The endless parade of dieters visiting my nutrition counseling
office has changed in the past year. My former high-carbohydrate
dieters -- the pretzel-and-bagel brigade -- have turned into
high-protein converts. I like to call them the bunless cheeseburger
chompers.
And you can bet they're aware of the army of health experts who
attack high-protein diets on TV. In fact, I used to be a critic
too. No wonder all my cheeseburger junkies share this one nagging
fear: ``Am I damaging my health for the sake of losing weight?''
ANOTHER LOOK
I still believe the answer is yes -- if you're following the
wrong hi-pro diet. Some, like the Atkins Induction diet, just drip
with artery-clogging saturated fat. They also lack the
health-protective benefits of plentiful vegetables, fruits and
whole grains. You've heard these diets panned in the media -- and
rightly so.
But what about the more moderate hi-pro diets, including Sugar
Busters! and The Zone? The truth is, I'm having second thoughts --
and here's why.
When I compare these diets to what most high-carb dieters are
actually eating -- tons of empty-calorie refined carbs such as white
bread, fat-free cookies, pretzels, bagels and crackers -- I've
started to think that the better hi-pro diets look pretty darn
healthy. There's also some scientific evidence that dieters
actually need more protein.
WEIGHT LOSS SECRETS REVEALED
To be sure, all the hi-pro diets are based on bogus science _--the erroneous idea that carbohydrates make you fat. You think
you're losing weight because you're following a ``scientific'' plan
that focuses on ``protein blocks'' or ``reward meals.'' You're
losing weight because you're eating fewer calories, not because
you're eating fewer carbohydrates. It's as simple as that.
But to follow the moderate hi-pro diets, you cut back on starchy
carbohydrates and sweets, substituting meat and tons of vegetables
in their place. For most people, that means trading in
nutrient-empty white flour and sugar for nutrient-laden protein and
produce. As a dietitian, I'd say that's a big improvement -- not
perfect, but a huge step in the right direction. And if it helps
you achieve a healthy weight, great.
Just to make sure, I rechecked my facts with some top doctors --
and here's the truth I now tell my clients about those ``nasty''
high-protein diets.
What You Hear: High-protein diets make your kidneys work harder
to flush out waste products, and may wear them out.
The Truth: ``They do increase risks for people with kidney
problems,'' says Lisa Giannetto, MD, associate in medicine at Duke
University Medical Center in Durham, N.C.
If you have diabetes, high blood pressure, heart disease or
other risk factors for kidney disease, before considering such a
diet, discuss it with your doctor and have her give you a complete
physical and a blood test.
If you have healthy kidneys, there's no research that says that
excess protein will damage them -- even though most high-protein
diets call for an amount of protein about three times higher than
Recommended Dietary Allowance levels. To be on the safe side,
however, if you're on a hi-pro diet, your doctor should monitor
you, says George Blackburn, MD, director of the Center for the
Study of Nutrition and Medicine at the Beth Israel Deaconess
Medical Center in Boston.
For dieters with healthy kidneys, there may actually be bonuses
with higher protein levels. When it comes to satiety -- keeping you
satisfied longer -- high-protein foods do it better than high-fat or
high-carbohydrate foods.
Another hi-pro benefit for dieters: Your protein needs increase
when you restrict calories. When your energy intake is restricted,
some of the protein that you eat is used for energy, making it
unavailable for maintaining muscle tissue and other important
substances such as antibodies. On moderate-weight-loss diets such
as the 1,500-calorie minimum that Prevention recommends, protein
needs increase only slightly -- up to about 15 percent of calories.
But what if you go below 1,500?
``The lower the calories, the higher the protein,'' Blackburn
says.
If you do follow a high-protein diet, drink at least 8 cups of
fluid daily to help your kidneys flush away extra waste products.
What You Hear: High-protein diets thin your bones by raising
blood acid levels, which force the bones to release calcium in
order to neutralize all that acid -- the same way that calcium in
Tums neutralizes stomach acid.
The Truth: ``Yes, excess protein increases calcium loss, but
that's only a problem if your diet is calcium-poor. If you take in
enough calcium, studies suggest that your bone density is
maintained,'' says calcium expert Robert P. Heaney, MD, of
Creighton University in Omaha, Neb.
If you're on a high-protein diet, Dr. Heaney recommends aiming
for 1,500 to 2,000 milligrams (mg) of calcium daily -- slightly more
than Daily Value DV levels -- from a combination of diet and
supplements.
What You Hear: High-protein diets are bad for your heart because
they're high in saturated fat and raise your cholesterol.
The Truth: Some diets fit that description perfectly. One of my
clients came to me after 2 months on the Atkins diet. She loved her
rapid weight loss while still eating saturated-fat-laden Cheddar
cheese, sausage, burgers and ribs, but was alarmed when her total
cholesterol rose to a high-risk 276 and her ``good'' HDL plummeted.
With a family history of heart disease, she knew that for the
long term this was not good. She's now on a new eating plan low in
saturated fat. Her cholesterol has returned to normal and she's
maintained her weight loss.
Fortunately, not all hi-pro diets are like the Atkins or
carbohydrate addict's diets. Several, including Sugar Busters! and
The Zone, focus on heart-healthy lean meat, poultry, fish and
low-fat cheese -- all of which are low in saturated fat. Preferred
fats include olive and canola oils, olives, nuts, seeds, avocados
and fatty fish that actually lower heart disease risk by raising
HDL, lowering ``bad'' LDL, and controlling triglycerides.
What You Hear: High-protein diets increase cancer risk because
eating lots of meat has been linked to higher rates of breast,
colon and prostate cancers and non-Hodgkin's lymphoma.
The Truth: Yes, some studies do link high-meat diets with higher
cancer risk, although why isn't certain. Is it the fat? Choose lean
cuts. The nitrites? Eat fewer sausages and hot dogs. The
heterocyclic amines from cooking? Cook meat over low heat -- don't
char. Choose more vegetable proteins such as tofu, beans and
legumes. The lack of fiber? Choose one of the hi-pro diets that
really maximizes your intake of fruits and vegetables, and make
sure that you eat all that are allowed. Along with the fiber,
you'll get phytochemicals that are known to protect against cancer.
What You Hear: High-protein diets cause a potentially dangerous
condition called ketosis.
The Truth: Only hi-pro diets that are exceptionally low in
carbohydratesabout 50 grams or less per day, as in the Atkins
plancause ketosis. Your brain depends on carbohydrates for its
daily fuel, but in a pinch, your body will ravage fat fragments to
create compounds called ketone bodies that can also be used as fuel
by the brain. Ketone bodies are prized by Atkins dieters because
they suppress the appetite -- but they also upset the acid-base
balance of your blood.
So is ketosis dangerous? No one really knows for sure. But the
ketosis caused by very low carb diets is not as severe as the
potentially fatal ketosis sometimes experienced by people with
diabetes. Also, there is a lack of research pointing to adverse
outcomes from ketosis in people who are dieting. No expert I talked
to recommends any diet that provokes ketosis.
The good news is that the better-balanced hi-pro diets, which do
not restrict carbohydrates so severely, don't cause ketosis.
What You Hear: The weight that you lose on a hi-pro diet is only
water, not really fat.
The Truth: It's true that your body will lose several pounds of
water in the first few days of a low-carbohydrate diet. So those
first few pounds that you drop in a flash at the start of a hi-pro
diet are water. But that's only true in the beginning. After that,
the weight that you continue to lose represents true weight loss,
the same as you'd get from any low-calorie diet.
What You Hear: High-protein diets cause bad breath and
constipation.
The Truth: Only the very low carb diets cause bad breath as your
lungs try to blow off some of the ketones created by too much fat
burning. And low-carb diets that limit high-fiber fruits,
vegetables and whole grains are responsible for constipation. So
choose one of the high-protein diets that allows you more than 50
grams of carbohydrates, emphasizes high-fiber foods, and reminds
you to drink 8 cups of fluid daily.
Copyright 1999 Rodale Press Inc.
