March 23, 2001 (Orlando) -- By his own admission, Robert C. Atkins, MD, author of the best-selling diet books The Diet Revolution and Dr. Atkins' New Diet Revolution, has experience "not as a research scientist but as a practicing internist/cardiologist with 41 years of practice, in which time I treated 20,000 patients with heart-related problems or vulnerabilities."
WebMD: Is your diet plan appropriate for everyone, or are there people who should not be on it?
Atkins: The whole idea that one diet is best doesn't make any sense to me. But there are many people who can benefit from my diet.
WebMD: Such as?
Atkins: There are an awful lot of people who have an insulin disorder, and among the people with insulin disorder are certainly the overweight group; diabetics; people with unstable blood sugar, which is called low blood sugar; and people with hypertension. It's also very useful for preventing the recurrence of breast cancer, it's useful for polycystic ovary syndrome, and we use it for [the digestive disorders] Crohn's disease and colitis. So there are an awful lot of situations where we might use our diet.
WebMD: Your diet allows high-fat foods such as bacon and sausage, but that flies in the face of conventional wisdom in cardiology, which holds that to prevent heart disease you need to avoid fats, and if you're already at risk -- overweight, high cholesterol levels, etc. -- you should seriously cut back on your intake of fats from animal sources.
Atkins: As far as cardiovascular disease is concerned, I think it's the treatment of choice for people who have [high levels of] triglycerides [harmful blood fats] ... and it's also very useful for raising the HDL [good] cholesterol levels when they're too low.
Any time you have a heart patient, there's a combination of prevention and reversal and controlling the illness, so that when people have heart problems the diet is quite appropriate.
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.
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.