I read recently that the low carbohydrate diet craze has gone the way of the hula-hoop - that the Atkin’s diet, the Zone, and similar regimens have lost their appeal. Perhaps, I thought to myself. Low-carb diets may not be as popular as they once were, but they are far from extinct. When people consult me regarding their health challenges I routinely ask about their eating habits. The number one answer remains, “I’m eating low-carb.”

I’m disappointed when I receive that response. Low carbohydrate diets will trigger short-term weight loss in many cases, but the decrease in adiposity comes at a price. Low carbohydrate eating is not a strategy for long-term wellness.

To grow and remain healthy our bodies require nutrients, constituents in food that provide building blocks for maintenance and repair. Three major substances – fat, protein, and carbohydrate – are found in the foods that we eat. They are referred to as “macronutrients”. Other important constituents such as vitamins and minerals are called “micronutrients”.

Each macronutrient plays important roles in the body. It is important to understand some of these when making dietary choices.

Protein is comprised of amino acids. The body needs amino acids to manufacture enzymes, hormones, and, of course, proteins. Proteins are an important component of every cell. Hair and nails are comprised almost exclusively of protein, and protein is an important building block of bone, muscle, cartilage, skin, and even blood. Protein is also needed to repair damaged tissues.

The amount of protein required to perform these functions is grossly overestimated by most individuals. A common myth among bodybuilders says that extra protein is required to build muscle mass, but this is not the case.

Active men and teenage boys require more protein that other groups, but all of their needs can be met with only seven ounces of protein daily. Most people, including older children, teenagers, active women, and sedentary men do well with six ounce of protein daily. Young children, sedentary women, and seniors need only five ounces.

The wide variety of protein sources are also unappreciated by many. “Where do you get your protein?” is almost always the first question asked when someone learns that I do not eat meat. The answer is that legumes, nuts, and whole grains are rich sources of high-quality protein. Ounce per ounce, legumes and nuts provide as much protein as beef or poultry. Whole grain products, such as whole wheat bread provide about half the protein per ounce.

Proteins are not created equal, however. When animal protein is digested and metabolized an acidic ash is created, which must be neutralized. The body uses minerals such as calcium to accomplish this. Therefore, diets high in animal protein promote the development of osteoporosis over time as minerals are pulled from the bone to maintain a normal pH in the blood.

When plant proteins break down an alkaline (non-acidic) residue is created. Alkaline environments are associated with a lower incidence of cancer, osteoporosis, and degenerative diseases such as arthritis.

Fats give texture and flavor to food, and provide a greater feeling of satiety than proteins and carbohydrates. The low-fat diet craze that preceded the low-carb approach resulted in a significant increase in obesity rates. People who restricted their fat intake were found to be eating more calories because they did not experience “fullness” as quickly.

Fats are also needed for the absorption of fat-soluble vitamins including A, D, E, and K. The body uses fats to manufacture anti-inflammatory compounds, cell membranes, and brain chemicals. Fats are needed to maintain healthy skin and hair and for a host of other maintenance tasks.

Different fats, like different proteins, behave differently. Saturated fats, which are solid at room temperature, increase the risk of atherosclerosis and promote inflammation. Unsaturated fats, which are liquid at room temperature, tend to lower the risk of atherosclerosis, enable the body to produce anti-inflammatory compounds, and manufacture cell membranes appropriately. This is particularly important in the case of platelets, elements in the blood that are designed to clump together and plug up leaks in the system.

When the diet is high in saturated fats, platelet membranes will become sticky and the platelets will have a tendency to clump together unnecessarily, increasing the risk of a heart attack or stroke. When an adequate amount of unsaturated fats are available, platelets will be manufactured properly and they will not clump together abnormally.

Carbohydrates, although much maligned in recent years, are also essential to good health. Carbohydrates provide energy and increase our ability to perform prolonged activity. They are the primary energy source in the brain and as such enhance mental performance. Carbohydrates are needed to restore energy stores in muscles after activity and they increase the body’s ability to build muscle mass. They are essential to maintenance of blood sugar levels and free proteins for use in the areas in which they are needed.

Like proteins and fats, carbohydrates are available in different forms. Simple carbohydrates, sometimes referred to as simple sugars, are generally found in fruits. Complex carbohydrates, which are made up of starches and fibers, are found primarily in vegetables. While some have attempted to define simple carbohydrates as “bad” and complex carbohydrates as “good”, both types provide distinct benefits. Far more important than the distinction of simple or complex is the question of the source of the carbohydrate.

Whole foods (fruits, vegetables, and whole grains) typically contain a combination of simple and complex carbohydrates. In many cases, fats and proteins are also present. Refined and processed foods (white rice, white flour, white sugar, candy bars, sodas, etc.) are typically high in simple sugars without the fiber, vitamins, and minerals found in whole foods.

A simple carbohydrate eaten as part of a whole food behaves much differently than when it is consumed alone. The disparity can be seen by comparing the glycemic index of a food with its glycemic load.

All carbohydrates affect blood glucose levels. The degree to which a food influences blood sugar is determined by comparing it to the effect of pure glucose. Glucose is given a value of 100 on the glycemic index. While knowing a food’s glycemic index is somewhat helpful, recognizing its glycemic load, which is defined as the effect of a typical serving, is much more revealing.

The humble carrot provides an excellent example of the difference between a food’s glycemic index and its glycemic load. Carrots were initially reported to have a glycemic index of 92, causing people to believe that eating a carrot affects the blood sugar nearly as greatly as eating pure sugar. It has since been discovered that the glycemic index of carrots is closer to 47.

The glycemic load of eating a serving of raw or cooked carrots is only 3. This is because the starch and fiber within the carrot limit the amount of carrot sugar that can be consumed at one time. In contrast, carrot juice carries a glycemic load of 10 and a carrot muffin a glycemic load of 20!

To put this in perspective, it is currently believed that a total glycemic load of 160 or greater is associated with a significantly increased risk of developing diabetes. To remain in good health over one’s lifetime it is advisable to keep the glycemic load of one’s daily diet 100 or less. This means that an individual could safely eat the equivalent of 33 servings of raw or cooked carrots each day, but only 5 carrot muffins over the course of a day.

One would not limit one’s diet to carrots, of course, but this example points out the dramatic difference in glycemic load between carbohydrates in the form of whole vegetables and foods containing refined carbohydrates. It would be nearly impossible to reach a daily glycemic load of 100 by eating vegetables alone.

Fruits show a similar pattern. Fresh strawberries, for example, carry a glycemic load of 1, while that of strawberry jam is 10. A whole orange has a glycemic load of 3, but orange juice a value of 12. Most fruits produce a glycemic load of 3 to 7. Bananas are the exception, having a glycemic load of 12.

Approximately ten years ago I introduced seven simple rules for healthy eating. My goal was to provide a common sense approach to eating that could be followed without consulting a book, using a calculator, or checking a list. Given the dozens of “Diet Books” and hundreds of articles that have appeared over the past decade it is well to review them to see if they have stood the test of time. 

Rule 1: Keep Your Diet Colorful Fruits and vegetables provide most of the color to any meal. (Artificial colors don’t count!) They are higher in nutrients and lower in saturated fats and empty calories than nearly anything else we eat. Their glycemic load is the lowest among carbohydrates and they are rich sources of fiber. They are an important part of what is referred to as a Mediterranean diet, which is now accepted by many authorities as one of the most healthy possible.

It is currently estimated that eating at least five servings of fruits and vegetables daily could reduce deaths from stroke, heart disease and cancer by at least 20 percent. It light of this it has been said that increasing consumption of fruits and vegetables ranks second only to smoking cessation as a means to prevent cancer.

One study showed that each portion of a fruit or vegetable eaten lowered the risk of heart attack by four percent and the risk of stroke by six percent. Other health benefits conveyed by fruits and vegetables include a lower risk of cataract development, an easing of asthma symptoms, improved bowel function, and improved control of diabetes.

Rule 2: Stick to Foods that Would Be Edible at Room Temperature Foods that are high in saturated fat are unappealing at room temperature because the fat they contain has solidified. This gives them an unpleasing appearance and greasy taste. Studies continue to demonstrate that diets low in saturated fat convey health benefits, including longevity and a lower incidence of degenerative disease. The China Study by T. Colin Campbell, Ph.D. was released in 2004. The book draws insights from dietary surveys done in China, where widely diverse patterns of disease are seen. The study’s main conclusion is that diets containing animal fat and animal protein are one of the leading causes of cancer.

Rule 3: Avoid Refined Foods, Additives, and Preservatives Refined sugars, flours, and grains carry very high glycemic loads. They are largely responsible for the dramatic rise in the incidence of Type 2 diabetes in the United States. Even children are being affected, as one in every three newly diagnosed childhood diabetics in Oklahoma has Type 2 diabetes. In addition, refined foods deplete B vitamin stores and adversely affect the body’s immune system.

Rule 4: Include Oils that are Liquid at Room Temperature Evidence that oils from fatty, cold-water fish and plant oils such as olive oil, flaxseed oil, and evening primrose oil are essential to health continues to mount. Omega-3 fish oils (Marine Lipids), for example, have been reported to improve cholesterol ratios, prevent platelets from clumping together unnecessarily, improve mental function in children, and decrease the risk of heart irregularities and sudden death. These oils provide the building blocks the body needs to manufacture anti-inflammatory compounds, making them an effective tool in the management of arthritis and other inflammatory conditions.

Rule 5: Include Soy Products (Provided they are clearly labeled Non-GMO) Data demonstrating that ongoing consumption of soy foods provides protection against breast cancer, prostate cancer, and osteoporosis continues to mount. Soy intake also lessens symptoms commonly associated with menopause.

No other rule has fallen under greater criticism, however. Opponents of soy, some of whom attack its use as a food with evangelistic zeal, commonly set forth two arguments against its inclusion in a healthy diet. The first is that, due to the presence of substances that have an estrogen-like effect, soy consumption sends girls into early puberty and emasculates boys.

The medical literature does not bear out these accusations. A large number of milk-intolerant babies have been fed soy formulas for over sixty years. Long-term follow-up studies of infants raised exclusively on soy formula have shown no differences in onset of puberty, sexual characteristics, or fertility when compared to infants raised on milk-based formulas.

A second accusation is that soy consumption destroys thyroid activity. Evidence to support this allegation is meager, to say the least. It appears to be based upon a finding that a dosage adjustment is often required when infants receiving thyroid hormone replacement are changed from a cow’s milk formula to a soy formula. No evidence exists to support the theory that a child or adult with normal thyroid function will be adversely affected by consuming soy products as part of a balance diet.

Rule 6: Keep Meat Portions Small The benefits of soy consumption may, in part, be due to a corresponding decrease in the consumption of meat and poultry. The China Study confirmed the findings of other studies showing that the consumption of meat and poultry (animal fat and animal protein) is associated with an increased risk cancer development.

As previously explained, animal protein, when metabolized, leaves an acidic ash that must be neutralized. If the amount of acid-producing food is too great for the body to neutralize effectively, body tissues will become acidic, a state that promotes cancer growth.

I strongly recommend that beef, pork, and poultry be viewed as condiments – items that are used in small amounts to add texture and flavor – rather than as the main course. Think of a “stir-fry” dish as an example. Stir-fry recipes call for relatively large amounts of vegetables flavored by a small amount of meat or seafood.

Rule 7: Vary What You Eat Meals in the United States are usually very predicable: meat, potatoes, bread, and possibly a vegetable. Examples abound: A hamburger and fries (supersize that). Chicken salad and chips. A sirloin steak, a roll, and a baked-potato.

When the diet is limited, so are the number of nutrients available from it. Increasing the number and types of foods consumed significantly increases the chance of obtaining needed nutrients.

Varying the diet also minimizes the chance of developing a food allergy or intolerance. Food allergies, which are quite common in our society, are almost always to foods that are being eaten more than twice a week. That most food allergies resolve if the offending food is avoided for three to six months and then eaten only at intervals of four or more days is well documented.

Whenever diet is discussed the question of weight loss inevitably arises. I am confident that anyone who consistently follows the seven rules for healthy eating will experience as great or greater long-term success in weight control than that achieved by any “weight loss” regimen. Evidence strongly suggests that one’s ideal weight is that reached by consistently maintaining habits that promote general wellness. Roller-coaster dieting is not only unsuccessful in achieving the goal of sustained weight loss; it is associated with higher risks of disease and premature death as well.

I strongly encourage you to stop pursuing the magical formula for weight loss and begin consistently following simple rules for healthy eating. Your ability to remain well throughout your lifetime depends upon it.