TV: Horizon: The Atkins Diet
Authors: Nadeeja Koralage
Journal: BMJ (2004)

It is January again. People make and break their new year's resolution of getting in shape, while the Commons health select committee talks of introducing a “fat tax” on junk food. Cue Horizon: The Atkins Diet.

Fish and cheese have replaced the national institution of fish and chips, as we ditch the carbs and head for the protein and fat. Horizon said that last year bread sales slumped because of what has been “the most controversial diet in history.” This documentary was shown in the week that saw the latest twist in Dr Robert Atkins' 30 year story, when the company that he founded, Atkins Nutritionals, was reported to have revised its earlier advice and recommended a lower fat diet. The company later issued a denial.

A once overweight cardiologist from Ohio, the late Dr Atkins (obituary BMJ 2003;326: 1090) recommended that slimmers could eat as much as they wanted, as often as they wanted, as long as they avoided carbohydrates. But this, claimed Horizon, “broke a fundamental law of the universe”—that is, where did all the calories go? The 50 minute programme aimed to discover the answer.

Meet overweight Brian, who has tried many diets, from the Cabbage Soup scheme to UK television presenter Carol Vorderman's 28 day detox plan. Nothing worked until he discovered Dr Atkins' New Diet Revolution nine months ago, when he weighed 23 stone (146.4 kg). Having since lost five stone (31.8 kg), Brian hoped to achieve his ambition of getting into a pair of trousers from Marks & Spencer.

Thousands of dieters like Brian see the Atkins diet as an easy way to slim, but the Horizon team decided to put it to the test. In a six month study of 120 subjects, with 60 on the Atkins diet and the remainder on a low calorie diet, researchers found that those on Atkins lost twice as much weight as the low calorie group. Evidence also showed that cholesterol levels were improved on the Atkins diet, in spite of the increased levels of saturated fats that are presumably consumed.

Several more studies were mentioned, but the most interesting was one that concluded that the diet worked because protein consumption reduced the appetite. This study was carried out at a supermarket in Denmark, where all the food was free of charge. “When we announced the experiment on the television, our university here was bombarded and the switchboard broke down,” said Professor Arne Astrup from Copenhagen, apparently surprised. He selected 30 individuals who were told to eat a carbohydrate-rich diet and 30 who were asked to eat a diet of mostly protein. Results showed that the protein group lost more weight, but this was because they chose to eat less. Similarly, when UK dieters were put to the test on the television programme The Diet Trials, those on the Atkins diet lost as much weight as low calorie dieters. When their diet diaries were examined, they were again found to have eaten less.​less.




Figure 1



Surprised: Professor Arne Astrup




Another study was made up of just one pair of twins. Lasting a single day, it suggested that the ketosis induced by protein consumption did not use up extra calories, as Dr Atkins had suggested.

But at least Brian was happy. One month on, he had lost a further 12 pounds (5.45 kg) and weighed 17 stone (108.2 kg).

Horizon: The Atkins Diet provided an interesting recap for people who had missed out on the media hype over the past year. For the rest of us, the information was repetitive and interspersed with distorted images of an obese man eating a huge piece of cheese or a greasy chunk of meat. A fairy cake was dipped into liquid oxygen and then set alight to show how much energy, and therefore calories, it contained.

It seemed as if the Horizon programme makers did not expect their viewers to have a long attention span. But perhaps it was obvious even to them how little new information the programme contained.