Size of portions, wiser choices as important as number of carbs

By Bev Bennett, Globe Correspondent, 1/7/2004

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If you traded your favorite breakfast cereal for steak and eggs in order to lose weight on a low-carbohydrate diet, you'll be in for a big disappointment.

Sure, you can lose 5 to 10 pounds in a couple of weeks by eliminating bread, pasta, fruits, most vegetables, and dairy products -- just like the books say. But much of that weight loss will be water. And if you, like most people, fall off the program, the weight you regain will be fat and flab. "You start to look like the Michelin guy," says Dr. David L. Katz, director of the Yale Prevention Research Center in New Haven.

Carbohydrate reduction is the current "magic pill" for weight loss. Look on restaurant menus and supermarket shelves and you'll find an array of low-carbohydrate options. But low-carbohydrate plans actually sabotage your weight-loss efforts in several ways, according to nutrition experts.

Unless you work out, your body composition changes when you're on a high-protein, high-fat, and low-carbohydrate diet. Your body converts muscle to fat, according to Dr. Katz. And when you go off the diet and start to eat, the pounds come back as fat, not muscle.

In addition to being unsightly -- you probably went on a diet expecting to look fabulous fast -- having less muscle makes it more difficult to lose weight and keep it off. Muscle has a higher metabolic rate. The more muscle you have, the more calories you can consume without gaining weight.

And if that isn't enough, a low-carbohydrate diet can make you cranky. Eating carbohydrates helps increase serotonin levels, making you happier and more relaxed. Denying yourself carbohydrates may make you so irritable you self-medicate with cookies. Theoretically, low-carbohydrate diets have some positive potential. Learning to eat spaghetti by the cup, not the plateful, or skipping a daily doughnut should result in fewer weight problems. Unfortunately, many diets don't teach you to distinguish between high-fat refined carbohydrates and nutritionally superior ones. "Cheese doodles aren't the same as oatmeal. The notion of a carbohydrate as a single classification is ridiculous," says Dr. Katz, author of "The Way to Eat."Instead of slapping all carbohydrates with a negative label, nutritionists advise making better choices: Cutting back on white bread, and including more whole grains, fruits, and vegetables will help you lose weight, according to Marc O'Meara, a registered dietitian at Brigham and Women's Hospital. "I don't feel there's any one diet for everyone. Some people need a higher protein diet; others need more carbohydrates. If you moderate from a low-carbohydrate diet by adding whole grains, not refined grains, you probably won't overeat," he says.

The reason is that the fiber in whole grains, fruits, and vegetables provides satiety. You feel full. When patients complain to O'Meara that they're hungry on a low-carbohydrate diet, he recommends adding either a slice of whole wheat bread or an apple to each meal.

"You don't have to choose white bread," says O'Meara. "Eating a whole-grain carbohydrate will get the serotonin levels up, too."