"We are all devastated. I must inform you that Dr. Atkins died while you were in flight."
The call from his medical director came as we touched down in New York in April 2003. My consulting firm, Global Advisory Services, had been contracted by the largest manufacturer of Chinese herbs outside of China to help the company establish four integrative clinics in Australia and two in Singapore. The meeting with Dr. Atkins was part of a benchmarking trip to view clinical models for integrative medicine I had organized for their leadership team — Honolulu, Chicago, New York, London.
Some days before we left, Dr. Atkins had slipped in the snow and suffered head trauma. It is known that he had a heart attack the prior year, and his critics opined that his fall was the result of a second, fatal heart attack, musing that the head injury was secondary.
Dr. Atkins, a cardiologist, is best known for the Atkins Diet, which involves tight control of carbohydrate consumption and focuses on protein and fat as the primary sources of dietary calories. Ten years ago 10 percent of Americans claimed they were on the Atkins Diet. Upon his death his detractors suggested that the high fat content may have been responsible for his heart problems.
Since then the U.S. weight loss market has grown to more than $70 billion annually and continues to expand with Americans’ waistlines. As for obesity itself, Cornell University published a study last year estimating that it accounts for 20 percent of U.S. health care costs.
The Atkins-style diet favoring low carbohydrates and focusing on protein and fat with plenty of vegetables appears to be coming back in vogue. Last year a study published in the Journal of the American Medical Association demonstrated that a low-carb diet results in more calories being burned per day compared with other diets. According to market research firm IRI, Atkins Diet-branded products have grown 44 percent in the past two years.
The Paleolithic Diet is now drawing huge numbers of dieters. The premise is that for 2.5 million years our ancestors hunted and gathered. Agriculture introduced grain-based diets only 10,000 years ago. From the standpoint of evolution, that’s not long enough to modify our genes to accommodate the grain-based, high-carb diet so prevalent today.
The Paleolithic diet consists primarily of fish, grass-fed pasture-raised meats, eggs, vegetables, fruit, mushrooms, roots and nuts. It recommends against grains, legumes, dairy products, potatoes, refined salt, refined sugar and processed oils.
In addition to Atkins and Paleo, other popular, back-to-the-land, low-carb plans include the Pritikin and the South Beach diet.
Taking this dietary strategy into consideration together with local foods and core values, here are some key recommendations:
Vegetables on top: The more the better. When consuming large amounts of vegetables, it is especially important that they are organic or at least non-GMO and pesticide-free.
Aggressively minimize carbohydrate intake: Any carbs eaten should have a low glycemic index, which is a measure of how fast the sugars get into the bloodstream. Taro is good, white potatoes are not. Whole wheat, whole-grain food and brown rice work, but watch the portions. Eliminate refined sugars including soda.
Healthy amounts of protein: Lean meat works. Free-range and grass-fed are huge. Don’t overdo it. Excess protein is hard on the kidneys. Easy on the laulau.
Good fats in moderation: Best are unsaturated fats high in omega-3s. Enjoy fish and limu! Avoid saturated fats such as butter and trans fat from processed oils found in snack food and fatty meats.
Cultivate a healthy relationship: Stay close to the source of the food you eat.
Grow it or raise it if possible. If not, go local if feasible. Prepare meals at home and take time to eat among loved ones and friends.
For weight management, watch portions. If you binge, seek to understand triggers for overeating and mind the comfort foods.
Following the suggestions above will result in weight loss for those who need to lose and weight gain for those who are underweight. This is not a crash diet or a temporary fix, but a healthy, sustainable way to live.
With another congressional budget standoff in the making and funding of Obamacare back on the chopping block, eating like a cave dweller could go a long way toward curbing the 20 percent of our health care dollars now spent on obesity.
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Ira Zunin, M.D., M.P.H., M.B.A., is medical director of Manakai o Malama Integrative Healthcare Group and Rehabilitation Center and CEO of Global Advisory Services Inc. Please submit your questions to info@manakaiomalama.com.
