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WebMD: Your most vociferous critic, Dr. Dean Ornish [proponent of a very low fat, high fiber, and complex carbohydrate diet], says that your diet can be harmful. In his words "When you go on a high-fat, low-carbohydrate, you're mortgaging your health to lose weight." He says that "you can also lose weight on chemotherapy, but you wouldn't want to do it." What kind of evidence do you have about the safety of your approach?

Atkins: I would venture to say that I have reviewed every scientific study since the year 1919 on a low-carbohydrate diet of the magnitude that applies to the alternate metabolic pathway, and I have never seen a study published in any language that says that people are getting worse.

It's absolutely impossible for people to be on my diet without losing weight. It's the one thing that can't happen because weight loss is one of the criteria indicating you're doing the diet correctly.

WebMD: Could you please explain for the benefit of our readers what you mean when you talk about "the alternate metabolic pathway."

Atkins: It involves switching your entire metabolism from glucose-burning to fat-burning. Our bodies can't store glucose for more than about 48 hours; so when you switch to a low-carbohydrate diet, and carbohydrates are no longer available to convert into glucose for energy, fat becomes the primary fuel. Fat's a triglyceride -- the chemical composition of body fat is triglycerides -- and when fat becomes the primary energy source, the ... triglycerides are lowered.

WebMD: How do you answer those who warn that your diet has unforeseen healthcare consequences -- in other words, short-term weight loss in exchange for long-term health plans.

Atkins: Try the diet. I tell my colleagues: Find a patient with high triglycerides who's overweight, has type 2 diabetes, and who isn't responding to low-fat diets and cholesterol-lowering drugs. Check lab results, and look for clinical improvements in 3-4 weeks. And when you see dramatic improvements, consider the alternate metabolic pathway as a new treatment option.

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