Tuesday, May 11, 1999
High-protein, high risk?
You lose weight, but experts caution against cutting carbs
BY SUE MacDONALD
The Cincinnati Enquirer
You know who they are by what they order in restaurants or cook at home.
They gobble bacon and eggs for breakfast — no toast, no hash browns, no jam. For lunch, it's a double cheeseburger, hold the bun, and maybe a small salad. For dinner, plenty of steak, pork chops and chicken — forget the pasta, potatoes, rice, corn and bread.
In an old-is-new-again cycle, people are flocking to high-protein, low-carbohydrate diets with names like Protein Power, Dr. Atkins' Diet, The Zone and Sugarbusters.
On this point, supporters and critics agree: People on these diets do lose weight quickly — 10-20 pounds or more in a matter of weeks or months.
But nutritionists worry that people enamored by the diets' quick weight-loss capabilities remain oblivious to the long-term health effects from a steady consumption of high-fat, cholesterol-rich foods. The result can be overworked kidneys, constipation, altered insulin metabolism and the risk of gallstones. And that doesn't take into account the inevitable result of nearly every fad diet: once the dieting stops, the weight comes back.
“Nobody wants to hear the message that we have, because they want the quick-fix, the gimmick,” says Pat Streicher, dietitian manager at the Jewish Hospital Cholesterol Center.
Call the high-protein diets what they really are: low-calorie diets, says Ronda Gates, author and nutrition consultant with Lifestyle, in Lake Oswego, Ore.
On any diet that categorizes “good foods” and “bad foods,” people will regain their lost weight as soon as cravings begin, the diet ends and regular metabolism returns, she says.
“I always say to people, talk to me in three months or six months and then tell me how it works,” says Ms. Gates. “Talk to your parents because they were on these diets 20-30 years ago. They're just being recycled.”
Moreover, many people who pursue these quick weight-loss diets admit — although none we talked to wanted their names used — that they don't always follow the diets' recommendations. They should be monitoring cholesterol, kidney function and insulin levels. They should be drinking at least 8 glasses of water daily. And they should be doing that old bugaboo, exercising regularly.
Says a Cincinnati marketing manager who lost 40 pounds in eight months on the Atkins diet: “I'm one of those people waiting for the pill you take and you lie down on the bed and it exercises for you.” Needless to say, she does not exercise, even though it's one of the Atkins cornerstones.
Lauren Niemes, director of the Nutrition Council, says her agency's hotline is fielding numerous calls about the low-carbohydrate, high-protein diets, and many callers say their doctors recommended the diets.
“I just don't understand how these health professionals can think that there's some new evidence that these are safe and effective approaches to weight management,” Ms. Niemes says. “These low-carbohydrate diets work because they're low-calorie, but they don't address the biggest problem in this country, which is our sedentary lifestyle. People think that this is the answer to eating too many calories and not being physically active.”
Normally, the body burns carbohydrates for energy — found in fruits, vegetables, pasta, rice, bread, cereals, etc. Most of the high-protein diets are very low in or void of carbohydrates, so when the body is deprived of its normal energy source, it begins burning its own protein, in the form of muscle tissue, and stored fats to produce energy.
Ketones are byproducts of the fat-burning process, and once ketones begin to rise in the bloodstream, the kidneys work overtime to produce more urine to flush them from the body. Much of the early weight loss on these diets is actually water loss.
Continually deprived of carbs, the body keeps burning its own tissues and protein stores to make energy. Critics say long-term reliance on these diets upsets the metabolism and puts people at risk for health problems linked to too much fat and protein: cancer, carbohydrate cravings that come from flattened insulin levels, gallstones, possible kidney damage and an imbalance of other nutrients.
Dr. Jerry Sutkamp, a Fort Mitchell physician who specializes in weight loss, says his early-career fascination with the weight loss achieved by high-protein diets waned when he realized that people eventually are done in by the body's natural craving for carbohydrates.
His advice is simple: eat less, exercise more and most importantly, get a grip on food portions and sugar. Once people learn to control sugar in the diet, he says, weight comes off without the hazards of too much protein or excess fat.
Because the low-carbohydrate diets limit or outlaw certain fruits and vegetables, nutritionists worry that people are missing out on vital vitamins, minerals, fiber and other nutrients that increasingly are being linked with overall good health.
Of course, the diets have their supporters.
A Cincinnati veterinarian — who didn't want his name used — says he's lost 80 pounds in 10 months on the Atkins diet. Moreover, his problems with gastric reflux — a heartburn-like condition of stomach upset after eating — disappeared the day he cut carbohydrates out of his diet.
But he hasn't had his cholesterol checked, even though he regularly eats eggs, bacon and double cheeseburgers. And he upped his exercise — tennis — only slightly. He tells friends interested in his success to check first with their doctor before relying on a high-protein diet, but he hasn't done so himself.
“I don't see myself sticking to this so strictly in the future,” he says, “but I also won't go back to eating so many carbohydrates.”
Nutrition educators just want the diet followers to know the full story, and the reality is that these diets are like most diets: prone to failure once the diet ends.
“This is an all-or-none diet. Either you stay on it or don't,” Dr. Sutkamp says. “You can lose 40-50 pounds on it in four or five months, but then you quit because you can't stand to not have the spaghetti or the bread you're dying for. And when you quit, you gain all the weight back. It's not a diet you can stay on.”
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