Living Low Carb - Weight Loss Plan

What It Is
What You Can Eat
How It Works
What the Experts Say
Food for Thought

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What It Is
Since low-carbohydrate dieting has taken America by storm, it was only natural that cookbooks would follow. First came The Low-Carb Cookbook, succeeded by Living Low-Carb, both by Fran McCullough, an avowed foodie and award-winning cookbook editor. Struggling to keep her own weight down, McCullough was led to a low-carb diet, which suited her to a T. In her quest for meal-time pleasure without plumpness, she put together a collection of more than 250 recipes for the 1997 The Low-Carb Cookbook. The book was an instant success and best seller. Living Low-Carb followed in 2000, which contains more explanation and adds 175 recipes.

McCullough's latest book explains the differences between the most stringent low-carb diet plans and the more liberal ones that she favors. She then outlines how to adapt the latter group of diets to fit a pleasure-eater's perspective. Rather than a "diet" book, Living Low-Carb is more of a lifestyle and self-help guide with recipes for everything from home fries to Moroccan-styled chicken to what she calls Intense Chocolate Cake.

McCullough dismisses the raft of objections to the low-carb diet by the nutritional establishment, but she does note that for some people this type of routine is not ideal. She discusses the particular needs of diabetics, those with low-thyroid function (her own condition), and includes caveats for those pregnant or nursing. Living Low-Carb is full of motivational suggestions, as well as practical ones for stocking the pantry, eating on the road, in restaurants, and at the homes of friends, and finally how to deal with a dieter's bete noir, the sweet tooth.

She encourages exercise, not because it will make you lose fat, but because it's good for you, and she gives you more than a dozen reasons why you should.

What You Can Eat
Living Low-Carb doesn't go into great detail about how this kind of eating regimen works -- it takes its cues from the plethora of other diet books written by doctors pictured on the dust jackets in their white coats and lets them do the heavy scientific lifting in this regard. McCullough does, however, accept the basic theory of a low-carbohydrate regimen: "restricting carbohydrates -- sugar and starch in whatever form, from Popsicles to baked potatoes -- puts the brakes on insulin, the hormone that's responsible not only for storing fat (and worse, keeping it stored) but also for raising blood pressure, damaging blood vessels, and wreaking other bits of havoc throughout the body for those of us who are genetically predisposed to obesity, diabetes, and heart disease."

Furthermore, McCullough supports the often-debated theory that a poor diet makes our body's insulin receptors resistant, requiring ever greater amounts of insulin to respond, which may lead to type 2 diabetes, and secondly that the only way to cut back on this outpouring of insulin is to restrict carbohydrates.

Do calories count? Yes and no, she says. If you are genetically predisposed to being overweight, you are probably genetically predisposed to insulin problems, too, and you may not do as well as others on a restricted-calorie diet unless you cut way back on the carbohydrates. If you have no insulin problems and have a normal metabolism, she adds, you may do just fine with a standard diet that simply cuts calories.

McCullough notes that most low-carb diet books profess to be for everyone, but she notes that for some, this may not be the way to go. For example, some people will feel foggy and lethargic, and may need more carbohydrates to function well. Since the kidneys are called upon to work harder than usual with this way of eating, she urges everybody to have blood work done before beginning. And anyone with a known kidney problem should avoid low-carb eating.

How It Works
McCullough gives you lots of choices, because neither Living Low-Carb nor The Low-Carb Cookbook is a diet book as such. The recipes are for everything from canap?s to deserts. However, she does present a basic plan for low-carb eating:

• Have protein at every meal -- about one-half gram of protein for every pound of your ideal weight, typically somewhere between 60 to 85 grams unless you're very large or very small.
  
  
• For weight loss, keep the carbs low, anywhere from zero to 30 grams daily.
  
  
• Choose whole foods, organic if possible, and raw, ideally. The more fiber, the better.
  
  
• Avoid nearly everything white -- potatoes, rice, bread, flour, sugar, popcorn. Of course, this doesn't include cauliflower, turnips or giant white radishes.
  
  
• Eat fruit at breakfast, particularly low-carb fruits, such as berries, melon, peaches, kiwi. Half a banana is all you get.
  
  
• Although you are allowed cream and butter, save it for treats, and cut down on them if you are trying to lose weight. Choose cold-pressed olive and nut oils, and avoid processed oils, partially hydrogenated fats and margarine.
  
  
• Eat dinner early and make it minimal.
  

Now, what about the recipes? All are low-carb with the exception of several moderately higher-carb desert recipes. McCullough points out that the carbohydrate counts she gives will not be the same as those in standard books, because the fiber count has been subtracted from the total carb count. What does that mean? The fiber component, she says, is not metabolically active and does not raise blood sugar levels, which allows you to have more carbs if they are in the form of fiber.

Appetizers include roasted almonds, grilled Parmesan chunks and stuffed mushrooms; main courses include pork tenderloin, several ways of preparing salmon and something called A Lot Like Lasagna, made with zucchini, spinach, Italian sausage and ricotta; deserts run from Rummy Pumpkin Mousse to Capri Chocolate Almond Torte.

What the Experts Say
The U.S. Department of Agriculture is developing a well-funded, long-term study of various diets popular today. Until the research is in, conventional wisdom is withholding approval while granting that low-carb diets do work for weight loss. According to James Hill, PhD, the director of the Center for Human Nutrition at the University of Colorado Health Sciences Center in Denver, "The problem I have with all the diets is not that people don't lose weight -- they do, and for some it feels like the greatest thing ever. My concern is that we have nothing to suggest that these diets work in the long term. This kind of research is missing."

Then are these diets dangerous? "That's the debate going on today," Hill continues. "All that protein really makes your kidneys work very hard. One school of thought is that the high-protein content of these diets is damaging to the kidneys." But, he adds, the most recent data shows that at least the "markers for kidney damage do not show a problem," and so probably in the short-term these diets are not dangerous.

Another question, though, is whether the high-fat content of most of these diets is detrimental to our health, as high-fat diets have been shown to be factors in heart disease and some types of cancer. "For lower risk of cancer and other chronic diseases, the scientific evidence goes against the low-carbohydrate, high-protein diets," states Melanie Polk, RD, director of nutrition education at the American Institute for Cancer Research (AICR) in Washington, DC.

In 1997, an AICR report reviewed some 4,500 diet and cancer studies from around the world comparing diet and cancer rates and found that a mostly plant-based -- in other words, high carbohydrate -- diet was protective against cancer and many chronic diseases. "Vegetables, fruits and grains are foods low in protein but high in carbs, but also high in vitamins, minerals, phytochemicals, dietary fiber -- and we know all of these things are protective. Beans are high in vegetable protein but low in fat. We need to eat more plant-based food and less animal food, the exact opposite of a lot of these fad diets."

Food for Thought
One criticism of the low-carbohydrate, high-protein diets has been the lack of food choices and the resulting difficulty that some people have staying within the limited choices over the long term. Both of McCullough's books help to provide a greater variety and more satisfying series of recipes and options for dining out. That said, experts are still wary of promoting this form of low-carb diet until long-term studies can be completed.

Reviewed by Gary Vogin, MD, March 18, 2002.

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