Search Ask the Dietitian
Low Carbohydrate Diets
Where can I find a dietitian who works with low carbohydrate diets?
Wondering if there is any problems (kidney, liver, heart, prostate) with a high fat / high protein / low carbohydrate diet like Dr. Mario Dipasquale's anabolic diet. The diet's main energy source is fat and protein. It restricts carbohydrates to less than 30 grams per day during the week and then on the weekend (no longer than 48 hours) you do a carbohydrate loading phase when you concentrate on low glycemic carbohydrates. The diet is a lot of fun and it has helped me gain eight pounds of muscle. Just concerned about what it is doing to the interior of my body. Satisfied, but concerned.
I am glad you are interested in you body and long term health. However, the way you are feeding it does not support your body's optimal functioning nor increasing muscle.
Current recommendations by the American Dietetic Association, the U.S. Surgeon General and the American Medical Association encourage people to eat a diet centered around the Food Guide Pyramid and the Dietary Guidelines for Americans. The Pyramid is printed on many food labels, especially cold cereal boxes.
Carbohydrates should make up approximately 55% of your total calories, fat 30% and protein 15%. Excess fat and protein can be very harmful to the "interior of your body". Eating fat while limiting carbohydrate will increase blood fats which can build up to harmful levels. A high fat diet has also been closely linked in many studies to a high incidence of heart disease and many cancers, such as prostrate and colon. A high protein diet can cause the body to lose calcium, which can lead to development of osteoporosis. Osteoporosis can result in broken bones. After a few days on a low carbohydrate diet of less than 130 grams per day, a person develops ketosis. Read below for more information on ketosis. Then on weekends, when you re-feed carbohydrates, your body is busy replenishing depleted carbohydrate stores (glycogen in liver and muscle).
How do you know the weight you gained was all muscle? One method to assess your muscle mass is a body fat analysis. Did you have your body fat tested before and after you tried this diet?
Muscles increase in size when you make a muscle do more work than it is used to doing like in weight training. Eating more protein does not cause a person to gain muscle. Your body can easily convert protein to glucose if your body needs it due to an inadequate intake of carbohydrates.
I hope this information has been helpful for you to assess your diet. See your local Registered Dietitian for more suggestions on a healthier diet for the interior of your body.
What is your opinion of the "Zone" diet promoted by Dr. Barry Sears? Although it does restrict carbohydrates, it prescribes them at 1.33 times the grams of protein so I don't think it is in the same category as the "low carbohydrate" diets. In other words, it is not at all ketogenic. In addition, the carbohydrates to be emphasized are those having a low to moderate glycemic index.
The protein requirement is calculated from a consideration of a person's lean body mass (LBM) and level of activity. So for example, since I have an LBM of 133 lb. and am moderately active my protein requirement is about 90 gm/day. Sears shows in his book that using the same calculations a "typical" (and mostly sedentary) American male (23% Body fat and 154 lb.) would require only 60 gm/day, as is usually recommended for everyone.
Initially the fat intake on this diet (emphasizing monounsaturated) is calorically equal to the protein intake. Later, one increases monounsaturated fat in order to maintain weight (this part is probably controversial).
I have concluded that my caloric intake is somewhat lower overall than it was before - more like 1800 calories/day as opposed to 2600/per day before, though my weight seems to be holding steady now.
I was drawn to this diet due to high triglycerides (which were made worse on a low fat/high carbohydrate diet). I have lost about 8 lb., which my gym confirms were entirely fat, as my LBM has stayed the same. I feel more energetic and have more exercise capacity as well.
Do you have any concerns about this diet?
Your protein component is higher than your RDA of 63 grams per day. 90 grams of protein in an 1800 calorie diet equates to 20% of calories from protein, but not excessive. If you calculated your protein requirement from your present lean muscle mass, then you would not have additional protein to build muscle through weight lifting. Adding a level of activity (usually calculated in calories) would contribute calories. Would these activity calories be from protein food sources? If so, then you would have additional dietary protein to build muscle through exercise.
Your fat component is calorically equal to protein at 961 calories in an 1800-calorie diet and equals 53% of calories from fat. This is way higher than the 30% fat calories currently recommended for healthy diets. Monounsaturates are the best at not increasing blood cholesterol levels. If increasing your protein intake, you invariable will increase your consumption of saturated fats unless your proteins are entirely from vegetable sources.
Elevated triglycerides are therapeutically treated with a moderate carbohydrate, sugar and alcohol free diet, not high fat, low carbohydrate. Low carbohydrates will decrease triglycerides, which should measure below 150 mg/dl. Triglycerides comprise all the VLDL (very low density lipoprotein) component of blood cholesterol.
Your carbohydrate is 120 grams (90 grams times 1.33) in an 1800 calorie diet and equals only 27% carbohydrates. This is too low, even for a diet to lower triglycerides. Carbohydrates that produce a low to moderate glycemic index (increase in blood sugar caused by eating a particular food) are recommended to lower triglycerides. Around 50% of calories from carbohydrates would be better.
I believe that your calculations may be off if you eat 90 grams of protein (360 calories = 20%), 961 fat calories (107 grams = 53%) and 120 grams of carbohydrate (1.33 times 90 grams protein = 27%). You have underestimated the carbohydrate in your diet if in fact you are eating 1800 calories per day. Otherwise, you have overestimated how many calories per day you eat and are eating far less. Anyway, recheck your nutrient and calorie math. Try my Healthy Body Calculator to calculate your calorie target and grams for protein, fat, carbohydrate.
As to your lean body mass, I wonder what method was used to calculate it. If your gym used calipers or electrical impedance, both can produce erroneous readings depending on the client's hydration and the skill of the person performing the test.
Your information on low carbohydrate eating is questionable. You do not cite a single study, nor do you rely on information from research of any type.
What I know to be true is that since I have begun restricting my carbohydrates during the day to virtually zero grams and enjoying as much carbohydrate as I want during dinner, my cravings for cookies and junk has virtually disappeared. It used to be that one cookie meant 40 cookies. Now the cookie is not even an issue. My blood sugar is so level that I haven't suffered an anxiety attack for a few weeks. I used to have them DAILY. I eat vegetables, salads, tofu and a variety of meats during the day.
At night I might enjoy pasta or burritos with plenty of fresh vegetables. I enjoy full fat varieties of all of the things that I obsessively only used if they were fat free before. Low fat eating caused me to be constantly hungry and obsessive about food. It caused me to binge on fat free goodies ad nauseum. Since I have been eating low carbohydrate I have not had a single carbohydrate binge. Not one. The simple sugars that used to haunt me are a thing of the past. So are the violent mood swings and crying jags.
Someone would be hard-pressed to convince me that this is not healthy and that I should go back to restricting calories and eating low fat. Not in this lifetime.
The nutritional information provided here on carbohydrate controlled diets is based on research, education and clinical experience. I don't quote specific research studies as this website is for the general public not for nutrition scientists to debate various studies.
If restricting carbohydrates for you have improved your cravings for carbohydrates, congratulations. However, there is no research to substantiate what you have experienced by eating carbohydrates at particular time of the day. There are carbohydrates in all foods, even trace amounts in meat and therefore would be impossible to eat 0 carbohydrates at a meal unless you only ate fats like butter or margarine.
Secondly, high or low blood sugars do not cause anxiety attacks. The cravings and obsessing you describe are more indicative of binge eating.
Some studies are beginning to suggest that the broad based use of fat free or fat reduced foods does not decrease calorie intake. It seems that a person will eat the same amount of calories. Calories do count, not just fat grams!
High blood sugar is one symptom of diabetes and is caused by a lack or insufficient production of insulin. Low blood sugars is one symptom of hypoglycemia which is triggered by eating high carbohydrates, especially simple sugars and sweets, which causes an overproduction of insulin.
While looking up different diets, we came across the Atkins low carbohydrate diet. What are the differences between such a diet and a low calorie diet?
Are low carbohydrate diets safe? Are low calorie diets safe for that matter?
How do these diets affect people with different profiles i.e. athletes vs. overweight people?
Are there perhaps different strategies that should be applied to the different profiles?
Do you perhaps have menu plans that we could obtain from you?
Low calorie and low carbohydrate diets can be used under medical supervision for morbid obese persons (twice their healthy body weight or at least 100 pounds overweight). Under other circumstances, these diets are not recommended. The problem with these diets is that after the first few days, body stores of glucose (glycogen) are depleted and the body turns to the only other source of glucose which is lean muscle tissue (organs and muscles). Metabolic rate decreases because the body thinks it is starving and because the muscles that burn calories are cannibalized to provide glucose.
Starvation affects all persons the same. The difference is how much stored glycogen and lean muscle tissue does the person have to lose before dehydration or death occurs.
I generally do not provide menu plans for diets, especially not low calorie or low carbohydrate diets for weight loss. If your doctor recommends a low calorie or low carbohydrate diet, ask to see a dietitian for assistance in meal planning. In the meantime have you tried HELP Healthy Eating for Life Plan#8482;? It will create a healthy eating plan for you wihtin within healthy limits of carbohydrate, pregnancy protein and fat.
Thanks so much for your prompt and detailed response regarding my question about a low carbohydrate diet. I very much appreciate your professional opinion because I don't want to do anything harmful. Just so you know, when I said I "had trouble" with a low calorie diet, I simply meant I had trouble staying on it because I felt hungry most of the time. Again, I appreciate your help very much.
You're welcome. Did you try the Healthy Body Calculator? It will calculate calories based on your personal weight goal including 1 - 2 pound weight loss or weight maintenance. Use that as a guide to meal planning.
If you have trouble staying on a low calorie eating plan like 1200, perhaps, you should try a slightly higher calorie level that still will achieve slower weight loss. You may not lose as fast, but you may be more likely to stay on your weight loss plan. Also remember to include exercise.
My fiancÚ has been trying to lose weight using a low carb diet. She is just slightly overweight and has never really been dedicated enough to ever be successful at a regular reduced calorie diet. When I try talking her into a more sensible diet, she accuses me of being unsupportive. Any suggestions?
Instead, create opportunities for you two to exercise together. Make it fun like walking, biking, rollerblading or even shopping. Choose exercises that she likes so she is more likely to participate. Don't make a point by saying that you are trying to get her to exercise. Just provide the opportunity.
Second, when you go out to eat or cook together, plan meals that have a variety of foods, but low on the sweets and desserts. Limit alcohol as your body turns it to fat in order to metabolize it. Don't dangle foods in front of her that will increase her weight.
She'll definitely need your support when she goes off the low carbohydrate diet. You can't eat that way forever.
Thank you for your response. There are very accurate ways to measure fat loss. Dr. Atkins' book talks about documented fat loss tests performed on patients.
Once again, your response is very biased in the words you use and the way you use them. Any "diet" is a fad diet. People that reduce calories and start exercising on January 1 are on a fad diet. They will most likely be affected by the yo-yo syndrome as well since 95% of them will quit.
Granted, a low carbohydrate diet requires permanent changes which are hard to keep indefinitely (as with most diets). However, I think it is much easier when you do not feel hungry, but feel very well physically (which is the reason phen-fen worked as well as it did, less the side effects).
People can lose weight on low carbohydrate diets in the short term. However research has shown that 97% re-gain the weight lost. So short term success does not translate into long term weight loss maintenance. The problem I have with most diets is that you have to eat one way to lose weight, but can't eat like that for the rest of your life. After losing weight, most people go back to their usual diet of when they weighed more and eventually the weight creeps back.
Phen-fen is no longer sold in the US since 1997 due to heart valve problems.
Everyone, including yourself, seems to be attacking low carbohydrate diets. If your traditional weight loss programs of balanced diet and exercise is the way to go, than why do we have an obesity epidemic with the majority of obese people having tried that way of dieting (myself included) without long-term success?
You are so eager to show how much water or lean tissue a person looses on the low carbohydrate diets, but you make no attempt to calculate the stored fat loss almost implying none occurred.
Low carbohydrate diets (less than 100 grams per day) are dehydration diets which do cause a loss of water and lean tissue. We can measure protein and water loss with blood and urine tests. There is some fat lost, but how would one calculate fat loss? You would have to have a very accurate body fat analysis at the beginning and end of a low carbohydrate diet. Even then, it would have to be over a long period of time (at least 3 - 6 months) before any change is noticed. Unfortunately when a person increases their carbos, weight gain is common due to re-hydration.
What researchers have found is that people who try fad diets frequently often have a yoyo weight changes. Researchers have also noticed that people who try fad diets often end up heavier after going off a fad diet than before they started dieting.
The human body is capable of storing practically an infinite amount of body fat while waiting for the next famine to come along. We are the result of our cave person's genes. The fat cave people survived famines long enough to pass along their fat genes. The skinny cave people died first during a famine. So in this technological world, humans need to stop eating when they are full and get regular exercise 3 - 5 times a week. It doesn't happen overnight, but diet, exercise and emotional support have been found to keep weight off longer than just diet alone. Any diet.
My daughter is a dietitian. She fought it but now consults positively. What I am discussing is the Low Carb Diet. I have attended 2 seminars in past 6 weeks. Other dietitians are disputing your negative statements. May I suggest you rethink and investigate a bit past what you have been taught? As my daughter said, "I am a product of my education and beliefs that now I discover is wrong and that upsets some of us". She works with heart and cancer patients, has written nationally and you would know her. This is a private communication to just suggest that you CONSIDER your stance as there WILL eventually be a backlash with the diet. My own physician is on it and lost 68 pounds. His entire office practices low carbs as does his 2 partners. Low fat is being disputed! Thanks.
Low carbohydrate diets do cause weight loss, much of which is water, stored glycogen, lean tissue and fat. The problem I have is that 97% of people who have lost weight on low carbohydrate diets re-gain their weight. Low carbohydrate is not a long term weight loss solution.
I base my answers on current research. When research substantiates that low carbohydrate or any other type of diet is successful long term in helping people achieve and maintain a healthy weight, then I will jump on that bandwagon. Until then testimonials have no place in my recommendations to consumers.
Just wanted to let you know how happy I am to have found this site.
I work with several women who are on the high protein / low carbohydrate diet. They continually pester me, saying that the way I am aiming for weight loss (exercise and well-balanced meals) is no good.
I am part of the minority who don't normally enjoy red meats, while loving whole grain breads, pastas, etc. I also love to eat plants (veggies, fruits, seaweeds...and yes, I even love Brussels sprouts). The thought of eating bacon and a 3-egg omlette in order to lose weight turns my stomach.
While they have lost weight faster than I have, I can run 3 miles and they cannot. I also don't suffer from "lower back pains", alleviated by drinking water and I can eat out anywhere, anytime.
I have lost "only" five pounds in the last month, but I did it without having to buy special foods or completely avoiding others. Your site is like my personal cheering section, backing me up in what I consider the only *sane* and healthy way to lose weight. Thank you!
Thanks a bunch for your cheers.
Yes, it is difficult to combat the fad diets that constantly appear on the horizon with promises of a silver nutrition bullet to cure their overweight. But with time, they all fade away when the next popular fad diet comes along.
While you may have lost less weight than your high-pro co-workers, you probably have added muscle and reduced body fat while they are depleting muscles to supply the carbohydrate in short supply in their diets.
Aim high for a strong, healthy woman's body.
I wanted to know your opinion of the protein power diet that is gaining popularity. As you probably know, it's promoted by two MD's (Drs. Eades). They have two levels: one is about 30 grams of carbohydrate a day; the other is a little less restrictive, about 55 grams per day (which is the one I'm following). I seem to be doing pretty well on it and I have a lot of trouble with the typical 1200 calorie a day diet. I do think I have trouble with carbohydrates and may in fact be insulin resistant. Do you think there's any harm in this at least until I lose the ten to fifteen pounds that I'm looking to lose?
I'm eating pretty healthy stuff, mostly meat, chicken, fish and lots of fresh vegetables. I take a good multivitamin, potassium supplement and vitamin C every day.
Another question if I may? Have you ever heard of a dietary supplement that is called blue-green algae? If so, what do you think of it? Thanks so much for your help.
Both 30 and 55 grams of carbohydrate per day are less than the minimum 130 grams necessary to prevent loss of lean tissue (muscles and organs). I would not recommend either for weight loss as you are likely to regain this weight once you stop dieting. Read the questions and answers below for more information.
Good thing you take a multivitamin vitamin as it is impossible for women to meet the RDA on less than 1600 calories per day. But why take additional potassium or Vitamin C? Read my Potassium
and Vitamin C
nutrition topics. If you have normally functioning kidneys, you probably have very yellow urine from these two supplements.
Insulin resistance occurs when fat cells are full and more insulin is necessary to enter a cell to metabolize glucose (blood sugar) into energy (calories). As little as a 10% weight loss does improve insulin resistance, lower blood glucose and lower blood insulin levels. Type II diabetics often have insulin resistance and this is reflected in their higher blood sugar. Often they have higher blood insulin levels even without taking insulin shots. What makes you think you have insulin resistance? Do you have high blood sugar? If so, you should be treated for diabetes.
You don't explain why you have trouble with 1200-calorie diets in particular carbohydrates.
Yes, I have heard of blue green algae. It is not the silver bullet for weight loss that you are looking for. Would suggest you talk to a Registered Dietitian who could help you plan a healthy weight loss / exercise program for life. It takes a lower calorie intake, exercise and writing down everything you eat to successfully lose weight according to current research.
I've read a couple of the Q&A articles under "Ask the Dietitian" and noted your concerns on low-carbohydrate diets. You are probably familiar with the Atkins diet. My wife is currently on this diet (2 weeks now) and has lost approximately 10 pounds. I guess the idea is that the carbohydrates are kept under 20 gm/day initially, while protein & fat are essentially unlimited, no calorie count restriction. This being the case, do the concerns that accompany a low carbohydrate/low calorie diet apply also to a low carbohydrate diet with unlimited protein?
You mention low carbohydrate diets of fewer than 900 calories not providing enough protein for muscles and organs and not supplying an adequate resource for glucose. What about 20 gm/day of carbohydrates and, say, 500 gm/day protein and 30 gm/day of fat, for example. Does this supply enough protein for adequate glucose production & protein reserve?
I don't think all the weight my wife lost was water. She has been consuming approximately 2000 calories/day total, limiting the carbohydrates to 20 gm max. and not really watching anything else. Is she headed for trouble or is the high protein/fat intake compensating for the missing carbohydrate?
If she were to transition from a carbohydrate-restricted diet to a fat-restricted diet at a later time, would this prevent regaining weight?
Yes the concerns are similar when restricting carbohydrates whether or not you have unlimited protein or even fat in your diet.
Your wife is in ketosis because of restricting carbohydrates. Your body can scavenge from dietary protein and fat to supply glucose. But the hoops your body has to jump through to do that requires more effort than depleting your body's stores of glycogen. Glycogen is converted to glucose rather easily. The problem is when you've depleted your stores of glycogen (stored glucose in muscle and lean tissue) your body turns to burning muscles or organs (lean muscle tissue) and dietary protein or fat to provide blood glucose to supply energy needs. When this happens, your basal metabolic rate drops because you have less lean muscle tissue burning calories and your body thinks its starving and cuts back on energy requirements. The human body's genetic material is 12 million years old and still thinks in terms of feast or famine.
A 25+-year-old female needs 50 grams of protein per day. Protein is used to build and repair lean muscle tissue. This would not provide enough glucose to prevent ketosis. A diet of 500 grams of protein per day would be equal to 71.4 ounces (4.5 pounds) of meat, fish or poultry. Do you really think you wife can eat that much? (Did you mean 50 grams?) Also, since most sources of protein also have fat, I would guess that a diet that included 500 grams of protein would also inherently contain at least 214 grams of fat. (One ounce of lean meat, fish or poultry has 7 grams of protein and 3 grams of fat.) A diet high in protein usually turns off the appetite (as do the ketones being produced) and puts a strain on the kidneys. Proteins are large molecules and you blood is constantly filtered by your kidneys.
Twenty grams of carbohydrate is only 80 calories. If the remaining calories are protein and fat, she could be eating 35 ounces (2.2 pounds) of lean meat. Could this be possible?
I would bet that a lot of the weight your wife has lost is water because each gram of glycogen in muscles and lean tissue holds 3 grams of water. When you deplete glycogen, you lose water. Muscles and lean tissue are 70% water; fat is only 15% water. Usually these low carbohydrate diets encourage 8 glasses of water per day. This is to help flush the ketones out of the body through the kidneys and to prevent dehydration. One method of determining if you are dehydrated is to grab a pinch of skin on the back of your hand and let go. If you skin snaps back flat, you probably are not dehydrated. Also, look at the color of your urine. During the day it should be colorless and odorless unless you take Vitamin C supplements which will turn your urine yellow.
Look at a ten pounds box of butter. Does you wife think she has lost that much fat in two weeks? Probably not.
What is your wife going to eat when she goes off her low carbohydrate diet? When she starts to eat a low fat diet, she will experience weight gain just due to re-hydration. A weight loss program that is more like her normal eating habits with fewer calories and less fat with a regular exercise program has been shown to be the most successful to keeping weight off long term.
Search Ask the Dietitian