To Carb or Not to Carb?

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You’ve heard it before. Cutting carbs is the quickest, sure-fire way to lose those extra holiday pounds, right? And if you lose weight on low-carb diets, they must be healthy, right?

The truth is that not all carbohydrates are the same. Your body needs some naturally-occurring carbs, the sugars, starches, and fiber found in food, to function at its best. Eliminating all carbs from your diet can lead to constipation, nutritional deficiencies, and chronic health conditions like heart disease and diabetes. Chances are, if you deprive yourself of carbs for too long, you’ll slip back into your old eating habits and put the weight right back on.

Sure, following a carb-restricted diet like Keto or Atkins might help you drop a few pounds. But, you can achieve the same weight loss goals — with lifelong success — on a balanced nutrition plan that includes a variety of healthy carbs.

Why are low-carb diets so popular?

Low-carb diets eliminate or significantly reduce nutrient-dense foods like fresh fruits, whole grains, and starchy vegetables. Then, they commonly replace them with saturated-fat and calorie-dense meats, cheeses, and highly processed “health food” products like sugar-free sweets.

This might sound like a dream if you love a good cheeseburger.

But you’d have to skip the burger bun, fries, mac and cheese, onion rings, mashed potatoes, and soda or beer, which are all high in carbohydrates. Also off-limits? Pantry staples like rice, beans, corn (and tortillas), wheat flour, lentils, potatoes, plantains, and malanga are a no-go. And you’ll have to avoid sugary beverages like blended coffee drinks, fruit smoothies, fresh-squeezed juices, sodas, energy drinks, and alcohol.

low-carb diets

“Having boundaries, like no fruits and starchy vegetables, can be effective in the short-term," said Dr. Michelle Pearlman, a board-certified gastroenterologist, obesity medicine, and physician-nutrition specialist with the University of Miami Health System, "Because people often need some degree of restriction when starting a weight loss plan. These restrictive diets are trendy because people lose a significant amount of weight in a short period of time.”

It is possible, however, to limit saturated fat on a low-carb diet. Filling up on fatty fish, eggs, avocado, nuts, nut butters without added sugar/molasses, olives, soybeans (and tofu), seeds, coconut, and low-sugar dairy products (most dairy contains naturally occurring sugars) will help. A diet like this can also include non-starchy vegetables like dark leafy greens, zucchini, cauliflower, green beans, and asparagus. Eating a variety of whole foods can provide the fiber you need, reduce your risk of developing nutritional deficiencies, and ultimately promote your overall health by diversifying your gut microbiome.

The problem? Low-carb diets are boring.

“People get bored when their dietary choices are limited," says Dr. Pearlman. "They often fall off the wagon and binge on the high-carb foods they’ve been craving most: pasta, bread, crackers, chips, fries, and other processed foods with trans fats, added sugars, and refined flours.”

And then? Many people gain more weight back than they had initially lost.

Snacks and desserts, in particular, can be major roadblocks for dieters. Packaged munchie foods are full of carbs and added sugars (including crackers, granola bars, trail mixes, popcorn, chips, real-fruit strips and gummies, cookies, pastries, candy, boxed cereal, and glazed nuts).

Even whole fruits like bananas, apples, mangos, grapes, and strawberries are made of natural sugars that count as carbs. The same is true for other healthy snacks like hummus with carrots. And let’s not forget that carb-packed alcohol, especially wine and beer.

People on low-carb diets are often left with animal fats and proteins as the foundation of their meals and snacks. This diet is high in saturated fat, cholesterol, and calories, yet lower in some vitamins and nutrients your body needs for cell renewal, energy and restful sleep, heart health, and brain function. Because of this, Dr. Pearlman says, “Some studies show higher mortality rates for those following very low-carb (and very high-carb) plans.”

A nutrient-deficient diet could result in heart disease, diabetes, some cancers, and, surprise, eventual weight gain.

But can you eat carbs and still lose weight?

“For long-term success, it is very important to eat a more balanced diet and monitor portion sizes,” Dr. Pearlman says. “I hate the word ‘diet’ because it refers to a time-limited plan. Healthy eating should be a daily practice that can be modified based on one’s progress and goals over a lifetime.”

The foundation of a healthy nutrition plan is whole foods of all kinds. “We should be eating foods in their natural state,” Dr. Pearlman says. “Consuming pizza, candy, and pumpkin pie are social norms. But these foods are far from normal. All man-made food products and baked goods are highly processed.”

The good news? There are a variety of delicious foods you can enjoy while following these tried-and-true guidelines:

  • Avoid processed foods and beverages, including those with added sugars, trans fats, and refined flours.
  • Fill your meals and snacks with mostly plant-based whole foods like vegetables and fruits, whole grains, eggs, nuts, and seeds.
  • Limit meats and dairy products high in saturated fat.

“I prefer to limit my patients’ carb intake to no less than 40% of their daily caloric intake,” Dr. Pearlman says. “Based on their specific health and weight loss goals, we make adjustments to their nutrition plan over time, including finding the right balance of carbs, protein, and fat. We consider a number of factors, including any underlying health problems like diabetes or high blood pressure, food preferences, and any dietary restrictions based on allergies or intolerances.”

So, what’s the bottom line?

“Too much dietary restriction long-term can lead to nutrient deficiencies, an imbalance of the gut’s microbiome, serious health problems, and eventual weight gain,” Dr. Pearlman said. “Unfortunately, most of the popular diets on the market are very restrictive, preach a one-size-fits-all approach, and often lead to disordered eating habits and fear of food.”

That’s why Dr. Pearlman says “the best nutrition plan for you is one that’s realistic, balanced, and sustainable.”


Dana Kantrowitz is a contributing writer for UMiami Health News.


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