SCENARIO 3.

Now let's a.s.sume that you left OWL with a CLL of 35.

- Week 1 : You move to 45 grams of Net Carbs, adding small portions of legumes. Although your weight remains stable, by the end of the week, you've had some ravenous episodes and feel bloated.- Week 2 : You drop back to 35 grams of Net Carbs and back off the legumes. Your weight loss resumes, and the bloating and cravings disappear.- Week 3: You're feeling good and slowly losing weight, so you decide not to push your luck and remain at 35 grams of Net Carbs for another week.- Week 4: You move up to 40 grams of Net Carbs and try reintroducing small legume portions. You continue to feel good and lose another half pound.- Week 5: You move up to 45 grams of Net Carbs and add small amounts of fruit, which produce cravings and stall weight loss.- Week 6 : Understanding that feeling good and in control is more important than trying to push things, you back down to 40 grams of Net Carbs, experimenting with new foods in small portions, until you've achieved your goal weight.

As you can see, there is a tremendous variation in how individuals respond to increases in carb intake and to different foods. Your own scenario will undoubtedly differ. Also remember that your weight can vary by a few pounds from day to day, independent of increments in carb intake and different foods. That's why it's important to continue to use the weight-averaging method described on page 77.

YOUR CARB TOLERANCE.

Like it or not, you may find that there are some foods you simply cannot handle or must eat very carefully in order to not regain weight and stimulate cravings. Likewise, if elevated blood sugar or metabolic syndrome has been an issue for you, it's likely that you'll need to be very careful about introducing higher-carb foods. (For more on metabolic syndrome, see chapter 13 chapter 13.) Knowing your limits will enable you to have a realistic approach to meal planning once you're in Lifetime Maintenance. Anxious as you may be to reach your goal weight, achieving it in a way that's close to the way that you'll be eating to sustain that new weight makes it more likely you'll succeed long term.

Once you've achieved your goal weight but before you move to Lifetime Maintenance, you'll have to find your Atkins Carbohydrate Equilibrium (ACE). In contrast to your CLL, which relates to weight loss, your ACE is the number of grams of Net Carbs you can eat each day, while neither losing nor gaining neither losing nor gaining weight. Many people wind up with an ACE of 65 to 100 grams of Net Carbs, but some people have a considerably lower ACE and a very few people an even higher one. weight. Many people wind up with an ACE of 65 to 100 grams of Net Carbs, but some people have a considerably lower ACE and a very few people an even higher one.

It's important to understand that looking merely at weight loss can oversimplify the issue of carb tolerance. Your energy level, ability to concentrate, tendency to retain fluid, and, of course, the old signals of unreasonable hunger and carb cravings must also be considered. For example, even if you're losing weight at a CLL of say, 50 grams of Net Carbs a day, you might still be reawakening food cravings or blood sugar swings or experiencing low energy, which could make maintaining that level of carb intake problematic long term. Why are we bringing this up? Because some people, for a variety of reasons, find that they do best at 25 to 50 grams of Net Carbs in either the weight loss or weight maintenance phases. Your objective is not to push your carb intake to the absolute limit but to advance to the point where you're comfortable and don't stimulate the return of any of the old symptoms that originally got you into trouble. Bottom line: finding your ACE is not just a matter of getting to the right weight; if you're pus.h.i.+ng your ACE too high, it is probably not sustainable.

What's unique about the low-carb way of eating compared to other diets is that adhering first to your CLL and later your ACE results in profound changes in your metabolism, enabling you to better control your intake of calories. The flip side is that if you exceed your ACE, you're forcing your body to burn more glucose while inhibiting fat breakdown and utilization. This makes it harder to control appet.i.te and feel satiated, with the result that you'll almost certainly regain lost pounds. You'll lose the Atkins Edge and the metabolic bully will rear its ugly head again, blocking fat burning.

CUSTOMIZING PRE-MAINTENANCE.

We generally recommend that you introduce carbohydrate foods in the sequence shown by the carb ladder in both OWL and Pre-Maintenance. But if you're continuing to lose weight at a reasonably regular pace and the foods you've reintroduced recently haven't sparked uncontrollable hunger or other symptoms, you may be able to change the order. If you'd rather have a small serving of brown rice with your chicken curry than sink your teeth into a crisp apple, that's your choice. But be alert to the dangers. The desire for a certain food, particularly one higher in carbs, may be a sign that you'll have trouble handling it in moderation. As always, count carbs to make sure you're not exceeding your revised CLL and watch for those familiar warning signals.

GETTING (THE FAT) UP THERE.

From everything we've told you so far, you'd think that it's the carbs in your diet that stop weight loss at your goal. That's partially true, because carbs do exert a strong control over your metabolism-the bully thing. But when you move from losing weight to maintaining weight, you need to increase your consumption of healthy, natural fats slightly to meet your maintenance energy needs. No, you don't need to measure or count your intake of fatty foods. With your appet.i.te as your guide, you just need to let it happen. We'll tell you how in the next chapter. All you need to know for now is that as you approach your goal weight, you may become aware of something that hunting peoples have known about for centuries: "fat hunger." It's a different and subtler feeling than having the bottom drop out on you after a sugar rush. But if you find yourself staring into the fridge and eyeing the b.u.t.ter, cheese, or salad dressing, you've probably been skimping on fat. Learning to recognize and respond appropriately to fat hunger is an important skill for success in Lifetime Maintenance.

THE RIGHT WEIGHT FOR YOU.

When you began your journey on Atkins, we advised you to establish your goals, including a target weight. Undoubtedly, you've kept this number and the image of yourself at that size in your mind's eye. You may be zeroing in on that figure (pun definitely intended) at this very moment. But setting a goal weight is more of an art than science. Following the Atkins Diet seems to allow people to find their natural healthy weight, which might be higher or lower than the one you'd originally envisioned.

It's not uncommon at this point for people to find themselves shy of their initial goal. So what do you do if you work your way through Pre-Maintenance and reach a point where you're able to stabilize your weight but it's slightly higher than the number you were targeting? If it's merely a matter of a few pounds and you're pleased with how you look and feel, this is the right weight for you. After all, wouldn't you rather be at a weight that you can maintain relatively easily instead of waging an ongoing struggle to be three or four pounds thinner?

But what if it's more than a few pounds? If you haven't already jumped onto the activity wagon, one option is to finally climb aboard. Do keep in mind that not everyone is genetically programmed to lose a lot of weight by exercising. Nonetheless, even if you don't shed a few more pounds, you may be able to shape your body with weight-bearing exercise. The other option is to be patient, hone your maintenance skills, and give your mind and body a break for six months or so. If you find that you're unduly stressing yourself by trying to lose 50 pounds in one fell swoop, sometimes it's better to lose say, 30 pounds, and then move to Lifetime Maintenance to stabilize your weight by practicing your new habits. After at least six months-your body is likely to resist further weight loss before that rest period-you can return to OWL to lose some or much of the remaining excess pounds, before returning to Pre-Maintenance to shed the last 10.

What about the opposite scenario? You've lost the 25 pounds you set as your goal but now realize that you could probably pare off another 5. Just stay at the same level of carb intake you're presently at, and the rest of the pounds should drop off slowly.

PRE-MAINTENANCE FOR SPECIAL GROUPS.

Whole grains usually loom large for vegetarians and vegans, and starchy vegetables are often important components of their meals. However, they're among the very foods that may have gotten you in trouble in the past. Follow the general guidelines for reintroduction and think of these foods, as well as legumes, as side dishes, rather than the mainstays of a meal. You may find that over time you can tolerate larger portions as long as you steer clear of refined grains and most processed foods. Both vegetarians and vegans should add back starchy vegetables followed by whole grains before higher-carb fruits (other than the berries and melon acceptable in OWL).

Likewise, legumes, starchy vegetables, grains, and tropical fruits are key components of all Hispanic cuisines. Again, it is this very combination of foods (often in the context of the American junk-food culture) that's likely led to weight gain and other metabolic danger signals. If you're able to reintroduce all these foods, we recommend the following ways to minimize weight regain and elevated blood sugar and insulin levels.

- Continue to season protein dishes with traditional seasonings, but avoid carb-laden sauces.- Continue to focus on foundation vegetables such as garlic, sweet and chili peppers, chayote, jicama, nopales, tomatillos, pumpkin, cauliflower, and white turnips-along with that delicious source of fat: avocado.- Reintroduce such starchy vegetables and tubers as calabaza, yuca (ca.s.sava root or manioc), potatoes, taro, arracache, yams (name), and yautia, in small amounts and one by one. Have them rarely, and be on the alert for signals that you cannot tolerate the carb load. Gram for gram, they're among the highest-carbohydrate foods.- Use brown rice instead of white rice, and keep serving sizes small. Do the same with corn (maize).- Use legumes that are relatively low in carbs, such as black soybeans, pinto beans, and red kidney beans.- Treat all fruits, but particularly bananas, plantains, cherimoya, and mangos, as garnishes, rather than major components of a meal.- Continue to eat low-carb or corn (maize) tortillas in moderation. (A conventional 6-inch corn tortilla contains about 11 grams of Net Carbs compared to 3 or 4 grams for a low-carb one; a low-carb 6-inch "flour" tortilla is comparable in carb count, in contrast to the roughly 15 grams of Net Carbs in a conventional flour tortilla.) Your long-term objective is to honor your culinary heritage without falling back into the same eating patterns that got you into trouble in the first place. This juggling act will inevitably involve some compromises.

WOULDN'T YOU RATHER?

Paradoxically, the closer you get to your weight goal, sometimes the harder it is to stick to your resolve. This slowdown can leave you vulnerable to instant gratification. "I'm not losing much anyway, so why not have that chocolate cupcake?" you say to yourself. For a moment, that momentary pleasure seems more important than how you'll look in that new bathing suit or expensive suit. a.s.suming that you're continuing to eat enough fat, protein, and fiber to remain satiated, often the ability to stay the course is a matter of having a list of reasons to remind yourself why it's worth resisting temptation. These may reside in your head, on an index card, in your diet journal, or even on your PDA. Here are some ideas that should stimulate you to come up with your own list. Say to yourself, I love to: - Be able to see my feet when I look down.- Slide easily into my pants instead of waging a tug-of-war.- Get admiring looks.- Have a social life.- Feel pleasantly full but not stuffed after a meal.- Feel at ease in the buff.- Feel s.e.xually desirable.- Wear clothes that show off, rather than hide, my body.- No longer have to avoid mirrors.- Feel full of energy.- Partic.i.p.ate in activities with my family.- Know my size no longer embarra.s.ses my spouse or children.- Feel healthy and comfortable with myself.- Know that I'm in control of my destiny.

READY TO MOVE ON TO LIFETIME MAINTENANCE?.

Of all the phases, the whether-to-move-on question is easiest in Pre-Maintenance. It's a simple black-and-white issue.

Have you reached your goal weight and maintained it for a month?

If so, it's time to move on to the rest of your life in Lifetime Maintenance.

Have you not yet reached your goal weight? Have you not maintained it for a month? Have some newly reintroduced foods triggered cravings that are making it hard for you to stay in control and provoked other symptoms?

If the answer to any of the above questions is yes, you're clearly not ready to move on. (The exception is the decision to take a vacation from weight loss and go to Lifetime Maintenance, resuming weight loss after at least six months, described above.) Review this chapter, and proceed slowly. Yo-yo dieting can make you resistant to weight loss. You may need to reduce your ACE to lose and then maintain your goal weight.

Have you reached your goal weight and your ACE is somewhere between 25 and 50? Did you have type 2 diabetes or did you have any signs of metabolic syndrome before you began Atkins?

If many of the foods considered acceptable for Pre-Maintenance give you trouble and/or your ACE is close to the number of grams of Net Carbs (50 or less) that you were consuming in OWL, you should consider the lower-carb version of the Lifetime Maintenance program described in the next chapter. This is particularly the case if you still have metabolic syndrome (see chapter 13 chapter 13) or type 2 diabetes (see chapter 14 chapter 14).

In the next chapter, we'll look at how Lifetime Maintenance-which you can customize to your individual circ.u.mstances-will enable you to make your new weight permanent as you continue to retain your health and vitality. But first, read how Jennifer Kingsley finally adopted Atkins as her lifestyle after using it twice as a quickie diet.

SUCCESS STORY 9.

THE THIRD TIME'S A CHARM After two experiences with Atkins and the loss of more than 100 pounds, Jennifer Kingsley gained much of it back during pregnancy. Once she "got it" that Atkins is more than a weight loss diet, she was able to finally say good-bye to foods that made her heavy, depressed, and subject to ailments.

VITAL STATISTICS.

Current phase: Lifetime Maintenance Daily Net Carb intake: 120 grams Age: 39 Height: 5 feet, 4 inches Before weight: 230 pounds Current weight: 117 pounds Weight lost: 113 pounds Has your weight always been an issue?

Growing up, I was definitely heavier than most of the other girls. In high school I was dealing with backaches, knee pain from an injury, nearly debilitating PMS symptoms, depression, etc. At 19, I was told I had high cholesterol. I began to slowly gain weight after my first son was born. Eventually, I just stopped weighing myself. I estimate that I was at least 230 pounds.

What motivated you to try Atkins?

Shopping for clothes was the most painful experience. I finally broke down crying in the middle of a department store after weeks of looking for a dress to wear to a special event. After that, I constantly made excuses not to accept invitations. Then in December of 2002, I learned that my boyfriend was to be best man in a wedding in February. I knew just the dress in my closet that I wanted to wear. Problem was, it was several sizes too small. So I started Atkins-and six weeks later I wore that dress to the wedding.

Why didn't you stay with Atkins?

At the reception, I ate whatever I wanted. That night I felt really sick, and I realized that over the last few months on Atkins, I hadn't felt the old aches, pains, and bloated stomach. And I wasn't depressed. But it was really hard to start Atkins again. I didn't have the wedding to keep me motivated, and I could still fit into my old clothes. At first, that is. When they kept getting tighter and tighter, I realized I didn't want to be back where I was before-crying in the middle of a department store.

What got you back on track?

A coworker was preparing for her wedding and I wanted to get back to a size 12 again, so we started Atkins together in July of 2003. By June of the following year, I reached what I thought thought was my goal. Then I wondered, "Maybe I could get into a size 10 again." When I reached a size 8, I went out and bought a new wardrobe. But it turned out that I was on a plateau. Suddenly I was wearing a size 6 and then a 4, and finally a 2. I weighed 120 pounds and happily stayed there until July of 2006. was my goal. Then I wondered, "Maybe I could get into a size 10 again." When I reached a size 8, I went out and bought a new wardrobe. But it turned out that I was on a plateau. Suddenly I was wearing a size 6 and then a 4, and finally a 2. I weighed 120 pounds and happily stayed there until July of 2006.

What happened then?

I realized I was pregnant. My weight gain was mostly normal at first. But I wasn't sure how to maintain my low-carb way of eating while pregnant-or even if I could. My doctor told me to get plenty of whole grains. So I did. Almost immediately, I wanted every simple carbohydrate I could get my hands on. My exhaustion returned, along with aches and pain. At one point, my doctor even tested me for gestational diabetes because of my excessive weight gain. After my son was born, I breast-fed him. People told me nursing helps shed pounds, but I was gaining a pound or two each week until I was back up to 170 pounds. I gained a bit more before I found the Atkins Web site and backed into Lifetime Maintenance, which got me down to 151 pounds. Once my son weaned himself in March of 2008, I decided to return to Induction.

What was different this time?

I spent several months reacquainting myself with the diet on the Atkins Web site and message board. I began to understand there was a lot more to Atkins than dieting. I realized that the only time I truly felt good in my life was while I was on Atkins. There was obviously a nutritional reason for many of those health problems. This time I focused on my nutritional needs-not just my weight loss. By September of that year, I had lost the "baby" weight and was back into my prepregnancy clothes.

What did you learn about yourself in the process?

On Atkins, my depression is gone. My chronic fatigue, yearly urinary tract infections, back and knee pain, and bloating are all gone too. And cholesterol? One doctor called my blood work "stellar." I also realized that I get ill when I eat gluten. I have two cousins with celiac disease, and once I researched it, I realized that whether or not I actually have celiac disease myself, gluten is a major problem for me. Now I avoid wheat altogether, but I can eat some other whole grains like oats and teff.

What's your fitness routine?

I do yoga regularly, but haven't been able to go to the gym as much as I would like. Having a three-year-old around is actually quite a bit of exercise!

What advice can you offer other people?

Visit the Atkins Community message board. The support I've received has been incredible, and I hope to return the favor by supporting others. I know that this is still a journey for me. I continue to learn and grow. There is no finish line.

Chapter 10.

KEEPING IT OFF: LIFETIME MAINTENANCE.

Long-term success with weight maintenance has both practical and psychological components. Fortunately, you've already learned and practiced many of the skills necessary for this momentous task.

You've done it! You've reached the goal for which you've striven long and hard and proved that you have the persistence to realize your dreams. You're now officially out of the weight loss phases of Atkins and into Phase 4, Lifetime Maintenance, aka the rest of your life. The very fact that you've found your ACE and reached your goal weight is proof that what you've been doing works for you. Keep it up-with certain modifications-and you should be able to extend that success. If you started Atkins to resolve such health issues as high blood sugar or insulin levels, hypertension, or unfavorable lipid levels, in addition to maintaining your new weight, you'll obviously want to maintain your improvements in these markers as well.

Regardless of your health when you began Atkins, now is the time to revisit your health care provider. (If your weight loss journey has lasted more than six months, you may have already done so.) You'll almost surely receive good news. Obviously you don't need your physician to tell you that you've lost 30 pounds (or whatever), but you'll likely discover that you've also scored some significant improvements in your health indicators. That news should relieve any lingering concerns you may have about the healthfulness of following a low-carb lifestyle.

As you well know, making these changes permanent is at least as challenging as achieving them. Success with weight maintenance has both practical and psychological components, and we'll help you deal with both. Fortunately, whether or not you realize it, you've already learned and practiced many of the skills necessary for this momentous task. Think about it: - You've developed a whole set of new habits.- You've experienced the empowerment that comes with controlling what you put into your mouth.- You know how many carbs you can consume without regaining weight.- You can distinguish between empty carbs and nutrient-dense carbs.- You understand why eating sufficient fat is key to appet.i.te control and the Atkins Edge.- You've learned how to distinguish between hunger and habit and between feeling satisfied and feeling stuffed.- You recognize the signs that a certain food or pattern of eating triggers cravings.- You've experienced the exhilaration of feeling good and full of energy.

Before you started your weight loss journey, we asked you why you would consider not not doing Atkins when its benefits are so obvious. Now we ask you a similar question. Knowing what you now know and succeeding as you have, why would you ever go back to your old way of eating-letting sugars and other processed carbs bully your metabolism-which is almost sure to result in weight regain and the reemergence of health problems and self-esteem issues? doing Atkins when its benefits are so obvious. Now we ask you a similar question. Knowing what you now know and succeeding as you have, why would you ever go back to your old way of eating-letting sugars and other processed carbs bully your metabolism-which is almost sure to result in weight regain and the reemergence of health problems and self-esteem issues?

PROTECT YOUR WEIGHT LOSS, BUT MAINTAIN YOUR WEIGHT.

Early in this book, we talked about the two definitions of the word "diet." Now that you've lost that extra padding, it's time to focus on the word's primary definition: a way of living. Because your weight loss diet has smoothly morphed into your permanent lifestyle, there shouldn't be any big surprises. The lessons that you've learned about which foods to eat in which amounts remain valid now that your goal is to hold steady.

You want to arrive at a place where you're mindful of your weight but not obsessed with it. Weigh and measure yourself once a week. As you know, the scale may "lie," thanks to natural day-to-day weight fluctuations within a four-pound range, but the measuring tape tends to be less variable. (For a review of weight averaging, see page 77.) If your measurements consistently increase and your clothes feel and look tight, it's time to act. As long as you've gained no more than 5 pounds, simply drop down 10 to 20 grams of Net Carbs below your ACE and the extra pounds should retreat. But it's not just a matter of weight. It's equally important to stay alert for cravings, unreasonable hunger, lack of energy, and other familiar indicators that you may be veering away from your fat-burning safety zone and losing the Atkins Edge. All these may signal that you're consuming too many carbs or that you're sensitive to the effects of one or more recently added foods. As you adjust your intake accordingly, with every pa.s.sing week you'll get a better idea of your limits.

Now that you're no longer trying to trim pounds and inches, you clearly need more energy from food sources since you're no longer relying on your body fat for some of your fuel. Most people find that their appet.i.te increases slightly as they approach their body's healthy natural weight, even as they stay within their ACE. It's important to understand that the extra fuel to keep your weight stable should come primarily from dietary fat so that you remain in a fat-burning mode. If you find that your weight is dropping below the desired level or experience fat hunger, you'll need to allow a little more fat into your diet.

FAT REMAINS YOUR FRIEND.

When you were losing, say, an average of 1 pound a week, each day you were burning about 500 Calories of your body fat for energy. As you transition into Lifetime Maintenance, your body doesn't really care where your favorite fuel comes from hour by hour: inside-your stores of body fat-or outside-dietary fat. Say that you're consuming 75 grams of Net Carbs per day (300 Calories) and 15 ounces of protein (roughly 400 Calories); together they add up to just 700 Calories. If you're a five-foot, four-inch-tall woman and your body is burning 1,800 Calories a day, the other 1,100 Calories have to come from fat. Why not simply increase your protein intake instead? Because, as you learned in chapter 5 chapter 5, the amount of protein you've been eating all along is close to optimal, and more isn't better. As for adding more carbs, once you've found your Atkins Carbohydrate Equilibrium (ACE), it's likely to remain your upper limit for the foreseeable future.

If you ignore this advice and continue to add carbs beyond your ACE, you'll soon be revisited by the same old demons of hunger and carb cravings. Overconsuming carbs only invites that metabolic bully back into your life. Your metabolism is already adapted to efficiently moving fat into your cells and using it for energy rather than storing it for later use, providing a sustained and predictable fuel supply. Perhaps you've noticed that once you've adapted to a low-carb diet and complying with your ACE, you can be an hour or two late for a meal and not feel desperate. How so? The answer is that even when you're at your goal weight, you still have a couple of months' worth of energy reserve tucked away as body fat. This means that your muscles, your liver, and your heart are getting a continuous, uninterrupted flow of energy directly from fat. Even your brain, which requires more than 500 Calories per day, gets much of its energy from fat. If you've banished 30 pounds of body fat since you started Induction, your body has burned off an awesome 100,000 Calories more than you ate. And there's no reason your metabolism can't continue that same burn rate for fat-keeping the Atkins Edge-as you maintain your new weight.

How can you add fat calories in a palatable way? Follow the meal plans for Pre-Maintenance, adding small portions of salad dressings, sauces, and spreads. Many cultures have used sauces, gravies, and meat drippings this way for millennia. For more ideas, see the sidebar "Delectable Choices" and check out the recipes for sauces in part III part III.) There's no need to count fat grams or calories. Just let your taste and appet.i.te dictate, without letting fat phobia get in your way. It may take a while to learn to trust your instincts. Fat has an inherent ability to satisfy your appet.i.te and to keep you feeling satisfied longer than the same amount of carbohydrate. You'll probably get a chuckle out of the fact that you, who once had a weight problem, now have to be careful not to go too far in the opposite direction.

DELECTABLE CHOICES.

Add some of the following healthy fats to those you've been eating throughout your weight loss journey to maintain your goal weight without fat hunger or carb cravings. Each portion provides 100 or so Calories of healthy fat. The difference in energy intake between OWL and Lifetime Maintenance for most people is somewhere between 300 and 500 Calories, so making this dietary transition is as simple as adding three to five of these portions to your existing daily intake. See the recipes in part III part III for more delicious choices. for more delicious choices.

- 1 tablespoon oil for dressing salads- 1 tablespoon b.u.t.ter or herb b.u.t.ter/oil mix- 1 ounce cream- 2 ounces cheese- 10 large ripe olives with a teaspoon of olive oil- Haas avocado- 1 ounce almonds, walnuts, pecans, or macadamias- 1 tablespoon mayonnaise (made with canola, high-oleic safflower, or olive oil)- 2 tablespoons pesto- 2 tablespoons nut b.u.t.ter Here's one more issue not not to worry about. You may be concerned that you can't digest all this fat. With the possible exception of someone who has had gallbladder surgery, this is not likely to be a problem. Why? Have you ever eaten a pint of ice cream at one time? Honestly now, the last thing on your mind back then was worrying that your digestive system couldn't handle 75 grams of fat in less than an hour, right? Given that experience, why would you worry about whether it can handle 50 to 60 grams of fat as part of a whole foods meal? to worry about. You may be concerned that you can't digest all this fat. With the possible exception of someone who has had gallbladder surgery, this is not likely to be a problem. Why? Have you ever eaten a pint of ice cream at one time? Honestly now, the last thing on your mind back then was worrying that your digestive system couldn't handle 75 grams of fat in less than an hour, right? Given that experience, why would you worry about whether it can handle 50 to 60 grams of fat as part of a whole foods meal?

CUSTOMIZING LIFETIME MAINTENANCE.

Throughout this book, you've learned how the versatility of Atkins allows you to tailor the diet to your particular needs and preferences. You've already made many choices as you worked toward your goal weight. Likewise, there's no one-size-fits-all maintenance program. The single most important decision that you'll confront is this: What do I need to do to keep off the weight I've lost and maintain my health long term? From experience we've learned that you must do something different than you did in the past because maintenance doesn't just happen.

You already know about the tremendous variation among individual ACEs, which enables some people to consume considerably more carbs each day than others without regaining weight or seeing the return of cravings, low energy, and other symptoms. Others find that they just feel better with a lower intake of carbs. Just as we've advised you to increase your overall carb intake-and the variety of carb foods-slowly in the weight loss phases, we want you to think carefully about your carb intake in Lifetime Maintenance. Rather than push yourself to a level that makes maintenance hard to sustain, you may be happier and more successful at a lower level. In fact, you may even find you'll prefer to back down 5 or 10 grams from the ACE you achieved in Pre-Maintenance. Remember, the goal here is to banish the weight you've lost for good, not win some contest for having the highest ACE on the block!

HEALTH AND YOUR ACE.

If you have a condition such as hypertension, diabetes, a high triglyceride level, or low HDL cholesterol level, all of which indicate a risk of developing cardiovascular disease, you may find that they're better controlled if you remain at a lower level of carb intake than the ACE determined by your ability to maintain your weight. Rest a.s.sured, there's no risk in staying between 25 and 50 grams of Net Carbs. This is particularly worth considering if you previously needed medication to control any of these conditions. Ask yourself two interlocking questions: - Do I feel safer and better on the medication(s) ?- Or do I feel safer and better on a diet that gives me equal or better control of this condition with less medication or none at all?

For some people, staying at or less than 50 grams per day of Net Carbs gives them a better long-term response to these conditions. If ongoing health issues require medication or you've experienced weight regain despite your best efforts, you may also want to reduce your ACE. In effect, your choice of foods can work like your medicine. (Depending upon how severe the condition, you may still be able to cut back on or eliminate your medication at a somewhat lower level of carb intake.) Your best approach to Lifetime Maintenance is to understand all of your options and keep them open as you move forward. If you have to work hard to maintain your weight at a higher ACE, you may later decide that it's too stressful to do so. Or you may find that some of your health indicators have worsened. At that point, you might choose to reduce your carb intake to improve your life. Alternatively, if you've been able to maintain your weight for some time and/or your blood pressure, blood sugar, blood lipids, or other metabolic indicators remain in the low-risk range, you may consider gradually increasing your carb intake. Your ACE is never carved in stone, and you can raise or lower it as experience dictates.

TWO SUSTAINABLE PATHS.

If you've done well with Atkins so far, you'll very likely continue to do so by following one of two Lifetime Maintenance options: one at 50 grams of Net Carbs or less and the other above 50 grams. In either case, with the exception of omega-3s (such as fish oil or flaxseed oil), it's best to continue to stay away from high-polyunsaturated-fat vegetable oils such as corn, soybean, sunflower, cottonseed, and peanut oils. Instead, focus on olive, canola, and high-oleic safflower oils. Also feel free to continue to eat saturated fats. Each option meets all of your energy and essential nutrient needs and can be tailored to your individual metabolism. It's likely that you already have a pretty good idea which path is the one for you, based upon your metabolism, your ACE, and your experiences in OWL and Pre-Maintenance.

LIFETIME MAINTENANCE WITH AN ACE OF 50 OR LESS.

The simplest description of this approach is Ongoing Weight Loss with a bit more variety and some additional fat. Here's how to do it.

- Remain at the ACE you identified in Pre-Maintenance.- Continue to eat the same healthy whole foods you've come to rely on: -About 4 to 6 ounces of protein foods at each meal -Enough healthy fats to keep you satisfied -The right balance of fats -At least 12 to 15 grams of Net Carbs from foundation vegetables - Continue to consume 2 servings of broth (not low sodium), 2 tablespoons of soy sauce, or half a teaspoon of salt each day unless you're taking a diuretic medication or your doctor has advised you to restrict salt.- In addition to Acceptable Induction and OWL foods, continue to eat any Acceptable Pre-Maintenance foods you've been able to reintroduce. If you find it hard to eat moderate portions of any food, new or otherwise, or it causes cravings, stay away from it.- If you still have indicators of metabolic syndrome or type 2 diabetes despite your weight loss, don't keep increasing your carb intake. Instead, if you're not satiated, try increasing your fat intake as described above. (For more on how Atkins addresses these health conditions, see part IV part IV.)- Follow the meal plans for OWL at the appropriate number of grams of Net Carbs, but add more healthy natural fats as your appet.i.te dictates.- Continue your multivitamin/multimineral and omega-3 supplements.

LIFETIME MAINTENANCE WITH AN ACE ABOVE 50.

This path can be best described as your last month of Pre-Maintenance, again with a bit more fat. The main difference from the lower-carb path described above is that you can select from a broader range of carbohydratecontaining foods. With greater variety, however, comes a greater risk of temptation, so you may need to exercise extra vigilance to conform to your ACE. Here's how to do it.

- Remain at the ACE you identified in Pre-Maintenance.- Continue to eat the same healthy whole foods you've come to rely on: -About 4 to 6 ounces of protein foods at each meal -Enough healthy fats to keep you satisfied -The right balance of fats -At least 12 to 15 grams of Net Carbs from foundation vegetables - Continue to add new foods as your ACE allows as long as they don't stimulate excessive hunger and cravings. If they do, back off and try to reintroduce them at a later date. Stay away from any foods that provoke old bad habits.- If you drop below your desired goal weight, increase your fat intake as described above.- Broth or other ways to introduce salt are no longer necessary, but you may continue to consume them, if you prefer.- Follow the Pre-Maintenance meal plans at your ACE but add more healthy natural fats as your appet.i.te dictates.- Continue your multivitamin/multimineral and omega-3 supplements.

Perhaps the best way to think of the two paths in Lifetime Maintenance is like a pair of fraternal twins. They share many similarities but have some significant differences, as summarized below.

DAILY INTAKE IN TWO LIFETIME MAINTENANCE PATHS.

ACE.

Above 50 Grams of Net Garbs Below 50 Grams of Net Garbs Foundation vegetables Minimum 1215 grams Minimum 1215 grams Total daily protein Women: 1218 ounces Women: 1218 ounces (meals plus snacks) Men: 1622 ounces Men: 1622 ounces Healthy natural fats As your appet.i.te dictates As your appet.i.te dictates Total grams of Net Carbs 50100 2550 Range of carbohydrate Foundation vegetables Foundation vegetables foods possible Nuts and seeds Nuts and seeds

Berries and other fruits Berries