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The Carbohydrate Addict's Diet
What
It Is
What
You Can Eat
How
It Works
What
the Experts Say
Food
for Thought
back
to diet list
What It Is
The remarkable success of The Carbohydrate Addict's Diet -- by Rachael
Heller, MD, and Richard Heller, MD, and first published in 1993
-- led to a handful of best-selling books. Each is based on a single
theory: Many overweight people are "carbohydrate addicts."
Among these people, biological processes that convert food into
energy fail to perform as they are supposed to and, the Hellers
say, "for reasons that are not yet clearly understood, sustained
high levels of insulin in the blood result." The elevated insulin,
according to their theory, makes carbohydrate addicts crave food
throughout the day. But a big question -- why does this condition
create carbohydrate craving? -- is not answered.
Given the premise, the Hellers claim that this is not a diet for
everybody -- only for those with this metabolic imbalance that they
call "carbohydrate addiction." However, their "documented
research" shows that 75% of overweight adults identify themselves
as "carbohydrate addicts," but they maintain that the
actual figure may be as high as 85%. Alas, these theories on addiction
and the related figures are not founded on scientific research.
The diet is based on the Hellers' own theories about controlling
fat-storing insulin in the body. And insulin, they claim, can be
controlled by drastically reducing carbohydrate consumption during
most of the day.

What You Can Eat
For the first two weeks, you eat two small Complimentary Meals
daily, consisting of a portion (three to four ounces) of meat, fish,
or fowl or two ounces of cheese, and roughly two cups of vegetables
or salad. The third meal is your Reward Meal, which can be anything
you want, in any quantity -- though it should be nourishing and
well balanced. You can have wine or a cocktail or a glass of beer,
promise the Hellers. This meal can be breakfast, lunch, or dinner.
But there's a time limit. The Reward Meal -- from cocktail to dessert
-- must be consumed within an hour.
After the first two weeks, the regimen splits into several eating
plans, depending on how much weight you still want to lose, or on
whether you just want to maintain what you've already lost. Some
will choose a plan that allows one prescribed snack a day, made
up of the same low-carb foods that you eat at the Complimentary
Meals. You may never choose carbohydrate-rich foods such as fruits,
fruit juices, breads, pasta, snack foods, or sweets as your snacks.
Never. And these snacks are limited to half the size of a meal.
The book gives an extensive list of food to chose from, which covers
five pages, and urges you not to deviate: "If the food is not
listed here, don't eat it during your Complimentary Meals or Snacks.
... When in doubt, save the food for your Reward Meal."
Other rules: Drink plenty of water. If you have milk or cream with
your coffee, you can have one cup a day the way you like it. Keep
to the rules, say the Hellers, and you will improve your metabolism
and miraculously lose weight, and all the time you'll feel great.

How It Works
The Hellers claim that by restricting carbohydrates drastically
during most of the day, the body releases far less insulin than
if you had been eating a high-carb diet at each meal. They say that
the entire chain of metabolic events is altered: Less insulin is
released, less fat is stored, and more fat is burned up. Because
the body is releasing less insulin, the brain regulates the appetite
better with a release of serotonin, a biochemical that gives that
nice, complete feeling of satiety.
The time limit on the Reward Meal, when you are eating and drinking
carbs to your heart's content, controls the insulin release, which
the Hellers say occurs about one-and-a-quarter to one-and-a-half
hours after you begin eating. If you are still polishing off that
apple pie, your body will compensate for the initial low release
of insulin with a big blast of it. But if you've stopped eating
within an hour, "this second phase appears to be kept low,"
they write.
High insulin in the blood leads to a decrease in the number and
activity of receptor sites in the muscles and fatty tissue that
absorb insulin and glucose. This is called insulin resistance. Only
one carbohydrate-rich meal a day, the Hellers say, lowers insulin
production and leads to an increase in receptor sites, which then
gobble up the insulin and glucose more quickly, removing it from
the blood. This in turn allows the "carbohydrate addict"
to feel less intensely hungry throughout the day, have fewer cravings,
and lose more weight.

What the Experts Say
This diet is hardly a favorite of nutritionists or specialists with
a medical background. It is well known that many individuals have
abnormally high insulin levels and insulin resistance, but this
is a part of the medical condition known as the metabolic syndrome,
which has a variety of causes -- notably obesity itself. "Carbohydrate
addiction" has never been shown to be among them.
"The whole premise that we are carbohydrate addicts makes
about as much sense as telling people they are oxygen or water addicts,"
says John McDougall, MD, one of the participants in the debate on
fad diets last spring in Washington, D.C., an event sponsored by
the U.S. Department of Agriculture. He is the head of the McDougall
Program, a center for the rehabilitation of dietary diseases at
St. Helena Hospital in the Napa Valley of California, and a lecturer
in nutrition. "We are designed to be seekers of carbohydrates,"
he says. "The tip of the tongue has one kind of calorie-seeking
taste bud, and that is for carbohydrates."
McDougall explains that the Hellers' science is unsupported and
as proof points to a 1997 article in the American Journal of Clinical
Nutrition, which demonstrates that many animal protein foods produce
more insulin than carbohydrates -- the reverse of their claims.
Their diet, he says, "is a way of tricking people into restricting
food intake," and for that reason it probably works in the
short term.
Neal Barnard, MD, president of the Physicians Committee for Responsible
Medicine, is likewise unconvinced by the Hellers' premise: "This
diet addresses a problem that is not even remotely the problem for
most overweight people," he comments. "It would be much
more effective to repair the body's ability to handle carbohydrates
rather than demonizing them, and this is done by cutting fat out
of the diet, boosting fiber, and choosing those carbohydrates such
as whole grains and vegetables that release glucose slowly -- and,
finally, by adding exercise to your routine."
Barnard believes it would be easier to break poor eating habits
than tease yourself with the one Reward Meal a day. "The problem
is not the carbohydrate in the potato, it is the butter on the potato."
He concedes that some people would find the diet helpful, but he
insists that it is a "Band-Aid approach" to generally
poor eating habits in this country. "In Asian countries people
have consumed huge amounts of carbohydrates -- rice, vegetables,
noodles -- and they are the slimmest people on the planet."
Until of course, he adds, "They swap that healthy rice for
KFC, Burger King, and other Western, meaty, cheesy choices."

Food for Thought
Though popular, this diet does not receive the support of nutrition
experts, who have a particularly hard time swallowing the Hellers'
claim that most overweight people are "carbohydrate addicts."
In addition, the Reward Meal is an aspect of the diet that merely
rewards unhealthy eating habits.
Reviewed by Gary Vogin, MD, March 18, 2002.
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