Intended for healthcare professionals

Student Education

Low carb diets

BMJ 2004; 329 doi: https://doi.org/10.1136/sbmj.0412450 (Published 01 December 2004) Cite this as: BMJ 2004;329:0412450
  1. Shairoz Samji, fourth year medical student1
  1. 1University of Bristol

Supermarket shelves contain an increasing number of low carbohydrate products, because of the popularity of the Atkins and South Beach diets. Shairoz Samji looks at how low carbohydrate diets works and takes a look at their consequences for health

Pub Medic:Impress your mates at the pub with your startling repertoire of esoteric medical knowledge.

The Atkins approach is a low carbohydrate high fat high protein diet. Although named after Robert Atkins, its origins can be traced back to 1862.1Dr Atkins' New Diet Revolution--a 504 page long guide--works on one major assumption. If insulin is the main hormone that causes the body to turn any excess sugars into fat, when its production is minimised, Atkins suggested that all fat production will cease. By preventing the body from being supplied primarily by sugars, it could instead begin to burn fats and proteins leading to a process called ketosis. If Dr Atkins' theory is right, someone following the Atkins diet will use their own fat as a source of energy and therefore lose weight.

Plan B

Physiological changes including ketosis induced by a low carbohydrate diet are similar to those induced by starvation. During the Atkins diet, the body is thought to switch to lipid metabolism--the body's “backup plan.” Ketones are formed and used by the central nervous system and other organs. This yields the initial rapid weight loss that is seen on the Atkins diet. However, long term reliance by the body on lipid metabolism may have detrimental consequences (table).

Atkins recommends that sugars must be controlled, initially to 20 g a day.2 Devotees are free to enjoy almost as much protein and fat as they wish, however.

Dish of the day

The book gives advice about menu ideas and what foods should …

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