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So I have become a convert. Carbohydrates in the amount we commonly consume them (particularly sugar and other refined carbos) are often prime saboteurs of our weight. What's more, cutting back on them--especially on wheat--seems to produce improvements in energy, mood and sleep for many patients. It is hard to do--our culture is carbo- and wheat-driven. But of all the diets I've seen over the past few decades, the moderate-fat, lower-carbohydrate ones are the most successful. They stress not how much food you eat but what kinds. Calorie counting is not as important as carbo counting. They are not so much diets as a permanent change to a more balanced eating pattern.
I still have a difficult time recommending an Atkins-style, high-saturated-fat diet to my patients. Though the diet does provide a quick weight loss and is very satiating, I am concerned about its possible effects on people with serious heart, liver or kidney disease and cancer. As long as you are healthy, a high-fat diet is usually fine for a while. But after about a month, you should go off it. That's the problem. When people begin to go off the strictest form of the diet, they have to be extremely careful as they increase the amount of carbos and dramatically cut back on fats. For most people, this is too much of a metabolic swing, and weight regain is all too common. The more moderate diets of Sears and the Hellers--cutting carbohydrates by about one-third and eating moderate amounts of fat, preferably monosaturated ones like olive oil--are more gentle to the system.
So we now have a new set of tools that can help reduce food cravings, lose weight, and often provide a better sense of well-being. But remember, amid all the talk about carbos and fats, that all responsible diets, low carbo or not, recommend a minimum of five helpings of vegetables and fruits a day. And there is not a diet in the world that is a substitute for that good old-fashioned metabolic jump starter called exercise.
DR. WOODSON MERRELL is executive director of the Beth Israel Center for Health and Healing in New York City