Atkins Food Pyramid Aims to Clear Confusion

Critics Say Recommendations Not Based on Science

From the WebMD Archives

Feb. 17, 2004 -- The format may look familiar, but experts say the new "Atkins Lifestyle Food Guide Pyramid" has little in common with the food pyramid issued by the USDA.

"It's completely flipped from what was always been done -- the whole grains are at the top and the meats are at the bottom," says registered dietitian Debbie Strong of the Ochsner Clinic Foundation's Heart and Vascular Institute in New Orleans.

Protein sources, such as poultry, fish, beef, pork, and soy products, form the base of the Atkins Lifestyle Food Guide Pyramid. Green vegetables and cauliflower form the next layer, followed by fruits, such as blueberries, raspberries, pears, and avocados. Vegetable and seed oils, cheese and dairy, nuts, and legumes are near the top with whole grains at the peak of the pyramid.

But the Atkins-based food pyramid is only the latest entry into an already crowded field of proposals about what the country's next official nutritional guide should look like.

The original food guide pyramid, which emphasizes bread, cereal, rice, and pasta at the base and limits fats and sweets at the peak, was developed in 1992. Federal officials have acknowledged it needs updating and have solicited comments from experts and the public on the process. A revised version is expected in 2005.

In the meantime, experts say we can expect a flood of food pyramids as groups continue to promote their own versions.

"The problem is we get so many pyramids out there," says registered dietitian Wahida Karmally, DrPH, spokeswoman for the American Dietetic Association. "Anybody can have their own food pyramid, and that's why it's really confusing. It really does a disservice to the American population who is already confused about what they have to eat."

The Food Pyramid, Atkins Style

Last week, the Atkins Physicians Council presented its version of the food pyramid to federal officials in Washington, D.C., and began a media campaign to educate the public about it.

"Clearly the standard food pyramid has not produced the results anticipated with obesity rates doubling among adults and children," says Stuart Trager, MD, chairman of the Atkins Physicians Council.

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Trager says the Atkins Lifestyle Food Guide Pyramid serves as a graphic representation of the group's approach to weight loss and weight maintenance.

"With over 30 million people following controlled carbohydrate nutritional programs, we feel it was important to present our version of what a controlled carbohydrate nutrition pyramid would look like, and it was important to clear up misconceptions about what Atkins is and isn't," Trager tells WebMD.

Trager says those misconceptions and confusions come from opponents who try to paint Atkins in an incorrect light by suggesting that it's just about red meat and even some of the copycat diets that have tried to repackage Atkins and market themselves as a "healthier" version.

The pyramid contains no guidelines for number of servings or type of food source in each of the categories. Instead, it makes broad recommendations, such as "Limit and control certain carbohydrates to achieve and maintain a healthy weight" and "Eat until you are satisfied."

The Atkins pyramid also rewards increased physical activity with additional food choices, allowing people to eat more carbohydrates if they are more active.

"As more energy is expended and activity level is increased, people can increase their individualized optimal level of carbohydrates," says Trager.

Building a Better Pyramid

Experts say interpreting those broad guidelines or finding an "individual carb level" may be problematic for many Americans.

"It means you're leaving a lot to people to figure out what they need," says Karmally. "Here they say, 'Discover your individual carb level to achieve and maintain a healthy weight.' How does person without a background in nutrition find out what is good for them?"

Strong agrees that the Atkins pyramid is too vague.

"It just says eat until you're satisfied," Strong tells WebMD. "I don't think anyone really knows the definition of satisfied. We eat what we're given."

Strong acknowledges that most Americans are eating too many refined carbohydrates, such as sugar and white bread. But other types of carbohydrates, such as whole grains and oats, are a valuable source of energy, fiber, and B vitamins and shouldn't be so severely limited.

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"I don't like them being at very top of the Atkins pyramid," says Strong. "I could understand refined sugars, simple sugars and things like that, being at the very top but not the whole grains."

Although the current food guide pyramid may be flawed, both Karmally and Strong say there's just too little evidence to support the Atkins pyramid as a healthy choice.

"What we need to tell the American public is how to eat healthily based on science," says Karmally. "The current pyramid was developed with the science that was available at the time it was developed, which was really focusing on a plant-based diet."

"The Atkins food guide pyramid is really not based on science, she says. "We need a lot more science to know what long-term effects of eating so much more protein are."

WebMD Health News Reviewed by Brunilda Nazario, MD

Sources

SOURCES: News release, Atkins Health & Medical Information Services. Stuart Lawrence Trager, MD, chairman, Atkins Physicians Council. Debbie Strong, MBA, RD, Ochsner Clinic Foundation's Heart and Vascular Institute, New Orleans. Wahida Karmally, DrPH, RD, spokeswoman, American Dietetic Association. USDA.

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