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General discussion

Diet Dr. had heart desease

Feb 10, 2004 4:37AM PST

Discussion is locked

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What is worse ... he was obese! Undercuts his credibility a bit.
Feb 10, 2004 7:04AM PST

I have mixed feelings about the low carbohydrate craze. There is evidence that reducing carbohydrates can help people lose weight because foods high in fat and protein tend to make people curb their appetites better than some high carbohydrate foods. However, the primary cause of the obesity problem in the US is NOT carbohydrates. The primary cause of obesity is a combination of too much food in general (too many calories from all sources, especially nutritionally empty fats and refined carbohydrates) and FAR too little exercise.

We won't lose weight until we eat sensibly and exercise regularly.

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My largest problem with the Aikens diet
Feb 10, 2004 7:26AM PST

is the fanaticism of some of it's supporters.

One guy at work lectured me for most of an 8 hours shift once about how wonderful it was.

It worked for him, glad for him. He'd come to work, fix breakfast of halfdozen bacon strips, then lay them on plate, with hunks of cheese between, heat to melt cheese, that would be breakfast.

He had some blood work done that showed he was doing better than before, but wouldn't tell doctor he was on Aikens diet till after doctor agreed whatever he was doing he was improving. I guess that does provide more impartial advice.

But he was fanatical about it, preaching it from a pulpit. He said he had read the book 3 times I think, and it's the first thing not related to car racing or hunting I've ever heard of him reading.

My personal opinion (though unfortunately I don't follow it) is that most of us just need to shift more of our diet to raw fruits and vegetables. Even high calorie fruit is better for us than much of what we eat. And we probably should limit meat to once a day (about the size of a nice porkchop). And I guess even that should be more fish and less beef and pork. (But I do love porkchops and NC barbeque, so bad for me.)

Shrug, different diets probably work for different people.

HUGE SIGH, and I'm going to have to pick one. My obesity and age has reached the point that my knees and ankles can't take it any more. Blood pressure thank goodness isn't bad, but it's climbing to borderline area. Oh well, you do what you gotta do, once you can convince yourself it's necessary, it's not so terrible I guess.

roger

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And my biggest problem
Feb 10, 2004 7:36AM PST

is with the people who judge without having read the WHOLE book.

Rejecting a message because one does not like a messenger?

You said yourself - he was loosing weight, his bloodwork was improving, of course the man was passionate about it - AND - he had read the book!!!! (three times).

Hmmmmmm......

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Shrug, as I said, glad it worked for him
Feb 10, 2004 8:08AM PST

Second day he started again, I told him one day was informative, another was aggravation. He started was going to help me whether I wanted to or not. I said nope, I'm leaving and made arrangements to be elsewhere not around him for a while. And he's not the only Aikens convert I've met like that. As I said, the people that are too pushy about it are what irritates me about it. The diet itself I don't believe I'd stick to the menu, so doubt it would work for me.

Shrug, different diets for differ folks, of course I also freely admit I'm not doing what I should do as far as eating habits.

My lady friend had several people where she worked that lost large amounts of weight on it. Interestingly there it was mostly men it worked for. Frighteningly enough, though probably pure coincidence, there were 3 women, one worked there, the other 2 spouses of coworkers, that had serious problems after going on the Aikens diet.

I forget the condition, but if I recall correctly, it was more a case of something that had never cause problems and therefore not even diagnosed that the Aikens diet aggravated into serious complications. Any restricted diet may do that for different people with different underlying conditions.

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Those who were harmed...
Feb 10, 2004 11:26AM PST

...probably did have pre-existing conditions, but I worry about the stress on the kidneys trying to get rid of all that extra ammonia and other nitrogen compounds from the breaking down of so much protein, and such little carbohydrates. I don't do the Aiken's diet, but have lost about 40 pounds in the last 4 months simply by cutting out all sugar and sweets. As long as that works for me, it's good enough.

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Re:My largest problem with the Aikens diet
Feb 10, 2004 9:22AM PST

I tried the Aikens diet and found it sooooo booorrrrring.

It did lower my cholesterol and triglycerides and I did loose weight.

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I've heard the same story from a coworker. He also says
Feb 10, 2004 1:03PM PST

his weight has dropped while he eats his fill. It's hard to argue with results.

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Yep ...
Feb 13, 2004 12:06AM PST

... those for whom any diet has worked do tend to become a bit preachy and devoted to the principals that worked for them.

Susan Powter (stop the insanity) being another example for a different diet ideology. I think you'll find most of the fanatics are long-term successes who just want to share their secrets .... kinda like there's nothing worse than an ex-smoker when it comes to giving out advice Wink

It is obnoxious to offer unsolicited advice. I think it's just more Atkins devotees lately because it's the current trend.

When most people find out I follow pretty much an Atkins diet they want to know and ask questions about how it works for me. I won't offer unless asked. I know it's not for everyone, but I get tired about the general attitude of the medical profession's dietary prescriptions are correct with any certainty for every body. If you put me on the AHA diet I can guarantee you that in a year I'll be worse off because my body doesn't deal well with low fat diets. I would fall off that wagon in a month.

It's sad that people have to lie to their doctors to get unbiased assessments. My doc doesn't know about my diet either because my general state of health speaks for itself. Those who deride the diet as unlivable have not read the whole book. Atkins pretty much advocates a low carbohydrate level that each person determines for themselves by incrementally adding carbs for maintenance. For me it's just a lifestyle. I call it "cheating" when I have a day that I eat a bunch of carbs mostly pasta or potatoes are my passion. One thing that it has done for me is totally eliminated any desire for sweets. I don't crave them ever. Even on days like Thanksgiving when I let myself eat whatever I want, I'ld rather fill up on wild rice and stuffing than save room for cake. Could I follow strict Atkins indefinitely? No. But I don't know anyone on any other diet that can follow it strictly indefinitely either, and even Atkins himself never advocated a no-carb fad diet approach either.

Evie Happy

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You're probably right about the good diet, but the obesity charge
Feb 10, 2004 12:59PM PST

looks very shaky. The account I read quoted the doctor's associates as saying his normal weight was about 195. I wish I was 195! They said he gained 60 pounds in one week from fluid retention while he was unconscious in the hospital.

BTW, the charges came from a doctor's group which advocates vegetarianism. A bit biased perhaps?

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Re:You're probably right about the good diet, but the obesity charge
Feb 11, 2004 8:37AM PST

The group that leaked the report is truly biased, as noted elsewhere in this thread. I had not seen the information about his pre-injury weight until later (it also came out elsewhere in the thread) but even so he should probably have been considered overweight.

The current standards for desirable weight are actually fairly strict, and they classify a large number of Americans as overweight.

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He never looked obese to me.
Feb 10, 2004 7:30AM PST
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The whole situation is both complex and sad ...
Feb 10, 2004 9:34AM PST

The obesity debate really should not focus primarily on his personal health or his obesity. It is wildly inappropriate for his detractors to celebrate his health problems in that manner. Moreover, there are more important scientific issues that will get lost if we look at it that way. Worse still, the medical examiner's records were apparently released inappropriately and then published in a fashion that was clearly intended to support a political agenda. However, that does not change the fact that he was obese by the most frequently used criterion.

I have never seen enough photographs of Dr. Atkins to have an opinion about his appearance or build, but the information about height and weight in the article from the original post establishes obesity.

The interesting piece you linked to included one bizarre quote: "... I have been assured by my husband's physicians that his health problems late in life were completely unrelated to his diet or any diet." That statement may be true, but if so the physicians involved made claims that they cannot possibly support from a medical perspective. We simply do not know enough about the relationship between diet and immune function to make claims of that sort.

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One other thought about that link ...
Feb 10, 2004 9:57AM PST

Note the quote: "The medical examiner?s report was given to the Journal by the Physicians Committee for Responsible Medicine, a group that advocates vegetarianism." The group apparently obtained the report via deception and then went public with it. Their behavior stinks.

Also, I should note that the "Physicians Committee for Responsible Medicine" is basically an animal rights group dressed up with medical labels so that they can promote their philosophical agenda. Their vegetarianism is not based on any particular desire to promote a healthy diet for humans.

Personally I'd rather pursue the question of diet and weight from a less biased perspective.

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Note Paragraph No. 7
Feb 10, 2004 10:03AM PST
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Duly noted, and if that is correct then ...
Feb 10, 2004 10:40AM PST

It might be incorrect to consider him obese. Some experts would quibble about that because people with heart problems generally should try to stay leaner than people who do not have heart problems.

If he was 6 feet tall and weighed roughly 200 pounds then his body mass index would have been about 27 (more-or-less) and he should probably have been considered overweight (but possibly not obese) because of his other health conditions.

It is obviously not completely fair to evaluate a diet based on the weight of its originator, but this does illustrate one of the basic truths about weight control. There is no magic formula. Even Dr. Atkins did not (or could not) keep his body mass index below the desirable value of 25.

Dr. Atkins' approach does work for some people. Dr. Ornish's approach works for some people. Other approaches work for other people, but what they all have in common is that people who lose weight have managed to reduce their calorie intake below their metabolic expenditure. That usually means that they have both reduced calorie intake (diet) and increased calorie expenditure (exercise).

Carbohydrate consumption is not the primary cause of obesity in this country. Overeating is. It happens that we do eat an excessive amount of refined carbohydrates (sugars and such) but we also eat an excessive amount of purely gratuitous fat. As a nation, we also exercise far less than we should. The combination is literally killing us. Following the Atkins diet is helpful only to the extent that it is a way that some people can successfully cut calorie intake. Even for those people, though, the diet by itself is not usually enough to control weight.

The best diet is not Atkins or Ornish or South Beach or "The Zone". The best diet is the one you can follow.

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My "beef" against carbohydrates is mainly against
Feb 10, 2004 11:35AM PST

sugar. Not allowing sugar in my diet reduces not only caloric intake from that source, but also reduces or eliminates an increased desire later for food. Eating no sugar means I end up with lesser desire to eat.

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Re: Note Paragraph No. 7 -- You could have quoted it...
Feb 10, 2004 12:42PM PST

Hi, Andrea.

Just FYI (and others), you can certainly quote one paragraph of a long report under the "fair use" copyright exception. You can't reproduce a "substantive portion," whatever that means!

-- Dave K, Speakeasy Moderator
click here to email semods4@yahoo.com

The opinions expressed above are my own,
and do not necessarily reflect those of CNET!

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Agreed, confidental information was misused and probably little revelance
Feb 10, 2004 10:22AM PST

The fame of his diet has led some to attack him and not evaluate the value or drawbacks of his philosphy on weight gain.

Too common in many things sadly.


roger

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Where is diogenes when we need him? (NT)
Feb 10, 2004 1:24PM PST

.

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Here's the claim of fluid retention.
Feb 10, 2004 1:19PM PST
Stuart Trager, chairman of the Atkins Physicians Council

As for his 258-pound weight - obese under federal guidelines - Trager said Atkins normally weighed between 180 and 195 pounds. During his nine-day coma, he packed on another 60 pounds in water weight, he said.

But some experts questioned whether such a sudden weight increase is possible.

"It is amazing how much weight can be gained as a result of fluid retention, but I find it difficult to accept he gained 60 pounds in nine days," said forensic expert Dr. Cyril Wecht, the coroner of Allegheny County, Pa.
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I believe it.
Feb 10, 2004 6:46PM PST

My mother suffers from renal failure and twice she has gained large amounts of weight due to fluid retention. Her normal is 145, but 2 years ago I picked her up at hospital weighing 235 and one month later she was back down to 145 through the use of magnesium sulfate to work the fluid out through the gut lining, since she had refused dialysis. This past year after 6 months on her own again, and continuing to ignore the diet she was supposed to follow she was almost 200 pounds again. I brought her here and used the same method and got her back to 163, but then she started having complications since she quit eating and drinking even good food and water. She finally decided to do dialysis and is now recovering in a rehab-nursing home, weighing about 135 pounds, a bit low for her. If Adkins had an adrenal problem or kidney disease, especially if still trying to follow his diet guidelines, he most definitely would have gained a lot of fluid weight without dialysis intervention.

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I also believe it!
Feb 10, 2004 11:42PM PST

When I first got kidney disease, I noticed I could no longer see my ankles, and my legs felt like sausage casings. When the Dr. gave me diuretics, I dropped 30 pounds in 3 days.

Later, when I went on prednisone and other meds, combined with fluid gain, I went from 5'8" tall 118 lbs. to 191 lbs. I've managed to drop 21 lbs, but that was basically when I stopped trying to lose it!

Cindi

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Re:I also believe it!
Feb 11, 2004 2:43AM PST

If you are having those kind of problems, to that extent, you should be doing dialysis. I would try just twice a week, I think 3 times is excessive. Mom is doing 3 times a week now, and I think it takes too much out of her.

If you cut out salt, cut out meat, and replace protein with Amino Fuel or Essential Amino Acids (Twin Labs = $30 bottle) about 1/3 cup each day, that will help. If you aren't doing dialysis and want to try what helped Mom in past before she got worse, you can use a teaspoon of epsom salts a day and lose the water out the bowel instead. Once you get back to the correct weight usually 1/2 teaspoon a day will suffice. It stretches out the years before dialysis becomes an absolute must. Doctors won't tell you about that option, many don't even know about it, but some are starting to take more of a look at it.

Run a search on MacKenzie Walser Diet and see if it might benefit you.

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Re:Re:I also believe it!
Feb 13, 2004 6:20AM PST

Hi James,

I take a BP drug daily which is what helps keep proteins in my body, since my disease causes me to lose it. I also have low blood pressure normally, so eliminating salt makes it run about 60/40. In other words, I'm told to eat salt! I just have to be careful in my balance of salt, potassium, and diuretics. My diet is now "if it doesn't hurt when I eat meat, I eat it, and if it does, I load up more on veggies." Along with fibromyalgia, CFS, and other auto-immune issues, my exercise is VERY limited, and I do what I can when I can. Best I can do. Dialysis is not an option, as my function is still too high. A bit under 50%. I'm just one very odd case that's so far beating the odds. Happy

All the best to you and your Mom!

Cindi

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You still have to be careful evaluating the weight ...
Feb 11, 2004 8:53AM PST

I can imagine a patient gaining 60# in fluid in 9 days, but that usually should not happen if the physicians caring for the patient are paying attention to fluid balance. Since he likely had IV fluids, and since elderly patients tend to have renal insufficiency, the weight gain may have been partly iatrogenic.

Even so, if his pre-injury weight was in the range of 180-195 (lower than the other article I saw quoted) then he was overweight. The target BMI for a cardiac patient (he had cardiomyopathy) should be less than 25. For a 6 foot patient that comes out to about 185# maximum weight, preferably less.

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What is the right weight?
Feb 13, 2004 1:10AM PST

Were the doctors all wrong 20 years ago when the standards were slightly higher weights?

This is one of my peeves Doc. According to his BMI, our President is overweight. I looked at Atkins and he appeared to have a pretty large frame on which he carried his weight -- whatever it was -- very well, would you agree? This slander that he was obese (and Michael Bloomberg should be ashamed of himself for his crass comments on this!) is so over the top. Even to call him overweight, sorry, is just an arbitrary assessment based on a one-size-fits-all standard with no scientific fact to back this up.

My MIL had an ideal BMI for a heart patient. She died in her sleep at 61 anyway. Maybe had she followed Atkins and taken fish oil as he advocates instead of Lipitor .... We all know thin people with crappy diets. Your seeming emphasis on BMI as indicator of health fails to explain why there are so many unhealthy thin people too.

Most people who are just moderately active and eat a reasonable amount of food are, unfortunately, now going to be labeled overweight. Is it any wonder, perhaps, why so many people don't wanna hear it any more and give up entirely? Is there any evidence that it really is healthier to be thinner than one might "naturally" be?

I'm curious, when a patient comes to you do you have some idea of what you consider their weight to be? I was at a party last summer with a few of my hubby's colleagues. We climbed a pretty rickety ladder to go to the roof to watch fireworks so there was a little joking going on about weights. Turned out his colleague that is in great shape and two inches shorter actually weighs more than my admittedly overweight hubby. Looking at this guy one would probably guess 180 but he's 220. So would your assessment of his weight change after he stepped on the scale?

I think that was Andrea's point. It doesn't matter to me what the number on the scale was prior to his fall. He looked a healthy weight to me any time I saw him on TV.

In the current hysteria and low carb fad with related diets, it's so easy for his critics to continue to mislead regarding exactly what the Atkins diet was all about. If one gets past the initial phase to maintenance, one sees that it is a rather easy way to maintain one's weight without going through this life hungry. Not for everybody, but sure has been for me. I'm sure some people will have heart problems anyway, but so too did Fix (the runner?). And just as high fat diets can have consequences so too can low fat diets -- maybe that's why there are so many more depressed skinny people. Atkins never advocated the "diet" for life, but he did advocate a lifestyle that works for many. It's very sad that the medical profession as a whole so derided him. Like Roger's friend, I have not discussed with my diet with my doctor because it's not one she advocates. Kinda sad.

Evie Happy

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I actually don't pay much attention to weight ...
Feb 13, 2004 9:38AM PST

From my perspective the important issues are lifestyle and fitness. There is some evidence that people who are thin or heavy have a sort of 'biochemical programming' to have a particular habitus. Also, there is evidence that obese patients who are physically fit have risk factors for most diseases that resemble the risks of thinner patients. The major exception is osteoarthritis. If you're heavy your joints have to carry more load. Thus, my main message to patients is that they need to eat a balanced diet, avoid gratuitous fat and carbs, and exercise regularly.

BMI has some limitations, primarily in heavily muscled individuals. Whether Dr. Atkins was in that category I cannot say. I suspect that Mr. Cruise is in that category. Did Dr. Atkins look overweight? I think he did, but I never met him personally, and the pictures I've seen were composed in such a way that it is difficult to be sure. Skilled photographers can 'cover up' a good bit of bulk.

I really don't care either way whether or not Dr. Atkins was obese. From my perspective his situation is interesting primarily because it illustrates the difficulty of weight management. His heart condition mandated a lower weight than his pre-injury weight, and he either could not or would not achieve that lower weight. That illustrates the difficulties of weight control.

Personally, I do follow a relatively low carbohydrate diet, but I strongly object to the message that Atkins is THE way to control weight. There is good reason to believe that different people have metabolic systems that respond differently to various diets and that there is no ONE optimum diet for weight loss. Certainly there is inadequate data right now to conclude that any particular weight loss diet is clearly superior to another.

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Re:I actually don't pay much attention to weight ...
Feb 14, 2004 12:30AM PST
Personally, I do follow a relatively low carbohydrate diet, but I strongly object to the message that Atkins is THE way to control weight. There is good reason to believe that different people have metabolic systems that respond differently to various diets and that there is no ONE optimum diet for weight loss. Certainly there is inadequate data right now to conclude that any particular weight loss diet is clearly superior to another.

And herein lies the problem. Atkins was derided as the equivalent of the Beverly Hills Diet quack for many years. If you have read his book, he his "diet" is more of a lifestyle. I don't have my copy on me but in one of the initial chapters he encourages doubters to try a week or so of Atkins and a week or so of some other diet, and if they feel better on the other one, then by all means go for it! If you adhere to relatively low carbs yourself you might be shocked and surprised to find that this is exactly what he advocates in the maintenance phase of his plan. He has never advocated that his is the only solution for all, but constantly had to fight derision by those who claim their diets are.

If Atkins was generally healthy at his weight before contracting a virus, why should he lose weight afterwards? If a person's obesity contributed to a disease, then losing weight seems a logical response. But restricting calories can stress the immune system, fat released from stores can temporarily alter lipid profiles as much as dietary fat, and I'm not sure exercise is good for a compromised heart. I'm not a doctor, but would really be interested in what logic there is to say that any and all heart patients are necessarily benefitted by lowering their BMI at that point, and there is certainly no evidence his BMI prior contributed to his cardiomyopathy.

Atkins' detractors are now looking to blame his diet for a viral infection. How about all the skinny folks with high cholesterol that have diet/lifestyle related heart disease? Oh yeah ... their disease is genetic and we'll just prescribe ya a little Lipitor.

Evie Happy
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Heart disease and weight
Feb 14, 2004 12:56AM PST

The logic behind the recommendation that cardiomyopathy patients lose weight may or may not be correct, but it is at least straightforward.

Patients with cardiomyopathy from whatever cause have impaired cardiac reserve. They may feel OK at rest but the heart lacks the capacity to increase blood flow in response to activity.

The more you weigh, the greater the metabolic requirements when you engage in any activity. Thus, the logic behind weight loss for cardiomyopathy patients is that decreasing body weight should decrease the load on the overloaded heart. This is, of course, in addition to avoiding salt (since it causes fluid retention and increases cardiac load) and using appropriate medications to decrease cardiac work load.

Most cardiomyopathy patients do not live long enough for issues related to cholesterol and fat metabolism to make much difference.

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Atkins and other methods for weight loss ...
Feb 14, 2004 1:05AM PST

I'm well aware that my current diet resembles the Atkins maintenance phase. It is not a coincidence. That said, I'm not a big fan of Atkins in general and I did not choose my current diet until relatively recently when additional data came out about Atkins and lipid effects.

Atkins's books may not have claimed that his was the best method for weight loss, but he certainly left that impression in an interview I heard a few years back. This was before there was any significant published data regarding the safety and efficacy of his approach. At that time he objected strongly to the suggestion from other physicians that he needed to do more research on his theories before presenting them to the public as the cure for obesity. His response was, basically, that he thought the theory was good and it wasn't his responsibility to defend it scientifically. I was decidedly unimpressed by both the content of his message as well as his cavalier approach to the data.

However, I was not even thinking so much about Atkins as his followers when I commented on Atkins not necessarily being the best approach to weight loss. Atkins himself had some appreciation for the diversity of human metabolism and such. I'm afraid that much of the nuance has been lost by some of his followers. The messages some Atkins devotees are preaching are enough to make me cringe.