Working part-time as a waitress, I’ve observed a common phenomenon: approaching a table with a basket of rolls, I’ll be waved away. “No bread; I’m on a low-carb diet,” the customer will explain (sometimes with wistful regret). The low-carbohydrate craze reached its peak in the early 2000s after Robert Atkins released his Dr. Atkins’ New Diet Revolution, an update on his 1972 original. In 2004, 24 million Americans were on some type of low-carbohydrate diet, with another 30-40 million considering an attempt (Bentley, 2004). The frenzy has since waned, but it seems to be picking up again with the recent publication of a study conducted at Children’s Hospital in Boston  that compares weight maintenance after a low-carbohydrate diet to weight maintenance after a low-glycemic index and low-fat diet (see the Times Magazine and New York Times press reaction pieces to this study).

The study examined 21 overweight and obese patients over four years, each of whom had lost 10-15% of their body weight. Each participant then went on a low-carb, low-fat, and low-glycemic index diet in random order for one month each. Resting energy expenditure and total energy expenditure were measured for each diet. Results showed that resting energy expenditure decreased most with a low-fat diet and least with a low-carbohydrate diet, suggesting that low-carbohydrate diets are best for enabling individuals who have recently lost weight to keep it off. The press jumped on the study, emphasizing its conclusion that low-carbohydrate diets seemed significantly more effective at keeping weight off and noting the resulting implications for millions of American dieters. Gary Taubes’ review of the study in the New York Times opinion section called the results “remarkable.”

The results of this study, however, should be taken with a (proverbial, as we’re talking about food here) grain of salt. On her blog Drop it and Eat, Lori Lieberman, RD questioned the study’s credibility, noting that with only 21 participants and a startling 34% dropout rate, the results were hardly groundbreaking. One month on each diet, she pointed out, is hardly adequate for evaluation. And the patients had just lost 10-15% of their body weight—on a near-starvation diet, no less—putting them in a different metabolic state than those whose weight had been stable. Thus, Lieberman asserted that even if the sample size was large enough, they may not have practical implications for those trying change their eating patterns.

It will be interesting to see whether publicity around this study leads to a second wave of a low-carbohydrate diet craze and whether we’ll see same trends in diet behavior all over again. The first time around we witnessed a tremendous mobilization by the food industry in response to the low-carbohydrate craze. In 2003, six hundred low-carb products were available in grocery stores, including low-carb beer, pasta, and ice cream. Restaurants created separate low-carb menus and even bakeries scrambled to come up with low-carb muffins and breads (Bentley, 2004). Also, the low-carb craze recruited men to dieting. Before the Atkins frenzy, the public face of dieting had traditionally been female. Traditional diet foods, such as salads, fruits and vegetables, and “low-fat” options were thought to be feminine food choices. In contrast, the low-carb diets offered men a “safe” option by allowing them to order a large steak in lieu of what may be perceived as an eyebrow-raising request of “just a salad.” Fueled by the new culture of masculine dieting, men came to diet in much the same social way women do, discussing their various challenges and successes with male friends over a meal of Atkins-approved chicken wings. It even acted as a means of social cohesion, emerging as a common topic of conversation and commiseration among men and women alike (Bentley, 2004).

The results from this recent research study will certainly prompt more people to try a low-carbohydrate lifestyle. But those optimists about to embark on a new diet plan should note that a staggering 95% of dieters regain their weight (Bijlefeld & Zoumbaris, 2003). One reason so many dieters are unable to keep weight off is that the severity of restriction that many diets demand is simply hard to maintain. Low-carbohydrate diets are especially difficult to sustain, so much so that the study itself acknowledges it: “The very low-carbohydrate diet involved more severe carbohydrate restriction than would be feasible for many individuals over the long term,” it concedes. Thus, even the limited findings of the study are only applicable to an extreme diet regimen. The strict demands of a low- or very low-carbohydrate diet make the odds of its long-term success especially scant.

Finally, it’s important to remember that carbohydrates are not an enemy. Carbohydrates and fats give us energy to survive and are necessary for proper functioning of the body. In the frenzy to lose weight, we’ve forgotten what food is for. Nothing is inherently bad—we need carbohydrates, fats, and calories to survive. We need to change the conversation from pounds lost or gained to how to achieve a healthy, balanced, and satisfying nutrition. So next time, maybe enjoy those rolls I place on the table but also listen to your body and be mindful of the signals your body sends you about when to stop eating them too.

References

Bentley, A. (2004). The Other Atkins Revolution: Atkins and the Shifting Culture of Dieting. Gastronomica, 4.3, 34-45.

Bijlefeld, M., & Zoumbaris, S. (2003). Encyclopedia of Diet Fads. Westport, CT: Greenwood Press.

Ebbeling C.B., Swain J.F., Feldman H.A., Wong W.W., Hachey D.L., Garcia-Lago E., & Ludwig D.S. (2012). Effects of dietary composition on energy expenditure during weight-loss maintenance. Journal of the American Medical Association 307(24):2627-34.

L. Lieberman. (2012, July 7). Carbs Still Don’t Make You Fat. But Taubes’ Words May Make You Crazy. [Web log comment]. Retrieved from http://dropitandeat.blogspot.com/.

Taubes, G. (2012, June 30). What Really Makes Us Fat. The New York Times. Retrieved from http://www.nytimes.com/2012/07/01/opinion/sunday/what-really-makes-us-fat.html?_r=2.

By: Cora Wilen