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The Atkins diet books have sold more than 45 million copies to date, and the diet they describe maintains its popularity in the current growing obesity epidemic. The diet claims to promote weight loss despite ad libitum consumption of high-protein and high-fat foods, restricting only the intake of carbohydrates to 30 g a day. A number of long-term (up to 12 months), randomised studies have recently compared a low-carbohydrate diet to a low-fat, calorie-reduced diet and reported a greater weight loss after six months of the low-carbohydrate diet, though there was no difference between the two diets after 12 months. A systematic review of low-carbohydrate diets concluded that the weight loss is associated with the duration of the diet and restriction of energy intake, rather than with restriction of carbohydrate per se. The cause of the weight loss may be attributable to increased satiety associated with the high protein intake and subsequent reduced energy intake, but other mechanisms might also provide an explanation for the paradoxical weight loss with ad libitum consumption of protein and fat. Low-carbohydrate diets appear to be safe in the short term, but more long-term studies that both measure the effects on weight and body composition and assess the potential health risks and adverse effects are needed before low carbohydrate diets can be recommended.

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