Once your patients are in Pre-Maintenance, they should know the drill that enables them to stay in fat-burning mode. Just as in Induction and Ongoing Weight Loss (OWL), they will need to:
- Count daily grams of Net Carbs.
- Have at least 12–15 grams of their total daily Net Carb intake in the form of foundation vegetables. They’ll continue to be the platform upon which to build as additional carbohydrate foods are reintroduced.
- Add new foods one by one, following the Carb Ladder, starting with legumes, unless they were reintroduced in OWL—as vegetarians and vegans almost certainly have.
- Keep eating the recommended amounts of protein and sufficient natural fats to feel satisfied at the end of each meal.
- Continue to drink plenty of water and other acceptable beverages.
- Consume enough salt, broth, or soy sauce (unless prescribed a low- sodium regimen) to avoid symptoms that may accompany the switch to fat-burning, as long as Net Carb intake is 50 grams or less.
- Take both a multivitamin/multimineral and an omega-3 fatty acid supplement.
What’s Different from OWL?
- Five instead of 10. Instead of increasing daily Net Carb intake in 5-gram increments as they did in OWL, your patients can now move up in 10-gram increments, as long as weight loss continues and they don’t experience undue hunger, carb cravings or any other symptoms they may have experienced initially.
- Higher but slower. In effect, by upping carb intake, the pace of weight loss is deliberately swapped for a slightly higher Carbohydrate Level for Losing (CLL) than the one found in OWL. A loss of a just half-pound a week is fine at this point.
- More carb options. One’s CLL may remain the same that it was in OWL, even as the remaining whole-food carbohydrates are introduced. (See Acceptable Foods for Phase 3.) A half-cup of whole milk (but not skim, nonfat or low-fat types) is also acceptable in this phase. Lactose intolerant people can have lactose-free dairy products or buttermilk, also in 4-ounce portions.
- No need for extra sodium. Once intake exceeds 50 grams of Net Carbs, there is no need to consume salty broth, soy sauce or a half-teaspoon of salt each day.
Approaching Goal Weight
Phase 3 marks the end of the process of weight loss and the beginning of holding weight constant. In this respect, it’s a training ground for Phase 4, Lifetime Maintenance. To succeed in this aspect of Pre-Maintenance, advise your patients to:
- Proceed carefully. If moving to a higher carb intake brings weight loss to a grinding halt or causes a regain that remains longer than a week, simply drop back 10 grams. Stay there for a couple of weeks, and if slight weight loss resumes, try increasing carb intake by 5 grams instead.
- Identify individual carb tolerance. Once one establishes his or her Atkins Carbohydrate Equilibrium (ACE), abide by it.
- Continue to be vigilant. Eat nothing that isn’t on the lists of acceptable foods without knowing the carb count and the ingredients (including added sugars).