Review on "Atkins Diabetes Revolution: The Groundbreaki...

Review on "Atkins Diabetes Revolution: The Groundbreaking Approach to Preventing and Controlling Type 2 Diabetes"

Review on "Atkins Diabetes Revolution: The Groundbreaking Approach to Preventing and Controlling Type 2 Diabetes"
Received: 13 October 2004
Accepted: 9 November 2004
Published: 9 November 2004
Surender Arora1,2 and Samy I McFarlane1,2
Nutrition & Metabolism 2004

1State University of New York Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, New York 11203, USA

2Kings County Hospital, Brooklyn, New York, USA

The electronic version of this article is the complete one and can be found online at: http://www.nutritionandmetabolism.com/content/1/1/14

© 2004 Arora and McFarlane; licensee BioMed Central Ltd.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Book details
Vernon MC, Eberstein JA: Atkins Diabetes Revolution. The Groundbreaking Approach to Preventing and controlling Type 2 Diabetes. William Morrow; 2004, 538. ISBN 0-06-054008-7

Before beginning the review of this book, we had no particular opinion about the role of low carbohydrate diets in diabetes. In order to write a fair and unbiased review, we have done a rather extensive search on the subject. One of the most disturbing findings of our search is the amount of hostility towards low carbohydrate diets that is on the web and in the scientific literature. We found several sites that present no scientific arguments but are, rather, full of ad hominem attacks. This was particularly disturbing in that we are in the midst of a growing epidemic of obesity and diabetes with very alarming figures and projections from all over the world. Any intervention that has the potential for helping curb this dangerous epidemic which claims thousands of lives every day should be looked at with a great deal of objectivity.

The low carbohydrate approach, in fact, is not new and was used in England more than a century ago, made popular by William Harvey [1], an ENT surgeon. He prescribed a low carbohydrate diet for William Banting, an obese carpenter who had been having a great difficulty losing weight. Banting was able to lose weight and as a service, he published in 1863 a small booklet entitled Letter on Corpulence Addressed to the Public [2], the first book to be published on obesity and one which popularized low carbohydrate diets. He has been called "Father of low carbohydrate diets" and was honored by his name being included in the dictionary as the verb "to bant" meaning "to diet". The low carbohydrate diet also been called a "Harvey-Banting diet" after the names of these pioneer. Since then, it has been in and out of fashion with different versions and names but with the same underlying concept, most recently popularized by the late Dr. Robert C. Atkins.

The Atkins Diabetes Revolution [3] plan is similar to the Atkins weight loss strategy: four levels of carbohydrate restriction are instituted. The induction phase restricts dieters to 20 g of carbohydrate. On the weight loss plan, this is recommended for about 2 weeks. In diabetes this is maintained until glycemic control is attained. In the latter stages, carbohydrates are added as long as weight loss or stability is maintained. For diabetes, carbohydrates are only reintroduced if glycemic control is acceptable. In the later phases, the Atkins Diabetes plan adds a Glycemic Ranking (AGR), derived from the glycemic index, glycemic load and net carbs. Preference is given to whole fruits and berries and juices and dried fruits are low on the list. As in weight loss, exercise is "mandatory."

The Atkins Diabetes Revolution book is an attempt by the authors to present the low carbohydrate diet as a preventive and treatment strategy for patients with type 2 diabetes and those with the metabolic syndrome, who are at high risk for developing diabetes and cardiovascular disease. In doing so, the book, which is very well written, and which clearly presents illustrative cases, explains very complex metabolic concept in a very easy to read and understandable format. The first nine chapters explain the different concepts involved in glucose and lipid metabolism and the interplay of the various cardiovascular risk factors that culminate in cardiovascular disease the number one killer of Americans today. Definitions of metabolic syndrome, pre-diabetes, body mass index, waist to hip ratio, central obesity and their relationship to diabetes, heart attacks and strokes, are eloquently presented with a great deal of accuracy yet in a simple format. Most impressive were the case presentations, especially that of reactive hypoglycemia and carbohydrate craving. This response is associated with hyperinsulinemia in the pre-diabetic phase and sometimes puzzles clinicians unless they know to look for it.

The second section of the book is devoted to an in-depth discussion of the various macro and micronutrients and their role in diabetes and obesity. Concepts such as the glycemic index and glycemic load are very well illustrated. The last section consists of meal plans and menus of low carbohydrate diet that the book is advocating.

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