There has been a flurry of activity lately on the Forums concerning whether to count net carbs or total carbs. Every practitioner will have their own take on things and it will vary depending on the situation. For example, Dr. Westman uses total carbs in his practice because he is following the old version of the Atkins diet and he thinks it is easier for his patient population to use cups vs. counting net carbs. However, when he wrote The New Atkins for a New You, he recommended net carbs for the general public because he thought that was a better idea to insure adequate fiber for those who are not under medical supervision.

My take on it is that since fiber is not digested, and we need to get in 25 grams of fiber daily, why should you only count total carbs? Plus, I believe vegetables are an important aspect of Atkins. Controlled carbohydrate nutritional practices are now more than ever being studied for efficacy and long-term safety, as well as in connection with a variety of health and disease modalities. The vast majority of nutrition experts agree that the real challenge in the war against obesity is not weight loss, but maintenance of a healthy weight and a healthy way of eating. One by one studies comparing low-fat and low carbohydrate regimens show a significantly greater rate of long-term compliance among the controlled-carbohydrate subjects.

Various studies are presently exploring the possible reasons for this. But at the end of the day, we may find overwhelming evidence that over the long term, many Americans find it easier to follow controlled carbohydrate regimens rather than low-fat ones and it may be due to better appetite control. Protein, fat, and adequate fiber from vegetables will produce the fullness factor.

I will say this again, every practitioner will have his or her own take on it. Here is my rational for the recommendation of 12 net carbs from veggies:

1. Avoids the issues of constipation reported by some individuals when vegetable consumption was lower than 12 net carbs.
2. Provides a feeling of fullness, or satiety, because vegetables are full of fiber, making it easier to stick with Atkins.
3. Supplies the needed alkalinity to avoid the minor trend toward acidity in the first week. (It is never outside of normal range but there is a trend in the first week.)
4. Provides and replenishes the minerals and electrolytes that are lost in the first two weeks when water loss is most prominent.

Even Dr Phinney described foods and nutrients we should eat to help lower our risks of inflammation in the body. The nutrients he found most important were:

1. Omega 3 fish fats EPA and DHA.
2. Polyphenols, found in tea, wine and cocoa.
3. Gamma-tocopherol (not to be confused with alpha-tocopherol/Vitamin E), found in olive oil and canola oil.
4. Fiber from nuts and fruits and vegetables.

With this being said, Dr. Atkins did use cups and total carbs for years in his practice for years before he started using net carbs in 2002, and it was fine because the nutritionists, nurses, and doctors at the Center managed any issues that arose from lack of fiber and/or electrolytes with nutritional supplements. So if someone is insisting on following Dr. Atkins’ original approach, then “to each his own.” Whatever works as long as it is within certain boundaries. I don’t believe counting total carb vs. net carbs is out of boundaries.

The main point is that the Atkins Nutritional Approach should not be followed as a quick way to shed a few pounds. The approach is meant for those who seek a lifestyle change that involves better eating habits, ultimately leading to better health and a sense of well-being. Make the most of your carbohydrate grams, and “spend” them wisely. Choose vegetables that provide the most antioxidant protection in combination with the fewest grams of net carbs.