost because it's important that they maintain their weight.
STERN: But, Colette, you're ignoring the body of literature. I'm looking at a paper in the "American Journal of Kidney Disease" where this high protein, low carb is really exacerbating kidney disease, from the University of Chicago. Excellent study last year.
HEIMOWITZ: That was a very short-term study and there was a slight shift in key age...
COHEN: Ladies, before we get into a squaring off here over studies, let's get an e-mail from a viewer, because it relates to some of the topics that you're discussing here.
COLLINS: OK.
COHEN: The question is, "I recently saw Dr. Atkins on a local station promoting his Atkins diet. He says he's trying to convince mainstream doctors that eating foods such as steak, eggs and cheese are fine. What is your opinion on the appropriate amount of fat that a person should consume on a daily basis?"
Quickly, let's hear from Colette and then quickly let's hear from Judy.
HEIMOWITZ: On the induction phase, the diet composition is 35 percent protein, 60 percent fat and five to 10 percent carbohydrate. As you progress through the stages, protein stays constant, fat comes down, carbohydrates come up. But only the nutrient dense carbohydrates.
STERN: And what does fat come down to, Colette?
HEIMOWITZ: It depends on how many carbohydrates. Each individual has a critical carbohydrate tolerance. They have to stay beneath that to keep their weight off. So the ratio will depend on the individual's metabolism, age, genetics.
COHEN: Judy, what do you think? What's the ideal amount of fat in a person's diet?
STERN: You know, again, to maintain weight, relatively low fat diet, below what we're getting, which is about 30 percent of our calories from fat. To lose weight, about 25 percent of calories from fat. But Dean Ornish, in a very extreme diet, about 10 percent of calories from fat, reverses heart disease.
COHEN: We have...
STERN: So I think it depends on where you're approaching it.
COHEN: We have a phone call. Evelyn from Florida is waiting to talk to you ladies. She has a question about caffeine. Evelyn, go ahead.
EVELYN: How are you?
COHEN: I'm doing fine.
EVELYN: Well, good.
I love this Atkins diet. The only thing I want to know is why I cannot have caffeine? I've been on the diet seven months. I've lost 65 pounds. I'm smaller than I've been in a hundred years and I'm 60 years old. And I'm proud of this diet.
COHEN: Colette, why don't you go ahead and talk about caffeine in the Atkins diet.
HEIMOWITZ: In the initial phases of the program there is some water loss that quickly levels out after two weeks and all of the fat and composition studies are from fat. And caffeine is a natural diuretic. We don't want people to lose too much water. And at the same time, it is -- there are some studies that show that excessive caffeine could cause hypoglycemia, low blood sugar, and then people who are craving sugar. So we want to avoid that, as well.
But after the first two weeks, you could have green tea. In fact, research has shown that some caffeine for women...
COHEN: Colette Heimowitz, I am sorry to interrupt you, but thank you.
HEIMOWITZ: OK.
COHEN: I think that probably answered Evelyn's questions.
HEIMOWITZ: Sure.
COHEN: Thank you to Judy Stern from the University of California at Davis and Colette Heimowitz, a spokeswoman for the Atkins diet.
And thank you to all the folks who e-mailed and phone called us.
COLLINS: Right. Right.
Another seven months for 60 pounds, though. It just concerns me with how much weight people seem to be losing in a short amount of time.
COHEN: Yes, yes, because there are some dangers to that.
COLLINS: OK.
All right, well, we will be back in just a few minutes, everybody, for some final thoughts on the Atkins diet and what's coming up tomorrow, too. Stick around.
COMMERCIAL COLLINS: Great discussion this morning on the Atkins diet with Elizabeth Cohen, our medical correspondent.
Some final thoughts?
COHEN: Some final thoughts to something that you brought up, which is how much weight are people losing at one time. I mean there are real concerns when people lose more than, let's say, a pound to two a week. One, it might not be so good for your body. And, two, it's hard to keep that kind of weight loss off.
COLLINS: Right.
COHEN: If you're losing six pounds in a week, how are you, when you, you know, you have to live a long time on that diet and that would be very, very hard to do.
COLLINS: Yes, so obviously consult your doctor first with any diet.
COHEN: Absolutely.
COLLINS: And as long as you're going to eat bacon or sausage or red meat, just don't have a big pile of rice. And also don't drop it on the floor.
COHEN: That is crispy bacon, I'll tell you. It just broke right there in your hands.
COLLINS: All right, what are we going to talk about tomorrow?
COHEN: Well, tomorrow we're going to talk about sleeplessness in America. Many people with lots of sleep problems. You'll want to wake up for tomorrow's House Call. That's what we'll be talking about. The problem isn't just costing you a little shut eye, it's costing millions of dollars. We'll look at some common sleep problems and get some new advice to get you to go to sleep. And we will be taking your e-mails and phone calls. So if you have sleep problems, give us a -- wake up. Wake up.
COLLINS: I have lots of sleep problems.
All right, very good. This is an excellent topic, especially for the working world.
COHEN: Great. Oh, yes.
COLLINS: And people with little tiny babies.
COHEN: That wake them up at three in the morning.
COLLINS: That's right.
COHEN: Yes.
COLLINS: All right, Elizabeth Cohen, we will see you tomorrow on House Call at 8:30 Eastern time.
COHEN: Great.
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Aired February 1, 2003 - 08:29 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
HEIDI COLLINS, CNN ANCHOR: Do you need to lose a little weight? Maybe you're like 60 percent of Americans, who need to lose more than a little. Dr. Robert Atkins has been preaching his low carb, high fat diet to the pudgy masses for 30 years.
But, medical correspondent Elizabeth Cohen joins us now with our weekend House Call to explore what appears to be a little bit of a change in tune to this diet. People might be confused now about what's going on with this.
ELIZABETH COHEN, CNN CORRESPONDENT: Absolutely. So we're going to try to get rid of the confusion. I know when most people think of Atkins they think meat, meat, meat. That's why I'm going on the diet, right, so I can eat bacon...
COLLINS: Bacon, sausage...
COHEN: Exactly. So I can eat all of that. But now the Atkins folks are saying oh, no, that's not what we meant.
(BEGIN VIDEOTAPE)
COHEN (voice-over): Whenever you think of Dr. Robert Atkins and the Atkins diet, you think ah, freedom to eat meat as much as I want and still lose weight. Now, after 30 years as a diet author, Dr. Atkins says this is not what his diet is all about. Surprised? So were we when we heard this from Dr. Atkins' spokeswoman.
COLETTE HEIMOWITZ, ATKINS SPOKESWOMAN: My concern is that when you talk about Atkins, the images of steak and frying food is always in the media. And people might interpret that as well, I'll just cut back on brad and pasta and eat lots of steak and cheeseburgers, and that's not what the Atkins nutritional approach is all about.
COHEN: Really? Just two years ago, the same woman told us she loved red meat.
HEIMOWITZ: So it's safe to take in steak, and that's the beauty about the diet, you know, you can have your steak and not have to worry.
COHEN: This new Atkins P.R. video says the media distorted the Atkins diet and that Atkins really advocates eating fish and chicken and fruits and vegetables. Do you know anyone who went on Atkins so they could pig out on fish and broccoli? We don't. In fact, right here in Dr. Atkins's 1999 book, it says to eat bacon and ham for breakfast, for lunch a bacon cheeseburger, no bun, of course, and steak, roasts, chops or chicken or fish for dinner.
And so that left us confused. Why does it seem Atkins is suddenly de-emphasizing red meat, the thing everyone loves about his diet? A spokesman for Atkins simply says that over the past year or two, there's been an evolution in the diet revolution. But you have to ask, will people still want to go on Atkins if it means eating unlimited amounts of chicken?
(END VIDEOTAPE)
COHEN: Now, you'll notice we talked about Dr. Atkins's 1999 book, which said meat, meat, meat. Well, in his new book, which has just come out, there's recipes for things like chicken salad in an avocado shell or smoked salmon and cream cheese on low carb bread. So there seems to be a real change here.
We have two guests with us here today to talk about some of those changes.
From New York, we have nutritionist Colette Heimowitz. She is director of education and research at the Atkins Health and Medical Information Systems. And from San Francisco, we have nutritionist Judith Stern. She is professor of nutrition and internal medicine at the University of California at Davis and she is not a fan of the Atkins diet.
Colette, I have a question for you first.
What's going on? Why this change?
HEIMOWITZ: There are different phases of the Atkins diet. On the induction phase, you have the luxury to have meat two times a week if you choose to. It's not necessary for the success of the program. It depends on people's likes and dislikes.
When you're burning fat for fuel and carbohydrates are restricted to less than 40 grams, you burn fat for energy and fat poses no risk. In the new book, "Atkins For Life," it addresses maintenance where carbohydrates are increased. And the amount of carbohydrates will depend on the choices of fat in the menu. And we warn you cannot have a lot of fat and have a lot of carbohydrates. That's the combination that's dangerous.
COHEN: And, Colette, do you think that people have misunderstood to Atkins diet, that they think it's meat, meat, meat all the time, and that that's not the case?
HEIMOWITZ: Absolutely, and that's a real concern of mine, because research has shown that fat will increase cardiovascular risk in the presence of excessive carbohydrates, where they're 40 percent or more of the total calorie composition. But in emerging research and in the research in the literature, you find that when carbohydrates are restricted to less than 20 percent, like 10 percent of total calories, fat poses no risk. In fact, cardiovascular risk diminishes when carbohydrates are restricted because you're burning fat for fuel. COHEN: Judy Stern, tell me, what do you think about this evolution in the Atkins revolution?
JUDY STERN, UNIVERSITY OF CALIFORNIA, DAVIS: Well, Elizabeth, I'm always happen to see an evolution, but I think it's a little bit misleading. First of all, cardiovascular risk can decrease on any diet that's calorically restricted. It can be high carb, it can be low carb. And you lose weight because you eat less. It's not rocket science. But, in fact, if you're limited to 20 calorie, 20 grams of carb a day, guess what you can't have? An apple.
The other thing is you're supposed to have berries and fruit on the Atkins diet. You can't have a lot of strawberries. They're wonderful. I adore strawberries. These are California strawberries, by the way. So that your choices are very limited. You're not taking in very much fiber. And the diet is very dependent on supplements plus, my real concern is Atkins is saying that if you can follow this approach for a lifetime, and that's on the Web site, and when I went on the Web site to look at the good health reference list, it says none at this time.
So, in fact, we have no data for the long-term effect of staying on the Atkins diet. There are a few six month studies. The National Institutes of Health is doing a five year study. But that's not well under way. It's about a year into the five year study and we just don't know.
So if I were to hedge my bets, Elizabeth, and say do I want to have a long life and a happy, you know, and a healthy life, I'd put my bets on fruits and vegetables because that's what we know.
COHEN: Judy Stern, thank you.
We're going to have more of this debate on the Atkins diet from two people who feel very differently about it, as you can tell, when we come back.
COLLINS: They do.
COHEN: And phone calls and e-mails.
COLLINS: That's right. You know, I know a lot of people who have done this and they've been very successful at it. So I'm interested to know of those who've even had success at the old Atkins, if that's safe to say, you know, if they're going to change their eating habits or just going to stick to it, because it's worked.
COHEN: Right, exactly. So you're going to try something that might not necessarily work.
COLLINS: Yes, exactly.
COHEN: Absolutely.
COLLINS: All right, we're going to talk more about that when we come back. And you can certainly weigh in on our debate. So keep it here on CNN SATURDAY MORNING.
COMMERCIAL
COLLINS: Welcome back to weekend House Call.
We're talking about the popular but controversial Atkins diet with our medical correspondent Elizabeth Cohen.
And, hey, I went down and got some bacon during the break.
COHEN: There you go. Well, chew away. One of our guests will be happy with what you're doing, maybe not the other one.
COLLINS: Well, but, you know, I imagine that you can still eat the bacon. You just have to make sure you're really low on the carbs, right?
COHEN: Yes, really low on the carbs. And basically what we're seeing, what the Atkins people have told us is there has been, as they say, an evolution in the Atkins diet revolution. They used to say meat, meat, meat and now they're saying well, we didn't really mean that. We think actually that you ought to be getting your protein, also, a lot of it from fish and chicken.
So the question is will people still be as enthusiastic about the Atkins diet if it means fish and chicken and not just fun stuff like bacon that Heidi is chomping on over here?
We have an e-mail. We have a question here. "I have had great success on Atkins but worry about switching back to so-called normal eating. Will I gain what I lost? Are there other negatives?"
I know that's a question that many people have, once you go off the first part of Atkins, can you still keep that weight loss down later on?
Colette Heimowitz, a spokeswoman for Atkins, can you answer that question for us?
HEIMOWITZ: That is exactly why "Atkins For Life" was written, to show people how to progress through the phases, to add nutrient dense carbohydrates like berries. And if Judy read the book, she would see that berries is the first thing that we add back in. And calorie for calorie, vegetables are much more nutrient dense as far as antioxidants and phytochemicals and fiber. So vegetables are increased, berries are one of the first fruits that are added, seeds and nuts. So you learn how to choose the lowest carbohydrates, the highest nutrient dense choices, and you learn how to stay away from the refined flours, the refined sugars. And you appreciate fruit as a sweet rather than candy.
So it's very important to learn how to progress through the phases and how to still keep your risks down and achieve permanent weight control. COHEN: Now, Judy, I know that you have concerns that people might lose weight on Atkins but then their weight might go back up when they try to stay on it for life.
STERN: Right, Elizabeth.
First of all, the Atkins people have no data that you can stay on this for life, or even stay on this for two plus years. It just isn't published. But basically when we look at the National Weight Loss Registry, and that's a study supported by the National Institutes of Health of over 3,000 men and women who've permanently kept off weight, less than one percent, fewer than one percent do so on a high protein, higher fat diet.
They mostly are on a low fat diet. And so, in the absence of evidence, Colette, which you all don't have, I can't say this is something that you can go on for life. And I have one other...
HEIMOWITZ: I think...
STERN: Can I just make one other point, if that's OK?
HEIMOWITZ: Sure.
STERN: OK, I'm not against supplements. However, I don't think we know what duplicates things like what's in carrots, what's in peppers or what's in dark, green leafy vegetables. We do know fruits and vegetables decrease cancer risk. But when they did a study in Europe with beta carotene, because we all thought it was beta carotene and people at high risk for lung cancer...
COHEN: Judy, I'm going to bring in a phone call here.
STERN: OK, sorry.
COHEN: Because I think this phone call wants to address some of these concerns.
STERN: Great.
COHEN: Deb from Illinois, you have a question.
Go ahead, Deb.
DEB: Well, my first part of my question was is it for life? And you guys have touched upon that. The second part was would it be a great diet for a diabetic?
COHEN: Colette, why don't you go ahead and answer that.
HEIMOWITZ: Diabetics have high blood sugar. You know, that's how they're diagnosed as diabetes. Carbohydrates are the macronutrient that raises blood sugar. When you control carbohydrates, you control the amount of blood sugar the body produces. So absolutely, this is the type of the population that responds best to controlling carbohydrate consumption. Whether or not induction phase is appropriate is a question your health care professional needs to answer. But controlling carbohydrates is very important.
COHEN: And Troy from New York -- thank you, Colette.
Troy from New York...
STERN: But, Elizabeth...
COHEN: ... has a question about red meat.
Troy, go ahead.
TROY: I've been on the Atkins diet and lost 12 pounds in two weeks and I think it's very successful. I just took a trip to Paris and was able to eat there freely and have no problems and was able to follow the carbohydrate rules.
My question is whether or not it's possible to substitute other items for red meat, because I don't like red meat.
HEIMOWITZ: Absolutely. Absolutely. You can do this program without red meat. It's so important, all of the research, Judy, has shown better compliance because you can eat luxuriously on the induction phase, like steak. But it's not necessary. You could have fish and chicken and tofu and some cheese. We limit it to three ounces a day. As long as you're controlling carbohydrates, and that's the most important point. It's not about meat, it's about controlling carbohydrate consumption so that the body burns fat for fuel. That is our backup fuel system.
And you will live longer...
STERN: But Colette...
HEIMOWITZ: ... when your weight is lower.
STERN: Actually, Colette...
HEIMOWITZ: It includes vegetables.
STERN: ... just a minute, OK? You can lose weight on anything. What the Atkins diet does, it restricts whole classes of foods so you eat less.
HEIMOWITZ: You're wrong, Judy.
STERN: And just to comment...
HEIMOWITZ: We include vegetables.
STERN: No, no. Just...
HEIMOWITZ: We include strawberries.
STERN: No, no, 20 grams of carbs.
HEIMOWITZ: There are seeds and nuts...
STERN: Just a comment, OK...
HEIMOWITZ: For two weeks...
STERN: People with Type II diabetes who go on a Slim Fast plan that actually has a lot of carbohydrate do just as well. They control their diabetes. Their insulin levels are down and their insulin resistance are down.
HEIMOWITZ: When you go very low calorie...
COHEN: And ladies, this discussion is so fascinating and I'm sure our viewers find it fascinating, too.
But, unfortunately, Heidi, I'm told we have to go to a break, right?
COLLINS: Right. But I just wanted to point out really quickly that when Troy called, the first thing that caught my attention was he said he lost 12 pounds in two weeks. And nobody touched on that. That is an awful lot of weight to lose in a very short amount of time.
COHEN: Right.
COLLINS: You know, certainly I am not a doctor, but I would be curious to know if, in fact, that's even safe.
COHEN: Right.
COLLINS: He feels very happy about that, but that sounds a little fast to me.
COHEN: Right. Most people will tell you a pound or two a week. Six pounds is way too much.
COLLINS: Yes. Yes.
COHEN: That's what most people will tell you.
COLLINS: All right, we'll touch on that, hopefully, in just a little bit, too.
COHEN: OK.
COLLINS: So maybe with all of this talk of diets you are wondering if you should try to lose a few pounds. Well, to help you make a decision, you can go to our Web site to find your body mass index. A lot of this is based on your body mass index, this huge mathematical calculation. So you can learn how to do it on our Web site. Just go to cnn.com/health and use our BMI calculator.
And stay with us right here on House Call as we dish up more of the skinny on the Atkins diet. COMMERCIAL
COLLINS: Magic weight loss earrings?
COHEN: I bought them here yesterday.
COLLINS: You did? Wow, I'm interested in those.
All right, we are, of course, back with CNN's weekend House Call and medical correspondent Elizabeth Cohen talking about the Atkins diet today. Heated debate.
COHEN: Heated debate between a spokeswoman for Atkins and a critic of Atkins. And what you heard on our air just before the break was actually something that I think will shock a lot of Atkins dieters, which is that, as the spokeswoman for Atkins said, it is not about meat. That's not what we're telling people to do, eat meat, meat, meat. She says that the diet has been misunderstood.
Judy Stern, who is a professor at U.C. Davis in California -- Judy, I'd like you to weigh in on this a little bit. Were you surprised to hear that Atkins is sort of stepping away from the meat?
STERN: Well, it's about time they did because all the data and the evidence shows very high meat consumption with high saturated fatty acids increases heart disease risk. So thank you for changing your diet.
HEIMOWITZ: In the presence of carbohydrates.
COHEN: And we have...
STERN: And, pardon me?
HEIMOWITZ: In the presence of carbohydrates.
STERN: Oh, baloney.
HEIMOWITZ: That will do that.
STERN: You know, caloric restriction is what it's all about...
HEIMOWITZ: OK, Judy, let's talk evidence...
STERN: ... and give us maintenance, you know, you don't have the evidence.
HEIMOWITZ: Let's talk evidence. Good.
STERN: Let's talk evidence.
HEIMOWITZ: You haven't read what's been presented at conferences in the last two years. There's been six independent trials head to head with low fat and Atkins at the University of Connecticut, the University of Cincinnati, Duke University. And what they find is that on Atkins, the risk for cardiovascular disease is better when compared to low fat. Weight loss is better. Compliance is better. And they studied it for six months to a year on induction.
What "Atkins For Life" is telling people is that they need to add carbohydrates back in and teach them how to keep that weight off that they lost because it's important that they maintain their weight.
STERN: But, Colette, you're ignoring the body of literature. I'm looking at a paper in the "American Journal of Kidney Disease" where this high protein, low carb is really exacerbating kidney disease, from the University of Chicago. Excellent study last year.
HEIMOWITZ: That was a very short-term study and there was a slight shift in key age...
COHEN: Ladies, before we get into a squaring off here over studies, let's get an e-mail from a viewer, because it relates to some of the topics that you're discussing here.
COLLINS: OK.
COHEN: The question is, "I recently saw Dr. Atkins on a local station promoting his Atkins diet. He says he's trying to convince mainstream doctors that eating foods such as steak, eggs and cheese are fine. What is your opinion on the appropriate amount of fat that a person should consume on a daily basis?"
Quickly, let's hear from Colette and then quickly let's hear from Judy.
HEIMOWITZ: On the induction phase, the diet composition is 35 percent protein, 60 percent fat and five to 10 percent carbohydrate. As you progress through the stages, protein stays constant, fat comes down, carbohydrates come up. But only the nutrient dense carbohydrates.
STERN: And what does fat come down to, Colette?
HEIMOWITZ: It depends on how many carbohydrates. Each individual has a critical carbohydrate tolerance. They have to stay beneath that to keep their weight off. So the ratio will depend on the individual's metabolism, age, genetics.
COHEN: Judy, what do you think? What's the ideal amount of fat in a person's diet?
STERN: You know, again, to maintain weight, relatively low fat diet, below what we're getting, which is about 30 percent of our calories from fat. To lose weight, about 25 percent of calories from fat. But Dean Ornish, in a very extreme diet, about 10 percent of calories from fat, reverses heart disease.
COHEN: We have...
STERN: So I think it depends on where you're approaching it.
COHEN: We have a phone call. Evelyn from Florida is waiting to talk to you ladies. She has a question about caffeine. Evelyn, go ahead.
EVELYN: How are you?
COHEN: I'm doing fine.
EVELYN: Well, good.
I love this Atkins diet. The only thing I want to know is why I cannot have caffeine? I've been on the diet seven months. I've lost 65 pounds. I'm smaller than I've been in a hundred years and I'm 60 years old. And I'm proud of this diet.
COHEN: Colette, why don't you go ahead and talk about caffeine in the Atkins diet.
HEIMOWITZ: In the initial phases of the program there is some water loss that quickly levels out after two weeks and all of the fat and composition studies are from fat. And caffeine is a natural diuretic. We don't want people to lose too much water. And at the same time, it is -- there are some studies that show that excessive caffeine could cause hypoglycemia, low blood sugar, and then people who are craving sugar. So we want to avoid that, as well.
But after the first two weeks, you could have green tea. In fact, research has shown that some caffeine for women...
COHEN: Colette Heimowitz, I am sorry to interrupt you, but thank you.
HEIMOWITZ: OK.
COHEN: I think that probably answered Evelyn's questions.
HEIMOWITZ: Sure.
COHEN: Thank you to Judy Stern from the University of California at Davis and Colette Heimowitz, a spokeswoman for the Atkins diet.
And thank you to all the folks who e-mailed and phone called us.
COLLINS: Right. Right.
Another seven months for 60 pounds, though. It just concerns me with how much weight people seem to be losing in a short amount of time.
COHEN: Yes, yes, because there are some dangers to that.
COLLINS: OK.
All right, well, we will be back in just a few minutes, everybody, for some final thoughts on the Atkins diet and what's coming up tomorrow, too. Stick around.
COMMERCIAL COLLINS: Great discussion this morning on the Atkins diet with Elizabeth Cohen, our medical correspondent.
Some final thoughts?
COHEN: Some final thoughts to something that you brought up, which is how much weight are people losing at one time. I mean there are real concerns when people lose more than, let's say, a pound to two a week. One, it might not be so good for your body. And, two, it's hard to keep that kind of weight loss off.
COLLINS: Right.
COHEN: If you're losing six pounds in a week, how are you, when you, you know, you have to live a long time on that diet and that would be very, very hard to do.
COLLINS: Yes, so obviously consult your doctor first with any diet.
COHEN: Absolutely.
COLLINS: And as long as you're going to eat bacon or sausage or red meat, just don't have a big pile of rice. And also don't drop it on the floor.
COHEN: That is crispy bacon, I'll tell you. It just broke right there in your hands.
COLLINS: All right, what are we going to talk about tomorrow?
COHEN: Well, tomorrow we're going to talk about sleeplessness in America. Many people with lots of sleep problems. You'll want to wake up for tomorrow's House Call. That's what we'll be talking about. The problem isn't just costing you a little shut eye, it's costing millions of dollars. We'll look at some common sleep problems and get some new advice to get you to go to sleep. And we will be taking your e-mails and phone calls. So if you have sleep problems, give us a -- wake up. Wake up.
COLLINS: I have lots of sleep problems.
All right, very good. This is an excellent topic, especially for the working world.
COHEN: Great. Oh, yes.
COLLINS: And people with little tiny babies.
COHEN: That wake them up at three in the morning.
COLLINS: That's right.
COHEN: Yes.
COLLINS: All right, Elizabeth Cohen, we will see you tomorrow on House Call at 8:30 Eastern time.
COHEN: Great.
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