Low-Carb Diet Research and News

The Low-Carb Diet Craze
Fad diets come and go, but this one is exploding. Can you really lose weight by feasting on beef, eggs and bacon? And should you?
BY JOEL STEIN

A diet is more than a fad. In fact, it's more than a diet--when skinny people are on it. Yet there they are, jogging into Noah's Bagels in Santa Monica, Calif., proudly ordering bagels with the innards scooped out, disposed like toxic waste and replaced with full-fat cream cheese. In Chicago restaurants, the unpaunched are gorging on porterhouse steaks but banishing the baked potato back to Idaho. And Jennifer Aniston has been publicly chastised by her former trainer, who thinks Aniston's low-carb, high-protein diet is too extreme. When even the scrawniest cast members from Friends are on a diet, something is happening.

What's happening is a boom in low-carb diets, the weight-loss schemes that allow you to eat all the protein you want--steak, eggs, even fatty bacon--so long as you cut way down on carbohydrates like bread, pasta and soda. The fat-embracing diets, like so many other fads that we shouldn't have invited back, are from the '70s, when high-protein plans like the Scarsdale Diet and Dr. Atkins' Diet Revolution made fondue hip. Now the low-carb diets are back and bigger than ever. Low-carb-diet books will clog the top four spots in next Sunday's New York Times paperback best-seller list for advice and how-to books. Dr. Robert Atkins, at 69 still the reigning guru of the movement, is back on the charts with Dr. Atkins' New Diet Revolution. Other low-carb diet books jamming the shelves include The Carbohydrate Addict's Diet and a plateful of spin-offs by Rachael and Richard Heller, Protein Power by Drs. Michael and Mary Eades, Sugar Busters!, The Zone and Suzanne Somers' Get Skinny on Fabulous Foods. Some probably bought the Somers book for the color picture of her licking a butterflied-lamb-slicked finger, but it still became a No. 1 best seller, something her poetry collection (despite Johnny Carson's best efforts) never did. Even bread-loving France has had a best-selling high-protein diet book, Eat Yourself Slim by Michel Montignac, and Poland has the Optimal Nourishment plan. Russia would have one too if it had meat.

It's not hard to find people talking about these diets, because the only thing people like to talk about more than eating is not eating. Jan Rowell, 52, a technical writer in West Linn, Ore., went on the Hellers' diet and knocked off 105 lbs., getting down to 140. "I could have lost this much eating low fat," she says. "But the times I dieted that way before, it was always a struggle. With these diets, you just feel miraculously free of the craving and the drive to eat." The weight-beleaguered Cathy confronted the low-carb diet craze in her comic strip last week, uncharacteristically stifling an "Aack!" through five days of her co-workers' cheeseburger-eating braggadocio. Demand for beef in 1999 is projected to rise 1.6% over last year, and for pork 2.3%. Having it your way now includes having a plate, fork and knife included with a bunless Whopper at Burger King. Celebrities and everyday folks alike are bragging about the bacon and eggs they downed for breakfast, followed by a midday repast of pork rinds. In return for this unlimited meat, all the new diets ask is that you lay off the penne and rice. Who wouldn't like a diet that works at a Vegas buffet?

Turns out most mainstream doctors and professional dietitians. They're attacking these latest fad diets on CNN and making Leeza seem like the McLaughlin Group. Last week 9,000 of them met in Atlanta for a conference of the American Dietetic Association, and even though the organization hadn't scheduled any Atkins talk for its seminars, it blasted low-carb diets as "a nightmare." JoAnn Hattner, a clinical nutritionist at the UCSF Stanford University Medical Center who attended the conference, worries about the high levels of protein and fat in many of these diets, as well as their lack of fiber. "Removing fiber causes constipation, fluid dehydration, weakness and nausea. It's a great strain on the kidneys," she says. Keith Ayoob, a professor of nutrition at Albert Einstein College of Medicine in New York City, warns about other "very unpleasant side effects--sometimes really bad breath."

But millions of people are willing to risk halitosis, or worse long-range health effects, to get rid of their obesity. The U.S. is by far the fattest country in the world, with 54% of the population overweight. If Americans didn't travel overseas, they'd think 200 lbs. was normal. They eat 7% more calories than they did 20 years ago. Even the nation's children, the ones so hyperactive they need Ritalin, are pudgy; 25% of them are overweight. To combat this, Americans, in lieu of exercise, spend $33 billion a year on the diet industry.

Carb paranoia struck when people discovered that all the fat-free food they loaded up on during the last diet craze was making them fat. Diet plans like the Pritikin Program of the early '80s and Susan Powter's Stop the Insanity! in 1993 caused a run on processed low-fat food like SnackWell's and frozen yogurt. But those treats, it turned out, were chock-full of sugar and a whole mess of calories. Result: you gained weight. The reaction in recent years has been to eliminate sugar by dropping carbohydrates from the menu altogether. So instead of the 1994 book Butter Busters, we now have Sugar Busters! and a series of the most guy-embraced diets ever, regimens with Henry VIII as a role model and beef jerky as a food group. 

The science behind these diets is less intuitive than the old fat-makes-you-fat theory and therefore easier to argue over. Each of the low-carb diets is a variation on the theme that cutting down on carbohydrates and thus decreasing blood-sugar levels will cause the pancreas to produce less of the energy catalyst insulin. With less insulin to draw on, the body is forced to burn fat reserves for energy, thus leading to a quick weight loss. Opponents argue that cause and effect have been reversed: excess insulin is caused not by too many carbs but by being too fat. The reason people lose weight on low-carb diets, they say, is simply that by cutting out carbs, these dieters are reducing their calorie intake. In response, Atkins throws out scientific terms like ketones (fat-burning by-products), while The Zone author Barry Sears talks about eicosanoids, which he claims are all-powerful hormones. Opponents use words like charlatan.

Perhaps the most appalled is Eat More, Weigh Less author Dr. Dean Ornish, one of the most respected of the low-fat, heart-healthy gurus and hence Atkins' natural enemy. "These books say you should eat healthy foods that won't provoke an insulin response, like bacon, as if insulin is the only mechanism that affects health," he says. "Most people eat so much sugar that when they stop eating it, they lose weight. But they're mortgaging their health in the process." Ornish, who has published studies in various medical journals, challenges the upstarts to do the same. "What's the evidence? None of these authors have ever published any data validating their claims."

The hottest of the low-carb authors, the Hellers, are not medical doctors, though they pose in lab coats on their books and refer to themselves as Dr. Rachael F. Heller and Dr. Richard F. Heller. They're probably just very proud of their Ph.D.s and happen to like hospital wear. The Hellers were propelled to stardom after a guest spot on Oprah in October. Winfrey, an adherent, originally planned to have them back this month, but the Hellers scored such good ratings that they were brought back a few days later. Last week the Hellers had books in the No. 1 and No. 2 spots on http://Amazon.com's best-seller list as well as the No. 10, 13, 23, 70 and 87 positions. This Oprah apparently has some pull.

Rachael Heller, who once weighed in at 320 lbs., speaks intensely about her childhood, recounting how she selected her baby-sitting gigs according to who had the best-stocked refrigerator and explaining a lunch-trading Ponzi scheme she invented in third grade to score extra sandwiches. Basically she blames her jones for carbs as the cause of her unhappy past. "They have actually located what they call the carbohydrate-craving gene, which is on chromosome number 11, close to the alcoholism gene and the cocaine-addiction gene," she says, before taking a brief talking break to join her husband in a mating dance that involves methodically removing the croutons from their chicken Caesar salad. Though her science may be suspect, her earnestness is not. During the meal, she leans over the table to confide details from her fat, ugly past. "I have stretch marks from my neck to my knees," she says sotto voce. Her husband tells her they are battle scars. They are in love in ways that even Codependent No More never imagined.

The Hellers' diet follows the basic plan of Atkins'--up with protein, down with carbohydrates--with one important concession: the Hellers allow one "reward meal" each day in which carbs are allowed. Atkins sees this as a betrayal of his science. In fact, Atkins sees most people as part of an intricate conspiracy against the truth of bacon. Twenty-seven years after publishing his trend-setting diet book, you'd think Atkins would be used to the critics by now. But sitting in his art-filled office last week in the Atkins Center for Complementary Medicine, a seven-story alternative-medicine facility in midtown Manhattan, he was angry about the spanking he had received 20 min. earlier from the American Dietetic Association. "People in power have a tough time admitting they were wrong," he says. "The same problem exists with the American Heart Association." He is also disgusted by most other diets, which he considers either poor copies of his own or plain bad science. He has an enemies list that would impress Richard Nixon.

But there are many who love him. Tom and Betsy Sales, Atkins adherents in Chicago, have jointly lost 85 lbs. this year on meals like bacon and eggs without toast. Lots of their friends are on the diet, and local waiters have learned to expect bizarre requests. "At Bijan they do a baked brie that's out of this world. I asked to have the brie cheese with celery instead of bread," says Betsy, "and the waiter didn't even blink. And Dan O'Toole, a sales executive at the Los Angeles Times Syndicate, shed 50 lbs. while eating fatty food. He says the diet gives him much more energy than he had in the past, though this may just be because he used to weigh 250 lbs. 

But then there are people like Sherri Miller, 32, a full-time mother in Manhattan who tried the Atkins diet, lost 3 lbs. but quit when she tired of the fare. In fact, one of the tricks behind these diets, detractors say, is that by cutting out one major food group, like carbohydrates, people get bored quickly. "These diets work primarily by making people feel sick," says Dr. F. Xavier Pi-Sunyer, chief of endocrinology, diabetes and nutrition at St. Luke's-Roosevelt Hospital in New York City. "If you go on a strict high-protein diet, you feel nauseated and a little sick to your stomach after about four to five days, so you lose your appetite and eat less." By this theory an all-chocolate-and-cheese diet would work too, because eventually you'd find you can stomach only so many calories of Hershey's and Swiss each day. It would also be delicious.

Most of the other low-carb diets are less restrictive, lower-fat versions of the Atkins formula. Sugar Busters!, written by a mess of New Orleans doctors led by H. Leighton Steward, 64, vice chairman of Burlington Resources, advises avoiding white flour and refined sugars but allows you to eat cheese omelettes. "We think that if you eat the right kinds of carbohydrates, you won't get such a surge in blood sugar," says Steward. And while they don't advocate the heavy fats of Atkins, the diet still has a fair share of buttery goodness. Pam Hoffman, 33, a housewife in Metairie, La., knocked off 120 lbs. eating, among other things, ham, eggs and cream of broccoli soup. In Louisiana, of course, this might not be considered a high-fat diet.

The Zone's Sears is defensive about having his diet, which is lower in fats and proteins, grouped with Atkins'. "Any meal that you have to take potassium supplements, there's something wrong with that," he says of the high-protein diets. He advises eating a protein portion the size of your hand, lots of vegetables and water, and treating carbs and fat like condiments. (The goal: a 40-30-30 caloric ratio of carbs to protein to fat.) Yet his diet can be boring and requires an incredible attention to detail, like eating three olives or one macadamia nut. Still, the Zone has become so popular that it has spawned a gym for devotees in Hollywood and a catering service in Los Angeles, the Delivery Zone, which serves about 120 people a day. A similar service, Perfect Balance, has started in New York City and delivers to 1,200. Kristin Davis, who co-stars in HBO's Sex and the City, gets a delivery every day, and it has helped her lose 10 lbs. "I feel so much better that I'd be really shocked if there was a [health danger] that we didn't know about," she says. "It's more healthy than I would eat if I were left to my own choices. In that case, I probably wouldn't be eating a salad or fruit."

Like the Zone, Suzanne Somers' diet, which she calls Somersizing, avoids white flour and sugar, but it argues that the important thing is to combine foods in the right way. Her program (developed with endocrinologist Diana Schwarzbein, who has her own diet book) permits a meal combining protein and vegetables, but eating protein within three hours of eating carbohydrates is taboo. "The reason I used to be bloated was a gastric war between the protein and carbohydrates," says Somers. "Now I never have gas, I can proudly say. It's a great thing not to have gas." She adds that with her diet "you can even eat at McDonald's. I order two Big Macs but no buns." This is the kind of talk that men like. Men named Stocky. Stocky White, 37, the owner of a lodge in Livingston, Mont., lost nearly 50 lbs. on the Suzanne Somers diet. "It was awesome," he says, "and I've kept it off."

The next wave of fad diets base their low-carb logic on even stranger theories than insulin or food combining. Peter J. D'Adamo's book Eat Right 4 Your Type advocates diets tailored to your specific blood type. Type O's get to eat red meat. Type A's aren't as lucky; they're stuck with mostly vegetables and fruits. Type A's, however, get to keep using their arteries. D'Adamo sells vitamins for each body type and claims he has got the already skinny Elizabeth Hurley, Hugh Grant and Andy Dick to buy into his logic.

Dr. Abravanel's Body Type Diet and Lifetime Nutrition Plan divides people into thyroids, adrenals, gonads or pituitaries, recommending different foods for each one. The big drawback of this diet is discovering that you are a gonad. Followers of the raw-foods diet eat only uncooked food; the Caveman Diet allows you to eat only what Stone Age people ate; and The Body Code, by Jay Cooper, divides dieters into warriors, nurturers, communicators and visionaries. Nurturers, in addition to eating lots of fruits and vegetables, no doubt do most of the cooking. More popular is Gwen Shamblin's The Weigh Down Diet, which advises using spirituality to avoid overeating and has sold more than 1.2 million copies to overweight Christians--a kind of What Would Jesus Eat? plan. 

The medical evidence for many of these diets is flimsy, but you can find an expert somewhere to support almost every one. Though Atkins' high-fat regimen has drawn widespread criticism in the medical community, it has vocal adherents as well. Dennis Gage, an endocrinologist at Lenox Hill Hospital in New York City, immediately takes his patients off relatively nutrient-poor pastas and white breads. Like many of the diet gurus, he argues that naysayers are using outdated science. "Some of the registered dietitians trained the old-fashioned way, saying you have to have 50% carbohydrates. The government is always behind. The next update will probably correct that." And it's hard to dispute people like David Kirsch, a New York City celebrity fitness trainer and diet guru (among his clients: Ivana Trump), mostly because he's really big. Kirsch makes a lot of protein drinks and lectures strongly against processed foods. "I have converted most of my 300 clients into not eating bread," he says. "In the long haul, you can deal with not eating any bread."

Still, the majority of dietitians and doctors remain wary of low-carb diets, favoring the traditional carb-heavy food pyramid with a reduction of calories and an increase in exercise. They aren't getting many book contracts. "Most Americans don't eat enough fruits and vegetables, and now you have diets like Atkins that say don't eat sweet potatoes, don't eat carrots, don't eat corn," says Franca Alphin, administrative director of the Duke University Diet and Fitness Center. "Those foods are so beneficial. It's really frustrating." The low-carb diets, they insist, eventually fail. "The more unusual a diet is, the more different from the standard of what people normally eat and find around them, the more apt they are to go off the diet and regain the weight," says Dr. Bruce Zimmerman, a vice president of the American Diabetes Association and an endocrinologist at the Mayo Clinic.

For the traditionalists, there are the old reliable calorie-reduction diets, like Weight Watchers, which sees 600,000 unshapely bodies each week, and Jenny Craig, which caters to dieters at 600 centers around the country. Sure, unlike the other hot diet programs, these guys may have to pay their celebrities (Sarah Ferguson for Weight Watchers, Monica Lewinsky for Jenny Craig), but they get the approval of dietitians for free. Weight Watchers assigns points for each type of food, so people can sneak some fatty, sugar-filled food into their point allotment. But the program rewards eating vegetables, and especially fiber. "When you have a fad diet, you wind up trading one obsession for another," says Linda Webb Carilli, the company's general manager of corporate affairs. "High-protein diets are not good for women because they leach calcium."

But as long as happy dieters and supportive doctors keep going on talk shows, people with eating problems aren't going to resist a diet that lets you eat pork rinds. Sam Panayotovich, 53, the Illinois state liquor commissioner, has been following a combination of Atkins and a 1979 local diet known as the whipped-cream-and-martini diet. The diet allows fondue, bourguignon, bearnaise, fried chicken, chunks of steak and enough alcohol for a buzz. He's lost 53 lbs. and kept it off for 11 months, a personal record. Like most Atkins adherents, the liquor commissioner talks about his diet with a mystical admiration. "When you talk about this diet, that you can drink and have a nice steak and lose weight, people look at you like you really have been drinking." And nothing cures a hangover better than a big, greasy bacon-and-eggs breakfast.

-- REPORTED BY DAN CRAY/LOSANGELES, JULIE GRACE/CHICAGO, DAVID NORDAN/ATLANTA AND ALICE PARK AND ANDREA SACHS/NEW YORK