Posted on 09/06/2003 2:02:32 PM PDT by SamAdams76
Diet food makers use a little fancy counting to make snack add up
Riding the popularity of pre-wrapped meals and low-carb diets, low-carbohydrate bars have started elbowing diet shakes and whole-grain cereals off grocers’ shelves. Even beers and candies are showing up in low-carb versions, indulging the eternal American fantasy of effortless weight loss.
The math behind the label
Removing carbohydrates from a convenience food is no easier than taking the odor out of garlic, so the manufacturers of low-carb bars took another approach. They stopped counting the carbs in artificial sweeteners.
The Atkins Endulge chocolate candy bar, for example, proclaims 2 grams of "net carbs" on the package. The small, 30-gram bar actually has 16 grams of carbohydrates, unthinkably high on restrictive low-carb diets, but the manufacturer subtracts 3 grams of fiber and 11 grams of sugar-alcohol sweetener.
"That's not honest," said Dr. Daniel Preud'Homme, the Children's Medical Center's weight-control expert.
The carbohydrates in sugar alcohols and glycerin sweeteners are more conducive to weight loss than table sugar, and many nutrition experts say the bars can have a limited role in weight loss for some people. But they also say the bars have several health drawbacks, and highlighting the sweeteners’ carbs ignores the most important distinction among carbs — whether they have been refined into white sugar or flour.
Low-carb bars have little purpose except in the high-protein, low-carbohydrate diets popularized by Dr. Robert Atkins. The diets are growing in favor with the April publication of The South Beach Diet, Amazon.com's second-ranked book now, and the New England Journal of Medicine's recognition last spring that Atkins dieters tended to lose weight quickly and improve cholesterol levels.
Diets are short-term solutions
But even though dietitians and medical specialists don't routinely paint Atkins with horns anymore, they generally warn low-carb diets should be only a short-term vehicle for people who have life-threatening obesity or need a quick weight loss to get them started for the long run.
"I don't have a problem with using it in the short-term," said Sally Kattau, a longtime licensed dietitian with the Diabetes Association of the Dayton Area. But long-range, she said, it's both difficult to maintain and potentially dangerous, especially for diabetics. "It's not a nutritionally sound diet."
Low-carb diets were a response to the excesses of low-fat diets, with their brightly labeled snacks, desserts and meals. But just as focusing entirely on too much dietary fat led to some weight gains from too many refined carbohydrates, today's blanket reduction of carbs is another oversimplification, said Richard Cohen, the dietitian who directs Greene Memorial Hospital's HMR Weight Management Program.
"We've just gone from one extreme to another," Good Samaritan Hospital dietitian Michelle Kitze said. "People were gaining weight on the low-fat, higher-carb diets, but it wasn't necessarily the amount of carbs. It was the types of carbs. They were eating all kinds of simple sugars, and it was all being converted into fat.
"The big thing I would strongly recommend is not going on a low-carb diet, but instead cutting out the (refined) carbohydrates."
Refined sugars the real villain
The refined carbs in white sugar, breads and pasta are quickly digested, dumping all of their broken-down sugars into the bloodstream at once. The pancreas reacts to the sugar surge with what's called a high insulin response, unleashing the hormone that converts sugar into energy.
"Then after that, your sugar level has a tendency to drop off again and you want that fix again, so people go back to more simple carbs and it just keeps going," said Jane Key, an independent certified dietitian in Oakwood.
Sharp fluctuations in blood sugar can lead to insulin resistance, in which more insulin becomes necessary to break down a given amount of sugars. As many as 60 percent of Americans have the condition, said endocrinologist Dr. David Westbrock, medical director of New Profile Weight Management Center in Washington Twp. It can be a precursor to diabetes, heart disease, gout, high blood pressure, cancer and an increased tendency to convert blood sugar to fat.
"Insulin isn't the only hormone that acts to stimulate appetite, but it's the one we're surest of," Westbrock said. "One of the reasons the Atkins diet has been successful is there's less of that insulin stimulus."
Fiber, unrefined carbs best
The sugar alcohols of low-carb bars, such as sorbitol, maltitol and lactitol, also trigger less of an insulin response than refined carbs. They aren't absorbed as quickly or as thoroughly, so less sugar enters the bloodstream at once and less insulin is needed to break it down. Fiber stimulates even smaller insulin doses, as do the unrefined carbs of whole grains, fruits and vegetables.
The bars' manufacturers, having been ordered by the Food and Drug Administration to include sugar alcohol carbs on the labels, now contend their insulin response is so inconsequential that they can be subtracted completely from "net" or "effective" carbs. Hardly any nutrition experts agree.
"I can go along with subtracting fiber," Key said, "because it really helps stabilize blood sugar and you get all the helpful phytochemicals and vitamins. But sugar alcohol affects your blood sugar, just at a slower rate." It also can cause diarrhea, bloating and abdominal pain after fairly small amounts for some people, according to the Center for Science in the Public Interest.
Watch out for fats
"These bars oftentimes have a lot of fat," Kitze said. "Some of them are quite high in trans fats, which are actually even worse for you than saturated fats."
For the sake of convenience, she said, they're an improvement over a bag of chips or candy bar, although at a hefty price of $1.29 to $2.29 a bar in a random sample. But she knows that's not the only way they're used.
"I — and many other people in nutrition — are concerned about these bars' crowding out whole foods in people's diets," Kitze said. "Fruits and vegetables have phytonutrients which fight everything from cancer to heart disease, and you can only get these nutrients from actual fruits and vegetables."
People shouldn't focus so much on low carbs that they're afraid to eat unrefined carbs "like dried beans and peas, a bowl of lentil soup, or whole grains or a piece of fresh fruit," said Mara Lamb, the New Profile center's licensed dietitian. Nor should they be indifferent to the difference between bacon and butter fats compared with the healthy fats in olive oil, fish oils and nuts.
That's why she's encouraged to see the South Beach diet puts more emphasis on lean meats and healthy fats than other low-carb plans, while accepting more fruits and vegetables.
"For some people," Cohen said, "low-carb diets are the only way they can succeed."
Different people need different foods, Westbrock said. Those with heart disease are especially vulnerable to saturated fats, and refined carbohydrates are worse for the insulin resistant than for others. No matter what fond hopes leap off the best-seller list, he said, "There's no perfect diet for everyone."
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