Why the state of Dr Robert Atkins’ arteries and his weight when he died are irrelevant

I had an email from a doctor this week who tells me he and his wife are embarking on the dietary recommendations to in my last book Waist Disposal. He admits, though, that it’s hard for him to put his hang-ups about saturated fat to one side.

He asks in his email if Dr Robert Atkins (low-carb diet guru) had had his coronary arteries dissected. He also asks if I follow my own ‘diet’. I have not had time to respond personally to the doctor, but thought his line of questioning would be the good basis for a blog post.

When Dr Atkins died a few years back, there was a widely disseminated claim that he was obese when he died. However, some claim that he died as a result of a head injury sustained falling on ice, and that his considerable weight at the time of death was due in no small part to treatment he received while in the intensive therapy unit. A combination of steroids and fluids could, for example, have caused his weight to balloon due to fluid retention.

Because of the world I live in, I hear these claims and counter-claims on a not-too-irregular basis. And when I hear them, I always think ‘who cares?’

Let’s imagine that Dr Atkins was indeed obese prior to his fall. What does it tell us? Practically nothing. First of all, we really have no idea whether Atkins was following his own dietary advice or not. Perhaps he had a weakness for crappy carbohydrates and was obese as a result. In which case we could perhaps claim he was weak and lacking in self control, but that does not mean he was wrong about carbohydrate being the major dietary cause of obesity.

But even if he was following his own advice and was obese, this still tells us little to nothing. No approach (I’m aware of) works for everyone. Maybe, for instance, Dr Atkins had an undiagnosed problem with low thyroid function that meant he did not respond to his own diet like most.

There’s practically nothing we can learn from an single anecdote, and that’s why I have no interest at all in what weight Dr Robert Atkins was when he died.

The doctor who emailed me this week had a specific query regarding saturated fat and heart disease, and if you remember, asked if Dr Atkins had has his coronary arteries cut open. Again, though, why should we even be interested in the state of his coronary arteries? What truly useful information would be gleaned from such an exercise? Such an approach is about as unscientific as one could get.

Does science serve us better? I believe so. And what we have here is good evidence that supports the following facts:

1. Saturated fat intake is not linked with risk of heart disease.

2. When individuals modify their fat intake (usually with an emphasis on less saturated fat), it does not reduce their risk of heart disease.

3. Low-carbohydrate diets lead to beneficial changes in a range of heart disease markers including blood pressure, triglyceride levels, HDL-cholesterol levels, and LDL-cholesterol particle size.

As to my own diet, again, this has no relevance to the role of diet in health, but at the same time I have no issue declaring that, yes, I do generally follow the dietary advice I dispense. I am not obsessive about it though. If nothing else, life can get in the way.

Today is a prime example. I was out with my girlfriend and my parents. At one point, my mother appeared and thrust ice creams in to mine and my girlfriend’s hands. My mother had not even asked if we wanted ice creams, she just went and bought them for us as well as one for my father. I don’t normally eat ice cream, but I did on this occasion. It’s the sort of indulgence that I most certainly don’t get hung up about.

17 Responses to Why the state of Dr Robert Atkins’ arteries and his weight when he died are irrelevant

  1. kem 15 September 2011 at 9:54 am #

    It would be worse than rude to deprive yourself of a well crafted lasagna or chocolate mud cake on occasions when one is invited out. Worse, yes… missing out on great food that probably has more going for it than against it. I am pleased to silently invoke Sisson’s 80/20 rule at these moments.

    BTW, England could play a little more entertaining rugby, IMHO. Go the All Blacks.

  2. Cordier 15 September 2011 at 2:53 pm #

    I have known a cardiologist who recommended to his patients(and he was right)not to smoke…But himself was addicted to smoking(cigars)!…He died at 56 year-old:lung disease!Most of his patients are still alive.

  3. T.P. 16 September 2011 at 3:26 pm #

    Hi Dr. Briffa – thanks for your post/reply to my email!

    You’re entirely right of course regarding a one off case not giving any real weight to the evidence behind something, hence all the “personal stories” online mean nothing – there will be such testimonies from every conceivable point of view.

    I suppose my slightly panicked email was more of a moral question! Whilst Dr. Atkins’ suitability for his diet or you for yours makes no significant dent in the evidence, I still derive some comfort (ridiculous as this may be) from the fact that you put your money, or rather, your health where your mouth is. Your writings have been largely responsible for the diet change of me and my wife, and as such even small reassurances as to your general integrity regarding your advice seem valuable! As I’m sure you’re aware, your advice as the capacity to affect people’s health significantly – positively or negatively – no light burden, and one I like to know you are taking seriously!

    In the end, I did a medline search using terms “Atkins”, “diet” and “cholesterol”. (I know your recommendations are not the same as Atkins but share some common principles). Pretty much every RCT or systematic review showed evidence of favourable changes in the parameters you mention. Pretty astounding stuff.

    (Incidently the ones that were less favourable were either done on rabbits, single case reports or “computer predicted models” – poor level evidence indeed).

  4. JT1 16 September 2011 at 6:06 pm #

    @TP. If you go to the official Atkins forum and ask your questions there too, I feel sure many members would be only to happy to share their relevant numbers and results with you. You can also find out more about Dr A’s death under the “myths” heading. (www.atkins.com)

    @Kem – if you were an alcoholic, diabetic or an ex-smoker, would it be considered rude to refuse? Just because ingesting simple carbs may not be immediately obvious to those lucky enough not to suffer from any of these ailments, it does not make it ok to indulge – even on an 80/20 basis. If you wish to eat these things, fine, but don’t hide under the 20% rule – that’s just making excuses for eating bad food and imo, it’s excuses like this that got us into the unhealthy and fat state we are today.

    PS – if you want interesting rugby, try watching League as opposed to Union :)

  5. Rob 16 September 2011 at 8:48 pm #

    Given all the contradictory certainties espoused in favour of this or that nutritional approach to optimal health I have now decided to decline to incline to any of them. I spread butter like a bricklayer, eat three eggs at one sitting, slice my way through half a loaf of wholemeal bread a day, drink rich, creamy unhomogenised whole milk and unpasteurised cheese most days and delight in spoonfuls of Tikka Marsala as a topping for tomatoes fried in butter or goose fat. Three or four times each week I eat free range belly pork. Oh I forgot to add that the above applies to August and September 2011. July 2011 was rather different. Then it was sardines every day, absolutely no wheat, no dairy and skip loads of steamed vegetables. June was different again whilst May was similar to August/September. Blood tests done only last week showed total cholesterol levels of 4.1 with triglycerides at just 37. What does one gather from this?

  6. Neil Fiertel 16 September 2011 at 9:35 pm #

    I have maintained a weight 30 kg lower than I had for a decade and have done so for nearly two years. I adhere to the diet that I used to drop the weight in the first place and that was that suggested by you, Dr. Briffa, so whom I can only say, Thank youi for the blog that set me off on doing research on blood glucose levels determined right after consuming various foods and it became obvious that certain types of foods did not cause Diabetes II responses and others most certainly did. In so changing my diet and consuming more protein and many fewer carbs, more fruits and vegetables ( especially fruit) and dumping so called healty juices other than a low salt vegetable cocktail loaded with potassium, I also eat dairy and meats and am nut lunatic about low fat diets which is a bizarre unproven fantasy and does not it seems have any benefits other than to diet food corporations. I have become if not svelte at least in the right weight range and more importantly, blood cholesterol, blood glucose and so forth are right on which is a huge change from before losing the weight and changing my diet. It impressed my doctor, believe me.

  7. Nina 16 September 2011 at 9:57 pm #

    TP Why focus just on Dr Atkins? Have a look at some of the other advocates of low carb/high fat diets for health.

    Dr Richard Bernstein was an early pioneer in using them in the treatmet of diabetes:
    http://www.youtube.com/watch?v=9VaNJO7KMgg

    Drs Michael & Mary Dan Eades also practise what they preach:
    http://www.youtube.com/watch?v=mNYlIcXynwE

    Dr William Davis (eliminate wheat … he’s just changing his mind on fats) :
    http://www.youtube.com/watch?v=1zIciBJNWFw

  8. kate 16 September 2011 at 10:15 pm #

    Has anyone read the report that Nathan Pritikin insisted that, should he die, the results of his autopsy be known? When that did happen, it was found that he as in the pink of health, judging from his arteries.

    http://www.pritikin.com/eperspective/specialissues/pritikinatkins/

    On the other hand, I don’t believe that was the case with Atkins. Does it matter? If it does, then I’d delve a little deeper into how healthy a diet guru can be.

  9. helen 17 September 2011 at 12:01 am #

    In the discussion about Dr Atkins one should remember he did a weekly tv spot right up until he had his fall on the icy footpath in new york, so I am sure if he indeed was obese it would have been obvious!

  10. Marly Harris 17 September 2011 at 1:51 am #

    Dr. Briffa, thank you for another even-handed article. I bristle at the mean and ignorant comments I read online about Dr. Atkins.

    At 78 and having lost 132 pounds (28 more to go), I behave differently regarding high-carb food/treats. Perhaps I’m viewed as a diva, but I simply refuse them. I already know how they taste;I’m divinely happy with my wild salmon, organic eggs, sardines and hot spices. Plus it’s a joy to have a waistline once again.

  11. Terry (Type 1 since 1969) 17 September 2011 at 2:00 am #

    The ‘trouble’ with a lo-carb diet compared to a high carb diet is purely time.

    It takes no time to open a loaf of bread, spread with butter and jam and consume. It takes quite a time to unfreeze meat, wash it and cook it and do the same with vegetables.

    Humans tend towards immediate gratification…

  12. Dave P 17 September 2011 at 4:21 pm #

    The big problem with the Carbs / Sat Fat debate is that is advocated by a lot of people as individuals whereas the Lo Fat debate is sanctioned by Official Bodies and Big Budgets.

    For me Dumping the Carbs has lead to almost 4stone off since 2007 and as its now a way of life my weight etc is stable within 2/3 lbs and no sign of bad breath, dizziness or other malady except my teeth dont get furry in the mornings anymore .

  13. Tony Kesteven 18 September 2011 at 2:16 am #

    I talked with Barry Groves, an English low-carb, hi-fat guru at a WAPF meeting in London last year. He and his wife, who have both followed what he preaches for more than 50 years, are slim, healthy and look a lot younger than their 70+ years.

    Anyway, we talked about Dr Atkins’ death. Mr Groves told me that a member of THINCS (I forget the name) was at a seminar in New York a month before Dr Atkins died, that the two of them had swum together in the hotel pool and that Dr Atkins was certainly not obese then.

  14. Glyn S 20 September 2011 at 1:23 am #

    Kate, did not Pritikin commit suicide, because his Leukemia returned? That is what I heard. If it is true then perhaps it was a result of his very low fat diet – cholesterol studies seem to vindicate higher cholesterol levels but there seems to be evidence of low cholesterol causing higher mortality rates via cancer and implicated in both depression and violence.

  15. Kaleein 21 September 2011 at 4:18 pm #

    @Terry Type1 … and now we know why you are Type1. I switched to low carb about a year ago and find it very easy with a countertop grill and a simple toaster oven. No thawing needed. Within 20 minutes a full, whole food, low carb and delicious meal is ready to eat. And, if you try it and leave off your bread, butter and jam for 30 days, I gaurantee you will FEEL so much healthier.

    I agree that it doesn’t matter the statistics of the health of diet gurus, but I enjoy a true LEADER and not just a research professional. It’s why I enjoy the leadership of Dr. Jack Kruse in this arena.

  16. Glyn S 21 September 2011 at 7:38 pm #

    Dr Briffa

    Have you as yet found your way to Dr Jack Kruse’ website, which Kaleein mentions, it is the most brain stimulating, absorbing and yet clear cut information that I have ever come across. If he is correct about the whole Leptin is King issue then perhaps there is real hope for those of us who are badly metabolically damaged. His latest post regarding concussion and the brain then being even more vulnerable to exitotoxins like MSG and Aspartame and the consequences was just mind blowing.

    http://jackkruse.com/jacks-blog/

  17. Chris 28 September 2011 at 6:52 pm #

    “Humans tend towards immediate gratification…”

    (Terry; @ #11)

    I feel there is an element of ‘the carrot and stick’ in the force(s) that direct this.

    Yes, convenience and instant gratification play a part in the appeal but there is also a way in which peoples’ circumstance might direct this too.

    We tend not to realise just how extensively modern economics dispossess people of time, or just how much rivalry is involved in making a living, mediated by the medium of exchange in most common circulation. Convenience may have a role as ‘carrot’ but relative dispossession of time and the essential scarcity of money work more like a like a ‘stick’. We tend to think we are exercising free choice when actually our choices repeatedly reference subtle selective pressures. Hard pressed people will scrimp on food to afford a bigger TV or a foreign holiday.

    The more highly capitalised are the enterprises involved in provision of the goods and services we need, or would desire, the stronger are the subtle forces that act as selective pressures upon our behaviour. The decline of small and medium enterprises (SMEs) represents an unhealthy decline in ‘diversity’, an unhealthy rise in command and control, and a concentration of market capitalisation amongst the ‘surviving’ big players.

    I was at an event on Saturday where I heard the phrase privatising profit and socialising risk which was worth the ticket price alone. I can’t help wondering if economics concerned with ‘yield’ and economics concerned with sales, profit, and short-termism have influenced agriculture, process, and food provisioning in a way that maximises profit (for a few select private individuals) but results in a diminution of quality or desirable attributes and thus propagates risk of obesity, ill health, or unhealthy aging, amongst large social groups.

    [Lucy, thank you for your kind and encouraging words]

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