Recently attention has been paid to the question of whether you should supplement low-carbohydrate diets (or in our case slow-carbohydrate diets) with any specific vitamins or nutrients. Most trials conducted have not used additional vitamin supplementation, and none have assessed the overall micronutrient impact of these diets.<\/p>\n

One trial in an adolescent population placed all patients on a regular multivitamin and a potassium chloride salt substitute. One trial in an adult population added an Atkins recommended vitamin\/nutrient complex to the low-carbohydrate group.<\/p>\n

The Atkins diet recommends the concurrent use of a specifically formulated multi-vitamin\/nutrient treatment regimen.\u00a0 This product contains higher than the normal recommended daily allowance of several vitamins. The vitamin portion contains, in addition to the regular assortment of vitamins and trace minerals, a variety of dietary supplements; including green tea extract, garlic, licorice and a number of other products. An essential oil component contains flaxseed oil, borage seed oil, fish oil, and additional vitamin E. The third element of the regimen includes a diet formula containing a variety of dietary supplements and amino acids, and additional B vitamins. Since many of the components in this regimen contain dietary supplements which are not regulated in the same way as conventional medications and may contain products of dubious quality, it is difficult to determine the absolute quality of some of these products.<\/p>\n

It is not known if low-carbohydrate diets deplete any particular nutrients, or require supplementation with specific nutrients<\/span>. The American Heart Association has issued a statement indicating concern that high-protein diets may “restrict healthful foods that provide essential nutrients and do not provide the variety of foods needed to adequately meet nutritional needs.” Studies need to be performed focusing specifically on the vitamin and mineral intake associated with these diets in order to identify specific deficiencies and needed supplementation.<\/p>\n

The effect on some nutrients has been assessed in small trials, but overall nutrient deficiencies have not been well studied. It is known that in the first two weeks of a low-carbohydrate diet people tend to lose a greater amount of body water than while on other diets, however this effect is not seen after the initial two weeks<\/span>.<\/p>\n

This can be managed by trying to stay well hydrated, drinking six to eight glasses of water daily<\/span>. It has been suggested that this water loss may cause depletion in supplies of potassium, magnesium and calcium.\u00a0 One case report of cardiac death due to hypokalemia in a patient on a low-carbohydrate, high-protein diet presents additional data indicating that potassium supplementation may be necessary.<\/p>\n

In this case it was not possible to definitely determine the cause of the hypokalemia. One study of ten patients for six weeks evaluated the impact of low-carbohydrate diets on calcium metabolism.\u00a0 Calcium excretion was increased while serum calcium had no significant changes. The study was not designed to assess bone turnover but markers of bone resorption trended upwards, though not significantly. So patients on a low-carbohydrate diet may want to supplement their diet with calcium.<\/p>\n

There are claims that the extra antioxidants contained in some vitamin supplements are necessary for ketosis. Ketosis occurs subsequent to fat burning and is an index of fatty acid utilization which may be used to measure compliance to dietary restrictions. Ketone bodies are generally eliminated from the diet via the urine with a action to maintain electrical neutrality. This may cause additional loss of magnesium or potassium. It doesn’t appear that antioxidants specifically affect the process of ketosis.<\/p>\n

Some product advertisements suggest that the body will need extra biotin to break down the fat and protein consumed. This probably is not true<\/span>. Biotin is involved in the metabolism of carbohydrates, fats and proteins, but the amount of biotin in a regular multivitamin is probably sufficient to meet the needs of most people, in fact some companies include the same amount of biotin in their “low-carb” vitamins as in the regular multi-vitamin.<\/p>\n

It has also been suggested that higher than normal intake of fat soluble vitamins (vitamins A, E, D, and K)<\/strong> are needed in low-carbohydrate dieters.<\/p>\n

The philosophy behind this claim is that most dieters had previously used a low-fat diet and therefore might be deficient in fat-soluble vitamins. This claim has not been specifically tested. You should watch the amount of fat-soluble vitamins consumed relative to the maximum daily intake recommended by the FDA. Some vitamins provide the recommended daily allowance without considering additional dietary sources of vitamins you may receive. High levels of some vitamins, like vitamin A and D, can lead to toxicity.<\/span><\/p>\n

Some vitamins contain increased carnitine, touted as necessary to achieve a beneficial effect with a low-carbohydrate diet. In a clinical trial evaluating the impact of a carbohydrate-restricted diet on carnitine levels it was observed that while carnitine did decrease at the start of the diet, it stabilized or increased slightly with long-term diet treatment. While the study was small, only 38 patients, there were no clinical symptoms of deficiency noted in any patients.<\/p>\n