Carb Consciousness

Philly Fit Magazine, Sept/Oct 2004 issue, p. 5-6

Whether you know it as the Atkins, South Beach or Sugarbusters diet, carbohydrate consciousness promises the eternally-awaited quick fix for those looking to trim weight and inches. It would seem to be a dream come true: Proponents of carb-cutting have pointed to scientific evidence that when you turn from blood-sugar-raising carbs to less-glycemic protein, fats, fiber, sugar alcohols, soy flours and cellulose, your body shifts from a fat-storing to a fat-burning mode.

What’s more, say the carb-cut crusaders, reducing your carbohydrate intake can also bethe heart-healthy diet prescription. In fact, according to a study reported in the Annals of Internal Medicine, despite consuming nearly unlimited meat, eggs, and full-fat dairy products, the blood lipid panels of “low carb” dieters actually showed improvement.Triglyceride levels and other blood markers of cardiovascular risk paradoxically were lower after a period of eating saturated fat and cholesterol-laden foods.

No wonder that carb-cutting has become the next-big-thing in dieting – with approximately 15% of Americans following some type of restricted carb regimen. But, before trading in that cookie and cake for unlimited bacon, due diligence requires addressing a few fundamental questions. Is it safe? Are carb-cutting and protein/fat-loading effective and healthy past the first rush of weight loss?

Let’s begin the question-answering exercise by jogging our collective memory. The craze of our not-too-distant past was the low-fat diet. With similar agility as THEY showed about carb-cutting, American food processors and packagers (and even fast-food chains) responded by reinventing their fare. We were given wave after wave of fat-free salad dressings, snacks and, even, fat-free desserts. Some of these products are still available on our grocery shelves.

Unfortunately, to compensate for the missing fat, the new products were often loaded with carbohydrates. And, sadly, it is carbohydrates (sugars) that are most closely associated with actual weight gain.

So, it was NOT a big surprise when the New England Journal of Medicine (NEJM) recently reported that those following a “low fat” diet for six months were less successful in their weight loss than those following a “low carb” diet. This would seem like good news for the low carb dieter trying to shed extra pounds and get healthier. Right? Well, no. Not in the long run. A follow-up study in the Annals of Internal Medicine reported that, after the passage of a year, the difference in weight loss between the two groups of dieters was insignificant. Not only did the low carb dieters–like other dieters–quickly put back on that initially lost weight, but we still have seriously limited data regarding the health risks associated with following this type of diet, especially over time.

For example, there’s the impact on our kidneys, the organs that have the critically important task of filtering waste products from our blood. When fats and proteins become our main source of energy, our blood accumulates ketones, chemical by-products of the shifted metabolism. Excess ketones mean much more work for our kidneys, and over time, may result in kidney impairment or failure.

What about the impact on your heart and blood vessels? While studies suggest that the carb-cutters’ blood lipid panels Trigyclerides, Total Cholesterol, HDL, LDL, etc.) improved in the short term, there is currently no scientific data about the risks of a high fat, high protein diet on our cardiovascular system beyond the one year mark. It remains plausible that the positive changes in these blood levels were a direct effect of the initial weight loss itself rather than an ongoing response to a constant bombardment withhigh quantities of fats and proteins.

We do know that the accumulation of ketones can lead to a condition called ketosis. In ketosis, the cells of your body including your brain cells are forced to use ketones—rather then their preferred source, gluose—for energy. Anecdotal evidence suggests that some low carb dieters (especially those following the most carb-restrictive Atkins diet) experience mental and physical sluggishness at least during the diet’s initial stages. Does this have profound, long term health implications for these “deprived”cells? Again, we just really do not yet know.

It also has been theorized that there could be an increased risk of cancer when the more restrictive low carb diets are followed blindly. Vegetables and fruits typically provide our main and natural sources of antioxidants– substances that protect cells from the damage caused by unstable molecules known as free radicals. Unless we carefully replenish the missing antioxidants, such as with a professionally devised and monitored vitamin protocol, we can make ourselves less able to ward off dangerous cellular mutations. The possible result could therefore be cancer. It is prudent, if not compulsory, for anyone considering one of these programs – even for the short-term – to consult their doctor and/or a trained nutritionist for guidance with making dramatic dietary decisions.

You also should know more about carb-substitutes and other low-carb products available widely on today’s market. Like with the low fat products of the past, the low-carb products have to do something to compensate for the missing sugar. Sugar alcohols are often used to replace sugar and fructose. Ex-lax is an alcohol sugar. Thus, it is unsurprising that many people using large quantities of carb-substitutes experience diarrhea, cramping, bloating and other gastro-intestinal distress.

And, you should be advised that low carb does not mean “low calorie.” Roughly 50% of ingested alcohol sugars are absorbed and treated in our bodies like sugars. So, eating more of these low carbs can often cause someone to actually gain weight. This is another pitfall a professional can help steer you away from and help you come up with a reasonable, well-balanced (and more effective) approach to health improvement and weight loss.

It all boils down to this: Your reasonable, well-balanced and more effective approach to health and weight loss should begin with a full dose of information, preferably from a professional who takes the time to know you and your body.

Take-Home MessagesLike most things in life, the low carb craze has good and bad features. I think I’ve provided enough food for thought about the downside of carb cutting.

By all means, have a healthy carbohydrate awareness. Sugars in their simplest of forms (sucrose or table sugar of all types, white flour, etc.) should be avoided. Instead, your diet can include more complex carbs such as whole grain rice and undercooked or raw vegetables with their skins. Clearly, excess sugar is not only one of the main culprits for our excess weight, but sugars also are highly related to such serious disease pathology as heart disease and diabetes.

Remember, sugar rarely exists in nature without its fiber component. Consider the apple or carrot with its peel the potato with its skin. Fiber serves to balance the sugar, and slow its absorption, and, possibly also reduce its glycemic impact. The fiber may also help us feel satiated longer. All these effects, in turn, may help curb cravings, and therefore overeating.

Also keep in mind that the more active you are, the more your body may effectively burn carbohydrates. Everyone is different. If you are training, you can – and should – take in some carbs (hopefully in their complex form) to provide the quick energy you need to fuel your work out. Working with a nutritionist may help elucidate what YOUR body likely can and can’t handle.

Another good thing to come out of the low carb craze is a reduced fear of fats. Contrary to what some believed in the recent past, fat does not cause obesity and cardiovascular disease. Not by itself. Not in moderation. In fact, some fats, such as omega 3 fatty acids found in many deep sea fish and flax seeds, are extremely beneficial to your entire body, particularly to your heart and blood vessels.

Again, your best course is to work with a nutritionist or another trained and skilled health professional, whether you wish to maximize your work-out, improve your overall health status, and/or shed those extra few pounds safely and effectively. Just as a trainer can help you stick to an exercise program, a nutritionist can help you adhere to a nutritional program that realistically fits your unique goals and needs.