| Low-carbohydrate, high-fat diet and associated controversies
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| American physician, Robert Atkins devised a weight reducing diet, which developed a large following worldwide. It is based on a 2-week period of lipolysis- and ketosis-inducing, very- low-carbohydrate, high-fat, and high-protein diet. After this short, intensive period there is a more prolonged transition to the so-called maintenance phase, which includes titration of carbohydrate intake to maintain weight. The program recommends avoidance of refined carbohydrates and strongly promotes regular exercise. This diet was devised primarily for healthy, severely obese persons. Its authors stress that persons with renal disease or diabetes can only consider it under medical supervision.
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| Figure 21.7 Surgical treatment such as gastric banding is used in severe cases of obesity. These photographs show the same patient before and after gastric banding surgery. Her weight before surgery was 136.1 kg; within three years it decreased to 63 kg. |
| This diet appears to be effective in weight reduction. As many other aspects of dietary management, it is not completely evidence-based. The persisting concerns about the low carbohydrate, high-fat diets include the potential risk of abnormalities of liver and kidney function, and the long-term
effects of the high-fat diet on cardiovascular risk. In any case, the impact the Atkins diet made on a general population is likely to stimulate research in the field.
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