Obesity Epidemic: Supersized Nation Still Rules (cont.)

The low-carb craze, many say, is fading fast.

Lessons Learned From Low-Carb Craze

"The best thing about 'low-carb consciousness' is that people have learned about smart carbs," Zelman tells WebMD. "There's very little nutritional value in simple low-carb items like sodas, white breads, and pastas. In a healthy diet, those are the extras, not the essentials -- fruits and vegetables, which are loaded with vitamins, minerals, antioxidants, and disease-prevention substances.

"You can lose weight any number of ways -- taking drugs or [by trying] any bizarre fad diet," she says. "But true weight loss is about making behavior changes that caused you to gain weight in the first place. It's about sustainability. You can't stay with the Atkins, low-carb lifestyle forever."

Skimping on food just isn't the answer, research is showing. A moderate-fat diet -- plus getting an hour of exercise daily -- that's what works best. In fact, the amount of carbs doesn't even matter, according to a 10-year study involving 2,700 members of the National Weight Control Registry.

The registry includes only people who have shed 30 pounds or more and kept it off. This year, the USDA used this database to develop the 2005 food pyramid guide.

"No body of evidence is more compelling than those in the National Weight Control Registry," Zelman tells WebMD. "It shows the magic bullet that's working for people who have lost weight and kept it off."

Exercise is that magic bullet, says registry director James O. Hill, PhD, director of the Center for Human Nutrition at the University of Colorado Health Science Center at Denver.

In his study, Hill analyzed eating patterns and lifestyle habits for registry members in 1995 and in 2003. He found striking differences:

  • In 1995, those joining the registry had a calorie intake of roughly 1,400 per day; 24% calories from fat, and 56% from carbs.
  • In 2003, calorie intake was the same, 1,400 -- but 30% fat and 49% carb calories, a significant shift. However, only a small percentage of these kept the weight off, he adds.

What works for successful, long-term weight loss? Based on data in Hill's registry, this pattern emerges:

  • Moderate-fat diet. That means 25% of daily calories from fat. "It's low, but it's not Dean Ornish low. You can do that in real life," says Hill.
  • Lots of carbs. Carbs fill in the bulk of remaining calories, then protein. The number of carb calories isn't really important if you eat a moderate-fat diet -- and if you exercise, he adds.
  • 60 minutes of exercise daily. Set up a "core" 30-minute activity, such as a noontime walk. Another 30 minutes gets worked in during the day.

With the low-carb South Beach and Atkins diets, physical activity doesn't get mentioned, Hill notes. "But without exercise, it's harder to keep weight off."