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The Physicians Committee

Atkins Diet Alert

In the 1980s and 1990s, the United States witnessed unprecedented increases in the prevalence of overweight and obesity. A Centers for Disease Control and Prevention report found a 61 percent jump in obesity cases during this period, along with a 49 percent rise in the number of diabetes cases.

Based on the sales of diet books, it’s obvious that Americans are well aware of their weight issues, and many are trying to shed pounds quickly. But too few realize that the method they use is just as important as the number of pounds they lose.

PCRM has launched a two-tiered campaign (directed at both dieters and the physicians who are treating them) to deliver accurate weight-loss information via new websites and Internet banners, as well as television and newspaper advertisements. educates viewers about scientific studies linking high-protein, meat-heavy diets to osteoporosis, kidney disease, heart disease, and colon cancer. A television ad based on its content ran during the Oprah Winfrey Show in Houston, Chicago, and Washington, D.C., and a print edition ran in USA Today.

PCRM’s “Got a beef with the Atkins Diet” Web banner was created for consumers searching the Internet for dieting and nutrition resources. It links to, a resource for physicians and laypeople with questions and concerns about low-carbohydrate, high-protein diets.

The Web site contains a wealth of information about the diets and a registry where dieters can record any health complications they have experienced while using them.

A second ad and Web banner links to information for physicians, alerting them to the potential legal risks, in light of what research has shown, associated with prescribing a high-protein diet to patients.

Risks of High-Protein Diets

A study in the American Journal of Kidney Diseases found that high-protein, low-carbohydrate diets, such as the Atkins Diet, caused a rapid and pronounced loss of calcium. On the maintenance phase of the Atkins Diet, volunteers lost calcium in their urine at rates 55 percent above normal.

Despite press accounts of seemingly dramatic weight loss, the effect of high-protein diets on body weight is similar to that of other weight-reduction diets. Two recent studies from Duke University and the University of Pennsylvania suggest that average weight loss with high-protein diets during the first six months is approximately 20 pounds, not demonstrably greater than the amount of weight lost on regimens such as a vegetarian diet with no calorie restrictions. It is the other biological changes that take place on a meaty diet that cause concern.

High-protein, very-low-carbohydrate weight-loss diets are designed to induce ketosis, a state that also occurs in uncontrolled diabetes mellitus and starvation. When carbohydrate intake or utilization is insufficient to provide glucose to the cells that rely on it as an energy source, ketone bodies are formed from fatty acids. An increase in circulating ketones can disturb the body’s acid-base balance, causing metabolic acidosis. Even mild acidosis can have potentially deleterious consequences over the long run, including hypophosphatemia, resorption of calcium from bone, increased risk of osteoporosis, and an increased propensity to form kidney stones.

High-protein diets typically skew nutritional intake toward higher-than-recommended amounts of dietary cholesterol, fat, saturated fat, and protein and very low levels of fiber and other protective dietary constituents. The Nutrition Committee of the Council on Nutrition, Physical Activity, and Metabolism of the American Heart Association states, “High-protein diets are not recommended because they restrict healthful foods that provide essential nutrients and do not provide the variety of foods needed to adequately meet nutritional needs. Individuals who follow these diets are therefore at risk for compromised vitamin and mineral intake, as well as potential cardiac, renal, bone, and liver abnormalities overall.”

In contrast, groundbreaking studies published in Lancet (1990) and Journal of the American Medical Association (1998) found that a low-fat, vegetarian diet not only leads to significant weight loss; it can also reverse heart disease—a leading health threat for U.S. citizens. And, each year, there is additional scientific evidence that a diet rich in fruit and vegetables is best for long-term health.

A study from Loma Linda University comparing vegetarians and meat-eaters living in California found that the vegetarian males lived about seven years longer and the vegetarian women nearly four and a half years longer than their meat-eating counterparts.

Going Vegan and Loving It

Thank you to Dr. Barnard and PCRM for actively promoting the incredible health benefits of a low-fat, vegan diet. I am 31 and have type 2 diabetes. After permanently switching to a vegan diet, my blood glucose levels have dropped and stabalized dramatically. I no longer have the hopless feeling that I will head down a path of ever more drugs, insulin, and all of the complications that follow.

—Thad Roe, St. Paul, MN

A Safer Solution for Permanent Weight Loss

Changing eating habits is the cornerstone of permanent weight control. There is no way to “lose 20 pounds in two short weeks” and make it last. Very-low-calorie diets lower metabolism, making it harder to slim down, and also lead to binging. Low-fat, vegan diets are proving to be the safest means of weight control. PCRM has distilled the essentials of this eating pattern into the New Four Food Groups, providing an easy guide for weight loss and for maintaining a healthy weight over time.

The New Four Food Groups—grains, legumes, vegetables, and fruit—provide the nutrients needed for optimal health. One common meal plan is to select approximately 8 servings of grains, 3 servings of legumes, at least 4 servings of vegetables, and 3 servings of fruit daily, but it is also fine to shift your portions to favor vegetables, beans, or fruits, for example. Be sure to take a daily multiple vitamin to be sure you’re getting adequate vitamin B12.

Meal Suggestions

Hot cereals (cream of wheat, creamy rice cereal, grits, or Irish oatmeal with cinnamon, raisins and/or applesauce); high-fiber cold cereals (wheat or oat bran cereals with non-fat soy- or rice milk and berries, peaches, or bananas); melons or any other fruit; whole grain toast topped with jam; bagels topped with apple butter or hummus; oven-roasted “home fries” plain or smothered with roasted mushrooms, peppers, and onions.

Salads: Garden salads with fat-free dressing; legume-based salads (three-bean, chickpea, lentil, or black bean with corn); grain-based salads (noodle, couscous, bulgur, or rice).

Soups: Vegetable-based soups (potato-leek, carrot-ginger, mixed vegetable, or mushroom-barley); legume-based soups (black bean, spinach-lentil, minestrone, or split pea).

Sandwiches/Wraps: CLT (cucumber, lettuce, and tomato sandwich with Dijon mustard); hummus sandwich tucked into whole wheat pita with grated carrots, sprouts, and cucumbers; sandwiches made with fat-free meat alternatives such as barbeque seitan or veggie pepperoni slices with your favorite sandwich veggies; black bean dip, peppers, tomatoes, and lettuce wrapped in a whole-wheat tortilla; Italian eggplant sub (baked eggplant slices, pizza sauce, and mushrooms on a multi-grain sub roll).

Pasta marinara or pasta primavera with fresh vegetables; soft tacos (using whole-wheat flour tortillas, beans, lettuce, tomato, and salsa); vegetarian chili; veggie lasagna (made with low-fat tofu to replace the ricotta, layered with grilled veggies); rice pilaf, Spanish rice, or packaged rice dinners; Asian-style rice and vegetable stir-fries; fat-free vegetarian burgers; fajitas (using sautéed bell peppers, onions, and eggplant in a non-stick pan, with fajita seasonings).

Problems with High-Protein Diets?
If you have experienced health problems while following a high-protein diet, we would like to hear from you. Please contact Jeanne Stuart McVey at 202-686-2210, ext. 316, or



Summer 2003
Volume XII
Number 3

Good Medicine

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