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Supplementary Appendix 1
The Atkins diet is organized into four phases: induction, ongoing weight loss, premaintenance, and maintenance. Persons following this program consume a self-selected diet consisting of liberal amounts of protein and fat but controlled amounts of carbohydrate.
Induction Phase
During the induction phase, dieters are restricted to 20 g of carbohydrate a day and to certain types of carbohydrate-containing foods (e.g., certain vegetables, cheese, olives, avocados, nuts, and seeds). The induction phase typically lasts a minimum of two weeks but may last longer, depending on the personŐs weight-loss goal.Ongoing Weight-loss phase
During the second phase of the diet, dieters have greater flexibility in the type and amount of carbohydrate-containing foods they can consume. Using a carbohydrate ladder (i.e., a hierarchy of carbohydrate-containing food groups that should be added back into the diet), dieters slowly increase their carbohydrate intake by 5 g per day per week to determine the maximal number of grams of carbohydrate they can consume and still lose weight at a rate of approximately 0.9 kg (2 lb) per week (known as the critical carbohydrate level for losing weight). Participants maintain this level of carbohydrate consumption until they are within 2.2 to 4.5 kg (5 to 10 lb) of their goal weight, at which point they enter the premaintenance phase.
Premaintenance Phase
Weight loss continues during the premaintenance phase, but at a slower rate. During this phase, dieters determine their new carbohydrate level for losing weight as well as the maximal number of grams of carbohydrate they can consume to maintain their weight (also known as the critical carbohydrate level for maintenance). More specifically, dieters increase their carbohydrate intake by 10 g per day per week until they stop losing weight. Dieters then drop back to the level of carbohydrate intake that supports weight loss until they reach their goal weight.
Maintenance phase
Once their weight goal is achieved, dieters move into the maintenance phase and adhere to their critical carbohydrate level for maintenance, which is designed to maintain body weight.
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