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  #1   ^
Old Thu, May-13-04, 11:48
gotbeer's Avatar
gotbeer gotbeer is offline
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Default "Carbs, low-carbs: A Mayo Clinic specialist cuts through the confusion"

Carbs, low-carbs: A Mayo Clinic specialist cuts through the confusion

By Mayo Clinic staff

With carbohydrate claims covering everything from cereal boxes to restaurant menus, you're likely wondering what the terms mean net carb, total carb, carb wise, carb fit, just to name a few. Low-carb options are prominent on grocery store shelves, but does that mean these foods fit into a healthy diet? And can a low-carbohydrate diet help you lose weight safely and permanently?

Donald Hensrud, M.D., a preventive medicine and nutrition specialist at Mayo Clinic, Rochester, Minn., answers these and other common questions regarding carbohydrates, low-carb diets and why you need carbohydrates in your diet.

Many food products claim to be low carb. What does this mean and are these foods healthier?

There's no legal definition for the term low carb. The Food and Drug Administration (FDA), which regulates health claims on food labels in the United States, hasn't yet defined what low carb means, but they're working on it.

Low carb and similar claims such as carb wise or carb fit are actually marketing terms created by manufacturers to sell food products. People may buy low-carbohydrate foods believing that they're healthier. But that isn't necessarily the case. For example, you can buy low-carb cakes and cookies, but that doesn't mean these foods, which may be high in fat and calories, are healthy. One low-carb nutrition bar, for example, can have 12 grams of total fat, 6 grams saturated fat and 240 calories.

Is there a downside to eating many low-carb food products?

Low-carb food products have only been on the market a short time, so it's too soon to tell what the potential pitfalls may be. We do know, however, that these food products can be high in fat and calories, and some can cause digestive symptoms. When food companies make low-carb products for example, low-carbohydrate candy bars they often replace the carbohydrates with substances such as the sweeteners sorbitol or maltitol. Sorbitol and maltitol can act as laxatives when consumed in large quantities and may cause diarrhea, cramping or other digestive discomfort.

What's the difference between the terms total carbohydrates and net carbohydrates?

The FDA calculates total carbohydrates by subtracting grams of protein, fat, water and ash a scientific term for the nonburnable part of a food that includes minerals such as calcium and phosphates from the total weight of the food. The resulting number is listed on the food label as "total carbohydrates."

Net carbohydrates a term not approved or defined by the FDA is the total number of carbohydrates minus fiber, glycerin and sugar alcohols. Net carbs, like low carb, is a marketing phrase used by proponents of low-carb diets to show a reduced carbohydrate amount on their products. Their theory is that fiber, glycerin and sugar alcohols which are all forms of carbohydrates don't raise blood sugar, so they shouldn't be tallied when counting carbs. But in reality, glycerin and sugar alcohols can raise blood sugar, and these substances do contribute calories.

Are there "good" carbs and "bad" carbs?

Historically, nutritionists and dietitians have supported the notion that there's no bad food everything can be eaten in moderation. But some foods offer no nutritional benefit beyond calories. Sugar is an example. Apart from the calories, there's no nutritional reason to consume sugar, so you could label that a "bad" carb. On the other hand, whole grains such as whole-wheat pasta, brown rice or oatmeal provide many vitamins and minerals, fiber, and other substances that promote health. This puts them in the "good" carb category.

But you have to watch how much you eat and keep your portions in check. Too much of any food, including whole grains, may provide excess calories. And excess calories from any source leads to weight gain.

What's the theory behind low-carbohydrate diets?

The theory is that carbohydrates raise blood sugar levels, which then kicks in insulin. Insulin drives blood sugar into the cells and prevents fat breakdown in the body, which means you won't burn excess fat and lose weight.

Proponents of low-carbohydrate diets take this one step further. They say that if carbohydrates raise blood sugar and insulin levels and cause weight gain, a decrease in carbs will result in lower blood sugar and insulin levels, leading to weight loss. And because you're not eating the carbs, your body breaks down fat to provide needed energy. Some people do lose weight on low-carb diets, but the weight loss probably isn't related to blood sugar and insulin levels. The weight loss is more likely the result of eating fewer total calories, whether they're from carbohydrate, fat or protein.

So why do low-carbohydrate diets work?

Three factors contribute to weight loss with low-carbohydrate diets:

Loss of water weight. The initial weight loss from low-carb diets is water weight. By eating fewer carbohydrates, your body burns its stored carbohydrates (glycogen) and fat for energy. When your body burns glycogen, water is released, and you lose weight.

Decreased appetite. Burning fat without carbohydrates creates byproducts called ketones that build up in your bloodstream (ketosis). When they're in a state of ketosis, many people find they have a decreased appetite or less drive to eat. But prolonged ketosis may deplete mineral stores in the bones, causing them to become porous and brittle.

Reduced calories. Most low-carbohydrate diets reduce your overall calorie intake because the diet limits a whole group of foods. And when you consume fewer calories than you need, you lose weight.

If you eat certain combinations of foods for example high-fat, high-protein foods with carbohydrates will you lose weight faster?

There's nothing special about certain foods or combinations of foods. A calorie is a calorie no matter when or how it's consumed.

What are the long-term health risks of low-carb diets?

No one knows the long-term health effects of low-carb diets. Though a few studies have looked at the benefits and risks, none has been conducted over a long enough period to show whether these diets increase the risk of health conditions that develop over many years, such as heart disease, cancer, and kidney or bone problems.

Do you have to stay on this diet throughout your entire life?

Theoretically, in order to maintain weight loss if you do lose weight, you need stay on the program. But a low-carb diet doesn't appear to be easier to maintain than any other diet. A study published in the May 2003 issue of the New England Journal of Medicine found that after one year, four in 10 people on one low-carb diet the Atkins diet dropped out, and four in 10 people on the traditional calorie-control diet dropped out. This may suggest that the low-carbohydrate diet, like so many diets, is no easier to stick to long term.

What's the difference between glycemic index and glycemic load?

Glycemic index is a measure of the degree to which a specific food enough to total 50 grams of carbohydrates raises your blood sugar. Potatoes raise blood sugar higher and faster than apples, for example. So potatoes earn a high-glycemic-index rating and apples get a low-glycemic-index rating. But glycemic index doesn't account for the amount of food you typically eat in a serving.

Glycemic load is a measure of how much a typical serving size of a particular food raises blood sugar. For example, the glycemic index for carrots is pretty high. But the amount of carbohydrates in a serving size of carrots about a 1/2 cup is low. So carrots have a high glycemic index but a low glycemic load.

Comparison of glycemic index and glycemic load of certain foods
Food Glycemic index Glycemic load
Apple 40 6
Baked potato 85 26
Brown rice 50 16
Carrots 92 5
Corn flakes 92 24
Orange juice 50 13
Plain bagel 72 25
Potato chips 54 11
Pound cake 54 15
Table sugar (sucrose) 58 6

Adapted from International Table of Glycemic Index, 2002

Ranges for glycemic index (GI) and glycemic load (GL)

High 70 or more 20 or more
Medium 56 to 69 11 to 19
Low 55 or less 10 or less


Can the glycemic index help you lose weight?

The theory behind low-glycemic diets is similar to that behind low-carb diets: high-glycemic-index foods raise blood sugar and insulin levels and cause weight gain. So if you eat low-glycemic-index foods, you'll lower your blood sugar and insulin levels and you'll lose weight. Though some people do lose weight on these diets, this theory hasn't been scientifically proved.

You may find potential problems with a diet that emphasizes eating only foods with a low glycemic index. Many factors play a role in how much your blood sugar rises, including your age and weight. And people typically don't eat single foods, but instead eat a combination of foods as part of a meal that affect blood sugar differently. Also, how much you eat of a certain food and how that food is prepared has varying affects on blood sugar levels.

If you're at a healthy weight, do you need to distinguish between various types and amounts of carbohydrates?

Yes but not the way people are doing it in terms of net carbs and total carbs. You need to look at the health effects of food and make wise food choices. Many carbohydrate-containing foods such as whole grains and fruits are loaded with essential vitamins, minerals, fiber and other substances that promote health. They form the foundation of a healthy diet, along with other plant-based foods, including vegetables, legumes, nuts and seeds. Variety and portion control are keys to a healthy diet. And excluding or severely limiting one food group such as carbohydrates or fat isn't a proven answer to long-term health.
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  #2   ^
Old Thu, May-13-04, 14:16
K Walt K Walt is offline
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Okay. So according to this fellow, low-carb doesn't work. Low glycemic doesn't work. Low fat doesn't work.

All he says is, "Variety and portion control are keys to a healthy diet."

There you go. Close the universities. The answer is found. There's nothing else to say on the matter.


For me, eating low-carb (with all the vegetables and seeds) makes it easy to eat a variety of foods and control how much I eat.

But of course, that doesn't work, says he.
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  #3   ^
Old Thu, May-13-04, 15:01
Kristine's Avatar
Kristine Kristine is offline
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Some people do lose weight on low-carb diets, but the weight loss probably isn't related to blood sugar and insulin levels. The weight loss is more likely the result of eating fewer total calories, whether they're from carbohydrate, fat or protein.

Then why does it improve PCOS? How is it restoring insulin sensitivity? Through calorie deficit alone?
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  #4   ^
Old Sun, May-16-04, 00:12
CLASYS's Avatar
CLASYS CLASYS is offline
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Eeech! Yet ANOTHER spun conclusion taken from the low-fat mantra and "bible".

These people never give up, do they?

How about the fact that a calorie is NOT a calorie is NOT a calorie!

One of these pinheads was quoted on a net-reported story that the conclusive study funded by the US govt PROVING that you can do better eating MORE calories than the low-fat version as long as it's actually true low-carb was "a violation of the laws of thermodynamics".

Oh! I didn't know that the human body was IDENTICAL to a calorie burning oven [used to actually measure calorie value of any material, the idea was touched upon in the article.]

Anyone with no spin or bias towards low-fat diets has to come to the Atkins' conclusions as we know it, but every one of these jokers has an agenda. After all, could the prestigious Mayo Clinic actually be WRONG about something?

Any diet fails with recivity; don't blame the diet, blame the [ex]-dieter. Drawing conclusions from people's lack of discipline is totally unscientific and unprofessional.

The conclusions here are an abomination and an embarassment to the TRUE scientific community which better have an open mind! To draw conclusions that it must be in keeping with the tired old low-fat mindset with a handwave is pure rot.

I have been able to keep myself in a state of ketosis for weeks on end. Inevitably, it was MY fault that I didn't maintain the diet, not the diet's "fault" inherently. The solution is to go back to induction and don't look back, etc.

Carbs are neither "good" nor "bad". In fact, they are ALL quite bad. To claim the old "empty calorie" theory by force of habit doesn't cut it anymore. Sure, you can get various vitamins and minerals from certain fruits and vegetables, but is it worth the sugar invariably accompanied when getting these nutrients in that form [as opposed to a carb-free vitamin supplement?].

One thing that cannot be underestimated is the effect of insidious carbs. If you go over your personal limit, you can instantly reverse the effects of ketosis and gain MANY pounds of fat weight overnight! I'm sure many of us have been through that weirdness [I have several times, not to be proud, just honest!]

Unless and until we get into the end-point maintainence phase of the diet, all carbs are unwelcome and to be avoided. The more we eat nearly unlimited quantities of fat and protein, the more important this actually is. Thanks, but no thanks. I'll eat lotsa meat and add lotsa Kraft extra-heavy mayonaisse to my nice juicy roast beef or turkey because it helps me get a total daily carb level down to the point I am in ketosis and also feeling satieted and increased energy in part due to the more stabilized blood sugar levels.

In the process I lower the incidence and intensity of diabetic complications, lower triglycerides and LDL while raising HDL, in essence lowering heart attack risk factors all the time practicing "heresy" according to the Mayo "experts".

The only points I can agree with them is almost a straw-man arguments. No one suggests that "empty calories" are any good for you, meaning processed sugars. But the unprocessed ones are just as bad.

This glycemic load crap is a scam. In essence, they say carbs are fine as long as you don't eat enough of them to do anything that would change their pre-ordained outcome. However, they ARE correct about this concocted "net carbs" myth invented by marketroids to sell high carb food as if it was lower carb.

The only [and TOTALLY IRRELEVANT] truth is that if one is severely diabetic, different carbs raise blood sugar levels in the short-term in different ways. One of the problems of being diabetic is attempting to maintain control of BS levels at all times; anything that makes the process more volatile isn't welcome. Thus, for the essence of long-term diabetic care assuming you are NOT stabilizing bs levels [which the Atkins diet may very well accomplish!], it is better to have sugar alcohols that will "spread out" the carb rise as opposed to spiking bs levels the way other carbs do. But when we are measuring carb INTAKE there is truly no difference between sorbitol and company and sucrose and company.

Curiously, "net carbs" also leaves out carbs attributable to digestible fiber, as if that's a "special" category off-the-board regarding carb intake as well. This is likely due to this somewhat "magical" property some make about by some ill-defined method, eating high-fiber is supposedly lowering heart attacks. [The truth there is likely merely that if you lower fat while eating too much carbs, you do better if the carbs are fiber. But no one, other than Atkins, ever studied that if you eliminate the carbs of ALL forms, you do far better because you lower the LDL, triglycerides, and raise the HDL, etc.] Statistical improvements can be quoted to spin any sort of study to skey the perceived results.

When are these guys gonna stop quoting their irrelevant and obsolete notions and FEELINGS about limiting fats when they have no evidence either way, just admit they simply don't know, and also be open to someone who CAN prove that their notions are wrong!

cjl (A founding member of the Mayo[naisse] Clinic)

ps: Anyone have an accurate carb count for Kraft REGULAR mayo versus the EXTRA-HEAVY variety only obtainable in 1 gal and 2.5 gal containers? [Note: Not all of the 1 gal containers are actually the extra-heavy variety!]
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  #5   ^
Old Sun, May-16-04, 10:10
Dodger's Avatar
Dodger Dodger is offline
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Originally Posted by CLASYS

ps: Anyone have an accurate carb count for Kraft REGULAR mayo versus the EXTRA-HEAVY variety only obtainable in 1 gal and 2.5 gal containers? [Note: Not all of the 1 gal containers are actually the extra-heavy variety!]

Both are listed as 0 carbs in a tablespoon. Kraft also has a extra heavy, extra egg mayo available in those huge containers.
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