The following information has been borrowed from the official Atkins Center website. Please feel free to visit there for more information. www.atkinscenter.com

This is not meant to be a primer on the Atkins diet. You will find here the "official" responses to many rumors and controversies that have been in the press. You will also find lots of great advice for those who are already convinced that this is a sound, healthy approach to weight loss.

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On Low Carb Dieting

I've heard that Atkins is unhealthy and unsafe. How do you respond?

There is a large body of scientific research showing that a controlled carbohydrate nutritional approach, such as Atkins, can help people significantly decrease their risk of developing heart disease, diabetes, and obesity. Following Atkins correctly will lower clinical parameters in the blood that are known to contribute to these conditions. We at the Atkins Health and Medical Information Services continually explain the scientific rationale of the benefits of the Atkins Nutritional Approach to health care professionals at medical conferences, in articles, and in the media. Please browse our Web site or read Dr. Atkins New Diet Revolution for a more comprehensive discussion of the safety and efficacy of Atkins.

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On Using the Word "Diet"

I see you don't use the term "The Atkins Diet" anymore. Why not?

The word diet has several meanings, the most basic one referring to the food we regularly eat. But in our culture, the word has become entwined with weight loss and implies a limited period during which intake is limited in order to lose weight. No matter how successful they are in losing weight, most people then go off their "diet" and return to their normal way of eating - and then regain the weight they have lost.

In contrast, the Atkins Nutritional Approach refers to a lifestyle and four graduated phases that encompass weight loss and weight maintenance as well as overall health and well-being and the reduction of risk factors for heart disease, diabetes and other illnesses. Depending upon your weight and health, you can personalize the Atkins Nutritional Approach to suit your individual needs and move from one phase of the program to another as your needs change. In sum, Atkins is more than a diet - it is a healthful approach to eating that will serve you for the rest of your life.

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On High Fat Intake

What is the Atkins position on studies that state fat intake is detrimental to your health?

A diet high in both fats and carbohydrates can cause cardiovascular problems. The Atkins Nutritional approach restricts carbohydrates, thereby putting your body into lipolysis. In this metabolic state, the body burns both the fat that you consume along with your stored body fat, and will not allow plaque to clog your arteries. Natural dietary fats such as olives, avocados, olive oil, butter and fat from red meat and poultry are not the culprits in heart disease. Fats that should be avoided, however, are trans fats (food labels refer to them as hydrogenated or partially hydrogenated oils). Found in packaged products such as crackers, bread, margarine and commercially baked desserts and snacks, these fats have been found to pose a serious risk of cardiac disease, according to several studies.

Selected reference: New England Journal of Medicine 1997; 337: 1491-1499.

Why do you allow "fried foods"? They are a known health risk.

Fried foods allow you to enjoy Atkins more and do not adversely affect the metabolic state of lipolysis, or "fat burning." However, we do agree that given a choice, broiling or roasting meat is preferable; both of these two ways of cooking eliminate the "trans fats" that are created by the ultra-high heat of frying.

I have elevated cholesterol and have been told to watch my fat intake. How can the Atkins Nutritional Approach, which is so high in fat, be safe for me?

It's only a diet high in fats and carbohydrates that can cause cardiovascular problems. The Atkins Nutritional Approach restricts carbohydrates, thereby putting your body into "ketosis." In this metabolic state, the body burns both the fat that you consume and your stored body fat, and will not allow plaque to clog your arteries.

Natural dietary fats such as olives, avocado, olive oil, butter and fat from red meat and poultry are not the culprits in heart disease. There are many studies that show that sugar is the real ingredient that triggers heart problems. The fats that should be avoided, however, are trans fats (food labels refer to them as hydrogenated or partially hydrogenated oils). Found in packaged products such as crackers, bread, margarine and commercially baked desserts and snacks, these fats have been found to pose a serious risk of cardiac disease, according to several studies.

Selected reference: New England Journal of Medicine 1997; 337: 1491-1499

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On Using Supplements

Do you recommend a lot of supplements because the Atkins Nutritional Approach is unbalanced and doesn't provide enough nutrition on its own?

On the contrary, a computer analysis using the software program most widely accepted by nutritionists shows that even a sample menu appropriate for the Induction phase of Atkins -- the one that can certainly be considered the most restrictive -- far exceeds the recommended daily intake requirements set for adults for most vitamins, minerals and antioxidants. We and many other nutrition-oriented doctors recommend additional supplements because of our polluted environment, our own lifestyles, and the degraded quality of the food supply. In an ideal world, we could depend on whole foods grown organically in nutrient-rich soils, free from pesticides and pollution. However, our depleted soils, the over-processing of foods and other chemical assaults to the environment leach vital nutrients from foods. By the time a meal arrives at our table, a lot of the nutrients have been lost. In addition, the chemical overload from antibiotics and other drugs, cigarettes, pesticides and pollution, as well as work-related stresses, all combine to strain our immune systems. Supplemental nutrients help neutralize the harmful effects of these insults to our bodies and prevent further breakdown of our health. Moreover, supplements are even more important when your body is under stress from weight loss or disease management.

This 2,000-calorie daily menu is nutrient-rich and suitable for the Induction phase of Atkins:

The recommended daily intake of vitamins and minerals found in this menu include:

Every time I take supplements, I get sick to my stomach.

Don't stop taking your nutrients; change the way you take them. Your nausea almost certainly is an absorption problem. Supplements only occasionally cause side effects. When they do, symptoms tend to appear before absorption into the bloodstream. That's quite unlike drugs; the side effects of which usually appear only after the medications are surging through your arteries.

The solution involves technique and timing. First, gather up all the supplements you would normally take for the day, put them in a food processor or blender, and pulverize them. Divide the powder in half or into quarters. Take each portion over the course of the day during the middle of your meals, not at the start. This is important, because you need some food in your stomach to stir the flow of gastric juices and better digest the nutrients.

You can mix the powdered supplements with anything you'd like -- you might stir it into a bowl of soup or mix it in a glass of water, for example. We usually recommend adding it to the Atkins Shake Mix.

The technique works for most people we know who have complained of stomach upset upon taking supplements. If it doesn't work for you, try dividing the powder into even smaller portions.

There is also the possibility that a certain supplement brand is behind your nausea. Through a process of elimination, you probably could find out which one. If you do identify a certain supplement, don't eliminate it from your program; switch to another manufacturer.

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On Counting Calories

Is it true that Atkins works because it's a low-calorie diet?

Ask anyone doing Atkins and they will tell you this is completely false. While some Atkins followers eat fewer calories than before, it's not because Atkins is restrictive or unduly limiting of food intake (as is true for every low-fat nutritional philosophy), it's because people are generally less hungry and are less obsessed with food while doing Atkins. This occurs for two reasons:

• Stable blood sugar throughout the day ensures that you will have fewer food cravings or false hunger pains.
  
  
• The food you eat on Atkins (meat, fish, cheese, nuts, eggs, low sugar/starch vegetables and fruit...etc.) is less processed and more nutritious than you were previously eating. Give your body fewer empty calories, providing it with more nutrient-dense alternatives, and your body will logically be satisfied sooner and require less food.

For those who need further convincing, try this 500 calorie test:

If you're like most people, the low-fat breakfast will cause your body to scream for more food well before lunch, while the Atkins breakfast will keep your mind off food so long you'll be shocked when lunch time comes around.

I'm used to counting calories. How many calories am I allowed during Induction?

There is no need to count calories. The Atkins Nutritional Approach counts grams of carbohydrates instead of calories. At the beginning of Induction, you are allowed 20 grams of carbohydrates, gradually adding them in 5-gram increments as you progress from Ongoing Weight Loss to Pre-Maintenance, and finally to the Lifetime Maintenance phase of Atkins. Although there is no need to count calories, they do count. Gaining weight results from taking in more calories than you expend through exercise, thermogenesis (the body's own heat production), and other metabolic functions. Research has shown that on a controlled carbohydrate program, more calories are burned than in a mixed diet, so there is a certain metabolic advantage to the controlled carb approach. But understand that this does not give you a license to gorge.

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On Carbohydrate Labeling

Is it true that Advantage bars are higher in carbs than it says on the label because the glycerine is not counted?

Our main concern for Atkins followers is the impact of carbohydrates on blood sugar and insulin levels. Glycerine does not metabolize like a carbohydrate. Instead, it actually has the same effect on blood sugar that protein does. Therefore, it has not been included on the label.

I've read recently that Atkins does not report carbohydrates correctly on its nutritional labeling on certain products. Is that true? If so, why is this happening and what does Atkins intend to do about the situation?

Atkins products are specifically formulated to minimize the impact of carbohydrates on a person's blood sugar level because elevated blood sugar and the resulting excess insulin production can inhibit weight loss, weight management and increase the risk of disease and illness. We accomplish this in our product formulation by understanding that not all carbohydrates behave the same way in a person's body. While most carbohydrates - sugar, which imparts 4 calories per gram, is the best example - are digested by your body and turned into blood sugar, other carbohydrates behave differently. Some carbs are digested by your body but not turned into glucose. And, some carbs - such as fiber - can impart as little as 0 calories per gram, are not digested at all, and pass through your body as waste. In either of these last two cases there is no noted impact on blood sugar levels. However, the FDA and other health organizations have not yet focused on this important biochemical difference and treat all carbohydrates as the same.

The nutritional information on Atkins food products is intended to help consumers understand exactly how we formulate our products so that the consumer has the knowledge necessary to follow a controlled carbohydrate nutritional approach and eat healthy foods. Thus, for Atkins Advantage™ Bars, the "net" carb count listed in the Total Carbohydrate statement is completely accurate for Atkins followers, and the "gross" carb count matters very little.

Example: Atkins Chocolate Mocha Crunch Advantage Bar

Millions of people have benefited and continue to benefit from the Atkins Nutritional Approach™ and the products we have created to support this approach. Healing and helping people is the cornerstone of the mission of the company.

Atkins has been working very closely with the FDA in a spirit of cooperation. Our goal has been to provide accurate information to Atkins consumers and others for whom blood sugar levels are a real health issue. Atkins believes consumers would benefit tremendously by understanding the relative importance of the impact different types of carbohydrates have on blood sugar and that this information should be presented right on the nutrition facts panel.

We certainly understand and respect that the FDA has now made the decision that requires all food products labels include all nutrients defined as carbohydrates by the FDA - and that these nutrients be listed in the Total Carb statement on the Nutrition Facts Panel.

Atkins will therefore update all its labels to comply with this directive. This process is underway and can be seen on Atkins™ Ready-To-Drink Shakes, Atkins™ Shake Mixes, Atkins™ Quick & Easy Mixes and many other Atkins products. It is presently being accomplished on Atkins Advantage™ Bars, Atkins™ Breakfast Bars and Atkins Endulge™ Bars. Current products with existing labels will be sold through, and will then be replaced by product with the FDA-mandated labels. Consumers should start seeing these new labels in early 2002.

The new labels will fully comply with the FDA ruling. And, our labels will also become even clearer about the benefits of the Atkins Nutritional Approach™ so that consumers who want to moderate their refined carbohydrate intake will understand the health benefits of Atkins products.

Atkins Nutritionals will be issuing shortly a detailed guide to carbohydrates that will help retailers better educate their consumers on the wide variety of carbohydrates found in food products.

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On Atkins for Children

At what age can a child start doing Atkins?

Babies, if showing signs of obesity, could be moved in the direction of the Atkins Nutritional Approach as soon as the tendency is noted (no sugar, less fruit and juice, and more protein). If this fails, the carbohydrates should be increasingly restricted. Please do not do this without the guidance of a knowledgeable pediatrician.

My 6-year-old is overweight. Can I put him or her on Atkins?

We don't recommend Atkins for children under 12 without supervision by a pediatrician. (Losing weight too quickly could stunt growth at this age.) But remember, young children tend to eat like their parents do. That's why it's important that the whole family eat healthy, balanced meals. We suggest that you cut out sugar, processed food, junk food and other refined carbohydrates.

The single most important thing you can do for an overweight child is wean him or her off sugar. Children can certainly eat Atkins Shake Mix, Advantage Bars, and certain sugar substitutes. What usually makes children overweight is a diet high in refined carbs, sugary treats and sodas, and the trans fats (hydrogenated oils) found in manufactured foods. If you put your entire family on a whole foods eating plan, your son or daughter will probably lose weight. That means no bread, bagels, pasta, crackers, potato chips, pretzels, soda, fruit juice or any food not in its natural state. Instead, offer nuts, cheese, fruit, raisins and other healthy snacks. The earlier parents instill good nutrition, the healthier their children will be as they get older.

If your son or daughter is a couch potato and eats a lot of high-carb and junk foods, he or she is heading for a lifetime of weight and health problems. Limit the amount of time kids spend in front of the television or the computer. Encourage them to get involved with sports and plan regular physical activities the family can enjoy together, such as hiking, biking and swimming. Again, the sooner you instill the habit of exercise, the better. The biggest problem for most overweight people is simply that they're inactive. Our culture's bad diet wouldn't cause as many health problems if people were more active.

Note: When you talk to your kids about eating habits, it's important not to focus on weight or body fat. You don't want to set the stage for a future eating disorder. Instead, talk to them about how healthy eating will make them feel better.

Tip: Don't restock the fridge, empty the pantry, and insist on a family hike all in one day. Make changes slowly, and you'll encounter less resistance from the younger set.

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On Atkins for Teenagers

My teenager wants to do Atkins. Is it safe for someone her age?

Yes, controlling carbohydrate intake is appropriate for adolescents and children over the age of 12. (Younger children should follow the program only under the advice and supervision of a physician.) There are, however, certain things parents should be aware of when an adolescent restricts carbs without expert supervision:

• Although appetite is usually decreased, teens should be encouraged not to skip meals.
• Like adults, they should consume at least eight glasses of water per day. If your child experiences constipation, add fiber, such as wheat bran, psyllium husks or flaxseed, to his or her diet.
• Adolescents should take a multivitamin/mineral supplement while restricting carbohydrates.

Recent research at Schneider Children's Hospital in New Hyde Park, N.Y., confirms the effectiveness of a controlled carbohydrate program for teens. Marc S. Jacobson, M.D., lead researcher and director of the Center for Atherosclerosis Prevention at New York Hospital, reported that 22 adolescents consuming a high-protein, high-fat carbohydrate-restricted diet were more successful at losing weight than those consuming a low-fat, high-carbohydrate one. Teens who restricted their carb intake also had improved cardiovascular risk factors and other clinical health markers.

Participants were 12 to 18 years old and 20 to 100 pounds overweight. Those following a controlled carb program lost 19 pounds in 12 weeks, while the low-fat group lost less than half that amount, 8.5 pounds. The research showed that the controlled carb group also showed a greater decrease in overall cholesterol levels, with triglycerides dropping 33 percent as compared to a 17 percent drop for the low-fat group. Kidney and liver functions were unaffected by the high-protein, high-fat diet. The high-protein group ate 66 percent more calories than the low-fat group (1,830 calories vs. 1,100 calories per day). After three months on a weight-loss regimen, the participants followed a weight maintenance program that included additional carbohydrates. Nutritionist Nancy Copperman, M.S., R.D., who designed both regimens, says that six to 12 months later, most members of the controlled carbohydrate group had maintained their weight loss.

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On Vegetarianism

Can a vegetarian follow the Atkins Nutritional Approach?

Animal proteins are a vital component of Atkins. Atkins cannot be done as successfully without them. They contain many essential fatty acids that cannot be found in any other sources. There are patients at The Atkins Center for Complementary Medicine, however, for whom we derived a modified ovo-lacto vegetarian diet; they can eat eggs, cheese and tofu for their protein (although it is usually necessary for a person to be able to also eat fish for Atkins to be enjoyable). Atkins food products such as the Advantage Bars and Atkins Shakes can also be used as occasional meal replacements.

A vegan cannot follow Atkins. A pure vegan diet could never be low enough in carbohydrates, because there are no plants that are carbohydrate free.

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On Atkins for Slender People

Can I join my partner on Atkins? My partner is overweight, but I am slim. Will I lose weight or mess up my metabolism?

Atkins is recommended for more than weight loss. It is your ticket to weight maintenance, good health and disease prevention. Anyone can experience the health benefits associated with controlled carbohydrate nutrition. Use your husband's Induction-level menu as a base, then add liberal amounts of vegetables low in carbs and some higher-carb ones such as yams, carrots and peas. Also add fruits such as melons and berries, as well as legumes and whole grains. While consuming a regular amount of protein, add as much of these foods as you wish at levels that allow you to maintain your normal weight. Do, however, avoid empty carbs in the form of packaged or processed foods.

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On Exercise

Do I need to exercise to lose weight on Atkins?

Exercise will not only speed up your weight loss (or help you maintain your weight) and enhance muscle tone, but also offers cardiovascular conditioning that is essential for continued good health.

Many studies have shown that inactivity is the greatest risk factor leading to heart disease, more so than the usual indicators such as high cholesterol. Regular aerobic exercise strengthens the heart muscle and widens the arteries called collaterals that supply extra oxygen-rich blood to weaker areas of the heart. Patients treated in the cardiology division of our clinical practice receive a prescription that includes a lifestyle change in nutrition, supplementation and exercise. Select a form of exercise that you enjoy, whether walking, running, swimming or bicycling. You actually need to engage regularly in two kinds of exercise. Isometric, or dynamic, exercise is aerobic, meaning it increases the heart rate and the blood pressure; swimming or brisk walking are good examples. Isotonic, or static, exercise, such as weight lifting, involves the muscles, but does not significantly increase the heart rate.

How long does it take to see results from exercise?

Be patient. Two weeks is not enough time to effect changes in your body from exercise. Some people, especially those who are flabby, may even gain a little weight. That's because muscle mass increases as you get stronger, and muscle weighs more than fat. As we start to age, from our 30s on, we begin to lose muscle mass. That's one reason your metabolic rate slows down. The more muscle you have, the more oxygen you take in; oxygen burns fat, so you in turn burn more fat. If you follow an exercise program five days a week you should see results within a month.

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On Ketosis

Exactly what is ketosis, and can it be dangerous?

There are two fuels your body burns for energy. Glucose, the primary fuel, comes from eating carbohydrates. When your body runs out of glucose, it turns to its secondary fuel source: your own body fat. When you reduce your intake of carbohydrates, your body must convert fat into energy, and this metabolic state is called "ketosis." So being in ketosis simply means living off your fat stores. Assuming you're overweight, this process is not only safe - it's desirable!

One reason why people become overweight in the first place is that their bodies have great difficulty in using this backup fuel system. Almost 50 years ago, scientists demonstrated that obese and overweight people differed dramatically from people of normal weight in that they were very resistant to developing ketosis. The Atkins Nutritional Approach helps your body activate its fat-burning system by restricting its primary source of fuel - glucose.

Ketosis is absolutely safe, unless you happen to have no excess body fat. So, why do so many people think ketosis is dangerous? Perhaps because the term is often confused with another K-word. Ketoacidosis is a potentially dangerous condition that occurs in a diabetic whose blood sugar levels are out of control. Ketoacidosis is not experienced on Atkins. We have diabetic patients at The Atkins Center for Complementary Medicine in ketosis whose blood sugar is under control, and they are burning fat and losing weight.

Anyone who is diabetic and wishes to do Atkins (or any weight-loss program) should seek a physician's supervision.

Selected reference: Bloom, W., "Fasting Ketosis in Obese Men and Women." J. Lab. & Clin. Med. 606, 1962; 784.

Why am I unable to get into ketosis even with a very low amount of carbohydrates? What should I do?

You are either metabolically resistant to weight loss or else you don't know all sources of the carbohydrates you may be eating. If you are losing weight and doing well, there is no need to do anything differently. If you are not doing well or losing weight, you may benefit from additional nutritional supplementation Vita-Nutrients, including L-Carnitine, HCA and chromium may prove helpful. To stimulate ketosis, the best diet is high in fat (cream cheese, macadamias, deviled eggs, etc.), moderate amounts of protein and a very low level of carbohydrates. You may also need to increase exercise from three times per week, to four or five times per week. If all else fails, you need to see a M.D. trained in the Atkins Nutritional Approach. To really understand what is occurring in your body, we strongly suggest you read Dr. Atkins New Diet Revolution

What shade of purple should my Lipolysis Testing Strips be?

Lipolysis is an indicator of whether a person is adhering to the Atkins Nutritional Approach. Ketones are formed when the body breaks down fat. If you are restricting the amount of carbohydrates you eat, then the body's preferred source of energy, fat, is used for metabolism.

There are many reasons why a person's lipolysis test strip would be varying shades of purple. Each person's metabolism level is different and therefore will turn the sticks a varying degree of purple. In addition, the time of the day, whether or not you exercise, and what you had at your last meal will all affect the ketone test strips. It also does not necessarily matter whether you are turning the strips a dark or light color. The important thing is you are in ketosis and are burning fat for energy. However, keep in mind that every individual's metabolism is different, and as a result, there are people who never even get into ketosis, yet lose all the weight they want.

In summary, don't worry about the exact level of ketosis you will find on the strip. The important thing is to worry about the restrictions of the Atkins Nutritional Approach, how your clothes are fitting and what the scale says. Because of this, we sometimes do not even use the strips, nor do we encourage you to weigh yourself every day. This should be done once per week. Don't make the common mistake of eating less fat to get into ketosis; the opposite is actually true.

No matter what I do, I can't get into ketosis, or the shade of purple on the sticks is very light. What am I doing wrong?

The first question to ask yourself is, "Am I seeing success with Atkins?" (loss of weight/inches, improved mental/physical energy, etc.). If you are, then don't focus on ketosis as a success gauge. If you are not seeing success, please review the question on our Web site concerning slow weight loss and plateaus for additional help.

In either case, please remember not to over test yourself. We recommend that you test your ketosis level no more than once a week.

Since starting Atkins, I have bad breath. Can I use Tic Tacs or other breath mints? Any other suggestions?

Lipolysis (the process during which your body primarily burns fat as fuel rather than glucose), causes ketosis, which generates ketones, the by-products of fat breakdown. During lipolysis, ketones are released in your breath and your urine. While this can be annoying, the good news is that ketone breath is chemical proof that you're burning stored body fat. The more ketones you release, the more fat you've burned. Drinking plenty of water helps dilute the concentration of ketones. Parsley, too, is a natural breath freshener, as is oil of peppermint (drops are available at natural food stores. (Read the label to ensure that it contains no sugar.) Chewing fresh parsley or taking capsules such as Breath-a-Sure, which can be found in any health food or drug store, will also help. As long as you drink enough water, the bad breath caused by ketones usually lasts only a few weeks.

We discourage the use of breath mints while doing Atkins because they may contain either sugar or artificial sweeteners. Even so-called "sugar-free" products are often full of carbs. Check the number of grams of carbohydrates on the label of any product before using it.

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On Serious Medical Conditions

Are there any medical conditions that can interfere with a person's ability to do Atkins?

Yes, and they include far advanced kidney disease, gout, urate kidney stones, or unmanageable constipation or allergy to the primary foods on the Atkins Nutritional Approach, such as meat and cheese. The absence of digestive enzymes needed to digest fat and protein also make the Atkins Nutritional Approach difficult to handle, but this can usually be corrected. People who are underweight or of normal weight should not use the Induction phase of Atkins, but rather begin with the Ongoing Weight Loss (OWL), Pre-Maintenance or Maintenance phase. For more information, read Dr. Atkins New Diet Revolution.

What medical conditions should be monitored by an M.D. during the Atkins Nutritional Approach?

All medical conditions requiring prescriptions, and even some that don't -- like diet controlled diabetes mellitus -- need to be monitored by a physician. This is necessary because the Atkins Nutritional Approach and nutritional supplements improve so many conditions that the prescriptions often become an overdose or unnecessarily strong.

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On Induction

I know I'm allowed up to 20 grams of carbohydrates a day during the two weeks of Induction. But if I stay under 20 grams of carbs a day, why can't I have some in the form of a slice of whole grain bread or even a peanut butter cup, which has 20 grams of carbs?

There are two reasons this approach won't work. For one, all carbohydrates are not created equal. The Atkins Nutritional Approach is designed to prevent blood sugar levels from spiking and causing the overproduction of insulin - a hormone that helps convert carbohydrates to body fat. The first carbohydrates you need to add back to your eating plan are more vegetables, then seeds and nuts, then berries and then - if you are still losing - grains. Even bread made from 100 percent whole-wheat flour contains enough refined carbs to produce the insulin-raising, fat-storing effect in many people. Later, if your weight loss is progressing well and you have increased your daily carb intake, you may eat an occasional slice of whole grain bread. As for the 20-gram peanut butter cup, it contains a lot of sugar - not to mention artery-clogging hydrogenated fat - and sugar is the worst kind of carbohydrate.

Second, Atkins is not just about rapid weight loss - it's about learning to eat only nutrient-dense carbohydrates for the rest of your life. These are foods that are packed with the most antioxidant vitamins and healthful phytochemicals relative to the amount of carbohydrates - so you're getting the most bang for your carbohydrate buck. Once you've reached your goal weight and established your personal carbohydrate level for maintenance, you can enjoy whole-grain bread, fruit and even the occasional plate of french fries. Unfortunately, that peanut butter cup just doesn't make the grade!

Can I eat Advantage Bars and Shakes during the Induction phase?

An Advantage Bar can serve as either a snack or an occasional meal replacement. Feel free to eat them during Induction as long as you continue to lose weight. (We generally recommend no more than one bar a day during Induction.) But keep in mind that neither the Atkins shakes nor the bars were formulated to be total meal replacements. Atkins does not recommend the use of meal replacements; instead, it is important to eat whole, unprocessed foods to learn wholesome eating habits.

I have been experiencing dizziness since beginning Atkins. Why and what should I do?

First, check with your physician to make sure you don't have a medical condition. Once your doctor has ruled out any conditions that require medical intervention, the possibility exists that you may be going through carbohydrate withdrawal. When your body becomes accustomed to burning fat for fuel, these symptoms should dissipate, usually within a week. You might alleviate them by adding more vegetables that are low in carbohydrates, such as leafy green vegetables. Then bring the quantities back down once your body adjusts to the controlled carb routine. You may find it helpful to eat protein snacks throughout the day, such as a slice of turkey or cream cheese in celery. Try a few days of eating every 3-4 hours and make sure you drink plenty of water.

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On Protein Powders & Flours

What is the difference between soy powder, soy protein isolate, soy flour, protein powder, and whey protein?

Soy (also called soya) powder (or soy protein isolate) and soy flour are both made from the same source: the soy bean. The physical difference between the two is that soy powder is ground finer than soy flour. You can use both when doing Atkins. However, soy flour has more carbs, so you need to keep this in mind when counting your carb intake. For best results, especially during Induction, use Atkins Bake Mix, which has a very low carb count.

Protein powder is a pure source of protein, usually an egg protein powder or vegetable-based protein powder that is very low in carbohydrate. Keep in mind that many protein powders may contain certain fillers and hidden sugars. Make sure you read the label to check carbohydrate and sugar amounts.

Whey Protein Isolate (WPI) is considered the highest quality protein available in terms of the body's ability to utilize it. It is extremely low in carbohydrate, high in protein, and contains virtually no fat. It has also been shown to possess immune boosting capabilities by increasing the body's cellular levels of glutathione, an important anti-oxidant. WPI is an ingredient in the Atkins Bake Mix.

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On Snacks for Kids

What are some healthful snacks kids will enjoy?

Try blueberries or other fresh fruit with whole-milk cottage cheese or whipped cream. Serving fruit with a source of protein moderates blood sugar swings. Or try a mix of nuts, seeds and raisins. Other ideas include: whole grain bread or crackers with cheese or peanut butter; celery sticks with peanut or another nut butter; popcorn made in an air popper and drizzled with melted butter; deviled eggs; or rolled up slices of turkey or ham. Instead of soda or fruit juice, offer kids flavored seltzers or iced herbal teas. If they're hooked on fruit juice, offer the whole fruit instead - which causes a less dramatic rise in blood sugar. In the winter, you can make hot chocolate using Splenda instead of sugar. Also, keep a supply of Advantage Bars handy for snacking, and make treats from Atkins Shake Mix. For sweet snacks, we offer dessert recipes ranging from popsicles to cupcakes, many of which are made with Atkins products such as the Bake Mix, Syrups, and Shake Mixes.

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On Alcohol Consumption

Why can't I consume alcohol while doing Atkins?

You should not drink alcohol during Induction, but you can drink moderate amounts of alcohol during the Ongoing Weight Loss, Pre-Maintenance and Lifetime Maintenance phases of the Atkins Nutritional Approach. When given the choice, your body will burn alcohol for energy before it burns fat. But alcohol does not act as a carbohydrate so it will not interfere with burning fat in the same way that sugars and other carbohydrates do.

Alcohol consumption may also increase yeast-related symptoms, such as bloating, gas and cravings for sweets, and can therefore interfere with weight loss. Beer, which contains yeast, probably has the most yeast-forming components of any alcohol. An occasional glass of wine or vodka is the best choice. Scotch and other grain-based spirits are more likely to promote yeast problems.

Note: Use only mixers that contain no sugar or fruit juices. Even tonic water contains carbs and regular soda is made with sugar. Seltzer, club soda, mineral water and non-aspartame diet sodas are better alternatives.

How many carbs does alcohol contain?

It varies by type of alcoholic drink. In the case of beer, read the label. For wine and spirits, refer to a carb counter. Wine usually contains about 2 grams of carbs per 3-ounce serving.

Is it OK to drink light beer, which is lower in grams of carbohydrates?

If you have yeast-related problems, such as bloating, gas, a coated tongue and cravings for sugar, you should eliminate beer or limit your beer intake. Otherwise, after the Induction phase, you can drink light beer as long as it does not make you gain weight or stall your weight-loss efforts.

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On Sweeteners and Sucralose

What kind of sweeteners do you recommend?

A main goal of the Atkins Nutritional Approach is to stabilize blood sugar (glucose) and insulin levels through the restriction of carbohydrates. Sugar is a carbohydrate, so it is strictly limited. Controlling carb content naturally curbs sugar cravings. However, if you still crave sweets, we suggest you use a sugar substitute. The prudent, moderate use of artificial sweeteners is usually acceptable. But be aware that not all sugar substitutes are created equal. We recommend specific sweeteners that will not interfere with weight loss. Some people experience negative reactions to certain sweeteners, and the risk increases with the amount used. With all artificial sweeteners, the less used, the better.

Our preference is sucralose, marketed under the name Splenda®. Derived from sugar, it is non-caloric, contains less than 1 gram of carbs per serving and it doesn't raise blood sugar. It has been used in other countries since 1991 and has been tested for safety and efficacy. In 1998, the U.S. Food and Drug Administration (FDA) approved sucralose for sale in the United States after reviewing more than 100 studies conducted during the past 20 years.

Atkins Nutritionals has since reformulated all of its products using sucralose, including the Atkins Shake Mixes, the Advantage Bars, and the Sugar Free Syrups. Sucralose is approximately 600 times sweeter than sugar. Unlike aspartame, it is inert in the body's digestive system, quickly passing through without accumulating in tissues. In addition, it does not lose its sweetness when heated, so it can be used in cooking and baking. (For more information about Splenda, go to www.splenda.com.)

If Splenda is not available, saccharin is the next best thing. The FDA recently removed saccharin from its list of carcinogens, basing its decision upon a thorough review of the medical literature and the National Institute of Environmental Health Sciences' statement that "there is no clear association between saccharin and human cancer." It can be safely consumed in moderate amounts -- no more than three packets a day. Sugar poses a greater threat to good health than saccharin does. Saccharin is marketed as Sweet 'n Low®.

Acesulfame potassium, also known as acesulfame K, another non-caloric sweetener, is approximately 200 times sweeter than sugar. Because it cannot be metabolized, it passes through the body without elevating blood sugar. The U.S. Department of Agriculture (USDA) has authorized the use of acesulfame K after evaluating numerous studies and determining its safety. It is sold under the brand name Sunett™.

We do not recommend the use of aspartame -- sold under the brand names of Equal® and NutraSweet® -- because of questions about its safety.

Note: During Induction, avoid sorbitol and mannitol (both fermented sugars), and natural sweeteners such as fructose, lactose or maltose. Tip: Sugar substitutes have a synergistic sweetness. Mixing together tiny amounts of each mimics the sweetness of sugar better than a larger amount of any single one.

I used artificial sweetener in a recipe using Atkins™ Bake Mix and the finished product tasted bitter. What did I do wrong?

Certain artificial sweeteners lose their effect when heated. This is especially true of aspartame, which you should avoid in any case because it can raise insulin levels and encourage fat storage. Try switching to a heat-proof sweetener, such as Splenda®.

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On Drinking Lots of Water

How much water should a person doing Atkins be drinking?

A minimum of eight (8) glasses is the usual recommendation. Coffee, tea and diet sodas do not apply to this minimum.

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On Caffeine

Why is caffeine unacceptable while doing Atkins?

Excess caffeine stimulates insulin production, which will drop blood sugar levels and leave you hungry for sweets. I you're addicted to caffeine, you must give it up. The best way to do this is to segue from the high-octane stuff to decaf by gradually adding decaf to your full-force brew until you are drinking straight decaf, which you can enjoy with cream. Water-processed decaf is preferable because it was not produced using chemicals, as some decafs are. Caffeine is found not just in coffee and tea but also in chocolate and many soft drinks. Switch to decaffeinated coffee and tea, experiment with flavorful herbal teas or stick to plain, pure water. You may miss caffeine or even experience withdrawal symptoms at first, but we often see weight loss start up again as soon as patients remove caffeine and aspartame from their diet.

Can I drink flavored coffees?

Some flavored coffees contain hidden carbohydrates. Hazelnut, almond or other nut- or grain-extracted flavors are fine, but do check labels for the carb count. You can also add a low-carb syrup to decaf coffee if you're looking for more flavor without added sugar. Some of these syrups are also good in decaffeinated tea.

I just started Atkins and I have a severe headache. What can I do to alleviate this symptom?

Don't worry; your headache will likely go away after the third day. Sometimes people will get withdrawal headaches from all the caffeine and all the sugar they are used to eating. Usually this resolves in the first three days and then your body will be able to start on its new efficient fat burning self. Make sure you are drinking enough water, as dehydration can aggregate this condition. If these symptoms do not resolve, you should contact your local physician. This usually convinces people of the addiction they may have had to either caffeine or sugar or both.

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On Processed Meats

How can I find bacon, sausage and other meats without nitrates and/or sugar?

Bacon and many other cured meats, including ham are cured with sugar. However, most lose the sugar in the curing process and the sugar does not become a factor when determining sugar and carbohydrate contents. There are many name brands not cured with sugar that may be available in your area. We would suggest contacting a local butcher who should be able to provide you with the information you need.

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On Fruit

I really miss eating fruit. Which ones are relatively low in carbs?

You should avoid fruit completely during Induction, because for most people it interferes with lipolysis/ketosis. When you move to Ongoing Weight Loss, you can try introducing berries, which are relatively low in carbohydrates, as long as they don't slow or stop your weight loss. Recent research shows blueberries are loaded with antioxidants and other phytochemical nutrients. A quarter of a cup of strawberries, blueberries, raspberries or blackberries contains approximately 5 grams of carbs (check a Carbohydrate Gram Counter for exact numbers).

When you reach Pre-Maintenance, most people can also enjoy low-glycemic fruits such as plums, nectarines, green apples, kiwi and cherries in moderate amounts. Again, continue to count carbs and refer to a Carb Counter. You can also eat up to one cup of berries each day. Have high-sugar citrus fruits only occasionally - grapefruit is lowest - and bananas only once in a while. Avoid fruit juices, which provide huge doses of sugar (a splash to flavor seltzer is okay). Choose whole, fiber-rich fruit instead. As a general rule, limit your fruit servings to two or a maximum of three a day. After you have tested your tolerance to fruit sugar and are still able to gradually lose or maintain your weight, depending upon your phase of the program, you can try the higher glycemic fruits such as pears, mangos, pineapple and so forth.

Eating fruit with nuts will slow down the release of the sugars into the blood stream. Eating fruit with animal protein may cause flatulence in some individuals.

Most nutritional recommendations lump together fruits and vegetables. While there is no question that fruits are loaded with phytonutrients and fiber, you cannot ignore the impact they have on blood sugar and insulin levels. Ounce for ounce, veggies - and the greener the better - can offer more of the same benefits with less of a blood sugar spike. Research has shown that a diet that includes sufficient vegetables can reduce the risk of colon and rectal cancer.

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On Nuts

Nuts have carbohydrates, but you include them in the Atkins Nutritional Approach. Why? And when can I eat them?

Different nuts and seeds have different percentages of fats, protein, and carbohydrates. We don't recommend eating them during the Induction phase of Atkins, the initial period of greatest carbohydrate restriction and, as a result, greatest weight loss. But you can certainly eat them during the other phases, when you won't have to count carbs so closely because you'll be nearing or have reached you desired weight.

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On Cheating & "Carb Creep"

After months of doing Atkins, I started cheating and fell off the wagon. What's the best way to get back on?

When someone "cheats," they often experience carbohydrate cravings caused by unstable blood sugar levels. The first thing you need to do is get back on Induction for a week or so to get your blood sugar level under control. When you are no longer craving foods high in carbohydrates and your energy level feels stable, you can move beyond Induction again. Pay careful attention to what happened that led you to "fall off the wagon" and make sure not to let it happen again. But don't fall into the trap of being too strict and denying yourself completely; this could lead to more cheating. Giving yourself an occasional treat - within your carbohydrate threshold - is part of the Atkins approach.

What is "carb creep" and how can I avoid it?

When you start adding carbohydrates back into your meals as you move from Induction into the progressively less restrictive phases of the Atkins Nutritional Approach, you may begin to lose track of how many grams of carbs you're eating. When that happens, you are likely to regain the pounds you lost. That is why it is very important to increase your daily carb intake by only 5 grams each week and to introduce only one new food at a time. That way, you'll also immediately notice if a new food is causing you to experience cravings that lead to over-eating. Another way to stay in control is to keep a food diary so you can spot troublesome foods before they set up a pattern of cravings and gorging. For example, if you find that after eating nuts you are hungry again in a few hours, cut out the nuts and see if the hunger disappears.

I always eat too much during the holidays and inevitably leave the table overstuffed. How can I avoid this situation?

Most of us spend hours at the dinner table during the holidays. It's easy to overdo it, and combining protein and fats with too many carbohydrates can lead to indigestion. The key to feeling well after holiday meals is to create an eating strategy.

• Stick to fats and protein-rich foods: They are far more satiating than carbohydrates, and can help you avoid overeating. Sugary foods and other refined carbs are more apt to cause indigestion. So load up on turkey - but pass on the stuffing; or if you simply can't resist it, have a small portion. Instead, focus on the nutrient-dense carbs such as leafy green veggies.
• Odd as it sounds, a good strategy is to eat a small meal before attending holiday dinners or other parties. All too often, people skip lunch because they know they will be sitting down to a big dinner. But you're much better off having a meal or a filling snack so you can get your blood sugar under control before you face an array of tempting carbohydrates. And drink plenty of water: Not only will drinking water help you feel full, it also helps you flush toxins from your body.
• Don't deny yourself completely: Giving yourself an occasional treat - within your carbohydrate threshold - is part of the Atkins approach.
• If you do feel an attack of indigestion, avoid antacids - they can interfere with protein digestion. Instead, try a digestive enzyme formula, available in most health food stores. (Be sure you use one that contains proteases and lipases.)

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On "Plateauing"

I lost weight nicely on Induction and for the first few months of the Ongoing Weight Loss phase, but now the scale just won't budge. How do I get off this plateau?

First, before you assume there is a problem, ask yourself some questions: Are you feeling better? Are your clothes fitting better? (You may be losing inches, not pounds, because muscle weighs more than fat.) Are you still losing, but at a slower rate? You may just need to go a bit longer, making slight modifications.

However, if you are truly stalled, you can usually get yourself off a plateau by going back to Induction, the strictest level of the plan. This level of the Atkins program serves several purposes, one of which is much like the way the starter in an old-fashioned automobile works. It gets the weight-loss reaction started because it throws your body into ketosis, making it burn fat for energy. You may need to be even stricter, consuming only meat, fish, fowl and eggs. You need not do this very long, just enough time to see your weight loss begin. Then, make sure you add new foods more gradually than you did before. Another way to lose faster is to increase the amount of fat and decrease protein.

I think I'm doing Atkins correctly, yet I'm not losing weight or my weight loss has plateaued. What are some of the factors that could make that happen?

First, recognize that there may not be a problem at all. Different people will respond to Atkins differently; some consistently lose weight while others do so in stages. Don't watch the scale and become overly concerned with short-term results. Also, make sure your expectations of weight loss are realistic. Atkins is designed to lead you to your natural ideal weight. For many people, that may still be more than they wish to weigh. We strongly recommend that you manage your expectations in a real and healthy way. Second, remember that success on Atkins should always be measured by more than just the scale. Consider the following questions and think about how they apply to your experience on Atkins:

• Are you experiencing more energy and vitality throughout the day?
• Are your clothes fitting you better? Are you experiencing less between meal cravings and hunger?
• Have your blood tests improved? Are you still losing weight, but just at a much slower pace?
• Have you lost inches in your body measurements?

If you answered "yes" to any of the above, then you have the right plan for the rest of your life. Continue to stick with it, modifying it as you go along to make it work for you, and you will continue to see suitable health enhancing results. Given all of the above, there are a number of key factors that may inhibit a person's ability to have success on a controlled carb program like Atkins.

Listed below are the difficulties people experience most frequently:

If you have reviewed all of the above and are still having problems, consider coming to The Atkins Center for Complementary Medicine as a patient or schedule a Telephone Nutritional Consultation (TNC), For information please call 1-888-ATKINS-8 and ask for the New Patients Department.

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On Eating Away from Home

Do you have any tips for eating away from home?

Think "big picture." Don't use your trip as an excuse to go off the program. Remember, if you continually take "detours" from your planned route, you'll never reach your destination.

Take it with you. Pack some controlled-carb snack foods like 1-ounce portions of cheese in plastic wrap. If you're traveling by car, pack a cooler with cold cuts and cheese or salad. Or stow away a few Atkins bars and some shake mix to use as meal replacements.

Eat first. Start out on the right foot by eating a well-planned, satisfying meal before you depart.

Go a little nuts. Snack on nuts and seeds, which are high in protein and fat. You'll feel more satisfied and in control of your appetite after eating a handful. Go easy on these snack options if you are in the Induction phase, particularly if you find it difficult to lose weight.

No skipping allowed. Tempted to pass on lunch to make better time? Don't do it. Omitting a meal could make you ravenous, out of control and more likely to grab anything edible.

Fly right. If you're on a flight where a meal will be served, call ahead and ask what's on the menu. You can probably find a seafood or chicken salad or another dish you can "remodel."

Drink up. Consume lots of water, which will help you feel satisfyingly full. But stay away from caffeine and diet sodas full of aspartame, which increase carbohydrate cravings.

Pack your pills. Once one element of your routine gets upset, other good habits tend to slide as well. Even if you make some mistakes with your food choices, staying on your supplements will help you focus on getting back to eating properly.

Speed counts. If you do slip off the program for a day or more, get back on ASAP. The longer you're derailed, the harder it may be to get back on track.

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On Fast Food Restaurants

What can I eat in a fast food restaurant when I'm in a hurry?

Sandwich Shops: Chicken or tuna salad is a good choice. Just be sure to pick out any carrots. In sub shops, bring on the turkey, roast beef, cheese and sausage, but try to steer clear of salami, bologna and other meat products preserved with nitrates. Ask for your selection on a plate instead of on a roll, and you're ready to rock.

Burger Chains: Sandwiches are usually a good bet. Yes, even the bacon cheeseburger! Just toss the bun. Mayo and mustard are permissible but beware of ketchup, which often contains a lot of sugar. Watch out too for special sauces, as they also often have sugar in them. Tomato slices and lettuce are fine. Steer clear of anything advertised as "low fat," a label that often translates to "high carb."

Fried Chicken Places: Avoid anything barbecued or breaded. Barbecue sauce is typically full of sugar and even if you remove the skin, the sugar has probably seeped into the meat. Dry-rubbed meats are fine, as are roasted chicken and allowed side dishes such as salad. If there's a grilled chicken filet sandwich available, grab it! Discard the bun, and you've got a pretty good selection. Or scrape the breading off a fried chicken breast and dig in!

Salad Bars: Here you'll find the choices you need for a nutritious meal. Use olive oil and regular red or white wine vinegar instead of a prepared dressing. Commercial dressings and balsamic vinegars often contain sugar. Baked stuffed potatoes are an absolute no-no.

Unless you're starving, avoid Mexican-style restaurants, pizza parlors, doughnut shops and yogurt/ice cream parlors.

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On Kidneys

Is it true that eating too much protein can damage your kidneys?

Studies show that the glomerular filtration rate (GFR) goes up with a high protein intake. The GFR is a measure of how efficiently the kidneys are filtering protein and other byproducts of metabolism from the blood. A high GFR may seem bad to some dietitians but, in fact, it is actually a sign of excellent kidney function. It simply means the kidneys are capable of doing a job beyond their usual requirements. Think of this analogy: Aerobic exercise raises your heart rate, yet everyone acknowledges that, because aerobic exercise raises the heart rate, it strengthens the heart. In our clinical practice, we have seen thousands of patients over three decades, and we have never seen a single case of a high-protein eating program causing kidney damage.

Can a person with kidney problems do Atkins? If so, how is the Atkins Nutritional Approach adjusted?

The Atkins Nutritional Approach can be used safely by any kidney patient whose creatinine level is under 3.0. However, monitoring creatine levels every 2 weeks is required. Creatinine levels above 3 require a doctor's management.

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On Muscle Mass

Doesn't ketosis lead to loss of muscle mass?

The notion that the Atkins Nutritional Approach -- high in protein, which builds muscle, and fat, which is used for energy -- will force your body to break down muscle is incorrect. Only dieters on very low calorie diets can lose muscle mass, because they have an inadequate protein intake. Atkins, however, is not calorie restricted (this isn't an invitation for gorging, but a recommendation to eat until you are no longer hungry) and the high protein intake required offsets any possible loss of body mass.

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On Hypothyroidism

I suspect I may have an underactive thyroid. Could that be why it is so difficult for me to lose weight?

Your thyroid gland's main function is to regulate the speed of your metabolism. So it is not difficult to understand that if it is underactive - the medical word is hypothyroid - your slowed metabolism makes you more resistant to weight loss.

Whenever a patient at The Atkins Center has real trouble losing weight, the physicians always check for a sluggish thyroid gland. As you age, it's not unusual for your thyroid to stop producing enough of the hormones that control the speed of your metabolism. When that happens, your whole body slows down; you gain weight and can't get it off. Hypothyroidism, or underactive thyroid, is easy to diagnose, even though it doesn't always show up on standard lab tests.

To ascertain whether you have hypothyroidism, your doctor will do blood tests to evaluate your production of thyroid hormones T4 (also known as thyroxine) and T3 (your body converts T4 to T3), as well as another hormone called TSH. However, these clinical tests do not catch all cases. First think about whether you are experiencing any of the signs of an underactive thyroid. These include sensitivity to cold, weight gain, hair loss, sleep disturbances, fatigue and lethargy, depression, dry skin, chronic constipation, poor nails, poor memory and elevated cholesterol levels. If so, there is a simple way - the Barnes technique of basal metabolism - to ascertain if you are hypthyroid.

Simply take your temperature orally four times a day (before each meal and before you go to bed) for four days. Average your temperature each day, and if it is consistently below 98 degrees Fahrenheit, you are likely to have a sluggish thyroid. If it is significantly lower such as below 97.6, you almost definitely have hypothyroidism, and you should bring this information to the attention of your physician, who will likely prescribe thyroid hormone replacement therapy. (Do be aware that not all doctors take basal metabolism as seriously as they should.)

The treatment for hypothyroidism is straightforward. As Dr. Atkins explains, "I use the therapeutic trial for thyroid. After examining blood test results, I start patients with a very low dose of a prescription thyroid hormone replacement and build up gradually and very carefully. In most cases, when we reach the right dose patients start to feel dramatically better. They have a much better sense of overall well-being, with much more energy and vitality. Best of all, they start to lose weight again."

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On Yeast Overgrowth (Candida)

Will a low carb approach help clear up my yeast problem?

After years of eating a high-sugar diet, it's quite possible that your digestive tract has an overgrowth of an organism known as Candida albicans. When that happens, the beneficial bacteria in your intestines get crowded out. Candida (also known as yeast) overgrowth also provokes food intolerances, headaches and immune-system weakness, and keeps you from losing weight by causing unstable blood sugar and major carbohydrate cravings.

Once your practitioner has diagnosed a yeast overgrowth, you'll need to eliminate some foods from your diet until it clears up. Typically, the first food to go is sugar. Candida thrives on sugar - so a sugar-free, controlled carb approach will starve it out. It's also important to eliminate yeast and fermented foods such as sourdough breads, pickles, beer, wine, vinegar and many cheeses. Also omit nuts, which can contain mold.

What blood tests should my physician perform to check for yeast infection?

The appropriate blood tests to check for yeast infections are Candida Antibody lgG, lgM, and lgA.

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On Prescription Medications

Could my medications be interfering with my weight loss?

Weight-loss plateaus are often caused not by what you eat but by prescription drugs. Drugs for high blood pressure, especially diuretics and the drugs known as beta blockers, can make your body extremely resistant to weight loss." As a cardiologist, I see a lot of patients who come to me taking these drugs," says Patrick Fratellone, M.D., medical director of The Atkins Center. "They can't lose weight while they're on them, but being overweight is a big reason for their high blood pressure."

At The Center, the solution to this circular problem, he explains, is to gradually taper patients off blood-pressure medications and replace them with herbs and dietary supplements. As patients lose weight and improve other aspects of their health, their blood pressure often returns to normal, eliminating the need for any treatment. Always discuss any change in medications with your health-care practitioner.

The same chicken and egg situation applies to patients who are taking selective serotonin reuptake inhibitor (SSRI) antidepressants. Common side effects of SSRIs, such as anxiety, sleeplessness, nervousness and headaches, actually create carbohydrate cravings. For example, about 10 percent of people on Prozac® have appetite loss, but about a third experience increased appetite. "It's surprising how quickly patients start to lose weight when they stop these drugs," Dr. Fratellone notes.

Natural substitutes for SSRI drugs include the herbs St. John's wort and kava kava or inositol hexanicotinate, a B vitamin. Dr. Fratellone warns, however, against stopping antidepressants on your own - you need to taper off these drugs slowly - and that there can be interactions with alternative remedies. Don't forget to consult your doctor.

When it comes to the cholesterol-lowering statin drugs, Dr. Fratellone is emphatic. "These drugs keep you from losing weight and they're potentially dangerous as well. At The Atkins Center, we stop statin drugs immediately. Our low-carbohydrate eating plan alone will improve blood lipids."

Are You a Diabetic? The most fattening of all the hormones is insulin. Diabetics who have to inject insulin find it almost impossible to lose weight. Oral drugs are almost as bad. According to Dr. Atkins, "The majority of oral medications for diabetes have a weight-gain effect. Even drugs that don't stimulate insulin have this effect. The one drug that does help diabetics control their blood sugar and lose weight is metformin, marketed under the brand name Glucophage®. I often prescribe this for my diabetic patients when they start the Atkins program. Once they've been following it for a while, their need for the drug almost invariably disappears."

After insulin, Dr. Atkins believes that hormone replacement therapy (HRT) is a leading offender in terms of inhibited weight loss. Menopausal women who take estrogen or estrogen/progesterone have a lot of trouble shedding pounds. In fact, weight gain, water retention and skyrocketing triglyceride levels are well-known side effects of HRT. "There are better, more natural ways to treat menopause symptoms," Dr. Atkins says. "Folic acid in prescription-strength doses, for example, helps minimize many symptoms, as do other nutrients, such as boron, soy isoflavones and herbs such as agnus cactus and dong quai." Also consume moderate amounts of soy products.

What medications interfere with or need adjustment once you are committed to the Atkins Nutritional Approach?

Virtually all medications will inhibit weight loss. The most incompatible medications are:

• Diuretics (water pills).
• Psychotropic drugs, including prozac, zoloft, lithium, etc.
• Hormones and steroids, including estrogen (premarin), birth control pills and prednisone.
• Arthritic drugs, especially NSAIDS (Non-Steroidal Anti-Inflammatory Drugs).
• Cholesterol-lowering drugs.
• All anti-diabetic medications, including insulin with the exception of glucophage.
• Tranquilizers.
• Seizure medications.

Doctors who work with the Atkins Nutritional Approach can usually use it and certain supplements to help you get off most of the above or taper you to minimal doses. Please DO NOT COME OFF MEDICATIONS BY YOURSELF without medical supervision. Please read Dr. Atkins Net Diet Revolution or Dr. Atkins Vita-Nutrient Solution for further information.

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On Food Allergies

What if I'm allergic to something that's a mainstay of the Atkins nutritional plan?

Unsuspected food intolerances can be a major roadblock to weight loss. Many patients at The Atkins Center, for example, turn out to be allergic to wheat and wheat products. Other common allergens include soy, milk, cheese and eggs. People with food intolerances often have gastrointestinal problems, along with joint pain, anxiety or depression and other symptoms. Your practitioner will use a process of elimination to uncover any food allergies. It takes time, but it will be worth it when your weight loss picks up and your overall health improves.

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On Carbs for Athletes

As a runner, I'm used to carb loading before competitive events. Will following the Atkins Nutritional Approach impact my endurance?

It is a misconception that carb-loading is the best way to prepare yourself for endurance exercise. Although an overabundance of carbs might give you an initial burst of energy, that surge can then lead to a sharp drop in your blood sugar - and, therefore, fatigue - later in your workout. This isn't to say that you should eliminate carbs, but endurance athletes will do better by consuming moderate amounts of healthy, unrefined carbohydrates, found in foods such as kale, spinach and broccoli, to ensure stable blood sugar throughout a workout.

A 1994 study of well-trained cyclists demonstrated the principle that a low-carb eating program contributes to improved endurance. Subjects on a 7 percent carbohydrate program were able to pedal nearly twice as long as those whose diet consisted of 74 percent carbs.

If you are contemplating switching to a lower-carb eating plan, do so during training, never right before a race. It should take your body about two weeks to adjust, so don't worry if you don't experience extra energy immediately. The amount of carbohydrates you should consume also relates to your percentage of body fat.

If you are an overweight runner, stay on the lowest level of carb consumption that suits your needs while still allowing you to lose weight. On the other hand, if your weight is normal, simply stick to vegetables, whole grains, berries and other fruits low in sugar and other healthful complex carbs, avoiding junk foods and sugar.

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On Attention Deficit Disorder

My child has ADD/ADHD. Can Atkins help? Does it help with other diet-related conditions?

It's important to remember that diet impacts not only weight, but also a number of other medical issues. There is a clear connection between what kids eat and such conditions as attention deficit disorder (ADD), moodiness, difficulty with learning, chronic ear infections, colic, and gastrointestinal problems. These diet-related disorders are often signs of food sensitivities, and the culprits are likely to be sugar and refined carbs. Children also may often have sensitivities to milk or other dairy products. Yeast, wheat and gluten are considered other common culprits.

You've probably heard that breakfast is vitally important for kids. Consider that most children start their days off with a bowl of sugary cereal and a glass of orange juice - perhaps some white toast with jelly, too. With nothing but sugar and refined carbohydrates coursing through their systems, it's no wonder so many have trouble sitting still and focusing. The typical American, high-carb, junk-food-laden diet, which is leading to greater numbers of obese people in this country every year, is putting our children at serious risk. A controlled carbohydrate lifestyle can help stabilize blood sugar, thereby increasing attention span and focus even when weight loss is not an issue.

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On Giving Blood

What can I drink and eat after giving blood instead of the usual OJ and cookies?

After donating blood, your fluid volume is reduced, which can make you lightheaded or dizzy. You will be offered something to drink to replace the fluid, which also decreases the volume of blood sugar available. Instead of sugary fruit drinks, consume water or other non-carbohydrate beverages and instead of a cookie, have a piece of cheese or a slice of turkey. If you are beyond Induction, you can combine whole fruit with nuts. It's a good idea to plan ahead and bring with you some of your allowable foods and beverages.

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On Cholesterol

Since I have been on Atkins, my cholesterol has gone up. Why? What can I do about it?

First, look at what you've been eating. Have you been following Atkins correctly? If you are just starting the Induction phase, be sure you stay below 20 grams of carbohydrates a day as recommended. You may also want to consider a couple of other things that could be happening.

First, the increase might be temporary. When a person loses weight, cholesterol usually rises because the body must break down stored fat for energy. Your total cholesterol should drop within two months. Look at your HDL (known as "good" cholesterol) levels. A rise in total cholesterol levels could even be a good thing, if it's all attributed to HDL cholesterol. Total cholesterol may temporarily go up due to the rise in HDL. If you've been following the Atkins Nutritional Approach for some time and your cholesterol levels have not come down, something else is going on.

You may also need to look at a third component of your blood tests: triglycerides. Cholesterol rises in some people when triglycerides drop significantly. If that drop is greater than the LDL increase, your lipid profile may, again, be improved.

High cholesterol that has a genetic component usually responds to changes in diet, but may be difficult to address with diet alone. You may still need to take supplements such as pantethine, essential oils, garlic and fiber. For a detailed discussion of cholesterol-lowering nutrients, see Dr. Atkins Vita-Nutrient Solutions. Exercise is also an important component, as is cutting back on processed meats, such as bacon, sausage and cold cuts and limiting intake of hard cheese.

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On Constipation & Diarrhea

I never suffered from constipation until I started doing Atkins. What should I do?

When you change your eating habits, you may experience constipation until your body adapts. The Atkins Nutritional Approach contains enough vegetables, which are rich in soluble fiber, to usually prevent constipation. But some constipation is not uncommon during the first week of the Induction phase. Be sure you are taking in at least 3 cups of salad vegetables and not using your carb allotment on other foods. After the first few days, your body should adjust and constipation shouldn't be a problem. And when you begin to add more carbohydrates, your first choices should be more vegetables, followed by berries.

However, during Induction, there are several remedies. It is critically important to drink eight or more glasses of water daily. Inadequate hydration is the main reason for constipation. Most people, especially women, don't drink enough water and are slightly dehydrated almost always. Exercise also stimulates the bowel, so step up your activity level.

If you still find yourself constipated, increase your consumption of insoluble fiber by sprinkling wheat bran on your salad or stirring a tablespoon of psyllium husks into a glass of water each day. The amount needed to stay regular varies from person to person. Start with a tablespoon and increase the amount gradually until you achieve results.

I have been experiencing diarrhea since beginning Atkins. Why is this happening and how can I control it?

It is not normal to experience diarrhea while doing Atkins. Several things should be considered: Are you eating more dairy than you did before? Are you allergic to any foods you are eating? Are you gorging yourself? Try adding 1 tablespoon of unsweetened Metamucil or psyllium daily. It acts as a sponge and forms a healthy stool. If you have been on a very low-fat diet prior to starting Atkins, it could be an adjustment period. Try cutting back on the amount of fat for a little while if that is the case. If the diarrhea continues for any length of time you should see your doctor.

Why is the Atkins Nutritional Approach so low in fiber? Will this be a risk for my colon?

The Atkins Nutritional Approach is low in fiber because most fiber-containing foods are also high in carbohydrates. Don't forget to eat salads as leafy greens provide an important source of fiber on Atkins. There is a colon risk only if you get quite constipated. Use 2 tablespoons of psyllium husks in 2 glasses of water every morning and/or 2 tablespoons of unprocessed Miller's bran if this is a concern. If constipation persists, magnesium oxide may be helpful as well as an herbal laxative tea.

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On Asthma

I've noticed that I have fewer asthma problems when I adhere to a controlled carbohydrate nutritional approach. Is there a connection?

Yes, they are related. There is evidence that asthma attacks can be linked to food allergies and mold and yeast exposure. While doing Atkins, you eliminate a lot of common allergens such as grains and moldy substances such as beans, fruit and bread. When you reduce the load of allergens to which your immune system is exposed, you can reduce the incidence of asthma attacks.

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On Diabeties

Can Type I and Type II Diabetics both do Atkins?

For a type II diabetic, the Atkins Nutritional Approach is a godsend. In fact, it is usually "curative", allowing for normal blood sugar without medication. For type I, it usually helps reduce the insulin requirements, but this can only be done if managed by a doctor extremely familiar with treating type I with the Atkins Nutritional Approach.

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On Pregnancy

Can I follow the Atkins Nutritional Approach while I'm pregnant?

Weight loss is not recommended while you are pregnant or breastfeeding, so the Atkins weight-maintenance phase is ideal during this time. As with all phases of the Atkins Nutritional Approach, build your diet around protein, including meat, poultry and seafood, and healthy natural fats such as olive and flaxseed oil and avocados. Eat plenty of vegetables and one serving of fruit such as strawberries, blueberries or grapefruit daily. Instead of hydrogenated oils, consume healthy fats, seeds and nuts. Cook meat well but don't burn it -- heavily charred meats can be unhealthy. Be sure to drink plenty of water. Try to walk 30 minutes a day at a comfortable pace. Avoid getting overheated during exercise and be sure to get plenty of rest. And have fun, this is a very special time!

Expect to gain at least 27 pounds over the full nine months - which will include baby, placenta and fluid. The weight should all come off a few weeks after delivery. Nursing your baby burns more calories and contracts your uterus, so it's good for both of you.

When pregnant or nursing, supplement your diet with the following nutrients daily:

• Atkins Basic #1 Multivitamin: 1 tablet x 3
• Atkins Essential Oils: 1 soft-gel tablet x 3
• Calcium: 1,000 mg
• Magnesium: 500 mg
• Zinc: 50 mg

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