Her story is familiar to doctors from Washington, D.C., to London, from Houston to Melbourne, Australia.
Yet, most of the more than 25 million Americans who have tried the Atkins Diet have probably never heard of Rachel Huskey.
Four years ago, the 16-year-old high school student from Sturgeon collapsed and died of a cardiac arrhythmia. Her parents, Paul and Lisa Huskey, and some medical experts believe her sudden death was caused by the popular high-fat, low-carbohydrate Atkins Diet.
“When Rachel died, that day and days prior, there was no warning,” Paul recalled. “She was perfectly healthy, and she just died.”
Doctors at University Hospital, where Rachel was pronounced dead the afternoon of Aug. 29, 2000, acknowledge that they can’t be certain the Atkins plan is to blame. However, they are perplexed as to what else it could have been.
In the wake of her death, Rachel’s pediatrician, Paul Robinson, and four other doctors from University Hospital documented her case in the Southern Medical Journal. Robinson reported finding dangerously low levels of potassium, calcium and magnesium in Rachel’s body, which he said probably caused her heart to stop.
“I can’t say for sure that the Atkins Diet did it,” Robinson said, “but she was on it and she was healthy.”
In the four years since their daughter died, Paul and Lisa have been searching for closure by telling Rachel’s story to the world. In November of 2002, they appeared on “Donahue,” and a year later they attended a conference organized by the Physicians Committee for Responsible Medicine in Washington, D.C. Participants urged the Centers for Disease Control and Prevention to study the effects of low-carb, high-fat diets.
“Everyday people don’t know about (the Atkins Diet),” Lisa said. “They don’t know what it can do.”
An autopsy found that Rachel’s body was in a state of ketosis, which occurs when the body starts burning fat instead of carbohydrates. When fat is burned, ketones form in the blood and are filtered out of the body through the kidneys.
Robert C. Atkins, the cardiologist and founder of Atkins Nutritionals, believed ketosis was the key to weight loss. Atkins Nutritionals declined to comment for this story, but pointed to a discussion on the company’s Web site that calls ketosis “safe and natural.”
“A person in ketosis is getting energy from burning ketones, which are carbon fragments that are created by the burning of the body’s fat stores,” the Web site reports. “There is nothing harmful, abnormal or dangerous about ketosis.”
Dr. Richard Veech, a Harvard-educated researcher with the National Institutes of Health, agrees ketosis is not a dangerous condition. However, he said, high-fat diets, like the Atkins and South Beach regimes, can pose serious health risks for certain people.
“There’s more things going on from elevated free fatty acids,” Veech said. “They can, from what I’ve seen, cause an induction of arrhythmia. But I’ve never seen that in the absence of underlying cardiac disease.”
Veech said it’s difficult to determine a person’s cardiac problems post-mortem. Robinson said there was nothing in Rachel’s medical history or her family’s history that suggests she might have had an undetected heart problem.
In documenting Rachel’s case, Robinson and his colleagues acknowledge that “it is possible” the Atkins Diet had nothing to do with her sudden collapse and death. However, they recommend low-carbohydrate, high-protein diets be avoided until more is known about ketosis and other physiological responses to such diets.
“We’ve got all these millions of people on this diet that hasn’t been proven safe,” Robinson said. “And that’s kind of scary.”
Some doctors outside the United States agree. A year ago, a survey in the United Kingdom showed 97 percent of registered dieticians believed the Atkins Diet gave “bad dietary advice,” according to the BBC. And in January, Health Minister Bronwyn Pike of Victoria, Australia, issued a health warning on the dangers of low-carbohydrate, high-fat diets.
Pike’s decision followed an article published in the Asia Pacific Journal of Clinical Nutrition in December. The paper’s authors, from Deakin University in Burwood, Australia, list possible effects of restricting the intake of carbohydrates, including arrhythmia, cardiac contractile function impairment, sudden death, osteoporosis and kidney damage.
In the United States, the Physicians Committee for Responsible Medicine, a nonprofit group that promotes preventive medicine and opposes unethical human experimentation and animal research, set up a registry for people who have had adverse reactions to low-carb, high-protein diets.
Dr. Neal Barnard, president of PCRM, said more than 600 people have responded, many of them recounting cardiac or kidney problems they believe were caused by these diets.
“I was shocked by how many people had problems and how serious they were,” he said.
Rachel went on the Atkins Diet with her mother. The Huskeys say they got their information about the diet from video tapes purchased from Atkins Nutritionals. The videos recommended that people with certain health conditions consult a physician before starting the diet. As far as the Huskeys and their physician know, neither Rachel or her mother had any of those conditions.
Like many girls her age, Rachel was concerned about her weight. Her friend, Emily Hendren, said she was also concerned with attracting the attention of a certain boy.
“She wanted to impress a boy that had just started going to our church,” said Hendren, who had known Rachel since early childhood She remembers her friend as “a really sweet girl” who got along with everyone.
Along with the special diet, Rachel and her mother also began exercising regularly, walking three miles a day. Hendren said Rachel seemed to be responding well to the new regime.
“We were all encouraging her,” Hendren said. “I remember telling her how good she looked.”
In the summer of 2000, the Huskeys took a vacation and Rachel and her mother went off the diet for about six weeks. But when school started again, so did the diet, although Rachel had to start from the beginning.
During the first two weeks of the Atkins plan, dieters should not exceed 20 grams of carbohydrates a day, and most of those 20 grams must be salad greens or other vegetables. Fruit, bread, pasta, grains, starchy vegetables and most dairy products must be completely avoided.
Rachel had been back on the Atkins Diet for eight days when she died. That day began like any other for her and her family. She woke up, got dressed and took her younger sister to school. After returning home to pick up her tennis shoes, she drove to Sturgeon High School. Shortly after noon, Rachel collapsed in her history class, unable to breathe on her own. She was transported to University Hospital by helicopter, but, upon her arrival, there was little doctors could do to save her. Attempts to restart her heart were futile.
Paul and Lisa remember their daughter as an intelligent young woman who aspired to be a doctor or a lawyer. She served on the student council. A member of the Sturgeon High School Pep Band and the Missouri Mass Choir, she loved music and was also considering it as a possible career.
As the Atkins Diet has become increasingly mainstream, Paul and Lisa say interview requests have been coming in from journalists all over the world. And the Huskeys have seized that opportunity to warn others that the Atkins Diet is, as Paul believes, “potentially dangerous.”
Paul said he realizes that Atkins and other low-carb diets have worked for some people without incident. But, because of what happened to his daughter, he believes the risks outweigh the benefits.
“If that one in a million is your family member,” he said, “than that’s one too many.”