Dietitians just plain don't like low-carb or high-protein
Whether it's The Atkins Diet, The Stillman Diet, The
Scarsdale Diet or Eat Yourself Thin Like I Did by Nancy
Moshier, a popular, new book that recommends a low-carb
regimen, medical experts say these diets are not part of
long-term weight maintenance.
"All of these diets, they are warmed-over versions of The
Atkins Diet," says Heather Holden, RD, LDN, clinical
dietitian at Vanderbilt University Medical Center in
Nashville. "Low-carb, high-protein, it doesn't matter what
you call them, they don't work in the long run."
But some aspects of Eat Yourself Thin are useful, says
Holden. In particular, the book's focus on calorie counting
can be useful.
How Many Calories Do You Need?
"The best thing about the book is that it teaches people how
to calculate an approximate basal metabolic rate," says
Holden. "That's the number of calories your body needs every
day to maintain a constant weight. The number is different
The book, says Holden, tells readers to establish their
ideal body weight and then multiply that number by 10 to
arrive at the daily calorie intake. For example, if your
ideal body weight was 130 pounds, you would multiply that
130 by 10 to get 1,300 calories per day.
"That is a very rough estimate of what you need to eat each
day at your ideal weight," says Holden. "So that gives you a
place to start. If you weigh 160 pounds, and your ideal
weight is 130 pounds, then you start a calorie diary to see
how much you're eating each day. Then you can get a better
idea of how much you can eat every day to start working off
weight to get closer to your ideal weight."
That much, she says, is useful. But the book goes on to tout
the wonders of low-carb eating as the best way to maximize
loss of body fat.
"That's the part you want to avoid," says Holden. "Low-carb
diets provide quick weight loss but do not help you maintain
The American Dietetic Association (ADA) says that both
low-carb and high-protein diets are bad.
"These diets are not safe, they are not healthy, and they
are not a good way to try to get healthy," says Leslie
Bonci, RD, nutritionist with the University of Pittsburgh
Medical Center Sports Complex and a spokesperson for the
ADA. "They provide short-term, rapid weight loss by causing
the body to shed water weight and muscle. But that is no way
to keep weight off for very long, and it's dangerous to your
According to the ADA, low-carb diets and others like it
trigger short-term weight loss through a process called
ketosis. This process kicks in when your body is in short
supply of carbohydrates, a prime source of energy for the
entire body, but especially for the brain, which operates
exclusively on carbohydrates.
During ketosis, your carbohydrate-depleted body grabs other
sources, including ketones from stored fat or protein, to
satisfy daily energy needs. This leads to ketoacidosis, a
state similar to that seen with type 1 diabetes. This type
of diet can have a negative long-term impact on health.
"Next time you talk to someone on one of these diets, pay
attention to their mental state, how alert they seem," says
Holden. "The lack of carbohydrates tends to make them seem a
bit fuzzy mentally because the brain is not getting enough
fuel. Is that any way to diet?"
New Research Supports It
But a study in the July 2002 issue of the American Journal
of Medicine showed that the most famous of low-carb diets,
the Atkins diet, does work.
Study participants lost an average of 20 pounds while on the
Atkins diet for six months, but they were not followed
longer to see if they kept the weight off. Most people also
had improved cholesterol levels at the end of the study,
even though the eating plan permits unlimited quantities of
cholesterol-rich foods such as eggs and meat.
The study was funded by a grant from the Robert Atkins
Center for Complementary Medicine. Duke researcher Eric
Westman, MD, says he became interested in studying the
Atkins diet after several of his patients lost large amounts
of weight on it.
But though researchers were impressed by the weight loss,
they say more study is needed to pronounce the
carbohydrate-restricting diet safe.
Here's how the American Heart Association says to take
weight off, and keep it off.
Be active: try walking 30 minutes a day most days of the
To lose weight, most women should eat 1,200-1,500 calories
To lose weight, most men should eat 1,500-1,800 calories a
A loss of one to two pounds per week is considered a healthy
People who lose weight gradually are more likely to keep the
Eat no more than 30% of your total calories from fat.
Include at least five servings of fruit and vegetables in
your diet each day.
Examine your eating habits -- keep a written journal of what
and when you eat.
Weigh yourself only once a week.
Eat breakfast to curb binge eating.
"There are still a lot of things we don't know about food
and nutrition," says Holden. "Nutrition is a relatively
young science, but we do know that you can trick the body's
mechanisms in the short run. In the long run, however, those
short cuts catch up with you in the form of weight gain."
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