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The Truth About Carbohydrates and Dieting
Judy Goffi MS, RD, CDE, LD
Recently popularized diets such as Atkin's,
Protein Power and The Zone recommend severe
restrictions of carbohydrates in favor of increases
in fat and protein. The shared theme among these
diets is that carbohydrates are bad because
insulin is released as a result of carbohydrate
ingestion. Insulin then supposedly takes the carbs and stores them as fat, rather than allowing
the body to use them as energy.
The recommendation therefore becomes diets
lower in carbohydrates - as low as 5-10% in
some cases! Still, nearly every professional
medical organization, led by the American Heart
Association and the American Dietetic Association
recommends that approximately 55-60% of your
calories should come from carbohydrates. Why
is this?
The simple fact is that when you lower your
carbohydrate intake below 55-60%, you have to
increase your protein and fat intake. The major
medical institutions will not support this because
the vast majority of medical research shows
two things: a diet high in fat is unhealthy
(1-5), and a diet excessively high in protein
is unhealthy (6-9,11-12).
High fat diets are associated with an increased
risk of cardiovascular disease (1-5). A recent
comparison study of eight popular diet plans
found that the low-carbohydrate diets had more
than twice the amount of recommended saturated
fat (13). All that saturated fat is a recipe
for clogged arteries, which leads to cardiovascular
disease.
And while a high carbohydrate diet (beyond
75%) does raise insulin levels which increases
the risk of heart disease, there is no good
evidence that high insulin levels make people
fat.
As a result of the lower carbohydrate composition
of these diets, protein is also increased to
more than twice the recommended levels. Increasing
protein levels to 40-50% of your caloric intake
places tremendous stress on your kidneys (6-9,11-12)
and liver (9,10). Studies have shown that high-protein
diets result in adaptations such as kidney enlargement
and increased filtration rate (6-9,11-12).
But what about the success of low carbohydrate
diets?
It is unarguable that low carbohydrate diets
are successful for weight loss, at least in
the short-term. The question isn't whether or
not this approach is effective, but why is it
effective, is it safe, and are there long-term
benefits or health risks?
The bottom line is that body weight depends
on calorie balance. If you are eating more calories
than you are expending, you are going to gain
weight. Low carbohydrate diets work because
they severely restrict calories, not because
of what is supposedly happening to insulin levels.
By restricting carbohydrate intake to such
a degree and subsequently increasing saturated
fat and protein levels far beyond normal, low
carbohydrate diets appear to be very unsafe
in the long-term, especially for those with
high levels of LDL cholesterol. Also, keep in
mind that while effective at making you lose
weight, these diets also rob you of important
fiber, vitamins and minerals derived from fruits
and grains.
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References: 1. Grundy SM,
Denke MA. Dietary influences on serum lipids
and lipoproteins. J Lipid Res. 1990;31:1149-1172.
2. Mensink RP, Katan MB. Effect of dietary fatty
acids on serum lipids and lipoproteins: a meta-analysis
of 27 trials. Arterioscler Thromb. 1992;12:911-919.
3. Ginsberg HN, Barr SL, Gilbert A, et al: Reduction
of plasma cholesterol levels in normal men on
an American Heart Association Step I diet or
a Step II diet with added monounsaturated fat.
N Engl J Med. 1990;322:574-579.
4. Ullmann D, Connor WE, Hatcher LF, et al:
Will a high-carbohydrate, low-fat diet lower
plasma lipids and lipoproteins without producing
hypertriglyceridemia? Arterioscler Thromb. 1991;11:1059-1067.
5. Frayn KN, Kingman SM. Dietary sugars and
lipid metabolism in humans. Am J Clin Nutr.
1995;62(suppl):250S-263S.
6. Manz F, Remer T, Decher-Spliethoff E, et
al: Effects of a high protein intake on renal
acid excretion in bodybuilders. Z Ernahrungswiss
1995 Mar;34(1):10-5.
7. King AJ, Levey AS: Dietary protein and renal
function. J Am Soc Nephrol 1993 May;3(11):1723-37.
8. Brandle E, Sieberth HG, Hautmann RE: Effect
of chronic dietary protein intake on the renal
function in healthy subjects. Eur J Clin Nutr
1996 Nov;50(11):734-40.
9. Millward DJ Optimal intakes of protein in
the human diet. Proc Nutr Soc 1999 May;58(2):403-13.
10. Hammond KA, Janes DN: The effects of increased
protein intake on kidney size and function.
J Exp Biol 1998 Jul;201 (Pt 13):2081-90
11. Huang PC, Chiang A: Effects of excess protein
intake on nitrogen utilization in young men.
J Formos Med Assoc 1992 Jul;91(7):659-64.
12. Bouby N, Trinh-Trang-Tan MM, Laouari D:
Role of the urinary concentrating process in
the renal effects of high protein intake. Kidney
Int 1988 Jul;34(1):4-12.
13. Anderson JW, Konz EC, Jenkins DJ: Health
advantages and disadvantages of weight-reducing
diets: a computer analysis and critical review.
J Am Coll Nutr 2000 Oct;19(5):578-90.
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