In The News  Kimkins is not Atkins  People who spend time on low carb sites or diet sites know that in the last few weeks we have been inundated with info and blogs about the latest diet many are doing called Kimkins. The controversy about this plan has escalated. I admit that I haven’t paid to register on the Kimkins site although I listened to an extensive interview she recently gave.  I will not go into the details of how she developed her program, her business arrangements, her photos, etc. After spending 34 years (30 of them with Dr. Atkins) as an RN working with people struggling with weight management and the numerous health and quality of life issues that result, I have a number of concerns about what I have been reading on blogs.  I know how desperate people can be to lose weight and lose it fast. Human nature and our culture focuses around having what we want NOW. There are many plans to lose weight but experience has shown when people are unable to adhere to them for a lifetime, they often begin the cycle of yo-yo dieting. There are healthy ways and unhealthy ways to lose weight. It isn’t just about losing but keeping it off for a lifetime. To do that, permanent changes in both behavior and food choices must be made. In my view this means embracing the idea of making a lifetime change and not just a short term quick fix with diet pills, special foods or starvation diets. There are also healthy and unhealthy ways to do low carb and I believe that the Atkins Lifestyle is a healthy way if done correctly. Atkins is not calorie restricted, not low fat, not no carb and not severely portion controlled.  I recommend you consider the following when choosing a plan to manage weight: Contains readily available foods found in the supermarket Includes whole, minimally processed foods Includes an adequate, regular protein intake Has a maintenance phase that you can commit to Includes exercise to maintain muscle and bone mass, supports  heart health and aides in stress reduction Allows one to eat food rather than relying on meal replacements Allows one to eat proteins containing the natural fats found in food Allows one to eat to satiety and satisfaction rather than severely limit calories Recommends a calorie intake of at least 1200 calories per day.  As I read the blogs, I have become increasingly concerned about what people are apparently doing to try to keep up the pound-a-day promise that Kimkins claims is possible and appropriate. Some people are using laxatives regularly and decreasing calorie intake to as low as 400 or 500 calories a day. Certainly less than 1200 calories daily seems to be common. Some bloggers who followed the plan complain that they were unable to exercise or even have the energy to get through daily activities.  Low calorie, ketogenic diets have been used for many years but under medical supervision. I have a number of concerns about such low calorie intakes long term especially if one is not monitored. Here are a few. Maintaining lean mass and metabolic rate We know that when the calorie intake drops too low the body will adjust to conserve energy and the thyroid can slow leading to a lower metabolic rate and a host of symptoms. This is undesirable under any circumstance but certainly when trying to lose weight. Research has shown in animal and human studies that when one can no longer maintain a low calorie diet and refeeding begins, weight is regained to an even higher level. When there is rapid weight loss from a restricted calorie intake the concern is that weight loss is lean mass instead of fat. This is especially true if protein intake is too low to meet the bodies’ needs. If muscle tissue is broken down to provide energy how will the heart and other tissues be affected in the long term? Bone strength can also suffer because of a too low intake of protein to replace the constant turnover of bone cells. Lower muscle mass also slows the metabolism making it more difficult to manage weight.  Benefits of fat intake A very low fat diet can lead to a decreased ability to absorb fat soluble nutrients. We know that vitamin D levels are already too low in many Americans. Research is strongly supporting the importance of a higher Vitamin D intake than is recommended to possibly protect from cancer, dementia, metabolic syndrome, diabetes, multiple sclerosis and other severe chronic illnesses. When following a low carb plan with an adequate intake of natural fats found in food, research has shown that LDL (so-called bad cholesterol) particle size can shift from a dangerous pattern B to a healthier pattern A. This will not happen with a low fat diet. One recently published study demonstrated elevation of lipoprotein a (an independent risk factor for heart disease) with a low fat diet. A very low fat intake can lead to the bodies’ inability to make adequate levels of estrogen and other hormones leading to menstrual disturbances.  Mineral and electrolyte balance Dehydration as well as loss of important minerals such as potassium, magnesium, calcium and sodium can lead to severe and even fatal consequences. This can be exacerbated by the use of laxatives. In summer, when mineral and water loss occurs through perspiration, adequate hydration and maintenance of electrolyte levels become even more important. There are other issues that can be discussed however; the bottom line is no matter what plan you choose, use common sense, educate yourself and choose one that meets your needs beyond simply rapid weight loss. If you feel ill for any length of time be sure to get checked by your healthcare provider.    Archived News Stories