It’s the New Year, a time when many of us examine where we are and what we want to improve in our lives. Unfortunately, we make resolutions that often fall quickly by the wayside. It doesn’t have to be that way. Remember that you don’t have to wait for the New Year to make change and take charge. You can do it at any time. Keep moving forward. Start Induction.
It’s time to assess where you are regarding your weight and health and determine your next steps. Hopefully you are pleased that you got through the holidays with minimal damage to your low carb lifestyle. Congratulations and keep it up. This is a good time to examine what you did that worked and what didn’t. The more you learn about being in charge of your dietary choices the more you can stay on track and reap the health benefits you desire.
If you fell back into old habits and veered off track it’s time to start again with a renewed sense of commitment and hopefully a better understanding of how to do better in the coming year. When it comes to the health and well-being of you and your family, you just can’t give up.
What’s Your Next Step?
This article is about Atkins induction. I’ll be focusing on that; however, some of you may be trying to decide if induction is what you should be doing.
Consider the following:
If you did well during the holidays but even some minor deviations triggered excessive hunger and cravings or a preoccupation with food, a spell on induction could calm these symptoms quickly. Resume induction for a week knowing that by the 4th day or so you’ll feel better. Then slowly work your way back up to the previous level of carb intake that worked for you.
If you have reached goal and are in control of hunger and cravings keep doing what you’re doing to maintain a healthy weight and normal lab values.
If you still have weight to lose, resume the level of carb restriction that led to weight loss. If necessary, refresh your memory by reviewing the carb ladder found in most Atkins Diet books.
If you blew your diet out of the water or are a newbie to carb restriction keep reading. It’s time for induction.
Doing the Atkins Induction Phase
Induction is the lowest level of carbohydrate restriction as described by Dr. Robert Atkins in Dr. Atkins’ New Diet Revolution. It is about 20 grams of very specific carbohydrates taken daily along with protein and natural fats. I’ll be more explicit later.
Fat is our backup fuel source. In the absence of a high carbohydrate intake the body can readily utilize our fat stores for fuel. That’s one reason why we store fat. The purpose of induction is to quickly switch your body from burning primarily carbohydrates for fuel to burning fat. Once you make that switch you will use both your excess body fat stores and dietary fat for fuel. You burn ketones, which are made from fat, when the dietary carbohydrate intake is less than about 50 grams per day.
The benefits of consuming an induction level of carbohydrates and utilizing fat for fuel are many:
- Initiating weight loss.
- Normalizing high insulin levels (more on that later).
- Stabilizing blood sugar levels within a normal healthy range.
- Preventing deterioration of the blood sugar/insulin balance from progressing to metabolic syndrome and diabetes.
- Preventing the numerous symptoms of an unstable blood sugar.
- Relieving dietary stress helping to normalize stress hormones.
- Controlling appetite with adequate protein intake.
- Controlling cravings.
- Breaking the addiction cycle.
- Allowing people with type 2 diabetes to better control their blood sugars with no or lower doses of medications.
- Allowing people with type 1 diabetes to use lower doses of insulin while experiencing fewer hypoglycemic reactions.
For many people induction removes some of their allergy provoking foods.
Who Should Do Induction?
At The Atkins Center a majority of our patients began their plan on induction. This was prescribed after an extensive workup that included serial glucose and insulin levels, lipid levels, a family, dietary and weight loss history and other pertinent testing. We knew well the risk factors our patients had.
Most of you don’t have the advantage of such an extensive evaluation. Yet experience dictates that people will do best on induction who exhibit signs of an intolerance to carbohydrate foods. Insulin resistance is the inability of the body to utilize insulin to regulate blood sugar. It can ultimately lead to type 2 diabetes and is common in people with the following:
- Overweight or obesity especially with an increased waist to hip ratio. More on that later.
- Excessive hunger, cravings and inability to control carbohydrate foods or a preoccupation with food.
- Symptoms of an unstable blood sugar.
- Consumption of a poor quality, high sugar, and high glycemic load diet.
- A family history of diabetes especially if on both sides of the family.
- Metabolic syndrome or pre-diabetes.
- Type 2 diabetes which responds well to carb restriction with the proper adjustment of any blood sugar lowering meds.
- Type 1 diabetes which responds well to carb restriction under the guidance of a physician familiar with this technique.
- Gestational diabetes which occurs during pregnancy. GD usually disappears but puts Mom at high risk within 10 years for type 2 diabetes.
- Delivery of a large baby over 9 pounds.
*Polycystic ovary syndrome (PCOS).
Beginning on induction is the easiest and fastest way to stabilize blood sugar and elevated insulin levels. This is especially important if people are close to having or have been diagnosed with diabetes.
High insulin levels are common as people gain weight. There are many negative effects of hyperinsulinemia including: increasing fat storage and decreasing our ability to use fat for fuel, increasing fat in the blood as triglycerides, promoting the manufacture of LDL cholesterol, causing an unstable blood sugar by depressing glucagon, increasing sodium retention causing high blood pressure, stimulating growth of smooth muscle cells lining arteries, increasing inflammatory and clotting markers and potentially stimulating cancer cell growth.
There are many everyday symptoms people experience when they have an unstable blood sugar after carbohydrate ingestion. Sometimes these symptoms are treated with medications rather than addressing the needed dietary changes. Beginning on induction can be very helpful to determine if symptoms you experience regularly are caused by diet. Within a week or so on induction many of these symptoms will begin to resolve. That’s a simple way of testing if you have abnormal blood sugar issues. Why take expensive and potentially dangerous meds to treat a food issue?
Symptoms that improve on Low-Carb are:
- morning headaches
- low energy
- mood swings
- faintness if meals are late
- shakiness inside
- difficulty concentrating
- and many more.
For a more complete list refer to Dr. Atkins’ New Diet Revolution. Take the symptom survey at the start and redo in a few weeks to measure your progress.
Symptoms of an unstable blood sugar usually appear several hours after eating and can be relieved by a carb fix. Just keep in mind the symptoms usually reappear several hours after that fix. If you continue to eat unhealthy carbs you will stay on the blood sugar roller coaster. People with an unstable blood sugar need to be aware that the solution is not sugar but a low carb intake to avoid further wear and tear on this mechanism that can lead to diabetes and its many serious and life-threatening complications.
There are circumstances when one need not start on induction. If you have few symptoms of an unstable blood sugar, have only a few pounds to lose, have a relatively normal metabolism, don’t take medications and have no difficulty controlling carbs, beginning at 30 or 35 grams of carbs can still be effective. However, for most of us at least a short stint on induction is useful to jumpstart the plan. It’s also better psychologically to begin to add to your plan rather than find that you began at a level that was too high and you had to cut back. Please note that to make up 30 to 35 grams one should follow the carb ladder and increase the appropriate carbs first such as nuts, seeds, more salad and more vegetables from the approved list. Grains are not your first choice.
What Do I Eat on Induction?
Let’s begin with a few general guidelines.
- Eat regularly. Do not skip meals or ignore hunger. Snack or eat at least every 5 hours or so.
- Always have protein at each meal or snack.
- Some people find it easier to have 2 snacks daily. After a time you may no longer feel the need to snack and can forgo them as long as you feel well and have control of hunger.
- Eat until comfortably satisfied not stuffed.
- Stay well hydrated.
- Read labels and avoid foods with added sugars.
- Avoid low carb products on induction.
- Be careful dining out. Ask how foods are prepared. Avoid sugar containing sauces, breading, thickened gravy, salad dressing with sugar, spices etc.
- No alcohol.
- Avoid aspartame. Be careful of artificially sweetened items as even the sweet taste in the mouth can be a trigger for some.
- Caffeine is a drug and can be problematic. If you have insomnia, irregular heart beats, anxiety or irritability I recommend you severely limit caffeine.
Since carbohydrates are limited to about 20 grams daily from the acceptable food list the diet consists primarily of a regular protein intake at each meal and snack. All proteins such as meat, fish, poultry, dairy and eggs are allowed along with the natural fats in the protein foods. This is not a low fat diet. Fat has nutritional and satiety value and is necessary. Fats encouraged are butter, olive oil and coconut oil. Avoid manufactured trans fats and vegetable oils high in omega 6 such as refined corn, soy and cottonseed oils. These oils are often found in processed foods with low nutrient value that are generally not recommended on Atkins.
You need not count calories. Once the blood sugar stabilizes and insulin levels begin to normalize and ketones become your primary fuel source, hunger and cravings moderate or completely disappear. You find the right amount of food you need without counting calories. It is possible, especially at the start, to force feed yourself beyond your needs. This is not the way to follow Atkins or create a healthy lifestyle. Eat until satisfied not stuffed.
For a complete printable version of induction and discussion about the various phases of Atkins read the article on my web site called The Atkins Lifestyle.
More information can be found in many of Dr. Atkins’ books. I always encourage people to read the books completely to have a full understanding of why carbohydrate restriction is healthy, works well, and is a long term lifestyle.
One version of carbohydrate restriction, even on induction, does not fit all. It may be necessary to individualize your plan since we do not all respond the same way. There are a variety of factors that can have a negative impact on weight management. These include aging, gender (women can have a more difficult time losing compared to men), medications, hormone changes, chronic stress, activity level, genetics and even a history of yo-yo dieting.
If you are a slow loser, be sure to keep within the recommended amounts of carbohydrates on induction and error on the lower side of carb intake. For example, cheese is allowed up to 4 ounces a day but I recommend no more than 2 or 3 ounces for people with a challenged metabolism. Once you see how well you do the first 2 weeks on induction you can always increase your intake. If you are someone who hates cooked vegetables increase your daily salad intake and add leftover broccoli and other veggies to salad.
During the first few days on a much lower carb intake than you are used to, especially if you are beginning on less than 50 grams of carbs, your body is changing its fuel sources and needs time to make the transition. Usually by the 4th or 5th day most people are burning ketones for fuel and make the transition to a low carbohydrate intake easily. Many will comment that on the 5th day they woke up feeling a significant increase in energy, less hunger and cravings and an improved sense of well-being.
Some people will have a more difficult time with the transition. Because of a low carb intake some experience a loss of excess body water. This is useful if you have high blood pressure or other conditions that cause fluid retention. However, there can be a loss of too much water and minerals such as sodium, potassium and magnesium. This can be more dramatic if you are taking diuretics (water pills) many of which also cause a loss of essential minerals. Stay well hydrated to prevent dehydration and take a good quality multivitamin/mineral. Some low carb doctors recommend 2 servings of salty broth daily to avoid this response. It usually works well. Another sign of low mineral levels is ascent weakness. This can occur climbing steps or going up an incline. Be sure to supplement minerals especially since many of us regardless of diet are low in minerals.
Another response some people call the “Atkins Flu” is fatigue, lightheadedness, headaches and even cold sweats. My experience is that these usually occur within 12 hours or so after cutting carbs and can last for 4 days sometimes up to a week. These are likely withdrawal symptoms from carbs such as sugar and grains, caffeine or both. Most people can deal with the symptoms. A few can’t so an increase in vegetables and even a small serving of fruit such as blueberries for a week or so moderates the symptoms. It is then easy to resume induction. Carbohydrate addiction does exist as do withdrawal symptoms. Keep in mind that these symptoms are only temporary.
For people with high blood pressure on medications, there can be a stage of weight loss with carb restriction when positive metabolic changes have taken place causing a natural lowering of blood pressure. If you remain on the same doses of medication you risk being over-medicated. This can occur at any time. At The Atkins Center we asked our patients to regularly monitor their blood pressure readings which helped us to know when a lower dose of medication was needed. If you have been feeling well and losing weight but suddenly you begin to feel tired and dragged out, lightheaded or dizzy you might be over-medicated. Be sure to discuss this with your doctor.
Research on Atkins
Over the decades there have been many criticisms of the Atkins Lifestyle. I have heard them all. I even had my doubts when I first began working with Dr. Atkins. I very quickly learned, from both personal experience and patient observation, that controlling carbs had numerous benefits including losing weight and inches without hunger and cravings (link: https://www.carbsmart.com/outout.html). It did not cause liver or kidney damage, osteoporosis or heart attacks or high lipid levels. Rather the plan helped people to feel better in many ways: avoiding the need for numerous medications, improving joints, skin conditions, GERD, moods, better blood sugar levels, increased HDL and significantly lower triglycerides. Of course the medical establishment continued to criticize while asking where are the studies to prove your clinical observations?
In the last 12 years numerous studies have been published that support Dr. Atkins’ clinical observations when compared to other diets including the usual calorie controlled low fat diet. We are finally beginning to read and hear more and more acceptance of the principles Dr. Atkins first wrote about in 1972.
There are a few published studies where the results of the low carb arm vs. the usual low fat diet showed no difference between groups. This is unusual. What one should observe is better blood sugar control in people with diabetes, increased HDL, lower triglycerides, decreased inflammatory markers, larger less atherogenic LDL particles and often better weight loss. One explanation is that there is no official definition of low carb. Some published studies are simply too high in carbs, especially in people with type 2 diabetes, to be effective. So when you hear that a low carb diet isn’t any better than one based on the USDA Guidelines be sure to determine the level of carb restriction used. Another explanation for similar weight loss is that lean mass is better preserved with low carb which off sets better fat loss on the scale.
Given the progress we have made in more than a decade, it is disingenuous for the establishment to ignore the research now readily available. Carbohydrate restriction must be recommended as an acceptable treatment option especially for people who are carbohydrate intolerant. Sweden has just done exactly that.
Measuring Waist-to-Hip Ratio
Waist-to-Hip Ratio (WHR) is a good marker to determine when the amount of abdominal fat poses a health risk. It’s very easy to do. Measure your waist circumference at the naval and measure your hips. Divide your waist number by your hip number. The higher your WHR the more “apple shaped” you are or the higher your deposition of fat around the belly. You can periodically re-measure to mark your progress. Females increase risk at >0.8 and males >1.0.
For most people their ultimate goal is to regain health and vitality, maintain as healthy a weight as one can and learn how to stay that way. On Atkins you can do this with a diet that controls hunger and cravings, improves lab values and recommends that you eat whole minimally processed foods. The same foods you would recognize on any dinner table in the 1950’s and 60’s before our demonization of natural fats, egg yolks, real butter and full fat cheese. Certainly well before the food industry developed their thousands of phony, addictive but lucrative items for us to consume.
To be successful you must not only change your food choices but behavior as well. I have been on Atkins since 1974.
Low Carb Induction Strategies
- Make a grocery list and stick to it.
- Never go grocery shopping when you are hungry.
- Stick to the outer aisles of the store away from temptation.
- Eat before going to social events. It is easier to make better choices when you are not ravenously hungry.
- Order an appetizer in a restaurant, if needed, to avoid the bread. Better yet, remove the bread basket.
- If you are beyond induction (when alcohol is allowed) do not drink alcohol on an empty stomach.
- Plan ahead when traveling. Take low carb snacks.
- Eat a good breakfast with an adequate amount of protein.
- Take an Atkins bar when eating at people’s homes. I used the chocolate chip granola bar when others were having dessert. Now I am so used to not having dessert that I am fine without bringing a bar.
One common reason some of us may get off track is simply because we get sloppy with the plan. You may have read the Atkins book years ago and think that you still remember everything you need to succeed. If you are struggling, read the book again.
Carb creep is very common. If you have reached a plateau keep a food diary, resume reading labels and measuring carb servings. Eating too much cheese and nuts can slow you down. Including ketchup and other processed foods that you didn’t eat before, may be increasing your carb intake beyond what works for you. Do you taste foods not on the plan as you cook? Do you clean your kids’ plates of leftover carb foods while clearing the table? Sometimes it’s simply a combination of small errors that can get you stuck.
This is not a low fat diet, keep up your intake of natural fats.
The road to attaining your goals doesn’t follow a nice straight line. Like anything worth doing, there can be ups and downs and even detours. The important thing is that you don’t give up. Yes, we all want to be that perfect weight but keep your eye on what really matters: Your health and well-being, not just a number on the scale.
Maintaining or regaining your health is a day to day process. Just take it a day at a time.