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The old version of this post said that the Atkins diet can help you “stay off the road to diabetes” and that high-carbohydrate diets caused the obesity epidemic. It also described the body’s response to carbohydrates in a way that was both garbled and oversimplified. Diabetes is a serious medical condition, so I have replaced those claims with what major health organizations say about low-carb eating and diabetes.

What causes type 2 diabetes?

According to the National Institute of Diabetes and Digestive and Kidney Diseases, type 2 diabetes is caused by several factors, including overweight and obesity, not being physically active, insulin resistance and genes. You are more likely to develop it if you are 45 or older, have a family history of diabetes, are overweight, or have prediabetes or had gestational diabetes. Symptoms often develop slowly and can include increased thirst and urination, tiredness, blurred vision and sores that do not heal. The old post’s statement that high-carbohydrate diets are the cause of the obesity epidemic is too simple, because many factors are involved.

What does insulin resistance mean?

Insulin helps move sugar from your blood into your cells. In insulin resistance, the cells respond less well, so the body needs more insulin to do the same job. The old post described the pancreas releasing “20 times more insulin” than needed and a chain reaction involving adrenaline. I could not find a source for those details, so I have taken them out. The key point is that being overweight and inactive makes cells less responsive, and losing weight and exercising can improve this.

Is low-carb eating a recognized option for type 2 diabetes?

Yes, for some people. The American Diabetes Association’s 2019 consensus report on nutrition therapy says that for select adults with type 2 diabetes who are not meeting blood sugar targets, or for whom reducing diabetes medicines is a priority, reducing overall carbohydrate intake with low or very low-carbohydrate eating plans is a viable approach. One meta-analysis cited in that report found larger A1C benefits for very low-carb plans at 3 and 6 months, but not at 12 and 24 months. So low-carb eating can help in the short term, and the benefits are less clear over years. Atkins itself recommends its 20-gram plan for people with prediabetes or type 2 diabetes, but that is the company’s advice, not a medical guideline.

What are the risks?

The main risk is low blood sugar. The ADA report says that a very low-carb plan can cause fluid loss and quickly lower blood glucose, so people should speak to a knowledgeable practitioner at the start to prevent dehydration and to reduce insulin and other drugs that can cause hypoglycemia. The ADA’s Standards of Care also say that these plans are not recommended for people who are pregnant or breastfeeding, who have kidney disease, or who have or are at risk of disordered eating, and that they should be used with caution in people taking SGLT2 inhibitors because of the risk of ketoacidosis. In other words, if you take medicine for diabetes, do not start Atkins on your own.

Does Atkins prevent diabetes?

I could not find good evidence that the Atkins diet prevents diabetes. NIDDK lists overweight and physical inactivity among the causes, so keeping a healthy weight and staying active are sensible steps for everyone. The old post said that studies show low-carb diets “can help” with pre-diabetes. The ADA report is about adults who already have type 2 diabetes. For prevention, speak to your doctor about your own risk, have your blood sugar tested, and choose an eating plan you can keep up for years. Our post on Atkins and ketosis explains how ketone strips work, and how Atkins handles cravings and low-carb swaps show practical ways to cut sugar and refined carbohydrates.

What should you do next?

If you have diabetes or prediabetes and are interested in low-carb eating, ask your doctor or a registered dietitian first, and ask what to monitor. Whatever plan you follow, include vegetables, protein and healthy fats, and stay active. If you are looking for gentle movement, our guide to yoga and diabetes: how to start safely covers the basics.

Atkins and sugar cravings

Why sugar cravings happen

Sugar is everywhere you look, and it turns up in some surprising places. Did you know that most whole grain breads have at least one form of sugar in them? Many people have a sweet tooth. Even if you do not eat a lot of sugary treats, you may get intense sugar cravings in the first few weeks of the Atkins diet. So many carbohydrate foods have hidden sugars in them that your body may be experiencing a kind of withdrawal.

The problem with sugar is that your blood sugar level has a strong effect on your energy, your activity levels and your overall health. When your blood sugar is too low, you can get intense cravings. High blood sugar follows high-sugar meals: when you eat concentrated sugar, your blood sugar rises sharply and your pancreas releases insulin to bring it down, which can leave you tired and hungry again. If this happens over and over for years, your cells can become resistant to insulin, which raises the risk of type 2 diabetes.

Fortunately, being on the Atkins plan can help put an end to this cycle, because eating fewer carbohydrates reduces the swings in your blood sugar. However, this does not mean that sugar cravings go away automatically. Sugar products are everywhere, and temptation is sometimes hard to fight.

Ways to deal with cravings

The first way to get the better of cravings is planning. If you plan a balance of protein, fat and fiber in your daily diet, you will prevent the blood sugar drops that lead to sugar cravings. Also, do not go too long between meals without eating. Snacks are an important part of keeping your blood sugar stable. Keep handy snacks such as cheese, nuts, seeds and boiled eggs with you, so you can quickly steady your blood sugar without turning to sweet treats.

Sugar cravings can also be a sign of poor sleep or stress. Some people link chocolate cravings to low magnesium, and zinc and chromium are sometimes mentioned too, but the evidence is limited. If you are worried that your diet lacks something, ask your doctor or a dietitian, or consider a standard multivitamin.

Another trick is to brush your teeth. Many Atkins dieters find that brushing their teeth or using Listerine breath strips helps with cravings. Both leave a fresh feeling in your mouth and take away the wish to eat. Drinking two large glasses of water can also help. If your stomach is full, you are less likely to reach for a sugary treat.

Sometimes out of sight, out of mind is the best approach. If you find yourself overcome by cravings when you are at home, get out of the house and take a walk. The distraction will have you forgetting your sugar craving in no time. Calling a friend for support or logging into an Atkins support forum can also go a long way towards preventing you from giving in to sugar cravings.

Having a low-carb version of your favorite treat is also a good idea. You are less likely to feel deprived if you can have a low-carb treat now and then. There is a wide variety of low-carb products on the market that can satisfy your sweet tooth. Low-carb yogurt, chocolate, ice cream and candy can all help you stay on the Atkins plan and still get something sweet to eat. Check the labels, though, because some of them contain sweeteners that can upset your stomach.

Sugar cravings are part of following the Atkins plan, but the tips above will help you manage them and stay committed to your weight loss efforts.

Carbohydrate Cravings and the Atkins diet

Carbohydrate cravings are difficult to deal with, especially when you are trying to follow a low carbohydrate way of life. However, carbohydrate cravings are not just a matter of will power. As Dr. Atkins points out in his book, refined carbohydrates can cause a quick rise in blood sugar followed by a surge of insulin. There is a physical side to carbohydrate cravings, and it is one of the reasons that it is so easy to develop a high-carbohydrate, low protein way of eating.

There are many signs of physical carbohydrate cravings. You will feel a strong attraction to carbohydrate rich foods. Over time, you will develop a growing need for starches, snack foods and sweets. Additionally, you may experience cravings and weight gain after using some of the carbohydrate act-a-likes such as sugar substitutes and alcohol.

High carbohydrate foods are everywhere, which makes the cravings even harder to overcome. Eating high-sugar foods can feed your cravings and create more, and some people describe it as feeling like a habit. Carbohydrate-rich meals may also have a small effect on the brain chemical serotonin, which affects mood. Prozac and similar anti-depressants do not contain serotonin; they work by increasing the amount of serotonin available in the brain. Some researchers think this mood effect is one reason people reach for sweets when they feel low, but the evidence is limited.

Stress and anxiety can also lead to overeating carbohydrate-laden foods. When we are stressed, the adrenal gland creates extra cortisol. Cortisol is a stress hormone that can increase appetite, especially for sugary and fatty foods. Over time, high cortisol levels are also linked to more fat being stored around the waist.

Considering all of these factors, it may seem difficult to stay on a low-carbohydrate diet. However, many people find that a low-carbohydrate program like Atkins helps them break the cycle of carbohydrate cravings. The Atkins plan helps you take control of your cravings and cut back on refined carbohydrates and sugar.

While on the Atkins diet, you may experience some carbohydrate cravings from time to time, especially during the early phases of the diet. However, these will diminish as your body becomes more used to eating a protein-centered diet. In order to keep your cravings in check, eat small meals or snacks that contain protein every few hours. This will keep your blood sugars stable and avoid the crash you feel when you go hungry. Skipping meals will cause drops in blood sugar and leave you craving sweets.

Protein and fat, which are the core of the Atkins plan, keep you feeling full for longer. Make sure you are getting enough of the essential fats. Some people find that an Omega 3 fish oil supplement helps them, though there is little evidence that it reduces cravings.

Cravings for foods can sometimes be caused by dehydration. It is a good rule of thumb to drink a glass of water before reaching for any type of snack. Sometimes thirst can mask itself as hunger. When your body is properly hydrated, it will run more efficiently and you will see a decrease in cravings.
Recognize that there is a real addiction to carbohydrates that will need to be broken. Do not despair if you feel overwhelmed with cravings for carbs during the first few days on the plan. This is normal. Your body is used to running on a diet full of sugar and carbohydrates. It will take some time to adjust to this new way of eating. Normally, these feelings do not last more than the two-week induction period. Stay committed to this new way of eating and you will see the benefits quickly.

The Atkins diet is one of the best-known low-carbohydrate plans, and the old version of this post listed its benefits and its few downsides. It also said that low-carb eating has been “scientifically proven” to improve insulin sensitivity, blood pressure and blood insulin, and that dieters lose less muscle than on low-fat plans. I could not support those claims, so this rewrite goes back to the studies.

What are the possible benefits?

A 2013 meta-analysis in the British Journal of Nutrition looked at 13 trials with 1,415 people who followed a very-low-carbohydrate diet or a low-fat diet for at least a year. The low-carb group lost about 0.9 kg (2 pounds) more on average, had lower triglycerides, a slightly lower diastolic blood pressure and higher HDL (“good”) cholesterol, but also higher LDL (“bad”) cholesterol. The authors described the differences as statistically significant but small in practical terms. A larger 12-month trial of 609 adults found no significant difference between a healthy low-carb and a healthy low-fat diet (6.0 kg lost compared with 5.3 kg), which fits the common advice that the best plan is usually the one you can keep following. See the meta-analysis abstract for the details.

Is it really “eat what you like”?

The old post argued that steak, butter and cream are a regular part of the plan, and that former dieters would enjoy the “forbidden” foods. That freedom is part of the appeal, but it is also the part doctors worry about. Harvard Health notes that these diets often look like plates piled with bacon, meat, eggs and cheese, and that the American Heart Association recommends about 13 grams of saturated fat a day (6 percent of a 2,000-calorie diet). A 20-week trial that fed people high-saturated-fat low-carb diets did not show worse heart-risk markers, but it was short, and how such diets affect heart attacks or strokes in the long run is unknown. Vegetables, nuts, fish and olive oil make a safer base than processed meat.

What are the downsides?

The first two weeks are the hardest. Cleveland Clinic says that “keto flu” symptoms (headache, fatigue, irritability, nausea, constipation or diarrhea) can appear two to seven days after you reach ketosis and last between two days and a month, usually somewhere in between. The old post said these effects are “transient” but that some people quit because of them, which is fair. Harvard Health adds that a strict ketogenic diet can raise LDL cholesterol, and that using it for a long time is linked to a higher risk of kidney stones, osteoporosis and gout. Low-fiber eating can also cause constipation, so keep non-starchy vegetables on the plate.

What about carb counting and your personal carb level?

The old post said some people can maintain weight on 90 grams of carbohydrate a day and others on 120. Atkins now says that most people’s personal carb tolerance is 40 to 120 grams of net carbs a day, and that you find yours in the later phases. Atkins has also renamed its plans, so the names of the phases may differ from the old ones. Our post on Atkins Diet basics explains the structure, and Atkins induction rules walks through the first two weeks.

Who should talk to a doctor first?

If you are pregnant or breastfeeding, have kidney disease or a history of disordered eating, or take medicine for diabetes, speak with your doctor before you start. The American Diabetes Association’s standards say that low-carb plans are not recommended for pregnant or lactating women, people with or at risk of disordered eating, or people with kidney disease, and that they should be used with caution with some diabetes medicines called SGLT2 inhibitors. Our guide to common mistakes Atkins dieters make helps you avoid the usual traps. Finally, the old post said “it works” for thousands of dieters, which is true for short-term weight loss, but the research shows that the long-term difference is small.

Atkins is a low-carbohydrate way of eating, and the foods you choose depend on which phase you are in. The old version of this post gave a muddled description of the “Atkins pyramid” and told readers to rely on the diet’s own products. This updated guide sticks to what Atkins itself publishes, and adds what independent sources say about labels and balance.

What does an Atkins plate look like?

The Atkins company describes the plan in terms of net carbohydrates, which it defines as total carbohydrate grams minus fiber grams, and in its low-carb foods also minus sugar alcohols. Protein foods such as meat, poultry, fish and eggs, together with fats such as olive oil and butter, are the base of each meal. Carbohydrates come mainly from what Atkins calls “foundation vegetables,” which are non-starchy vegetables such as leafy greens, asparagus, peppers, celery, cucumbers and cruciferous vegetables like broccoli and cauliflower. Avocados and olives count too. Root vegetables such as potatoes, sweet potatoes, parsnips, carrots and beets are not foundation vegetables. You can see the list on the Atkins healthcare professionals page on foundation vegetables.

Which foods are limited at the start?

In the first phase, Induction, Atkins allows 20 grams of net carbohydrates a day, with 12 to 15 grams coming from foundation vegetables. It asks people to avoid sugar, white flour and other refined grains, whole grains, most fruit (other than avocado, tomatoes and olives), legumes, starchy vegetables and milk. Berries and other foods are added back in later phases. The old post said that fruits are used sparingly in the early stages and whole grains only occasionally, which is in line with this. Our post on Atkins diet basics explains the four phases, and the Induction rules are covered in a separate post on the first two weeks.

Can you rely on low-carb labels?

Not blindly. The old post warned that manufacturers put “low carb” on labels to sell products, and that is a fair concern. The Ohio State University Wexner Medical Center notes that neither the FDA nor the American Diabetes Association endorses the idea of “net carbs” and that they advise people to look at total carbs on the nutrition label. Even so, it can be useful to know net carbs if you have diabetes or are trying to lose weight. A good habit is to read the Nutrition Facts label and the ingredient list, check the serving size, and subtract fiber from total carbohydrate yourself. See the OSU article on tracking net carbs.

How can you plan meals and shop?

Write a list of acceptable foods and keep it with you, so that you are not trying to remember what you can eat when you are hungry. Plan meals for the week and shop from a list. The old post suggested using Atkins cookbooks and online menu planners, many of which are written by companies selling food, so judge them as you would any diet advice. Our posts on planning meals for Atkins, low-carb swaps and eating low-carb on a budget give practical ideas.

Is it a balanced way to eat?

That depends on how you do it. Plenty of non-starchy vegetables, fish, eggs and nuts can be part of a healthy diet, but a plan built on processed meat, butter and packaged low-carb bars may not be. Talk to your doctor or a dietitian before starting, especially if you have diabetes, kidney disease or take medicine for blood pressure or cholesterol. The Atkins site itself says that the weight loss phases should not be used by people on dialysis and that you should consult a doctor before beginning.

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