Exploring Low Carb Lifestyles
- By Stephen Holt, M.D.

Low Carb Diets Increase in Popularity
More than one half of all people trying to lose weight in America have adopted a low carbohydrate intake. Low carbohydrate diets were once shunned by the conventional medical community. In fact, these diets were vilified by some physicians and national bodies of medical opinion. This situation has changed radically, as there is increasing recognition of the role of the dietary intake of simple sugars in the precipitation of weight gain and its associated problems. Refined carbohydrates are pivotal in the cause of the modern epidemics of the metabolic Syndrome X and Type 2 diabetes mellitus, but they are not the whole story. 

The most popular, contemporary low carbohydrate diet was described by Dr. Robert C. Atkins, MD, but his initial dietary recommendations were selfmodified over a period of 30 years. Dr. Atkins' Diet was joined in recent years by other popular "low or lower carb diets," including but not limited to: "The Zone," "Carbohydrate Addict's Diet," "Sugar Busters Diet" and "The South Beach Diet."

Which Low Carb Diet Is Best?
Dr. Atkins has to be revered as the modern proponent of low carb diets. That said, carbohydrate restriction in the diet was recommended in England as long ago as 1860 by Mr. William Banting, a coffin maker to the Duke of Wellington. While arguments prevail that one low carb diet is "better" than the other, there is no real evidence that such differences exist. Certainly, recent studies published in the New England Journal of Medicine in 2003 served as a "wake-up call" for conventional medicine, when the Atkins' Diet was shown to be effective and reasonably healthy, at least in the short term.
Contrary to popular belief, recent scientific studies did not openly endorse the Atkins Diet. Weight regain with the Atkins Diet was noted to occur at six or 12 months or so in most people a "yo-yo effect In fact every diet
described in the history of weight management has suffered from a lack of effectiveness for long-term weight control. These circumstances lead to the rational proposal that modifications can be made to low carb diets that may make them more effective in the longer term. Of course, an important emerging issue is the need for weight control to be part of a global health initiative. There is a need to examine ways of enhancing all low carb diets and the "ideal carbohydrate-restricted diet" remains a matter of debate.

Obesity or Overweight Status: A Major Public Health Initiative
Many people are tired of being told that they are overweight and sedentary, but any complacency about weight gain must be dismissed. Modern medicine has shown us the serious increase in disability and death due to weight gain. The Office of the Surgeon General of the United States has made several "calls" to engage initiatives to prevent obesity and an overweight status. These proclamations culminated in the U.S. Surgeon General's Report in 2001, where Americans were told that more than 60% of adult U.S. citizens were overweight. Recent statistics and trends are even more alarming, especially in children. Some soothsayers tell us that by the year 2050, almost every American will become overweight, if the
occurrence of obesity increases at its current level. Perhaps we have tended to focus on the cosmetic aspects of obesity which may precipitate a degree of embarrassment or shame for some people. These are not constructive thoughts. The real significance of obesity to Western nations and some Third World countries is the occurrence of many obesityrelated diseases together with associated, mounting death rates. Most people are aware of the pandemic of weight gain in Western society, but fewer appreciate that obesity has gone "global." As many as 1.7 billion people worldwide may be overweight. According to the World Health Organization, lesser degrees of being overweight are associated with illness and death in Third World Countries. Perhaps one can see the emergence of American "nutritional colonialism" that contributes to the global epidemic of obesity.

Diets Are Not "Stand Alone" Interventions for Many People
Obesity does not usually present itself as a "single" medical problem, requiring focused management. Low carb diets are certainly effective for short term weight loss in people wishing to lose 5 or 10 pounds of body weight, but this initiative is not relevant to the elimination of the disability and premature death that results from obesity. National registers that keep information on people who have lost weight in a sustained manner imply that weight control occurred by means other than diet alone. Successful dieters undertook modification of eating behavior, positive lifestyle change and exercise. In other words, few people can achieve sustained weight loss by diet alone.