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ATKINS NUTRITIONAL ATKINS NUTRITIONAL APPROACH APPROACH From weight loss to From weight loss to lifestyle lifestyle Jacqueline A. Eberstein, Jacqueline A. Eberstein, R.N. R.N.
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ATKINS NUTRITIONAL APPROACH From weight loss to lifestyle Jacqueline A. Eberstein, R.N.

Dec 24, 2015

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Page 1: ATKINS NUTRITIONAL APPROACH From weight loss to lifestyle Jacqueline A. Eberstein, R.N.

ATKINS NUTRITIONAL ATKINS NUTRITIONAL APPROACHAPPROACH

From weight loss to lifestyleFrom weight loss to lifestyle

Jacqueline A. Eberstein, R.N.Jacqueline A. Eberstein, R.N.

Page 2: ATKINS NUTRITIONAL APPROACH From weight loss to lifestyle Jacqueline A. Eberstein, R.N.

Rationale: Atkins LifestyleRationale: Atkins Lifestyle

Stored fat is the body’s backup fuel source.Stored fat is the body’s backup fuel source. The body cannot store more than a 2 day supply The body cannot store more than a 2 day supply

of carbohydrate.of carbohydrate. In the absence of significant dietary In the absence of significant dietary

carbohydrate and adequate protein, fat becomes carbohydrate and adequate protein, fat becomes the primary fuel.the primary fuel.

The steady burning of fat produces more energy The steady burning of fat produces more energy while dramatically decreasing appetite. while dramatically decreasing appetite.

Page 3: ATKINS NUTRITIONAL APPROACH From weight loss to lifestyle Jacqueline A. Eberstein, R.N.

From glucose burning to fat burning From glucose burning to fat burning metabolismmetabolism

The lipolytic pathway is the second of two The lipolytic pathway is the second of two primary pathways for energy primary pathways for energy

The body can readily produce the The body can readily produce the enzymes involved in fat mobilization enzymes involved in fat mobilization (lipolysis). When fat is burned for energy (lipolysis). When fat is burned for energy ketones are produced.ketones are produced.

When fat is being mobilized, it neither When fat is being mobilized, it neither accumulates nor deposits.accumulates nor deposits.

Page 4: ATKINS NUTRITIONAL APPROACH From weight loss to lifestyle Jacqueline A. Eberstein, R.N.

The truth about ketonesThe truth about ketones

Ketones are produced on any weight loss Ketones are produced on any weight loss plan where fat is burned.plan where fat is burned.

When controlling carbs the presence of When controlling carbs the presence of ketones is a positive sign and should NOT ketones is a positive sign and should NOT be confused with ketoacidosis. Acidosis be confused with ketoacidosis. Acidosis does not result from controlling carbs.does not result from controlling carbs.

Ketoacidosis is a concern in people Ketoacidosis is a concern in people primarily with uncontrolled type 1 diabetes primarily with uncontrolled type 1 diabetes or alcoholism.or alcoholism.

Page 5: ATKINS NUTRITIONAL APPROACH From weight loss to lifestyle Jacqueline A. Eberstein, R.N.

KetonesKetones

““Doctors are scared of ketosis…But ketosis is Doctors are scared of ketosis…But ketosis is the normal physiological state of man. Rather the normal physiological state of man. Rather than being poison, which is how the press often than being poison, which is how the press often refers to ketones, they make the body run more refers to ketones, they make the body run more efficiently and provide a back-up fuel source for efficiently and provide a back-up fuel source for the brain.” Richard Veech, NIH researcherthe brain.” Richard Veech, NIH researcher

Veech calls ketones “magic” and has shown that Veech calls ketones “magic” and has shown that both the heart and brain run 25% more efficiently both the heart and brain run 25% more efficiently on ketones than on blood sugar.on ketones than on blood sugar.

Page 6: ATKINS NUTRITIONAL APPROACH From weight loss to lifestyle Jacqueline A. Eberstein, R.N.

Levels of ketonesLevels of ketones

““Dietary” ketosis vs. “diabetic” hyperketoacidosisDietary” ketosis vs. “diabetic” hyperketoacidosis

Fed state: 0.1 mmol/LFed state: 0.1 mmol/L Overnight fast: 0.3 mmol/LOvernight fast: 0.3 mmol/L Ketogenic diet: 1-3 mmol/LKetogenic diet: 1-3 mmol/L 21 day fast: 10 mmol/L 21 day fast: 10 mmol/L Uncontrolled diabetes: more than 25 mmol/L Uncontrolled diabetes: more than 25 mmol/L

Page 7: ATKINS NUTRITIONAL APPROACH From weight loss to lifestyle Jacqueline A. Eberstein, R.N.

Ketones as a fuel sourceKetones as a fuel source

Results in a decrease in appetite.Results in a decrease in appetite.

Insulin is not involved in ketone Insulin is not involved in ketone production.production.

Lowered insulin requirements decrease:Lowered insulin requirements decrease:

triglycerides, blood pressure, adrenaline, triglycerides, blood pressure, adrenaline, cortisol, PCOS and cancer death rates.cortisol, PCOS and cancer death rates.

Page 8: ATKINS NUTRITIONAL APPROACH From weight loss to lifestyle Jacqueline A. Eberstein, R.N.

Four phases of the ANAFour phases of the ANA

Phase 1 InductionPhase 1 Induction

Phase 2 Ongoing weight lossPhase 2 Ongoing weight loss

Phase 3 Pre-MaintenancePhase 3 Pre-Maintenance

Phase 4 Lifetime MaintenancePhase 4 Lifetime Maintenance

Page 9: ATKINS NUTRITIONAL APPROACH From weight loss to lifestyle Jacqueline A. Eberstein, R.N.

The ideal controlled carb nutritional The ideal controlled carb nutritional approach: therapeutic principles approach: therapeutic principles

Every person has a level of carb intake below Every person has a level of carb intake below which weight loss is automatic and a level below which weight loss is automatic and a level below which weight maintenance is automatic.which weight maintenance is automatic.

Find the Critical Carbohydrate Level for Losing Find the Critical Carbohydrate Level for Losing (CCLL) and stay at or below this level until goal (CCLL) and stay at or below this level until goal weight is reached.weight is reached.

Once at goal, stay at or slightly below your Once at goal, stay at or slightly below your Atkins Carbohydrate Equilibrium (ACE). The Atkins Carbohydrate Equilibrium (ACE). The amount of carbs you can eat without losing or amount of carbs you can eat without losing or gaining weight.gaining weight.

Select the most nutrient-dense carbs, fats and Select the most nutrient-dense carbs, fats and proteins within established levels.proteins within established levels.

Page 10: ATKINS NUTRITIONAL APPROACH From weight loss to lifestyle Jacqueline A. Eberstein, R.N.

Phase 1: InductionPhase 1: Induction Ingest about 20 grams of Net Carbs with an adequate Ingest about 20 grams of Net Carbs with an adequate

protein and fat intake. Do not overeat. Generally expect a protein and fat intake. Do not overeat. Generally expect a 4 to 16 pound weight loss in 2 weeks.4 to 16 pound weight loss in 2 weeks.

Most people begin here and follow for 2 weeks. May Most people begin here and follow for 2 weeks. May follow longer if there is a lot of weight to lose.follow longer if there is a lot of weight to lose.

Do not stay on Induction until at goal. Move on.Do not stay on Induction until at goal. Move on. Drink 64 ounces of water during the day.Drink 64 ounces of water during the day. Be sure to eat 3 to 4 cups of salad and vegetables daily Be sure to eat 3 to 4 cups of salad and vegetables daily

from the approved list.from the approved list. Read labels- avoid many commercially prepared products.Read labels- avoid many commercially prepared products. Avoid or limit caffeine, trans fats AKA partially Avoid or limit caffeine, trans fats AKA partially

hydrogenated oils and margarine.hydrogenated oils and margarine. Use Splenda and limit all sweeteners to 3 packets daily.Use Splenda and limit all sweeteners to 3 packets daily.

Page 11: ATKINS NUTRITIONAL APPROACH From weight loss to lifestyle Jacqueline A. Eberstein, R.N.

Induction cont’dInduction cont’d

Unlimited to satietyUnlimited to satiety: : Protein-chicken, turkey, beef, lamb, fish, shellfish, pork, Protein-chicken, turkey, beef, lamb, fish, shellfish, pork,

veal, eggs, etc.veal, eggs, etc. Fat-oils, butterFat-oils, butter

LimitedLimited:: Carbohydrate-cheese (hard and fresh) 3 to 4 ounces, Carbohydrate-cheese (hard and fresh) 3 to 4 ounces,

vegetables 3 to 4 cups, olives 10, avocado-1/2, cream - vegetables 3 to 4 cups, olives 10, avocado-1/2, cream - up to 4 ounces, lemon/lime juice- 3 tablespoons.up to 4 ounces, lemon/lime juice- 3 tablespoons.

After 2 weeks can add 1 ounce of walnuts, almonds, After 2 weeks can add 1 ounce of walnuts, almonds, pecans, Brazils, macadamias, sunflower or pumpkin pecans, Brazils, macadamias, sunflower or pumpkin seeds. seeds.

Page 12: ATKINS NUTRITIONAL APPROACH From weight loss to lifestyle Jacqueline A. Eberstein, R.N.

Induction cont’dInduction cont’d

OmitOmit::

Beverages with caffeine and alcoholBeverages with caffeine and alcohol

Medications with sugar such as lozenges, Medications with sugar such as lozenges, cough syrups etc.cough syrups etc.

All foods with added forms of sugar and All foods with added forms of sugar and trans fats.trans fats.

Page 13: ATKINS NUTRITIONAL APPROACH From weight loss to lifestyle Jacqueline A. Eberstein, R.N.

050

100150

200250

300350

400450

500

Vita-Nutrients

Vitamin AVitamin CVitamin DVitamin EThiaminRiboflavinNiacinPyridoxineFolateCobalaminPantothenic AcidVitamin K

Nutrient analysis 0f 20 gram, 2000 Nutrient analysis 0f 20 gram, 2000 calorie menu based on RDIcalorie menu based on RDI

Page 14: ATKINS NUTRITIONAL APPROACH From weight loss to lifestyle Jacqueline A. Eberstein, R.N.

Nutrient analysis of 20 gram, 2000 Nutrient analysis of 20 gram, 2000 calorie menu based on RDIcalorie menu based on RDI

0

50

100

150

200

250

300

350

400

Vita-Nutrients

SodiumPotassiumCalciumIronPhosphorusMagnesiumZincCopperManganeseSeleniumChromiumMolybdenum

Page 15: ATKINS NUTRITIONAL APPROACH From weight loss to lifestyle Jacqueline A. Eberstein, R.N.

Symptoms On The Induction PlanSymptoms On The Induction Plan

Withdrawal from carbs can trigger Withdrawal from carbs can trigger headaches, moodiness, irritability and headaches, moodiness, irritability and fatigue. Usually begins within 12 to 24 fatigue. Usually begins within 12 to 24 hours of starting Induction.hours of starting Induction.

If there is a history of migraines, the If there is a history of migraines, the withdrawal may trigger a migraine.withdrawal may trigger a migraine.

Carb cravings may continue for 4 or 5 Carb cravings may continue for 4 or 5 days, rarely up to a week.days, rarely up to a week.

Page 16: ATKINS NUTRITIONAL APPROACH From weight loss to lifestyle Jacqueline A. Eberstein, R.N.

Carb AddictsCarb Addicts During the transition phase (the first 4 or 5 days) During the transition phase (the first 4 or 5 days)

maintain an adequate protein and fat intake. Snack as maintain an adequate protein and fat intake. Snack as needed and don’t miss meals.needed and don’t miss meals.

In rare, severe cases when you can’t go cold turkey, In rare, severe cases when you can’t go cold turkey, remove a carb food group every 3 days until you get to remove a carb food group every 3 days until you get to Induction.Induction.

days 1-3 eliminate only sugarsdays 1-3 eliminate only sugars days 4-6 eliminate flour containing foodsdays 4-6 eliminate flour containing foods days 7-10 eliminate fruit and juicedays 7-10 eliminate fruit and juice days 11-13 eliminate starches and legumesdays 11-13 eliminate starches and legumes

Page 17: ATKINS NUTRITIONAL APPROACH From weight loss to lifestyle Jacqueline A. Eberstein, R.N.

Ketones varyKetones vary

Time of dayTime of daySexSexAgeAgeActivity levelActivity levelHormone status-ketones can decrease Hormone status-ketones can decrease

before the menses.before the menses.MedicationsMedicationsFinger stick method is bestFinger stick method is best

Page 18: ATKINS NUTRITIONAL APPROACH From weight loss to lifestyle Jacqueline A. Eberstein, R.N.

The Carb LadderThe Carb Ladder

As the program progresses, moving from one As the program progresses, moving from one phase to another add back carbs in this order:phase to another add back carbs in this order:

Salad and vegetablesSalad and vegetables Nuts and seedsNuts and seeds Soft fruits i.e. berriesSoft fruits i.e. berries Other fruits i.e. melon, pineappleOther fruits i.e. melon, pineapple Starch vegetables and legumesStarch vegetables and legumes Whole grains- unrefinedWhole grains- unrefined

Page 19: ATKINS NUTRITIONAL APPROACH From weight loss to lifestyle Jacqueline A. Eberstein, R.N.

Ongoing Weight Loss- OWLOngoing Weight Loss- OWL Each week add 5 grams of extra carbs per day following Each week add 5 grams of extra carbs per day following

selections from the carb ladder.selections from the carb ladder. Continue to add each week as long as weight and/or Continue to add each week as long as weight and/or

inches are lost.inches are lost. If cravings or increased hunger occur, stop the latest If cravings or increased hunger occur, stop the latest

addition and allow yourself to re-stabilize. addition and allow yourself to re-stabilize. You are determining your CCLL-critical carb level for You are determining your CCLL-critical carb level for

losing. The maximum amount of carbs that can be losing. The maximum amount of carbs that can be consumed while still losing weight.consumed while still losing weight.

The level is an individual one. Varies due to age, sex, The level is an individual one. Varies due to age, sex, amount of muscle mass, activity level etc.amount of muscle mass, activity level etc.

Plan on losing more slowly- about 1 to 2 pounds a week Plan on losing more slowly- about 1 to 2 pounds a week on average.on average.

Stay on OWL until within 5 to 10 pounds of goal weight.Stay on OWL until within 5 to 10 pounds of goal weight.

Page 20: ATKINS NUTRITIONAL APPROACH From weight loss to lifestyle Jacqueline A. Eberstein, R.N.

Pre-MaintenancePre-Maintenance

About 40 to 90 grams of carbsAbout 40 to 90 grams of carbs Allow 2 months to lose the last few poundsAllow 2 months to lose the last few pounds Important phase that helps to instill permanent Important phase that helps to instill permanent

dietary behavior changesdietary behavior changes Add 10 grams daily of extra carbs each week as Add 10 grams daily of extra carbs each week as

long as less than 1 pound of weight is lostlong as less than 1 pound of weight is lost Follow the carb ladder for choicesFollow the carb ladder for choices Usually when higher glycemic fruits, legumes, Usually when higher glycemic fruits, legumes,

starches and unrefined whole grains are added.starches and unrefined whole grains are added.

Page 21: ATKINS NUTRITIONAL APPROACH From weight loss to lifestyle Jacqueline A. Eberstein, R.N.

Lifetime MaintenanceLifetime Maintenance Once you have reached pre-maintenance and you have Once you have reached pre-maintenance and you have

not lost any weight for at least 4 weeks you have found not lost any weight for at least 4 weeks you have found your ACE-Atkins Carbohydrate Equilibrium. The amount your ACE-Atkins Carbohydrate Equilibrium. The amount of carbs you can consume without gaining to losing of carbs you can consume without gaining to losing weight.weight.

To maintain goal weight, stay at your ACE.To maintain goal weight, stay at your ACE. Maintain your goal weight within 3 to 5 pounds. Never Maintain your goal weight within 3 to 5 pounds. Never

allow yourself to gain more than 5 pounds without taking allow yourself to gain more than 5 pounds without taking action.action.

Average grams of Net Crab is 40 to 120 grams a day.Average grams of Net Crab is 40 to 120 grams a day. Engage in regular exercise; those who exercise regularly Engage in regular exercise; those who exercise regularly

usually have a higher ACE.usually have a higher ACE. Your ACE can change over time. Readjust your diet to Your ACE can change over time. Readjust your diet to

adapt to a higher or lower ACE.adapt to a higher or lower ACE.

Page 22: ATKINS NUTRITIONAL APPROACH From weight loss to lifestyle Jacqueline A. Eberstein, R.N.

• control of eatingcontrol of eating• increased sense of well-beingincreased sense of well-being• decreased risk factors for diseasedecreased risk factors for disease• loss of sizeloss of size• management of weightmanagement of weight

What is Success?What is Success?