Jan. 21, 2004 -- For years, many people have thought of the Atkins diet as an all-you-can-eat meat, eggs, and cheese buffet.
But in seminars across the country, health professionals are hearing a different tune. An Atkins educator has reportedly said that only 20% of a dieter's calories should come from saturated fat, according to a recent New York Times story.
After all these years, is the Atkins organization reacting to criticisms that the diet advocates too much saturated fat? WebMD spoke with an Atkins advisor and other experts in nutrition and heart disease.
"Nothing has changed," Stuart Trager, MD, chairman of the Atkins Physicians Council, tells WebMD. "Our message is still the same. Atkins is, and always has been, about controlling carbohydrates -- teaching people to eat nutrient-dense whole foods and avoid refined carbohydrates like white flour and sugar."
Atkins never did -- and still does not -- prescribe amounts of fats or protein, Trager explains. "Instead, we teach people to be aware of and control carbohydrate consumption. When we eat a variety of protein sources and fats to satiate hunger, we eat less because the food tastes good and is filling. Without portion restriction, this has been shown to result in weight loss."
Do the Math
The "20% number" in the Times article was derived from meal plans and recipes in Atkins books, he says. In fact, during the diet's induction phase, people typically consume up to 60% of calories from fat.
If 60% is divided into thirds -- to reflect the variety of monounsaturated, polyunsaturated, and saturated fats that Atkins espouses -- the magic number pops up: 20% of calories would be from saturated fat.
"It's important and worth recognizing that both steak and eggs are a balance of fats," Trager tells WebMD. "In a porterhouse steak, saturated fat makes up 17% of total fat. In an egg, including the yolk, saturated fat is only 18% of total fat."
Read the Books
The Atkins diet is vastly misunderstood, says Trager. "Atkins has never been, as the media and opponents would have people believe, a red-meat diet," says Trager. "We need to spend less time criticizing individual nutrition strategies and more attention in defeating obesity. Weight loss solutions aren't one-size-fits-all."
The problem is, "An awful lot of people who follow these high-protein/low-carb plans haven't read the books," says Cindy Moore, MS, RD, director of nutrition therapy at The Cleveland Clinic. She is also a spokeswoman for the American Dietetic Association.
"What they've gleaned from magazines or newspapers or pictures is what they think the diet is -- a double cheeseburger without the bun, with extra bacon and cheese," Moore tells WebMD.
Nevertheless, the blanket "prescription" to eat all the protein and fats you want is what gets dieters into trouble -- it's just not healthy, she says.
"I still don't understand the rationale in limiting trans fats and not saturated fat," says Moore. "Trans fats act very similarly in the body as saturated fat -- they both increase LDL 'bad' cholesterol and decrease HDL 'good' cholesterol."
Shades of South Beach?
"I sense this cutback on saturated fat is in part a political positioning in response to the South Beach diet book, which is outselling the Atkins New Diet Revolution," says Robert H. Eckel, MD, chairman of the American Heart Association's Nutrition, Physical Activity, and Metabolism Council.
All the leading health organizations -- the AHA, the American Cancer Society, the USDA, the World Health Organization, and the American Dietetic Association -- agree about what constitutes a good nutritional diet, Eckel tells WebMD. "It's not so much about good food and bad food, but what the overall diet is like."
"The quantities of foods that Atkins recommends are unacceptable," says Eckel.
"In the short term, Atkins and similar diets won't cause health problems. But I don't think they teach anything about the importance of a healthy overall dietary program and lifestyle for long-term success in weight reduction."
Even in the maintenance phase, the Atkins diet is not balanced, Eckel tells WebMD. "The Atkins books says if you start to gain weight when you start eating carbohydrates, return to a more carbohydrate-restricted program. Of course, that's a diet higher in saturated fat, trans fat, and cholesterol. This is not a program -- despite the weight reduction -- that is consistent with good health and nutrition."
"Many professionals who criticize this approach demonstrate a lack of understanding and a lack of appreciation for how valuable this tool can be in helping the many who have been unsuccessful in maintaining weight and health through standard diet recommendations," says Trager.
Trager adds: "Dr. Atkins was the innovator in making better carbohydrate choices and recognizing the negative impact that simple carbohydrates have on obesity. He stood alone in this mission for many years, since 1972. He tried to teach people that just because a muffin says low fat, it's not OK to eat it."
The AHA diet, consistent with many other health organizations, says the maximum intake of saturated fat should be 10% of calories -- one-half what Atkins advises, says Eckel.