US experts have advised that low-carbohydrate diets, such as the Atkins diet, should not be recommended for weight loss as they fall short of being indisputably safe.1 Steffen and Nettleton said that low-carbohydrate diets are associated with ketosis, constipation or diarrhoea, halitosis, headache and general fatigue; further, the Atkins diet is not nutritionally balanced. They were commenting on a case report of life-threatening ketoacidosis in an obese woman.2 In this patient, an underlying ketosis — due to strictly following the low-carbohydrate, high-protein Atkins diet for a month — was thought to have been exacerbated by a mild illness which compromised her oral intake.
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