The Low-Carb Lowdown

Lots of Americans want to lose weight-including EMS providers. Currently, low-carbohydrate diets are popular among those seeking to slim down. But can low-carb plans like Atkins and the Zone work for dieters in the emergency services? Can they fit that busy EMS lifestyle? Are they the best options to pursue? What are the issues surrounding these much-hyped weight-loss plans?

When carbohydrate intake is reduced, some diet gurus profess, the body will start burning fat for its energy needs, and weight loss will result. This notion, considered radical when it was first introduced years ago by cardiologist Robert Atkins, has become the foundation of some of today's most-utilized slim-down plans. Proponents promise more energy and better overall health, while skeptics warn of lethargy, fatigue, dehydration and other problems.

The scientific community has not yet reached a consensus on such diets' effectiveness. The best available literature remains unclear: Studies recently published in the New England Journal of Medicine showed that low-carb dieters lost a bit more weight over the first six months than traditional (low-fat and -calorie) dieters, but after a year had regained more as well. Healthcare providers should not recommend low-carb diets, both studies' authors concluded, pending further investigation.

Yet in a culture obsessed with weight loss and enamored of easy solutions, these diets have achieved a popularity that outstrips their-proven, anyway-efficacy.

"I think any diet book you choose, you can learn something from, be it a quick recipe, or scheduled eating times, or ways to do better when you dine out," says Dawn Jackson, RD, LD, a registered dietician and spokesperson for the American Dietetic Association. "But if you think you're going to steadfastly follow any diet book for a lifetime, you're probably sadly mistaken."

The differences between Atkins and the Zone go beyond carbs. Generally, Atkins allows unlimited consumption of fats and protein, while the Zone controls those intakes a bit more.

Some dieters have reported great success with these plans. That may be, Jackson says, but probably not for the reasons they think.

"Just about any diet book you pick up probably will work for somebody for a short period," she says. "But it all basically revolves around calories. In the end, we really do know that it's calories that count. When somebody goes on Atkins, the Zone or any low-carbohydrate diet, they end up eating far fewer calories than they did before. You have somebody who dines out all the time, eating fries and pops and desserts and things, and then they go on a low-carb diet. Well, they can't have fries, they can't have pop, they can't eat dessert, so it excludes all these foods and basically allows them to eat fewer calories. They may lose weight, but they're attributing it to the wrong thing."

There may be negative effects to low-carb plans as well. Dieters who consume large amounts of protein over long periods of time may experience lethargy/fatigue, and may even incur heart damage or kidney problems. Leaner proteins are good, but all-you-can-eat bacon probably isn't, no matter what Atkins says.

"The No. 1 thing is, whatever book you're following, make sure it talks about the leaner proteins," says Jackson. "It should encourage portion control of things like turkey, chicken, fish, low-fat dairy, as opposed to just saying 'a protein is a protein-eat 'em up.' You also want to make sure fruits and vegetables are included. We know they are two very important reasons why people stay healthy and have good hearts and low blood pressure. And finally, it shouldn't completely eliminate any food group. If you see a book that says 'You cannot eat…' a whole list of foods, that's a red flag for a fad diet, and you can't stick on that."

There's one other component to losing weight, and there's simply no way around it: exercise. You have to-period. But the good news for EMSers is that they already get a lot of physical activity throughout their days. For you, the advice is to measure it, then increase it.

"We encourage people to wear pedometers, so they can count all the exercise they do in their typical day," says Jackson. "What we want people to do is about 10,000 steps or more, which usually boils down to about 3½-5 miles of walking every day. Basically that's parking a little farther away, or going for short, 5-10-minute walks here and there when you can grab a second. Wearing a pedometer can give you a baseline to see what you're getting and help you go beyond that."

With so many people having products to sell, reliable information on low-carb diets can be hard to find. Toward this end, the ADA offers scientific studies, healthy eating tips and objective advice on its website. For more, see www.eatright.org.