Dr. Robert C. Atkins, a cardiologist who devised a hotly debated weight-loss plan favoring steak and eggs over spaghetti and spinach that more than 30 million Americans have tried, died yesterday in Manhattan. He was 72.
Dr. Atkins fell and suffered head injuries on April 8 on the sidewalk in front of his Atkins Center for Complementary Medicine in Manhattan, where he also lived. The center offered an eclectic mix of traditional and alternative treatments for many illnesses and conditions, including obesity.
In April 2002, he was hospitalized for cardiac arrest, which doctors said was caused by an infection unrelated to his diet.
In 1972, Dr. Atkins published one of the most influential weight-loss plans of the 20th century, ''Dr. Atkins' Diet Revolution.'' Its various editions sold more than 15 million copies, making it one of the best-selling books ever. Dr. Atkins said he had helped people lose 200 million pounds, and his book has occupied the best-seller list for years at a time.
His newest book, ''Atkins for Life'' (St. Martin's, 2003), tops the hardcover advice book best-seller list in The New York Times, while the paperback edition of ''Dr. Atkins' New Diet Revolution'' (M. Evans, 1999) has led the paperback list for more than 300 weeks.
His weight-loss theory has nonetheless struck some experts on health and diet as dangerously wrongheaded: he told patients and readers to eat all the fat they wanted -- as much as two-thirds of their diet -- but to cut back significantly on carbohydrates, the food group most dietitians have come to advocate over the last quarter-century. He said the human body would burn its own fat if it had no carbohydrates to burn first.
Accordingly, Dr. Atkins advised dieters to choose bacon and eggs over fruit salad, to throw away the bun and eat the burger. He promised that lobster dripping with butter was better for weight loss than a bran muffin.
Indeed, part of the surge in the popularity of pork rinds in the 1990's was Dr. Atkins's endorsement.
The dietary villains, he said, are refined sugar -- per capita consumption in the United States increased by 30 pounds a year between 1960 and 1980 -- and white flour, which rose by 64 pounds during the same time. Fat intake, meanwhile, had sunk.
Dr. Atkins liked to point out that 100 years ago, when there were few recorded heart attacks, lard was the No. 1 fat.
His numerous critics countered that the Atkins diet would not work beyond a few months, and that it could cause heart problems, constipation, fatigue and bad breath. Dr. Dean Ornish, an advocate of low-fat eating and a fervent foe of Dr. Atkins, said that the fact that some people could lose weight by smoking cigarettes did not mean that smoking was good for them.
Dr. Atkins acknowledged that there had been no long-range studies to test his diet, although the National Institutes of Health have begun a large study. A team of doctors from Stanford and Yale Universities published a report on April 9 in The Journal of the American Medical Association that did not discount the Atkins diet, although it suggested that people on it lost weight because they consumed fewer calories -- not fewer carbohydrates, as Dr. Atkins maintained.
Citing recent small-scale studies, the current issue of The Harvard Health Letter said the Atkins approach, which it called ''the bad boy of diets,'' was becoming harder to dismiss out of hand. The letter called the diet ''an antidote to the dumbed-down antifat message.''
Fighting fat is an indisputably growing market. The Journal of the American Medical Association reported last October that the proportion of overweight Americans had increased to 64.5 percent, from 55.9 percent in 1994. The market for weight-loss plans and products is $35 billion a year, and Dr. Atkins tapped it with scores of products, including cookbooks, energy bars and diet-oriented ocean cruises.
Robert Coleman Atkins was born in Columbus, Ohio, on Oct. 17, 1930. His family moved to Dayton, Ohio, where his father owned restaurants, when he was in the seventh grade. At 14, he got a job selling shoes. At 16, he appeared on a local radio show with other youths and had thoughts of becoming a comedian.
He graduated from the University of Michigan and spent a summer as a waiter and entertainer at resorts in the Adirondacks.
He graduated from the Cornell University Medical School and did residencies in internal medicine and cardiology at hospitals affiliated with the University of Rochester and Columbia University.
