Diet Fads. High Protein Or High Carbohydrates.

diets. carbohydrates or high protein?

Confusion is nothing new in the diet world. Dietary fads come and go and come back again.

My nutritionist told me to eat more vegetables and less meat; my doctor's a total vegetarian and says that's the healthiest diet," your client says. "So I'm eating more grains, vegetables, and fruits. I feel pretty good, but I've only lost about five pounds in the past two months.

Lately I've been reading that high protein is the way to go for weight loss. In fact, my sister just lost 10 pounds in a month cutting out carbohydrates from her diet. Cutting carbohydrates -- I thought carbohydrates were the miracle food that gave you energy. Now it's protein. Anyway, that diet has really worked for her," she continues. "Do you think I should give it a try?"

Confusion is nothing new in the diet world. Dietary fads come and go and come back again. A kernel of scientific fact, often taken out of physiological context, helps these fads sound plausible to the average reader, especially the chronic dieter desperate for new advice. Perhaps your clients have been coming to you with questions about the carbohydrate-protein war. If so, here is some information to help them sort fact from fiction.

Calories eaten vs. calories expended

Weight gain occurs when you eat more calories than you expend. Does this sound familiar? It should. Of course, this basic thermodynamic principle has many metabolic permutations. Some people expend a great deal of energy while others tend to conserve energy, people are genetically predisposed to certain body types, etc. But in general, when people eat more food than they need, whether the extra calories come from fat, protein or carbohydrate, they will gain weight.

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Carbohydrate calories count, too

Fitness and public health professionals have been advocating a reduction in fat intake to prevent chronic health problems such as heart disease, hypertension and obesity. The basic message has been to eat less fat and more complex carbohydrates, such as fruits, vegetables and grains. Many clients have interpreted this message to mean that as long as food has little or no fat, you can eat all you want. When applied to a heap of high-fiber, low-calorie vegetables, this is almost true. How many vegetables can you eat (without butter or high-fat dressings)? Most people will naturally stop eating after a reasonable number of calories, because high-fiber foods fill you up. But what about a box of fat-free cookies? They go down pretty easily, don't take up much room in your stomach and deliver a lot of calories, without much nutrition. The bottom line is, even on a low-fat diet, calories count.

Insulin: An essential hormone

Many of the new diets advocating a reduction in carbohydrate intake cast insulin as the evil creator of body fat. But insulin is not to blame. It's an essential hormone performing its essential physiological function. Here's how insulin works: As you digest a meal, nutrients are released into the bloodstream to be used for growth, repair, energy production and many other functions. When glucose, the basic building block of carbohydrates, enters the bloodstream, the pancreas releases the hormone insulin. Insulin, in turn, signals the cells of the body to take up glucose to produce energy and manufacture glycogen. Insulin also signals fat cells to store extra glucose as fat. This is why some people have blamed insulin for the creation of excess body fat. But blaming insulin for fat stores is like blaming the people who work at the landfill for the amount of garbage. Just as the workers don't create the garbage excess, insulin does not create the energy excess. The landfill workers and insulin are simply doing their jobs.

What about people with type II diabetes? It is true that people with this type of diabetes, which is very common in North America, often overproduce insulin in response to rising blood sugar levels. This is because their cells have a reduced sensitivity to insulin, so more insulin is required to get the job done. It has been suggested that these high insulin levels may exacerbate high blood pressure or lipid abnormalities in people for whom diabetes is a component of a disorder known as metabolic syndrome. Diet does not appear to be the problem, however.

Consuming a high-carbohydrate diet does not cause insulin resistance. And high insulin levels are not the cause of excess body fat in people with insulin resistance. A sedentary lifestyle and midlife weight gain are much more significant factors. People with type II diabetes or metabolic syndrome reap enormous health benefits by increasing physical activity and losing a small amount of weight. A heart-healthy diet that is low in fat, sugar and salt, and that contains plenty of fruits and vegetables and adequate amounts of low-fat protein, can be part of this lifestyle approach.

Dietary protein: Essential, but no weight-loss miracle

Protein provides amino acids, the basic building blocks of life. Your body uses amino acids to build muscle and other tissues, repair damage, and make blood cells, immune cells and hormones. If carbohydrates are in short supply, your body will also use protein as a source of energy.

Many people mistakenly believe that protein and meat are synonymous. Meat does provide a concentrated source of protein, as well as essential minerals such as iron and zinc. Small portions of low-fat meats can be part of a heart-healthy diet. Protein is also plentiful in dairy products (look for low or no-fat varieties) and eggs. People who consume no animal products must work a little harder to obtain adequate protein, and consume plenty of grains, legumes, seeds and their products. A four-ounce serving of meat or fish has about 30 grams of protein; a cup of milk has eight; an egg has six; and a cup of baked beans has 14.

How much protein do you need? Sedentary adults require 0.4 grams per pound of body weight per day. Recreational exercisers need somewhere between 0.5 to 0.75 grams per pound. Extremely active or growing athletes may need up to 1.0 grams per pound. Contrary to popular opinion, body builders actually need less protein per pound than marathon runners, who burn protein for energy.

Why might some people, like the client's sister in the opening paragraph, lose weight rapidly on a high-protein diet? Probably because they lose a lot of water due to glycogen depletion. In the long run, short-term rapid weight loss doesn't work any better now than it did on the high-protein diets that were popular in the 1970s.

REFERENCES

Clark, N. The power of protein. The Physician and Sportsmedicine 24(4), 11-12, 1996.

Liebman, B. Carbo-phobia: Zoning out on the new diet books. Nutrition Action Healthletter. July/August 1996, pp. 3-5.

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Good nutrition for children ages six to 12 is quite similar to good nutrition for adults: Children need to eat a variety of foods from different food categories.