Forget the Wonder Bread:
Atkins Diet Has a Point

The battle heated up last week when the Journal of the American Medical Association weighed in, concluding there's nothing special about the low-carbohydrate diet promoted by best-selling diet guru Robert Atkins.

Dr. Atkins has long claimed that severely restricting carbohydrates results in metabolic changes that help dieters lose weight faster than a traditional low-calorie diet. The JAMA authors, however, reviewed nearly 40 years of medical studies and concluded the low-carb diet is simply another way to cut high-calorie foods.

But the calorie-vs.-carb debate may be missing a crucial point. While the science shows all calories are created equal, it's increasingly clear that all carbohydrates are not. Not only are many high-carb foods very fattening, but certain types of carbs also can make it tougher to stick to a diet.

Dr. Atkins has a legion of true believers who are convinced that the diet works better than the rest. Nearly 12 million Americans are now cutting carbs in an effort to lose weight. And the truth is that everybody, even those of us who don't think the diet is healthy in the long-term, still has something to learn from them.

"It's the same stuff [Atkins critics] have been saying for 30 years," says Doug Berry, 43, a Newberg, Ore., paralegal who decided to cut carbs 15 months ago and has since shed nearly 50 pounds. "There's no evidence -- except for people like me who have done Atkins and have changed their whole lives."

It's easy to criticize the Atkins diet. It encourages dieters to gobble down foods like steak, cheese and butter that are rich in unhealthy saturated fats. It shuns, particularly in the early stage of the diet, many fruits and vegetables, which tend to be high in carbohydrates, as well as whole grains.

But no matter what you think of the low-carb diet, Dr. Atkins, who is currently in a coma after falling last week on an icy sidewalk, should get credit for shifting the diet debate away from the frenzied focus on fat to raising public awareness about the pitfalls of carbohydrates.

Most experts don't believe in restricting carbs to the low levels Dr. Atkins espouses. But there's a growing body of research that shows eating certain types of carbohydrates -- like those found in potatoes and highly processed foods such as white bread -- can make you hungrier. That's because the body processes them more quickly -- causing a spike in blood glucose, which in turn gives you a quick surge of energy. But then you crash and you're quickly hungry again. And hunger is the primary reason diets fail.

"Those swings can make it harder to control caloric intake -- they stimulate hunger," says Harvard School of Public Health professor Walter C. Willett, a longtime critic of the conventional carb-focused food pyramid. "If you're hungry, you'll snack and may consume more calories in the long run."

This doesn't mean you should cut all carbohydrates. But if you're trying to lose weight, it makes sense to rethink the ones you do eat and how often you eat them.

Many high-carb foods, such as french fries, muffins and oil-laden pasta, are also very high-calorie foods, so cutting them out always makes sense. In addition, switching to the type of carbs found in brown rice, beans, vegetables and fruits may help curb your hunger; they are essentially "sustained-release" carbs that are harder for the body to break down. Choose whole-grain foods over highly processed ones. And restrict "white" foods such as sugar, white bread, white potatoes and foods made with finely milled flours.

Like most successful low-carb dieters, Bruce Herbitter of Midland, Mich., says he wasn't hungry after starting the Atkins diet in August. The 50-year-old steel-industry executive lost 38 pounds in five months, and is now in maintenance mode.

For brunch on Saturday, he downed three fried eggs, six slices of bacon, two slices of low-carb toast with butter and coffee with a sugar substitute and heavy cream. Other days he tones it down, substituting the better carbs of broccoli and cauliflower instead of pasta in dishes, and skipping the bun and fries when he orders fast food.

His wife, however, couldn't stick to the diet because she doesn't particularly like meat and missed pasta, bread and legumes. "The diet works for you if you can be happy with these foods," says Mr. Herbitter. "I love fish, chicken, pork and beef and I love vegetables. I don't miss bread or pasta."

Three years ago Wendy Becker, a University at Albany assistant professor of management, lost 54 pounds cutting carbs. She found it difficult to give up cereal, in particular, but switched to a home-made, wheat-free granola of seeds, nuts and flaxseed. To maintain her weight, she still severely restricts carbs and eats mostly protein, berries and melon and non-starchy vegetables. "Carbs are addictive," says Ms. Becker, 51. "I know if I went back to the way I was eating before, I would gain weight again."

Dr. Atkins in the past has said he believes his diet can be misunderstood. While the early part of the diet severely restricts carbs, the plan does allow salads, green vegetables and berries.

Once a dieter is in maintenance, he continues to banish junk food and suggests a variety of fruits and vegetables. He encourages foods with healthy fats, warns against dangerous transfats and, contrary to popular opinion, suggests moderation when eating meats like bacon and sausage.

"The reason you don't feel hungry is that you can eat enough so that you're not hungry," Dr. Atkins said in an interview earlier this year. "This doesn't mean we want people to eat a lot of food or want people to eat unhealthy food."

• E-mail me at healthjournal@wsj.com³.