It's enough to make your head spin.
A report in the latest issue of the Journal of Clinical Endocrinology & Metabolism finds that low-carbohydrate diets helped women shed pounds without raising their risk of heart disease. But a review of 107 scientific articles describing the use of low-carb diets in some 3,200 participants published last week in the Journal of the American Medical Association (JAMA) concluded that there's insufficient evidence to "make recommendations for or against the use of low-carbohydrate diets."
Confusing? You bet. "A lot of Americans are going to be left thinking: 'What message do I listen to?' " says Bonnie J. Brehm, associate professor of nutrition at the University of Cincinnati College of Nursing and author of the Clinical Endocrinology report -- one of the few studies to rigorously test the low-carb regimen against the low-fat approach.
So what's known now? "You can lose weight with low-carb diets," Brehm says. "That is not debated. The concern is the safety of the diet, and we have by no means done enough research to know about safety."
Here are a couple of basics to keep in mind:
* Americans eat too many carbohydrates. A recent U.S. Department of Agriculture (USDA) report found that many people exceed the nine servings of bread, cereal, pasta and other starchy foods recommended on a 2,200-calorie-a-day diet. Even more troubling, according to Judy Putnam, lead author of the report, is that most of these servings contain white flour, which can quickly spike blood sugar levels and overtax insulin production. The current recommendation is to eat at least three servings a day of whole-grain carbohydrates, such as multigrain bread, brown rice or popcorn.
* The latest recommendations from the National Academy of Sciences suggest consuming a minimum of 130 grams per day of carbohydrates. That's up to six times the amount suggested in such low-carb regimens as the diet named for Robert C. Atkins, who died last week after suffering a head injury in a fall on an icy sidewalk. Since most people now eat about 260 grams of carbs per day, "we can probably cut back on refined carbohydrates at least a little bit," Brehm says. Or meet that minimum with less processed foods. A banana, for example, has 24 grams of carbohydrates. A cup of wild rice provides 34 grams. Baked beans have 52 grams per cup. Multigrain bread provides about 14 grams per slice. A cup of broccoli has eight grams, and grapes provide about 16 per cup.
If you decide to eat fewer carbs, here are some tips:
Focus on complex carbohydrates. Complex carbs contain large sugar molecules plus fiber and other nutrients, including vitamins and minerals. This combination slows digestion and tempers a whole cascade of biochemical reactions in the body that affect fat storage, blood sugar, appetite and more. Sources of complex carbohydrates include oatmeal and other whole grains. Fruit and vegetables are frequently overlooked sources.
Eat healthy fats. Some people embark on low-carb, high-protein regimens thinking they can forego starchy foods and eat endless amounts of porterhouse steaks and eggs. That's a big mistake, Brehm says, because saturated fat and cholesterol are clear contributors to heart disease. Smarter choices for those adopting a low-carb diet, she says include high-protein foods with healthy fats, such as salmon, tuna, mackerel or sardines as well as foods rich in heart-healthy mono-unsaturated and polyunsaturated fats including olive, canola, and flaxseed oils, nuts and avocados.
Track portion sizes. Sorry, but calories still count. The JAMA study attributed weight loss on low-carb regimens to reduced overall calories. "We've always said that if you pay more attention to what you're eating, it helps with weight loss," Brehm says. "That may be what is happening with low-carb diets."
-- Sally Squires
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