Sunday, March 19, 2006

The Atkin's Diet: Help or Harm?

The current issue of Lancet carries an interesting article about a 40yr old obese female, who was admitted to Lennox Hill hospital with ketoacidosis, having been on the Atkin's diet in an attempt to lose weight. She had been feeling unwell for about 5 days, with dyspnea, anorexia, nausea and vomitting. She was tachypneic on admission, with some abdominal tenderness and hyperactive bowel sounds. The attending dotors made a diagnosis of mild pancreatitis with ketoacidosis, from adnerence to the Atkin's diet. She had a wide anion gap of 26mMols/L with low bicard levels of 8mMols/L and obvious ketonuria. She was rehydrated, with dextrose solution and bicarbonate. She made a good recovery.

This case highlights what sceptics of the Atkin's diet had always feared. That patients who adhere strictly to the Atkin's diet run the risk of severe ketoacidosis, which could be fatal. This patient told her doctors that she was strictly on a low carbo and high protein diet, with the recommended vitamins, omega-3-fatty acids, electrolytes and other various extracts. She was tracking her ketonuria, as required. What may have tipped the balance may be the mild pancreatitis/gasteroenteritis. Therein lies the danger of the Atkin's diet (one of the more popular weight reducing diet). It does help you to lose weight in the short-term but there certainly are dangers. After all, a low carbo and high protein diet must mean that we try and bypass the Kreb Cycle for energy production by turning to protein for energy, a very wasteful way and one full of metabolic upsets. It is true that one can lose weight, mainly through dehydration, but at the cost of severe metabolic upset. Insulin secretion comes down, accounting for ketoacidosis and increased fatty acid production. There is weight loss, but the side effects are many too.

This message must come out as more obese people try this diet, in an attempt to lose weight. Well, there is no short cut, a moderate diet of whole grains, fruits and vegetables with a good dose of exercise, remains the best recipee.

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