The Low Carbohydrate Diet ... Is It For You?

One of the most fundamental principles of the low carb diet approach is that most people are overweight because their bodies are "carbohydrate sensitive". Dr. Atkins, the "father" of the low carbohydrate diet, refers to these individuals as being insulin resistant. This so-called resistance reduces the bodies ability to turn glucose into energy, resulting in more sugar (carbohydrates) being stored as fat. The end result of this process is increased body fat percentage, overall slowing in metabolism, and weight gain. In what Dr. Atkins refers to as the "vicious cycle", the body responds to this inefficient processing of sugars (carbohydrates) by pumping out increased amounts of insulin, causing more carbohydrates to be converted to fat. In order to break this cycle, Dr. Atkins theorizes that a person must strictly restrict carbohydrates (20 grams per day) causing the body to enter a state of ketosis. The biological process of ketosis is associated with increased burning of fat stores for energy. Conversely, as fat stores are depleted the person's metabolism improves, and weight loss occurs.

Although the theory behind the Atkins low carbohydrate approach is compelling, in reality that's all it is...a theory. In fact, subsequent studies have confirmed that low carbohydrate diets are no more effective in reducing weight than diets loaded with carbohydrates. It is common for a person who reduces carbohydrates to initially lose more weight, but generally this is attributed to water loss and levels out after two to three weeks. Over the long haul, why do some people successfully lose weight on low carbohydrate diets? The answer is simple...because they are taking in fewer calories. In general, carbohydrates make up about half of an average Americans daily caloric intake. A person following an 1800 calorie diet would consume approximately 900 calories from carbohydrates (225 grams). By restricting total daily consumption of carbohydrates to 20 grams (80 calories) this person eliminates 820 calories from his or her diet. It is very unlikely that this same person will make up for this huge deficit with an appreciable increased consumption of fat and protein. At best, low-carbohydrate diets are nothing more than low-calorie diets in disguise.

In addition to the lack of scientific evidence to support his weight loss approach, Dr. Atkins slyly tap dances around and glosses over many of its dangers. Any plan that encourages significant consumption of saturated fats and foods rich in cholesterol should be suspect. Although it is true that individuals following the Atkins approach commonly experience a reduction in total cholesterol and triglycerides, unlimited intake of saturated fats can drive LDL cholesterol up. Patients with the greatest risk for experiencing a heart attack are those with insulin-resistance and elevated LDL cholesterol. Another potential problem is caused by the self induced state of ketosis, which can result in fatigue, nausea, vomiting, and dehydration. Severe elevation of ketones within the body can also result in coma and/or death. Eliminating or drastically reducing whole grains, fruits, and many dairy products may result in numerous complications such as osteoporosis, constipation, low blood pressure, liver damage, and/or kidney failure. New studies are even showing a possible link between diets rich in animal protein and the development of Alzheimer's disease. It is certainly not considered as the diet of choice for any person with a history of gout, kidney disease, pregnant women, and/or diabetes. And if you happen to be a vegetarian....forget about it!

In answering my initial question...whether or not to join the low-carbohydrate bandwagon, I would have to say no. The time I spent investigating the so-called magical properties of the low carbohydrate diet has only reaffirmed my previous beliefs. Effective weight loss involves changing lifestyle eating habits and consistently participating in an exercise plan that combines aerobic activity with weight training. Working out three to four times per week for 30 to 45 minutes is generally accepted as a standard guideline. When I work with individuals at our office, we focus on eating more frequent and smaller portioned meals (eating 5 to 6 times per day). I emphasize planning out the next day's meals before you go to bed. Eliminating any doubt over what you will be eating reduces the risk a person will make those last second food choices which rarely ever turn out to be healthy or low calorie. It also makes it much easier to track daily caloric intake, which is an essential component to any successful weight loss plan. For most of my patients who lead very busy family and professional lives, the best starting point has always been to combine quick low calorie supplements with real food items. This eliminates most of the thinking associated with trying to design a healthy eating plan, as well as significantly reducing the overall time constraints (weighing, measuring, calculating calories...)

Dr. Padla