When most people think about getting older, they assume that diminishment of mental skills, physical energy, muscle tone, and the like are inevitable. Moreover, they regard heart disease, hypertension, blood sugar imbalances, and even cancer as a part of the aging process. It needn’t be that way. We have all met or heard about men and women in their seventies, eighties, and even nineties who are enjoying active, healthy lives. Whether they are ace tennis players, tap dancers, artists, humanitarians, or individuals who are accomplished and fulfilled in a variety of other endeavors, such individuals are proof that getting older needn’t translate into a catalog of disease and diminishment.
In addition to their role in increasing your risk of heart disease and Type 2 diabetes, excess carbohydrate intake can affect the aging process in another important way. Chronic elevated levels of blood glucose due to high carbohydrate consumption can react with proteins, forming advanced glycosylation end products (AGEs), which can deteriorate organs and vascular function. One result is hardening of the arteries, diminishing the oxygen flow to vital organs, including the brain.1–5
How can you increase your chances of having your golden years be numerous and vigorous? Along with having a positive attitude, seeing change as an opportunity, and remaining mentally challenged, the following answers should come as no surprise. They are the same advice that appears elsewhere in this book.
Eat healthy. Control your carbohydrate intake and select a broad range of nutrient-rich foods.
Keep your weight under control.
Stay physically active. Exercise regularly to maintain your energy, oxygenate your body, strengthen your heart, and maintain muscle tone.
Take nutritional supplements to make up for any deficiencies caused by depleted soil or over-processed food.
To this, we would add: Take a proactive attitude to your health. Find a physician who is open to complementary medicine and who is willing to see you as an active and equal participant in your healthcare. Take note, you thirty-year-olds, this message applies to you as much if not more than it does to the sixty-year-olds reading this book. The sooner you adopt an all-encompassing healthy way of living, the longer you are likely to live and the better the quality of those years.
Doing Atkins is for life, but your ACE may be subject to change over your lifetime. No matter how careful you are about your diet, fitness program, and overall approach to wellness, life happens. You can be certain of one thing: you will age. What can you do about it? First of all, be in the best shape you can be so that you can fight the aging process; secondly, understand that you may have to make some changes in the face of new challenges.
As we age, our metabolism slows down, which makes it harder to maintain a constant weight. The only way to slow the effects of time is with more vigorous exercise. So while it is never too late to start a fitness program, if you’re already a regular exerciser, you’re more likely to be able to increase your activity level without injury. If you become more active, you may be able to increase your ACE. If you have an accident that limits your activity level for a while, you may have to decrease your ACE. Perhaps you have retired recently or have gone from walking to work, to commuting by bus. Or perhaps you’ve left an occupation that required a fair amount of physical effort and are now living a less active life. Or worse, perhaps you recently had surgery and were told not to exercise for a couple of months. All these situations could mean that your energy output has decreased. You have two options in order to maintain your weight. The first is to up your energy output another way. You may have to develop a more structured exercise program than you used to need. If your mobility is temporarily restricted, you may be able to find a gentler form of exercise you can engage in while on the mend—perhaps water aerobics, stretching, or chair exercises. A physical therapist will be able to tell you what is advisable for your particular condition.
The second approach is to lower your carbohydrate intake. If you were happily maintaining your goal weight on 80 grams of Net Carbs a day, you may need to scale back until you can resume your former activity level. Start by dropping to 70 grams. If you can maintain, fine, this is your new ACE. If you start to gain after a week or so, drop to 60 grams, and so forth. Your new ACE is where you can easily maintain your weight. (This is not to say that we recommend eating fewer carbs as an antidote to being inactive.) Most people find that a combination of exercise and dropping their ACE works best in a short-term situation.
If you begin to slowly put on weight despite adhering to your ACE and maintaining your fitness regimen, one possibility is that your thyroid function has slowed down. Ask your doctor to do a TSH (thyroid stimulating hormone) test to ascertain whether you are producing a lot of that hormone. If the results are high, it means your body is working hard to overcome a depressed thyroid.
Sometimes an individual has had his weight under control for years and is humming along happily with an eating and exercise routine that keeps him slim and trim. Then suddenly, without any apparent change in routine, the pounds pile on. What gives? The cause is often a side effect of a new prescription drug. Many pharmaceuticals (see a partial list on page 9) make it harder to control your weight, although this is not necessarily indicated on the information sheet. If your doctor suggests that you start taking a new drug, ask the following questions:
Is there a lifestyle change or combination of changes I can make instead?
Is there a natural alternative in the form of a dietary supplement or combination of supplements that I can take instead?
Will this drug make it harder to control my weight?
If so, is there another drug I can take that will not have this effect?
How long will I have to stay on this drug?
If you must take this drug and it does have a weight-gain effect, you might have to increase your activity level and/or decrease your ACE to maintain your weight.
From a weight viewpoint, being female poses special challenges at several phases of your life. Hormonal fluctuations may contribute to weight gain or water retention. Likewise, taking hormones during peri-menopause and menopause can cause a slow and insidious weight gain over time. If taking estrogen causes you to gain weight, discuss alternatives with your doctor. (The most recent research on Prempro, one brand of hormone replacement therapy which uses both estrogen and synthetic progesterone, raises questions about its safety and the long-term risk for breast cancer and heart disease. On the other hand, it does appear to have some protective effect on colon cancer and osteoporosis.)6
Men are not immune from hormonal changes. As they age, men produce less testosterone, the primary male hormone, so the effects of estrogen are not suppressed as they are when there is sufficient testosterone. The result can be difficulty in maintaining weight.
Many people who have struggled with their weight over the years cite a particularly stressful situation as the trigger that signaled the start of their difficulties. It can also be the occasion for backsliding. After years of keeping their weight under control, some people fall off the wagon in response to an event such as divorce, loss of a job, or death of a spouse. If you have encountered such an experience, you may have felt that no matter how much you have been in control of your health and your weight, this devastating event shows that you cannot really control what happens to you or those you love. And so you may find yourself falling back into old eating habits that promote weight gain.
The intimate relationship between food and emotions is the subject of a whole field of psychology. Our purpose here is to make you aware that if you previously had a problem with overeating or eating the wrong things—like a “dry” alcoholic—you may always be vulnerable to falling back into these bad habits when life throws you a curveball.
If something happens that pushes your stress buttons and points you in the direction of the refrigerator, fast-food restaurant, or candy jar, you need to be immediately aware of your backsliding. Awareness is the first step to avoiding a spiral into behavior that in turn triggers self-reproach and more bingeing. If you have an ongoing or even an occasional history of going off the program when you encounter a stressful situation, you need to get a handle on the time, the circumstances, and the food that have been your undoing in the past. Otherwise, your behavior could lead to a pattern of yo-yo dieting. And if you do temporarily fall into the pit of temptation, you need to know that you can dig yourself out, as you have before. If you find yourself in a stressful situation, try the following tactics:
Do talk to a person you trust, whether a family member, friend, or therapist. Airing your feelings is the first step to dealing with them constructively.
Don’t wallow in self-pity. If you’ve been disappointed in love, the real revenge is showing your ex-mate that you have the fortitude to be happy without him or her. If you’ve found that retiring has made you feel useless, get involved in volunteer activities or start a second career. If you have lost a loved one, reach out to other members of the family, who are also in pain.
Do talk to yourself. Remind yourself of how you have overcome other problems in the past and how you are strong enough to do it again.
Don’t fall into the guilt trap of punishing yourself for backsliding with more inappropriate eating.
Do acknowledge what you did, forgive yourself—and then get right back on the program.
Don’t ever allow yourself to gain more than five pounds. Losing that small amount of weight is always doable. (Here we are talking about real weight, not fluctuation throughout the day, which is reflected in an increase in inches as well.)
So long as you take control of your carb intake immediately, you should be able to lose the few pounds you may have piled on, which will make you start feeling better. Meanwhile, give some thought to why you went “off the wagon” and how to avoid doing so again in the future. Was it purely emotional eating? Or were you also letting yourself get too hungry? Are you drinking enough water? Do you keep controlled carb snacks around you at all times? After you eat something you shouldn’t or even too much of a perfectly fine food, how do you feel?
Here are some tips to help you avoid behavior you know is destructive:
Know your triggers. If it’s a certain bakery you pass every day, take another route. If it’s attending a birthday party with tempting birthday cake, make sure you’ve eaten before you go or bring a low carb substitute you can enjoy while the others overdose on sugar and white flour. If it’s going to a newsstand with its tempting array of candy bars, decide ahead of time that you will leave only with your newspaper. If it’s social drinking, set a limit on how many drinks you’ll have.
Plan your path through the grocery store. Simply avoid the aisles that hawk sodas, snack foods, and other junk food full of empty carbohydrates. You’ll be amazed at how quickly you can whiz through the store when you avoid all that unnecessary stuff.
Stay busy. It’s obvious but true. When you find yourself opening the fridge for something to do, it’s time to find yourself a task. On the other hand, getting so absorbed in an activity that you skip a meal or go too long between meals can lead to a drop in blood sugar and a desperate need to eat the first object in sight.
Start up that food diary again. You may have kept a diary while you were in the weight-loss phases of Atkins. Why not get back in the habit and make it a notebook you can carry with you. In addition to tracking your food intake and any shifts in weight, consider adding the following categories: Mood, Location, Hunger Meter (on scale of 1 to 5). A food diary works on a few different levels. In addition to listing your daily carbs, it interferes with unconscious nibbling and provides a history of your eating habits so you can see what does and doesn’t work for you.
Treat yourself. Remember that controlling carbs allows you to eat many of the ultimate luxury foods such as Pineapple Mango Layer Cake and Miso-Glazed Salmon, among the many delicious dishes in the recipe section that follows. Preparing and enjoying such foods will keep you from feeling deprived.
Ten Rules for a Lifetime
Count your Net Carbs.
Stay at or below your ACE (Atkins Carbohydrate Equilibrium).
Adjust your ACE as needed.
Eat primarily whole, unprocessed foods.
Stay away from sugar, white flour, and other junk foods.
Don’t go more than four to six waking hours without a meal or snack.
Exercise regularly.
Supplement with vitamins, minerals, and essential fatty acids.
Drink a minimum of eight 8-ounce glasses of water.
Never let yourself gain more than 5 pounds.
As part of your overall commitment to good health, you should have an annual physical exam. Of course, if you have any known health problems, you must be seen more often. If you have lost weight by doing Atkins and overall you’re feeling more energetic and positive, your doctor is probably willing to acknowledge that you have improved your health. And if he or she has seen that in addition to slimming down, you’ve improved your blood lipids, brought your blood pressure down, and corrected or improved any blood sugar imbalance, the proof is in the low carb pudding. If you did not share your decision to do Atkins with your physician (which we do not recommend), now that you have achieved your goals and are doing Atkins for life, it would be an excellent time to reveal the reason for your success. If you are just starting to do Atkins for health reasons, you definitely should discuss your decision with him or her. Also be sure to get baseline blood tests done. When you go in for another checkup—say, in three months—your doctor will likely see that you’ve improved your blood lipids and blood sugar levels, and brought your blood pressure down. Since you’ll also be feeling more energetic and positive, you’ll have made your point. Although some doctors still have a knee-jerk anti-Atkins reaction, many others have come to understand that controlling carbohydrate intake is a key component of good health, and they will support your decision once they understand what Lifetime Maintenance entails.
Your doctor may be pleased with your results, but it is up to you to be proactive about why you are doing Atkins for life. First of all, you need to make it clear that this regimen is distinct from the Induction phase, which was a short-term phase to jumpstart weight loss. Explain that Lifetime Maintenance is not about eating 20 grams of Net Carbs a day. Rather, it is about finding your individual tolerance for carbs so you can maintain your goal weight for life. It does not mean eating only steak, bacon, and eggs and eliminating all vegetables and fruit. It is about eating a wide variety of foods, including plenty of nutrient-rich carbohydrates. What is does cut out are foods full of white flour, sugar, and other empty carbohydrates in the form of junk foods.
If your physician is still bothered by the myths he or she has heard about Atkins, here’s what you might hear and here’s how you can respond:
MYTH #1: Lipolysis/ketosis is dangerous.
How you can respond: Many doctors believe this, but it’s not true. What is dangerous is a life-threatening condition known as ketoacidosis, which affects insulin-dependent diabetics or alcoholics. The two terms sound similar, but that’s the only connection. Ketosis is simply a shorthand way to say your body is burning stored fat instead of glucose as its primary fuel. This desirable and perfectly natural process of using fat instead of glucose to fuel your body happens in the Induction phase of Atkins. In any case, now that you are in Lifetime Maintenance, you burn both fat and carbs for energy so you are no longer in lipolysis/ketosis.
MYTH #2: Eating so much protein leaches calcium from your bones.
How you can respond: This is another myth that has been disproved. It is true that your body will excrete more calcium in the urine than usual when you are in the Induction phase of Atkins, but studies that looked for bone loss, found none.7–8After the first week on Induction, calcium excretion in the urine returns to normal with no long-term effects. And recent research with older adults has shown that eating a high-protein diet not only does not weaken your bones, it actually strengthens them if you also take a calcium supplement—as the Atkins program recommends.9
MYTH #3: Doing Atkins will raise your cholesterol.
How you can respond: Just the opposite is true. Almost every Atkins follower sees a drop in LDL cholesterol and a rise in HDL (“good”) cholesterol, along with a sharp drop in triglycérides, a type of blood fat that is an important indicator of heart health. If your blood lipid tests show this, the question should never arise. (Several of these studies are referenced in chapter 3.)
MYTH #4:
The amount of protein in the Atkins approach is bad for your kidneys. How you can respond: This may be the biggest myth of all, because there is absolutely no evidence for it—not one single study shows that a high-protein, low carbohydrate diet damages normal kidneys. (There are studies that show that too much protein in concert with too much carbohydrate can be problematic, but you are not consuming excessive carbs when you are doing any phase of Atkins.) If you already have severe kidney disease, of course, you must take the advice of your physician and he/she will probably tell you to sharply restrict your protein intake, as well as intake of other nutrients and even water. But kidney disease cannot be caused by eating protein.
MYTH #5: No one knows the long-term results of eating the low carb way. How you respond: How could it be unhealthy to eat whole foods such as protein, healthy fats, a variety of vegetables, low glycémie fruits, seeds, and nuts, and modest amounts of legumes and whole grains? And how could it be unhealthy to feel better, be more active, and reduce your need for medicines?
Once you’ve cleared up some misconceptions about doing Atkins, it’s time to provide your doctor with some solid scientific studies that support its underlying principles. There are far too many of these to provide a complete list here. At the end of this book are nine recent studies that you can share with your physician.10–18 For additional studies whose findings can be applied to the four Atkins Nutritional Principles—weight loss, weight maintenance, good health, and disease prevention—your physician can go to Research Summaries in The Science Behind Atkins on www.atkins.com.
We hope that reading the first half of this book has provided you with the knowledge and tools that you can use now and in the years to come to enrich your life with health and vitality. If you are like the other Atkins followers to whom we have introduced you, we trust that your feelings of empowerment about your weight and your health will spill over into other areas of your life. And as you read the recipes and review the meal plans that follow in Part 2, we are confident that you will feel equally empowered in the kitchen. You will also soon see tangible evidence of the wide variety of tasty, satisfying foods you can enjoy even as you remain slim, healthy, and full of boundless energy.
Annual Tune-Up
Maintaining your health, and with it a healthy weight, is an ongoing process. To evaluate where you stand, ask yourself these questions now, a year from now, and every year thereafter. In certain cases, there can be more than one correct answer to a question.
Weight: In the last year,
I have lost weight
I have maintained my weight
I have gained no more than 5 pounds
I have gained more than 5 pounds
I have seesawed up and down but basically maintained my weight
Eating habits: In the last year,
I ate mostly protein and fat
I have moderated my intake of protein and fat to include more healthy carbs
I have eaten a variety of carbohydrate foods
I could eat healthier carb foods than those that I am eating
I am eating too many carbs overall
I avoid all white flour and sugar
I rarely eat white flour and sugar
I eat some white flour and sugar
I avoid all fats
I am careful to avoid trans fats
I wouldn’t know a trans fat if I fell over it
Atkins Carbohydrate Equilibrium (ACE): In the last year,
I have been able to raise my ACE
I have stayed at the same ACE
I have had to lower my ACE
I do not know what my ACE is
I am able to maintain my weight without worrying about my ACE
Fitness: Over the past year,
I exercise about one hour a day every day
I exercise regularly but not every day
I exercise sometimes
I rarely exercise
I never exercise
I exercise more than I did the previous year
I exercise less than I did the previous year
I have stepped up my overall fitness level
My overall fitness level has declined
Activities: Over the past year,
I engaged in aerobic exercise
I engaged in anaerobic exercise
I engaged in both aerobic and anaerobic exercise
I have a regular exercise routine
I varied my exercise routine
I am enjoying exercise
I enjoy exercise more than I used to
I am exercising because I know it is good for me
I still hate to exercise but I do it anyway
Physical Exam: Over the past year,
I have had a complete physical
I have not had a physical
Blood Lipids: Over the past year,
My total cholesterol has risen
My total cholesterol has dropped
My total cholesterol has remained the same
My HDL has risen
My HDL has dropped
My HDL has remained the same
My LDL has dropped
My LDL has risen
My triglycerides have dropped
My triglycerides have risen
My triglycerides have remained the same
Other markers: Over the past year,
My blood pressure has risen
My blood pressure has dropped
My blood pressure has remained the same
My fasting blood sugar has risen
My fasting blood sugar has dropped
My fasting blood sugar has remained the same
Dietary supplements: Over the past year,
I have not taken any supplements
I have taken a multivitamin/mineral regularly
I have taken a multivitamin/mineral when I remembered
I have taken omega-3 and omega-6 fatty acids regularly
I have taken omega-3 and omega-6 fatty acids when I remembered
I have followed a regular vitamin and mineral regimen tailored to my needs
Review of medications: Over the past year,
I started taking one or more new medications on a regular basis
I continued to take one or more medications on a regular basis
I stopped taking one or more medications
I increased the dosage of one or more medications
I decreased the dosage of one or more medications
I took no medications