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Low Carb

Low Carb

Philip J Goscienski M.D.

Let's give the late Dr. Robert Atkins some credit. Over more than a quarter of a century he made us realize that we can get along with fewer carbohydrates than most of us have become used to. It's too bad that his weight loss plan has not lived up to its promise. There are some successes, to be sure, but since the beginning of the Atkins Revolution obesity has tripled in adults as well as children.

Physicians who care for children are aware that a high fat, low carbohydrate diet is nearly impossible to maintain. This is the ketogenic diet that they have been using for nearly 80 years in order to limit seizures in their patients. It is exceedingly difficult for parents to keep kids on this diet because of its unpalatability.

Low carbohydrate diets have reached their apogee. In rocket scientist jargon, that's the point where a missile's trajectory reaches its highest level and starts heading downward. Makers of low-carb foods are taking a hit, as did their high carb cohorts a few years earlier. Their timing was pretty bad. According to NPD, a research group, the number of Americans on a low carb diet dropped by half, to 4.6 percent, in September 2004.

There are no long-term studies that validate a low carbohydrate diet plan. After more than 25 years, the longest trial described in peer-reviewed medical journals lasted only 12 months. The dropout rate was high among all types of dieters, approximately 40 percent of the weight loss consisted of perfectly good muscle and other lean tissue, not fat, and weight loss was so modest as to be insignificant -- it averaged one pound per month. After all, when a person that weighs 250 pounds loses 12 pounds he or she is still seriously overweight. It's true that such a modest weight loss does lower the risk of type 2 diabetes and heart disease, but not dramatically. Without lifestyle changes that go far beyond carbohydrate control, 90 percent of dieters regain the weight that they have lost, and then some.

What's the future of low-carb? Diets never seem to die. You will see variations on that theme for the rest of this century. The entire industry somehow ignores the Mediterranean diet, whose original adherents in the Greek islands have been among the longest-lived and heart-disease-free people on the globe. Fifty percent of their calories come from carbohydrates and 40 percent from fat, almost all of that from olive oil. It relies heavily on fruits and vegetables, whole grains and very little red meat. Alas, no money-making potential there!