Sunday, March 19, 2006

Can the Atkins diet kill you?

Last week there was yet another negative story in the news about the Atkins diet. Briefly, a 40-year-old white woman was admitted to the hospital. She was diagnosed with ketoacidosis, and they blamed the Atkins diet - which the woman was following at the time - for her illness.

Sound incredible? The news media sure ate it up. Wait until we find out from Regina Wilshire the holes she sees in this hypothesis.

First, some basic facts. The woman was following the 1972 version of the diet. In the thirty years following its publication, Dr. Atkins learned a lot more. That's why he published a new edition. While people can have success following the old version, the new version is healthier and should be the one followed. The 1972 book is interesting only as history.

Secondly, this woman was morbidly obese with a BMI is 41.6. A normal BMI is 18.5-24.9. Anything over 25 is overweight. So at 41.6, she was carrying around A LOT of extra pounds.

Now, to get to the meat of Ms. Whilshire's arguments against Atkins as being the cause of this woman's ketoacidosis. First, she calls into question whether it really was ketoacidosis that she had.

(H)er blood pH was normal - yet the case report states she suffered ketoacidosis, which would lower her pH to indicate an acid environment and her glucose would be high (at a level greater than 14mmol/l - hers was 4.2mmol/l) and her sodium would be abnormal, yet it was normal...

Wikipedia agrees with this:
Ketoacidosis should not be confused with ketosis, which is one of the body's normal processes for the metabolism of body fat. In ketoacidosis, the accumulation of keto acids is so severe that the pH of the blood is thrown off.

Ms. Wilshire than goes on to name several other possibilities of illnesses this woman could have that would have caused her complaints, other than her diet. She then continues:

We just don't know since none of the other possibilities were explored - the diet was the cause in the mind of her physician, so there was no further investigation.

That troubles me - we have thousands of participants from hundreds of studies to date and not one incident of ketoacidosis. Is it possible this woman's ketoacidosis was a result of her diet? I would say it's not impossible, but very highly improbable given the reams of data from clinical trials to date that have not found ketoacidosis as a complication, even in diabetic patients following a low-carb diet.

The reason it isn't a complication is that dietary ketosis, in and of itself, does not cause ketoacidosis. More likely this woman experienced ketoacidosis as a result of something else and unfortunately her diet placed an obstacle in front of a complete investigation as to its cause
(emphasis mine).

In short, there's simply too many unanswered questions, questions her doctors don't care to answer. It's much easier to blame a diet you personally dislike, and jump on this poor woman as "proof" of your own personal bias.

Tell you what - do a thorough investigation of this woman's health issues, and then come back and tell me it was her diet. Until other causes are ruled out (or proven) there's simply not enough evidence to convict Atkins. In a court of law, one case against thousands of others would garner a verdict of "not guilty." But in the media, it's a different story...

If you have read any of the news stories about this case, then you owe it to yourself to get the other side of the story. As we all know, every story has two sides, and the media usually reports just one. Read Ms. Wilshire's full article here.


Laura S said...

Atkins can do wonders but only for the short term since it is a pretty hard diet to follow. KETOSIS is what your body should go into when you do atkins to burn fat instead of carbs since you are not consuming many. Nice blog BTW. I started my Atkins today. Go here for updates on my progress

Newbirth said...

It's a diet for a lifetime. It's a true lifestyle change. Carbs do very bad thing to me in fairly small amounts. I'm now in Lifetime Maintenance (for 7 weeks now), and will never go back to the way I used to eat.

If you are just looking at Atkins as a quick "short term" fix you are guarenteed to gain the weight back.