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Low-Carbohydrate Dieting: Exposing the Myths and Realities
By: Fred Pescatore, MD, MPH
Everywhere we look, we see something about low-carbohydrate dieting—television, radio, bookstores, and newspapers. Everyone we know seems to be on a low-carbohydrate diet. But what is low-carbohydrate dieting and how do we know which diet to follow, which is the healthiest, and most important, does it really work? In this brief article I am going to show you exactly what low-carbohydrate diets are and compare and contrast the most popular ones currently available with a diet I have been working with for the past few years.
I used to be the associate medical director of the Atkins Center for Complementary Medicine. Yes, that is the same Dr. Atkins whose very popular diet plan has swept the nation. In the five years I worked there, I was able to learn, first-hand, the health benefits of low-carbohydrate eating, but I was also able to learn which aspects were healthy and which ones were just hype.
When I first started working there, I had just finished residency training and knew nothing about nutrition. After all, they didn’t teach nutrition in medical school, nor was it emphasized when you were working in a hospital trying to handle life and death emergencies. Nutrition was something that was always left up to the dieticians. The doctor had to order the diet, but none of us really knew what the diets we ordered ever consisted of. Looking back, I now know what a terrible mistake this was.
Low-Carbohydrate DietingIn a nutshell, low-carbohydrate dieting consists of eliminating most forms of carbohydrates. Carbohydrates come in many forms. They can be sugars, breads, pastas, pretzels, crackers, fruit, vegetables, and soda and fruit juices. Many people can’t believe that fruit and fruit juices are carbohydrates because they are really mostly sugar. Several recent studies even go so far as to suggest that the rise in obesity in our population is directly attributable to the rise in the consumption of fruit juices.
For those of you who may not be aware of how fattening fruit juices can be, apple juice has more sugar in it than the same amount of soda. Sugar is the food that is eaten the most in this country. We eat 150 pounds per person, per year. That translates to 33 tablespoons each day. That may seem like an unrealistic amount, but when you begin to understand what you are eating, it is really quite easy to get to that level quickly without even realizing it. When I place my patients on the diet program I use in my practice, they come back in two weeks into the program, after having read all the food labels, and tell me that they can’t believe certain foods actually contain sugar. What’s worse, there are more than 300 foods that are not required by the federal government to list sugar as an ingredient, when in fact, they do contain sugar. As Americans, we consume more calories of sugar than we do of meat, chicken, vegetables, and breads combined.
Different forms of sugar
One of the main reasons we don’t know how much sugar we consume is because sugar has many disguises, such as brown sugar, corn syrup, honey, molasses, maple syrup, high-fructose corn syrup, dextrin, raw sugar, fructose, polyols, dextrose, hydrogenated starch, galactose, glucose, sorbitol, fruit juice concentrate, lactose , brown rice syrup, xylitol, sucrose, mannitol, sorghum, maltose, and turbinado. Essentially, any word on a food label that ends in -ose, or -ol is a sugar in disguise.
Why is keeping a low carbohydrate level so important? The explanation requires a little understanding of the basics of how food is metabolized in the body. Our bodies metabolize food in the same manner as the bodies of our prehistoric ancestors. The body preferentially uses sugar for fuel since the body doesn’t have to expend any energy to break it down for fuel. Next, the body will utilize simple carbohydrates such as pasta, bread, pretzels, and the like, simply because it doesn’t take much energy to convert these into sugar for fuel. Next, the body uses complex carbohydrates such as vegetables, brown rice, legumes, and whole-grain starches as fuel because the body has to expend energy to process these foods back into sugar in order to be used by the body. The body will then use protein for fuel, and use fat last.
The reason the body uses fat last is because fat is the perfect storage molecule for the body. Fat holds more than twice the amount of energy than either a carbohydrate or a protein, so the body, in its infinite greatness, will store those bits of energy (also known as calories) for a rainy day. For most of us in this country, that rainy day never comes and it is our hips and waist that suffer the brunt of this storage of energy.
The next logical assumption should be to eliminate fat from the diet and by doing so would solve the fat problem—right? Wrong! Because our bodies create stores of fat molecules, namely triglycerides, we have an excess of sugar in our bodies. The real key to dieting is therefore to eliminate the bottom of the food chain—sugar and simple carbohydrates—thus, forcing our bodies to utilize the complex carbohydrates, protein, and fat that we consume. Our bodies then begin to operate as they were meant to operate. Our prehistoric forefathers never had processed foods, and that is all sugar and simple carbohydrates are.
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