Experts clear up the confusion over the low-carb craze
By Jennifer Warner
WebMD Weight Loss Clinic - Feature
Reviewed By Brunilda Nazario, MD
Questioning your carbs? You're not alone.
The explosion of low-carbohydrate products and even special "Atkins-approved" menus at grocery stores and restaurants is enough to make even an Italian think twice about pasta.
Nearly 30 million Americans are now counting their carbs thanks to the popularity of diets like Atkins, South Beach, and the Zone. But millions more are also becoming "carb aware" or even fearful of carbohydrates and cutting back on carbs -- not because they want to lose weight, but because they think it's the healthy thing to do.
But are carbs something the average person should be concerned about? WebMD asked the experts to clear up the confusion on carbs.
Low-Carb Doesn't Mean Low-Cal
The rising popularity of low-carb products has manufacturers scrambling to meet the demand. In fact, more than 400 businesses recently gathered for the nation's first Low-Carb Summit in Denver to discuss ways to capitalize on the low-carb craze.
But nutritionists say the marketing of low-carb products is way ahead of the science, and it's giving carbohydrates a bad reputation that they don't deserve.
"Low-carb has become new fat-free and the new 'health' label," says Keith Ayoob, EdD, RD, spokesman for the American Dietetic Association, "and it's just as inappropriate as it was to think of fat-free as a health label because it doesn't tell the whole picture."
To add to the confusion, there is no legal definition of what "low-carb" means, according to the FDA. Any food or beverage product that says "low-carb" on the label is technically breaking the law, but the FDA has generally only issued a warning letter to offenders.
Therefore, any definition of low-, reduced-, or net carb is entirely up to the manufacturer.
Kathleen Zelman, RD, director of nutrition for the WebMD Weight Loss Clinic, says that creates a buyer-beware system when it comes to products that tout themselves as low-carb.
"Manufacturers are using this terminology, and it really doesn't mean anything," says Zelman.
But one thing is clear: low-carb doesn't mean low calorie. Carbohydrates and protein each contain about 4 calories per gram, and fats have 9 calories per gram.
That means a blue cheese-topped steak, one of the offerings on T.G.I. Friday's Atkins-Approved menu, is still going to pack more fat and calories than a grilled chicken sandwich from the regular menu.
Ayoob says he is also concerned that the Atkins name has been sold and licensed and has become a brand.
"I have some concerns when they come out saying this and that, and the truth is they have a huge monetary stake in their products and licenses doing well," says Ayoob.
Cutting Carbs Isn't for Everyone
Although short-term studies have shown that low-carb diets may help people lose weight, the safety and effectiveness of these diets has not been proven over the long term.
But experts say many long-term studies have shown that a diet high in saturated fats can raise cholesterol levels and increase the risk of heart disease.
In contrast, a well-rounded diet, such as the DASH (Dietary Approaches to Stop Hypertension) diet, that includes carbohydrates as well as lean meats, low-fat dairy products, and a bounty of fruits and vegetables has been proven to help lower blood pressure and heart disease risks.
"Weight management is one thing, and heart health is another thing," says Ayoob, who is also associate professor of pediatrics at the Albert Einstein College of Medicine in New York. "What may help you to lose some weight may not be healthful for your heart."
Nutritionists say the real issue isn't whether a food is low-carb, it's whether or not it's low-carb and high in saturated fat. Foods can be high in fat and be healthful, in moderation of course. For example, nuts are high in heart-healthy monounsaturated fatty acids and antioxidants.
But foods marketed as low-carb may often contain high levels of saturated fat and calories, which is why it's important to read the label when comparing low-carb vs. regular foods.
"If a low-carb product is higher in saturated fat, and they're thinking that they're going to get healthier, they may be wrong," says Ayoob.
Zelman says that if people want to eat healthier, there are better ways than ordering a bunless burger. Instead, she says people should gradually adopt changes in their diets that will improve the quality of carbohydrates they're eating.
Research shows Americans have increased their carb consumption in recent years, but Ayoob says they're not eating the right kind of carbohydrates.
"They're not eating a lot more fruit. They're eating a lot more liquid calories, such as sweet juice-like drinks and sodas," says Ayoob.
Rather than cutting carbs across the board, Ayoob and Zelman say a more healthful goal is to increase the "good" or complex carbohydrates found in whole grains, fruits, and vegetables and cut back on "bad" or simple carbohydrates, such as sugar and processed grains.
Some steps to achieve that goal include:
- Limit candy, cookies, muffins, and sweetened drinks that are often not only high in sugar but also often high in artery-clogging trans fats.
- Trade a simple carbohydrate for a complex one whenever possible, such as switching from white to whole-grain wheat bread.
- Control portion sizes. If you're having pasta, load it up with a low-fat sauce and vegetables rather than making the pasta the centerpiece of the meal.
Like any other trend, experts predict that the low-carb craze will eventually die out and go the way of the fat-free cookie. In the meantime, the same old boring nutritional advice applies: Eat a balanced diet that includes a variety of foods rather than eliminates entire food groups, and if you're trying to lose weight, cut the calories across the board.
"We've gone to the extremes, and now we have to go to the more moderate area," says Ayoob. "It may be less sexy, but it's probably healthier."
Published March 2, 2004.
SOURCES: Kathleen Zelman, RD, director of nutrition, WebMD Weight Loss Clinic. Keith Ayoob, EdD, RD, spokesman, American Dietetic Association; associate professor, Albert Einstein College of Medicine, Bronx, NY. FDA. WebMD Feature: "What Does Low-Carb Really Mean?" WebMD Medical News: "The Facts on Low-Carb Diets and Heart Disease." WebMD Medical News: "Atkins Food Pyramid Aims to Clear Confusion."
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