The Atkins Nutritional Approach™ (ANA) Colette Heimowitz, M.Sc. VP Nutrition Communication & Education Atkins Nutritional, Inc

America is Facing an Epidemic The U.S. is the fattest nation in the world. 64.5% of Americans are overweight or obese. Source: JAMA. 2002;288:1723-1727 Obesity is the second largest preventable cause of death in the U.S.! (Smoking is #1.) Source: JAMA 1996; 276: 1907-1950.

The U.S. is the fattest nation in the world.

64.5% of Americans are overweight or obese.

Source: JAMA. 2002;288:1723-1727

Obesity is the second largest preventable cause of death in the U.S.! (Smoking is #1.)

Source: JAMA 1996; 276: 1907-1950.

Obesity – America Needs a Real Solution Overweight Adults in the US Less than 30% More than 35% Not Available 30-35% DATA SOURCE: 2000 BRFSS, CDC 2000 1988 $117 Billion – Current cost to economy

Overweight Adults in the US

$117 Billion – Current cost to economy

The Diabetes Epidemic – Same Trend PREVALENCE OF TYPE 2 DIABETES AMONG US ADULTS DATA SOURCE: 2000 BRFSS, CDC 2000 1990 $130 Billion – Current cost to economy

PREVALENCE OF TYPE 2 DIABETES AMONG US ADULTS

$130 Billion – Current cost to economy

↑ Carbohydrate = ↑ Weight "Most of us would have predicted that if we can get the population to change its fat intake, with its dense calories, we would see a reduction in weight," admits Harlan. "Instead, we see the exact opposite.” Science Magazine , Harlan J. Onsrud, Professor of Spatial Information Science and Engineering, University of Maine Source: Beltsville Human Nutrition Research Center Overweight American Adults Average calorie intake from fat Average energy intake from carbohydrates

"Most of us would have predicted that if we can get the population to change its fat intake, with its dense calories, we would see a reduction in weight," admits Harlan. "Instead, we see the exact opposite.” Science Magazine , Harlan J. Onsrud, Professor of Spatial Information Science and Engineering, University of Maine

Overweight American Adults

Average calorie intake from fat

Average energy intake from carbohydrates

Per Capita Food Consumption Changes From 1970 to 2004 Source: U.S.D.A. Economic Research Service

From 1970 to 2004

Where are we headed as a population ?

Obesity Worldwide “ About 300 million people are estimated to be obese (with a Body Mass Index of 30 or more) with a further 700 million overweight. (a Body Mass Index of 25-29.9)” “ More than 2.5 million deaths annually are weight-related. Deaths directly related to obesity have been estimated at 320,000 a year in Europe and more than 300,000 in the USA.” The World Health Report 2004 estimated SOURCE: www.euro.who.int/hfadb

“ About 300 million people are estimated to be obese (with a Body Mass Index of 30 or more) with a further 700 million overweight. (a Body Mass Index of 25-29.9)”

“ More than 2.5 million deaths annually are weight-related. Deaths directly related to obesity have been estimated at 320,000 a year in Europe and more than 300,000 in the USA.”

The World Health Report 2004 estimated

Global Public Health Crisis: The Twin Epidemics Obesity and diabetes are global problems affecting millions of people. Over 1 billion people are overweight worldwide! Overweight and obesity is increasing around the world including the USA, Europe, and Australia. Obesity is a major risk factor for type 2 diabetes. Sources: International Diabetes Federation, “Press Release: Diabetes and Obesity: Urgent Action Needed,” available at: www.idf.org, accessed on June 17, 2004. World Health Organization, “Overweight and Obesity,” available at: http://www.who.int/dietphysicalactivity/publications/facts/obesity/en/, accessed on June 17, 2004.

Obesity and diabetes are global problems affecting millions of people.

Over 1 billion people are overweight worldwide!

Overweight and obesity is increasing around the world including the USA, Europe, and Australia.

Obesity is a major risk factor for type 2 diabetes.

Global Public Health Crisis: The Twin Epidemics Diabetes affects an estimated 194 million people worldwide! The International Diabetes Federation predicts 333 million will have diabetes by 2025. The prevalence of diabetes may be higher if obesity continues to increase. So what can we do? Source: International Diabetes Federation, “Press Release: Diabetes and Obesity: Urgent Action Needed,” available at: www.idf.org, accessed on June 17, 2004.

Diabetes affects an estimated 194 million people worldwide!

The International Diabetes Federation predicts 333 million will have diabetes by 2025.

The prevalence of diabetes may be higher if obesity continues to increase.

So what can we do?

Global Public Health Crisis: The Twin Epidemics International Diabetes Federation and International Obesity Task Force Recommend: Taking action against the “obesogenic environment” Encourage and facilitate physical activity Encourage a healthy diet Control access to energy dense foods and drinks Source: International Diabetes Federation, “Press Release: Diabetes and Obesity: Urgent Action Needed,” available at: www.idf.org, accessed on June 17, 2004.

International Diabetes Federation and International Obesity Task Force Recommend:

Taking action against the “obesogenic environment”

Encourage and facilitate physical activity

Encourage a healthy diet

Control access to energy dense foods and drinks

Fig 1a - Estimated EU country prevalence of overweight and obesity

Fig 1b - EU Accession Countries

Fig 2 – Prevalence of overweight children aged around 10 years Source: IOTF collated data. (Overweight in children corresponding to BMI ≥25 at age 18 using IOTF assessment method – see Cole et al British Medical Journal 2000)

What Has Happened? Major movement toward “Low Fat” Often high in sugar/carbs Lacking in satiety Larger portions Increase of convenience food Usually high carb and high fat Highly processed foods increase the amount of consumption of trans fats Low in nutrients Decrease in physical activity

Major movement toward “Low Fat”

Often high in sugar/carbs

Lacking in satiety

Larger portions

Increase of convenience food

Usually high carb and high fat

Highly processed foods increase the amount of consumption of trans fats

Low in nutrients

Decrease in physical activity

Excess Carbohydrate Consumption: Effects Health, Weight and Energy Getting off the Blood Sugar Roller Coaster Here's what happens when you routinely consume lots of cards

Sample Carbohydrate Counts Many “healthy” products derive at least 50% of calories from carbohydrates. Slim-Fast® is a registered trademark of Unilever Food Portion Carb gms. Cooked pasta 147g or 6.4oz 40 Cooked rice 186g or 6.6oz 50 Baked potato 141g or 5oz 33 Flavoured yogurt 227g or 8oz 45 Bran muffin 2.5 oz. 42 Honey 1 oz 34 Banana 120g or 4.2oz 26 Slim-Fast® Shake 11 oz. 40

Many “healthy” products derive at least

50% of calories from carbohydrates.

The Atkins Nutritional Approach™ Scientifically validated nutritional strategy for weight control and better health based upon controlling carbohydrate consumption. This nutritional strategy stresses nutrient-dense carbohydrates as part of a balanced eating plan that includes a variety of protein and good fats, while restricting carbohydrates which have the greatest impact on blood sugar. The ANA™ provides each person with the information that they need to find their individual level of carbohydrate intake, below which weight loss is achieved and above which weight gain occurs.

Scientifically validated nutritional strategy for weight control and better health based upon controlling carbohydrate consumption.

This nutritional strategy stresses nutrient-dense carbohydrates as part of a balanced eating plan that includes a variety of protein and good fats, while restricting carbohydrates which have the greatest impact on blood sugar.

The ANA™ provides each person with the information that they need to find their individual level of carbohydrate intake, below which weight loss is achieved and above which weight gain occurs.

What is the ANA? The Atkins Nutritional ApproachTM (ANA) is an easy-to-follow controlled carbohydrate program. Initially, you cut back significantly on carbohydrates to lose weight; then you gradually add back into your diet a variety of nutrient-dense carbohydrates as you get closer to your goal weight. The four phases is a tool to help you achieve your weight loss goals. The ANA brings your nutritional intake into balance, helping you to re-energize, lose weight and lay the foundation for a healthy life.

The Atkins Nutritional ApproachTM (ANA) is an easy-to-follow controlled carbohydrate program.

Initially, you cut back significantly on carbohydrates to lose weight; then you gradually add back into your diet a variety of nutrient-dense carbohydrates as you get closer to your goal weight.

The four phases is a tool to help you achieve your weight loss goals.

The ANA brings your nutritional intake into balance, helping you to re-energize, lose weight and lay the foundation for a healthy life.

The ATKINS LIFESTYLE FOOD GUIDE PYRAMID ™

How Does the ANA Work? Carbohydrates and fat provide fuel for the body. When carbohydrates are available, the body transforms them into energy first. Any excess carbohydrates are stored as fat. When carbs are sufficiently restricted, the body burns fat for fuel, including already stored own body fat, which allows people to lose weight or maintain their goal weight. Studies show that certain risk factors for heart disease improve when individuals follow a controlled carbohydrate programme (e.g. triglyceride levels can decrease on average 44%).

Carbohydrates and fat provide fuel for the body.

When carbohydrates are available, the body transforms them into energy first.

Any excess carbohydrates are stored as fat.

When carbs are sufficiently restricted, the body burns fat for fuel, including already stored own body fat, which allows people to lose weight or maintain their goal weight.

Studies show that certain risk factors for heart disease improve when individuals follow a controlled carbohydrate programme (e.g. triglyceride levels can decrease on average 44%).

What Controlling Carbs Means Finding each individual’s tolerance level for Net Carbs (carbohydrates that impact blood sugar levels), first to lose weight and then maintain a healthy weight for life. Cutting out processed foods full of sugar and white flour, as well as restricting other high-carb foods. Eating a wide variety of delicious foods, including protein, “healthy” fats and nutrient-dense carbs. It does NOT mean eating no carbs, eating only steak, bacon and eggs, or eliminating fruit and vegetables. It DOES mean retaining “good” carbs full of nutrients, found in foods like dark green leafy vegetables, nuts and berries.

Finding each individual’s tolerance level for Net Carbs (carbohydrates that impact blood sugar levels), first to lose weight and then maintain a healthy weight for life.

Cutting out processed foods full of sugar and white flour, as well as restricting other high-carb foods.

Eating a wide variety of delicious foods, including protein, “healthy” fats and nutrient-dense carbs.

It does NOT mean eating no carbs, eating only steak, bacon and eggs, or eliminating fruit and vegetables.

It DOES mean retaining “good” carbs full of nutrients, found in foods like dark green leafy vegetables, nuts and berries.

Atkins Carbohydrate Equilibrium (ACE) The amount of carbohydrate an individual can eat each day while neither gaining nor losing weight.

The amount of carbohydrate an individual can eat each day while neither gaining nor losing weight.

What are Net Carbs? Carbohydrates can have different metabolic effects on the body. Net Carbs are the carbohydrates that impact the blood-sugar level and are the only carbs that count when following Atkins. Certain ingredients, such as glycerine and sugar alcohols, have a minimal impact on blood sugar, and therefore, are not included in a Net Carb count. Note: In the US, fibre is reported as a carbohydrate. In the UK, fibre is reported separately and is not part of the carb count.

Carbohydrates can have different metabolic effects on the body. Net Carbs are the carbohydrates that impact the blood-sugar level and are the only carbs that count when following Atkins.

Certain ingredients, such as glycerine and sugar alcohols, have a minimal impact on blood sugar, and therefore, are not included in a Net Carb count.

Note: In the US, fibre is reported as a carbohydrate. In the UK, fibre is reported separately and is not part of the carb count.

What Are the Carbs That Count? Read nutrition labels: Look for servings/package (there can be more than one serving/package Total carbohydrates in grams/serving Dietary fiber in grams/serving Sugar alcohols in grams/serving Net Carbs Atkins products-see net carbs Other products (to be safe)-subtract grams of dietary fiber and sugar alcohols from total carbohydrate grams, this is the number of carbs that count when doing Atkins.

Read nutrition labels:

Look for servings/package (there can be more than one serving/package

Total carbohydrates in grams/serving

Dietary fiber in grams/serving

Sugar alcohols in grams/serving

Net Carbs

Atkins products-see net carbs

Other products (to be safe)-subtract grams of dietary fiber and sugar alcohols from total carbohydrate grams, this is the number of carbs that count when doing Atkins.

ANI Historical Net Carb Definition Total Carbs : 24 gms (Off Nutrition Fact Panel) Minus:Fiber -14 gms (Pass Undigested) Glycerine -4 gms (Digest Slowly, more like a fat) Sugar Alcohols -2 gms (Digest Slowly without insulin spike) NET CARBS 4 Gms

Total Carbs : 24 gms (Off Nutrition Fact Panel)

Minus:Fiber -14 gms (Pass Undigested)

Glycerine -4 gms (Digest Slowly, more like a fat)

Sugar Alcohols -2 gms (Digest Slowly without insulin spike)

NET CARBS 4 Gms

Breakthrough: “Net Atkins Count” Evolving from “Net Carbs” to a better method… Method based on actual measurement of Glycemic Impact vs. a calculated number.

Evolving from “Net Carbs” to a better method…

Method based on actual measurement of Glycemic Impact vs. a calculated number.

HOW THE NET ATKINS COUNT IS MEASURED Individually plot peoples Blood sugar response Create Standard Response Curve Administer real test product, overlay results against standard curve Net Atkins Count = Equivalent Blood sugar response Blood Glucose Response (AUC) 5 10 15 20 0 Grams of Glycemic Carbohydrate Net Atkins Count

The Atkins Nutritional Principles Four principles: Weight loss Weight maintenance Good health and well-being Disease prevention

Four principles:

Weight loss

Weight maintenance

Good health and well-being

Disease prevention

The Atkins Nutritional Principles Weight Loss Both carbohydrate and fat provide fuel for the body’s energy needs. Carbohydrate is the first fuel to be metabolized. However, when the intake of digestible carbohydrate is sufficiently restricted (without caloric restriction), the body converts from the primary metabolic pathway of burning carbohydrate to burning fat as its main energy source. This results in weight loss.

Weight Loss

Both carbohydrate and fat provide fuel for the body’s energy needs. Carbohydrate is the first fuel to be metabolized. However, when the intake of digestible carbohydrate is sufficiently restricted (without caloric restriction), the body converts from the primary metabolic pathway of burning carbohydrate to burning fat as its main energy source. This results in weight loss.

The Atkins Nutritional Principles Weight Maintenance For each individual there is a tightly regulated carbohydrate threshold below which fat burning and weight loss occurs. However, if the individual’s carbohydrate intake exceeds this threshold, carbohydrate burning predominates, allowing fat to be accumulated, resulting in weight gain. Therefore, each individual has a level of carbohydrate intake at which weight is maintained.

Weight Maintenance

For each individual there is a tightly regulated carbohydrate threshold below which fat burning and weight loss occurs. However, if the individual’s carbohydrate intake exceeds this threshold, carbohydrate burning predominates, allowing fat to be accumulated, resulting in weight gain. Therefore, each individual has a level of carbohydrate intake at which weight is maintained.

The Atkins Nutritional Principles Good Health By adhering to a controlled carbohydrate nutritional approach, an individual who chooses to eat nutrient-dense foods (including adequate fiber, healthy fats and supplementation as needed) is more likely to meet his nutritional needs and promote good health than he would by following a calorie-restricted, fat-deficient diet. Exercise is also essential for controlling weight, enhancing energy and maintaining a sense of well-being.

Good Health

By adhering to a controlled carbohydrate nutritional approach, an individual who chooses to eat nutrient-dense foods (including adequate fiber, healthy fats and supplementation as needed) is more likely to meet his nutritional needs and promote good health than he would by following a calorie-restricted, fat-deficient diet. Exercise is also essential for controlling weight, enhancing energy and maintaining a sense of well-being.

The Atkins Nutritional Principles Disease Prevention By following an individualized controlled carbohydrate nutritional approach that lowers carbohydrate intake resulting in lower insulin production, people at high risk for or diagnosed with certain chronic illnesses, including cardiovascular disease, diabetes and hypertension, can see improvement in clinical parameters.

Disease Prevention

By following an individualized controlled carbohydrate nutritional approach that lowers carbohydrate intake resulting in lower insulin production, people at high risk for or diagnosed with certain chronic illnesses, including cardiovascular disease, diabetes and hypertension, can see improvement in clinical parameters.

The Atkins Nutritional Approach The Atkins Nutritional Principles form the core of The Atkins Nutritional Approach Four Phases: Induction Ongoing Weight Loss Pre-Maintenance Lifetime Maintenance

The Atkins Nutritional Principles form the core of The Atkins Nutritional Approach

Four Phases:

Induction

Ongoing Weight Loss

Pre-Maintenance

Lifetime Maintenance

Phase 1: Induction Limit carbohydrate consumption to 20 grams of Net Carbs per day for a minimum of 2 weeks. For those with a significant amount of weight to lose, Induction can be followed for longer periods of time. Satisfy appetite with foods that combine protein and fat, such as fish, poultry, eggs, lamb, pork and beef. Consume a balance of healthy natural fats such as monounsaturated, polyunsaturated, and saturated. Avoid trans fats (e.g. hydrogenated or partially hydrogenated oils) Consume carbohydrates in the form of nutrient-dense foods such as leafy green vegetables. Drink at least eight 250 ml glasses of water daily. Exercise regularly. Don’t forget to take nutritional supplements.

Limit carbohydrate consumption to 20 grams of Net Carbs per day for a minimum of 2 weeks.

For those with a significant amount of weight to lose, Induction can be followed for longer periods of time.

Satisfy appetite with foods that combine protein and fat, such as fish, poultry, eggs, lamb, pork and beef.

Consume a balance of healthy natural fats such as monounsaturated, polyunsaturated, and saturated.

Avoid trans fats (e.g. hydrogenated or partially hydrogenated oils)

Consume carbohydrates in the form of nutrient-dense foods such as leafy green vegetables.

Drink at least eight 250 ml glasses of water daily.

Exercise regularly.

Don’t forget to take nutritional supplements.

Example of Induction Menu Breakfast Three-Egg Omelette with Avocado Mozzarella Cheese and Tomato Decaffeinated Coffee with Cream Lunch Sirloin Steak ( 8 oz.) Spinach and Mixed Lettuce Salad with Mushrooms, Onions, Celery and Parmesan Cheese Dinner Poached Salmon ( 9 oz.) Kale or Broccoli with Garlic, Lemon and Sesame Seeds

Breakfast

Three-Egg Omelette with Avocado

Mozzarella Cheese and Tomato

Decaffeinated Coffee with Cream

Lunch

Sirloin Steak ( 8 oz.)

Spinach and Mixed Lettuce Salad

with Mushrooms, Onions, Celery and Parmesan Cheese

Dinner

Poached Salmon ( 9 oz.)

Kale or Broccoli with Garlic, Lemon and Sesame Seeds

Phase 2: Ongoing Weight Loss Slow down weight loss by gradually increasing daily Net Carb intake in weekly increments of 5 grams. Go from 20 grams/day of Net Carbs one week to 25 grams/day the next week. Increase carbs by 5 each week until weight loss stops. Choose additional carbs wisely, adding back nutrient-dense foods: More non-starchy veggies (e.g., asparagus, broccoli) Berries (e.g. raspberries and strawberries) Nuts and seeds (e.g., hazel nuts, almonds) Soft cheeses (e.g., cottage cheese, Stilton, brie) Once weight loss stops, drop daily intake of Net Carbs by 5 grams to continue losing weight slowly. Average grams of Net Carbs are 40-60 for this phase. Phase 2 lasts until you are within 5-10 lbs of goal.

Slow down weight loss by gradually increasing daily Net Carb intake in weekly increments of 5 grams.

Go from 20 grams/day of Net Carbs one week to 25 grams/day the next week.

Increase carbs by 5 each week until weight loss stops.

Choose additional carbs wisely, adding back nutrient-dense foods:

More non-starchy veggies (e.g., asparagus, broccoli)

Berries (e.g. raspberries and strawberries)

Nuts and seeds (e.g., hazel nuts, almonds)

Soft cheeses (e.g., cottage cheese, Stilton, brie)

Once weight loss stops, drop daily intake of Net Carbs by 5 grams to continue losing weight slowly.

Average grams of Net Carbs are 40-60 for this phase.

Phase 2 lasts until you are within 5-10 lbs of goal.

Phase 3: Pre-Maintenance Goal is in sight – 5 to 10 pounds from goal weight. Lose the last few pounds very slowly to ease into a permanently changed way of eating. Each week add more grams of Net Carbs (as much as 10) to the daily allotment. As long as weight loss continues, gradually introduce foods such as lentils, melon, starchy vegetables (turnips, swedes and carrots) and whole grains. When goal weight is achieved and maintained for at least a month, you have found your ACE.

Goal is in sight – 5 to 10 pounds from goal weight.

Lose the last few pounds very slowly to ease into a permanently changed way of eating.

Each week add more grams of Net Carbs (as much as 10) to the daily allotment.

As long as weight loss continues, gradually introduce foods such as lentils, melon, starchy vegetables (turnips, swedes and carrots) and whole grains.

When goal weight is achieved and maintained for at least a month, you have found your ACE.

The Carbohydrate Ladder As the programme progresses, moving from one phase to another, add more carbohydrate foods back – in this order: Salads and leafy Vegetables Soft Fruits such as Berries Seeds and Nuts Soft Cheese such as Cottage Cheese Beans and Pulses Other Fruits such as Melon and Pineapple Higher carbohydrate Vegetables Whole Grains

As the programme progresses, moving from one phase to another, add more carbohydrate foods back – in this order:

Salads and leafy Vegetables

Soft Fruits such as Berries

Seeds and Nuts

Soft Cheese such as Cottage Cheese

Beans and Pulses

Other Fruits such as Melon and Pineapple

Higher carbohydrate Vegetables

Whole Grains

The Power of Five These portions contain roughly 5 grams of Net Carbohydrate each: Vegetables: 180g or 6.4oz cooked Spinach 98g or 3.5oz Red Peppers 1 medium Tomato (62g or 2.2oz) 156g or 5.5oz cooked Broccoli 12 Medium Asparagus spears (180g) 180g or 6.4oz cooked Cauliflower ½ medium Avocado (86g or 3oz) 2/3 cup Courgettes Fruits: 48g or 1.7oz Blueberries 92g or 3.3oz Raspberries 125g or 4.4oz Strawberries 44g or 1.6oz honeydew Melon Dairy: 142g or 5oz Hard Cheese 142g or 5 oz Mozzarella Cheese 158g or 5.6oz Cottage/Ricotta Cheese ¾ cup Double Cream Nuts and Seeds: (1 ounce) Macadamia (10-12 nuts) Walnuts (14 halves) Whole Almonds (14 nuts) Hazelnuts (14 nuts) Pecans (14 halves) Sunflower Seeds (3 tablespoons) Pumpkin Seeds (3 tablespoons)

These portions contain roughly 5 grams of Net Carbohydrate each:

Vegetables:

180g or 6.4oz cooked Spinach

98g or 3.5oz Red Peppers

1 medium Tomato (62g or 2.2oz)

156g or 5.5oz cooked Broccoli

12 Medium Asparagus spears (180g)

180g or 6.4oz cooked Cauliflower

½ medium Avocado (86g or 3oz)

2/3 cup Courgettes

Fruits:

48g or 1.7oz Blueberries

92g or 3.3oz Raspberries

125g or 4.4oz Strawberries

44g or 1.6oz honeydew Melon

Dairy:

142g or 5oz Hard Cheese

142g or 5 oz Mozzarella Cheese

158g or 5.6oz Cottage/Ricotta Cheese

¾ cup Double Cream

Nuts and Seeds: (1 ounce)

Macadamia (10-12 nuts)

Walnuts (14 halves)

Whole Almonds (14 nuts)

Hazelnuts (14 nuts)

Pecans (14 halves)

Sunflower Seeds (3 tablespoons)

Pumpkin Seeds (3 tablespoons)

Phase 4: Lifetime Maintenance To maintain goal weight, stay at your ACE. Average grams of Net Carbs is 40 to 120 per day, depending on metabolism, age, gender, activity level, or other factors. Engage in regular exercise; those who exercise usually have a higher ACE. Changes in activity level, hormonal status or other factors may raise or lower your ACE.

To maintain goal weight, stay at your ACE.

Average grams of Net Carbs is 40 to 120 per day, depending on metabolism, age, gender, activity level, or other factors.

Engage in regular exercise; those who exercise usually have a higher ACE.

Changes in activity level, hormonal status or other factors may raise or lower your ACE.

How You Do It Carbohydrates thresholds may vary by individual Time 2 - 4 wks 1 – 6 months 2 – 3 months Lifetime Net Carbs (gms/day) 20 20 + 5 40 - 80 45 - 125 Net Carbs in typical meal 7 8 - 15 13 - 27 15 - 33

Carbohydrates thresholds may vary by individual

Atkins Tips for Success Eat at least three meals a day; skipping meals can impede weight loss. You should not go more than 6 waking hours without a meal or snack. Eat until you are satisfied, but not stuffed. Drink plenty of water, at least eight 250ml glasses daily. Look for hidden carbohydrates in prepared foods Avoid excessive amounts of caffeine. Look for reductions in clothing sizes; don’t rely entirely on the scales. Don’t skip the supplements.

Eat at least three meals a day; skipping meals can impede weight loss.

You should not go more than 6 waking hours without a meal or snack.

Eat until you are satisfied, but not stuffed.

Drink plenty of water, at least eight 250ml glasses daily.

Look for hidden carbohydrates in prepared foods

Avoid excessive amounts of caffeine.

Look for reductions in clothing sizes; don’t rely entirely on the scales.

Don’t skip the supplements.

Top 10 Myths - and the FACTS

Myth No. 1: The ANA Is Unbalanced and Deficient in Basic Nutrition FACT: People frequently mistake the 20 gram Net Carbs per day Induction phase for the whole programme! Even during the Induction phase, the ANA calls 12 net carbs of veggies or 5 daily servings of veggies such as salad (leafy greens like spinach and watercress), 1 cup (two ½-cup servings) of broccoli, and half an avocado. After this phase, individuals raise their carb count gradually until they reach their ACE. A person’s ACE could be up to 120 grams or more daily of nutrient-dense carbohydrates, including fruit, occasional potatoes, brown rice and whole grain bread!

FACT:

People frequently mistake the 20 gram Net Carbs per day Induction phase for the whole programme!

Even during the Induction phase, the ANA calls 12 net carbs of veggies or 5 daily servings of veggies such as salad (leafy greens like spinach and watercress), 1 cup (two ½-cup servings) of broccoli, and half an avocado.

After this phase, individuals raise their carb count gradually until they reach their ACE.

A person’s ACE could be up to 120 grams or more daily of nutrient-dense carbohydrates, including fruit, occasional potatoes, brown rice and whole grain bread!

Example of 20 Gram CHO Daily Menu Breakfast Three Egg Omelet with Avocado, Mozzarella Cheese and Tomato Decaffeinated Coffee with Cream Lunch Beef Round Steak (8 oz.) Spinach and Mixed Lettuce Salad with Mushrooms, Onions, Celery and Parmesan Cheese Dinner Broiled Salmon (9 oz.) Kale topped with Garlic, Lemon and Sesame Seeds

Breakfast

Three Egg Omelet with Avocado,

Mozzarella Cheese and Tomato

Decaffeinated Coffee with Cream

Lunch

Beef Round Steak (8 oz.)

Spinach and Mixed Lettuce Salad with Mushrooms, Onions, Celery and Parmesan Cheese

Dinner

Broiled Salmon (9 oz.)

Kale topped with Garlic, Lemon and Sesame Seeds

Nutrient Analysis of 20 Gram CHO Sample Menu Based on Daily Values /RDI 2000 Calorie Diet

Nutrient Analysis of 20 Gram CHO Sample Menu Based on Daily Values/RDI 2000 Calorie Diet

Myth No. 2: You Lose Mostly Water Weight on the ANA FACT: A portion of initial weight loss on any diet is water weight. When one follows a controlled carbohydrate eating plan the body switches from burning carbohydrate to primarily burning stored fat for energy, resulting in the loss of stored fat. This is evident through the loss of inches! Research results have consistently demonstrated that weight lost after the first few days on a restricted carbohydrate programme is primarily fat and not water or lean body mass.

FACT:

A portion of initial weight loss on any diet is water weight.

When one follows a controlled carbohydrate eating plan the body switches from burning carbohydrate to primarily burning stored fat for energy, resulting in the loss of stored fat.

This is evident through the loss of inches!

Research results have consistently demonstrated that weight lost after the first few days on a restricted carbohydrate programme is primarily fat and not water or lean body mass.

Myth No. 3: The ANA Is Only Effective Because Calories Are Restricted FACT: Calories are not restricted when doing Atkins Individuals may end up eating fewer calories because they are generally less hungry and no longer obsessed with food. Stable blood sugar throughout the day ensures fewer food cravings. The food on this program is less processed and more nutritious than on the typical pre-Atkins menu.

FACT:

Calories are not restricted when doing Atkins

Individuals may end up eating fewer calories because they are generally less hungry and no longer obsessed with food.

Stable blood sugar throughout the day ensures fewer food cravings.

The food on this program is less processed and more nutritious than on the typical pre-Atkins menu.

Myth No. 4: The High-Protein Content of the ANA Causes Kidney Problems FACT: No one has as yet produced a study for review, or even cited a specific case in which the protein content of ANA causes any form of kidney disorder. When someone is already diagnosed with kidney disease, they need to modify their total protein intake and consult closely with their doctor.

FACT:

No one has as yet produced a study for review, or even cited a specific case in which the protein content of ANA causes any form of kidney disorder.

When someone is already diagnosed with kidney disease, they need to modify their total protein intake and consult closely with their doctor.

The Truth Behind Our Critics Claims Claim: “High total protein intake…may accelerate renal function decline.” - Dean Ornish The Facts: Scientific evidence is lacking for people with healthy kidneys. “… protein restriction does not prevent decline in renal function with age, and, in fact is the major cause of that decline. A better way to prevent the decline would be to increase protein intake.” “There is no reason to restrict protein in healthy individuals in order to protect the kidney.” - Mackenzie Walser, Johns Hopkins University Sources: Ornish, D., "Was Dr Atkins Right?," Journal of the American Dietetic Association, 104(4), 2004, pages 537-542. Walser, M.,”Effects of Protein Intake On Renal Function and On the Development of Renal Disease,” In: The Role of Protein and Amino Acids in Sustaining and Enhancing Performance , Institute of Medicine, Washington, DC: National Academies Press, 1999, pages 137-154.V

Claim: “High total protein intake…may accelerate renal function decline.” - Dean Ornish

The Facts: Scientific evidence is lacking for people with healthy kidneys.

“… protein restriction does not prevent decline in renal function with age, and, in fact is the major cause of that decline. A better way to prevent the decline would be to increase protein intake.” “There is no reason to restrict protein in healthy individuals in order to protect the kidney.” - Mackenzie Walser, Johns Hopkins University

Myth No. 5: Fat Intake is Detrimental and Will Lead to Heart Disease FACT: A growing body of scientific literature demonstrates that a controlled carbohydrate eating plan, if followed correctly, reduces risk factors for heart disease and improves clinical health markers. The body needs fats to survive and fats provide many health benefits. Natural fats make individuals feel full sooner and keep dieters feeling less hungry for longer. Low carb v low fat – followed correctly, studies show that a low carb eating plan can be more effective than a low fat plan in improving risk factors for heart disease

FACT:

A growing body of scientific literature demonstrates that a controlled carbohydrate eating plan, if followed correctly, reduces risk factors for heart disease and improves clinical health markers.

The body needs fats to survive and fats provide many health benefits.

Natural fats make individuals feel full sooner and keep dieters feeling less hungry for longer.

Low carb v low fat – followed correctly, studies show that a low carb eating plan can be more effective than a low fat plan in improving risk factors for heart disease

The Truth Behind Our Critics Claims Claim: “A wide body of evidence links the consumption of animal protein…CVD, cancer, and other chronic clinical illnesses” - Dean Ornish The Facts: Studies have shown inconsistent results. A study from Harvard University showed that a high intake of protein (from animal and vegetables) lowered the risk of ischemic heart disease in women. Replacing carbohydrates with protein may actually decrease the risk of ischemic heart disease. Sources: Ornish, D., "Was Dr Atkins Right?," Journal of the American Dietetic Association , 104(4), 2004, pages 537-542. Hu, F.B., Stampfer, M.J., Manson, J.E., et al., "Dietary Protein and Risk of Ischemic Heart Disease in Women," American Journal of Clinical Nutrition , 70(2), 1999, pages 221-227.

Claim: “A wide body of evidence links the consumption of animal protein…CVD, cancer, and other chronic clinical illnesses” - Dean Ornish

The Facts: Studies have shown inconsistent results.

A study from Harvard University showed that a high intake of protein (from animal and vegetables) lowered the risk of ischemic heart disease in women.

Replacing carbohydrates with protein may actually decrease the risk of ischemic heart disease.

Myth No. 6: Ketosis Is Dangerous and Causes a Variety of Medical Problems FACT: The primary fuel in the body is glucose, generated from carbohydrate consumption. When sufficient carbohydrates are not available the body turns to its secondary fuel source: fat. Fat is burned as energy (lipolysis), producing byproducts called ketones. The process is called ketosis. Ketosis should not be confused with the abnormal metabolic state, ketoacidosis. Ketoacidosis is only a concern for diabetics whose blood sugar is out of control, or for alcoholics.

FACT:

The primary fuel in the body is glucose, generated from carbohydrate consumption.

When sufficient carbohydrates are not available the body turns to its secondary fuel source: fat.

Fat is burned as energy (lipolysis), producing byproducts called ketones. The process is called ketosis.

Ketosis should not be confused with the abnormal metabolic state, ketoacidosis.

Ketoacidosis is only a concern for diabetics whose blood sugar is out of control, or for alcoholics.

Myth No. 7: The ANA Causes Constipation Because It Lacks Fibre FACT: Doing Atkins means including fibre-rich foods such as spinach, aubergines, broccoli, asparagus and leafy greens. After the initial phase, it also includes soft fruits such as berries. If the Induction phase is followed properly and all 5 servings of vegetables are included, the majority of individuals do not suffer from constipation. If more fibre is needed during the Induction phase, a fibre supplement is recommended. Supplementing with fibre is unnecessary in the Ongoing Weight Loss (OWL) phase and beyond because fruits and more vegetables are introduced into the eating plan. Drinking plenty (2 litres) of water each day is very important.

FACT:

Doing Atkins means including fibre-rich foods such as spinach, aubergines, broccoli, asparagus and leafy greens. After the initial phase, it also includes soft fruits such as berries.

If the Induction phase is followed properly and all 5 servings of vegetables are included, the majority of individuals do not suffer from constipation. If more fibre is needed during the Induction phase, a fibre supplement is recommended.

Supplementing with fibre is unnecessary in the Ongoing Weight Loss (OWL) phase and beyond because fruits and more vegetables are introduced into the eating plan.

Drinking plenty (2 litres) of water each day is very important.

Myth No. 8: The ANA Increases the Risk of Osteoporosis FACT: During the first week of any weight loss programme, one loses water weight. When water is lost, so are calcium, potassium and magnesium. That’s why taking a multivitamin is so important. Calcium is not being leached from the bones. Actual studies have shown urinary calcium loss lasted a few days. The body then re-adjusts itself to a regular state of homeostasis and the calcium loss in the urine stops. In several studies published in peer review journals researchers followed adults and studied the short-term and long-term effects of a high-meat diet on calcium metabolism. The studies found no significant changes in calcium balance, nor was there any significant change in the intestinal absorption of calcium during the high-meat diet.

FACT:

During the first week of any weight loss programme, one loses water weight. When water is lost, so are calcium, potassium and magnesium. That’s why taking a multivitamin is so important. Calcium is not being leached from the bones.

Actual studies have shown urinary calcium loss lasted a few days. The body then re-adjusts itself to a regular state of homeostasis and the calcium loss in the urine stops.

In several studies published in peer review journals researchers followed adults and studied the short-term and long-term effects of a high-meat diet on calcium metabolism. The studies found no significant changes in calcium balance, nor was there any significant change in the intestinal absorption of calcium during the high-meat diet.

The Truth Behind Our Critics Claims Claim: “High-protein diets may cause loss of calcium and decreased levels of urinary citrate leading to osteoporosis.” - Dean Ornish The Facts: Scientific studies do not support this claim. Hannan et al: Elderly people with lower protein intake had increased bone loss compared to those with higher intakes of protein. Dawson-Hughes et al: Protein supplementation along with a reduction in carbohydrates did not increase urine calcium excretion and did increase circulation of IGF-I, a bone growth factor. Sources: Ornish, D., "Was Dr Atkins Right?," Journal of the American Dietetic Association , 104(4), 2004, pages 537-542. Hannan, M.T., Tucker, K.L., Dawson-Hughes, B., et al., "Effect of Dietary Protein on Bone Loss in Elderly Men and Women: The Framingham Osteoporosis Study," Journal of Bone and Mineral Research , 15(12), 2000, pages 2504-2512. Dawson-Hughes, B., Harris, S.S., Rasmussen, H., et al., "Effect of Dietary Protein Supplements on Calcium Excretion in Healthy Older Men and Women," Journal of Clinical Endocrinology and Metabolism , 89(3), 2004, pages 1169-1173.

Claim: “High-protein diets may cause loss of calcium and decreased levels of urinary citrate leading to osteoporosis.” - Dean Ornish

The Facts: Scientific studies do not support this claim.

Hannan et al: Elderly people with lower protein intake had increased bone loss compared to those with higher intakes of protein.

Dawson-Hughes et al: Protein supplementation along with a reduction in carbohydrates did not increase urine calcium excretion and did increase circulation of IGF-I, a bone growth factor.

Myth No. 9: Lipolysis / Ketosis Causes Loss of Muscle Mass FACT: Typically, individuals on very low calorie diets can lose muscle mass because they have inadequate intake of protein. Atkins is not calorie restricted and the high protein intake offsets any possible loss of lean body mass.

FACT:

Typically, individuals on very low calorie diets can lose muscle mass because they have inadequate intake of protein.

Atkins is not calorie restricted and the high protein intake offsets any possible loss of lean body mass.

Myth No. 10: Atkins Will Cause Weakness,Fatigue,and a Lack of Energy FACT: During the first few days on Atkins, people may experience a mild fatigue as the body switches metabolic pathways. After 3-4 days, the body has switched from a glucose metabolism to a fat metabolism. Reducing caffeine and sugar intake can lead to short-term withdrawal symptoms, but they typically pass within the first week. After the transition, individuals consistently report high energy levels.

FACT:

During the first few days on Atkins, people may experience a mild fatigue as the body switches metabolic pathways.

After 3-4 days, the body has switched from a glucose metabolism to a fat metabolism.

Reducing caffeine and sugar intake can lead to short-term withdrawal symptoms, but they typically pass within the first week.

After the transition, individuals consistently report high energy levels.

The Science Behind Atkins Nutritional Principles

EMERGING RESEARCH As recently as one decade ago, there was little interest in the medical community to research low carbohydrate diets The Robert C. Atkins Foundation made the research possible Now, the medical community cannot ignore the compelling results of these studies and have been seeking funding from The RCA Foundation and other organizations so they can do their own research

As recently as one decade ago, there was little interest in the medical community to research low carbohydrate diets

The Robert C. Atkins Foundation made the research possible

Now, the medical community cannot ignore the compelling results of these studies and have been seeking funding from The RCA Foundation and other organizations so they can do their own research

THE RESEARCH IS GROWING! There are now 50 papers, reviews, abstracts, and conference presentations supporting Atkins There 46 separate studies supporting Atkins (researchers of three research groups published multiple papers from their studies)

There are now 50 papers, reviews, abstracts, and conference presentations supporting Atkins

There 46 separate studies supporting Atkins (researchers of three research groups published multiple papers from their studies)

KEY POINTS Most studies have found that people lose more weight on very-low-carbohydrate diets than on standard weight-loss diets. Mechanisms of weight loss on these diets may go beyond water loss and include suppression of appetite, increasing the metabolic rate, decreasing metabolic efficiency, and shunting of nutrients away from fat storage. Weight loss is usually associated with small to moderate reductions in lean tissue, very-low carbohydrate diets may have a protein-sparing effect compared with low-fat diets. These diets may also have favorable effects on specific risk factors for cardiovascular disease (eg, fasting and postprandial triglyceride levels, high-density lipoprotein levels, and low-density lipoprotein particle size).

Most studies have found that people lose more weight on very-low-carbohydrate diets than on standard weight-loss diets.

Mechanisms of weight loss on these diets may go beyond water loss and include suppression of appetite, increasing the metabolic rate, decreasing metabolic efficiency, and shunting of nutrients away from fat storage.

Weight loss is usually associated with small to moderate reductions in lean tissue, very-low carbohydrate diets may have a protein-sparing effect compared with low-fat diets.

These diets may also have favorable effects on specific risk factors for cardiovascular disease (eg, fasting and postprandial triglyceride levels, high-density lipoprotein levels, and low-density lipoprotein particle size).

Research Supporting Atkins The research has shown health benefits beyond weight loss in adults…

The research has shown health benefits beyond weight loss in adults…

Research Supporting Atkins Two studies showed improvements in obese children/adolescents . Nine studies included adults with diabetes and showed beneficial effects. All studies showed improvements in cardiovascular (heart) risk factors . Benefits included improvements in triglycerides and HDL “good” cholesterol. All references are available on-line at http://www.atkins.com/research-library

Two studies showed improvements in obese children/adolescents .

Nine studies included adults with diabetes and showed beneficial effects.

All studies showed improvements in cardiovascular (heart) risk factors .

Benefits included improvements in triglycerides and HDL “good” cholesterol.

Research Supporting Atkins One study using the Atkins diet showed benefits in treating epilepsy . One study showed benefits in treating gastroesophageal reflux disease ( GERD ). One study showed improvements in women with polycystic ovary syndrome ( PCOS ). All references are available on-line at http://www.atkins.com/research-library

One study using the Atkins diet showed benefits in treating epilepsy .

One study showed benefits in treating gastroesophageal reflux disease ( GERD ).

One study showed improvements in women with polycystic ovary syndrome ( PCOS ).

Longer Term Studies A Randomized Trial Comparing a Very Low Carbohydrate Diet and a Calorie-Restricted Low Fat Diet on Body Weight and Cardiovascular Risk Factors in Healthy Women , Bonnie J. Brehm, et al ., J Clin Endo & Met , Volume 88, April 2003, pp. 1617-23 A Low-Carbohydrate As Compared With A Low-Fat Diet In Severe Obesity , Frederick F. Samaha, MD et al., New England Journal of Medicine, Volume 348, May 22, 2003; pp. 2074-81 A Randomized Trial Of a Low Carbohydrate Diet For Obesity , Gary D. Foster, PhD et al., New England Journal of Medicine, Volume 348, May 22, 2003; pp. 2082-90 A Low Carbohydrate, Ketogenic Diet versus a Low Fat Diet to Treat Obesity and Hyperlipidemia: A Randomized, Controlled Trial , William S. Yancy Jr., MD, MHS; et al., Annals of Internal Medicine, Volume 140, Number 10, 2004, pp. 769-777 The Effects of Low Carbohydrate versus Conventional Weight Loss Diets in Severely Obese Adults: One- Year Follow-up of a A Randomized Trial , Linda Stern, MD et al., Annals of Internal Medicine, Volume 140, Number 10, 2004, pp. 778-786

A Randomized Trial Comparing a Very Low Carbohydrate Diet and a Calorie-Restricted Low Fat Diet on Body Weight and Cardiovascular Risk Factors in Healthy Women , Bonnie J. Brehm, et al ., J Clin Endo & Met , Volume 88, April 2003, pp. 1617-23

A Low-Carbohydrate As Compared With A Low-Fat Diet In Severe Obesity , Frederick F. Samaha, MD et al., New England Journal of Medicine, Volume 348, May 22, 2003; pp. 2074-81

A Randomized Trial Of a Low Carbohydrate Diet For Obesity , Gary D. Foster, PhD et al., New England Journal of Medicine, Volume 348, May 22, 2003; pp. 2082-90

A Low Carbohydrate, Ketogenic Diet versus a Low Fat Diet to Treat Obesity and Hyperlipidemia: A Randomized, Controlled Trial , William S. Yancy Jr., MD, MHS; et al., Annals of Internal Medicine, Volume 140, Number 10, 2004, pp. 769-777

The Effects of Low Carbohydrate versus Conventional Weight Loss Diets in Severely Obese Adults: One- Year Follow-up of a A Randomized Trial , Linda Stern, MD et al., Annals of Internal Medicine, Volume 140, Number 10, 2004, pp. 778-786

Atkins Advantage– The ONLY weight loss/ nutrition brand with continuous medical studies to back its efficacy March 6 – NIH funded Stanford University Diet Study Atkins Diet ranks #1 among 4 top regimens in total weight lost with the most beneficial overall metabolic effects. The latest of 50 clinical studies validating Atkins principles Comparison of the Atkins, Zone, Ornish, and LEARN Diets for Change in Weight and Related Risk Factors Among Overweight Premenopausal Women: The A TO Z Weight Loss Study: A Randomized Trial Christopher D. Gardner; Alexandre Kiazand; Sofiya Alhassan; Soowon Kim; Randall S. Stafford; Raymond R. Balise; Helena C. Kraemer; Abby C. King.

March 6 – NIH funded Stanford University Diet Study

Atkins Diet ranks #1 among 4 top regimens in total weight lost with the most beneficial overall metabolic effects.

The latest of 50 clinical studies validating Atkins principles

Trends & Opportunities Carbohydrate awareness is a trend that is being driven by science and consumers An increasingly knowledgeable public is reading food labels and taking note of sugar content, manufactured trans fats and excessive carbohydrates We have an opportunity to play an important role by offering healthy options, free of high sugar content and manufactured trans fats, high in protein and fiber The challenge is to develop products responsibly so they are healthy and effective, and to not just capitalize trends without regard for the impact on consumers’ health.

Carbohydrate awareness is a trend that is being driven by science and consumers

An increasingly knowledgeable public is reading food labels and taking note of sugar content, manufactured trans fats and excessive carbohydrates

We have an opportunity to play an important role by offering healthy options, free of high sugar content and manufactured trans fats, high in protein and fiber

The challenge is to develop products responsibly so they are healthy and effective, and to not just capitalize trends without regard for the impact on consumers’ health.

Atkins Nutrition Principles Vitamins and minerals Low sugar No trans fats High fiber High protein

Vitamins and minerals

Low sugar

No trans fats

High fiber

High protein

Compare for Yourself

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How we will Delight Consumers How we will Delight Consumers 1st Being the best in our area of core focus: ………… .. Healthy Weight Control Products which are nutritionally superior, loaded with hunger satisfying protein, fiber, and no trans fats. Products that work as promised

How we will Delight Consumers

1st Being the best in our area of core focus:

………… .. Healthy Weight Control

Products which are nutritionally superior,

loaded with hunger satisfying protein, fiber, and no trans fats.

Products that work as promised