ER DOCS - Severe carb restriction is its own new disease

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ER DOCS - Severe carb restriction is its own new disease JoAnn Guest Apr 14,

2005 08:25 PDT

ER DOCS

http://www.theolympian.com/home/specialsections/HealthandFitness/20040628/84050.\

shtml

 

 

JOE PELLICER, TOM BURKE ER DOCS

 

Last night, I encountered a man in his late 50s who felt so ill that his

wife brought him to the ER. He had been feeling horribly drained during

the past week and was restless at night. His bowels were intermittently

constipated and loose, but he had no other specific complaints. He

hadn't had fevers or any signs of lung or heart difficulties.

During examination, my patient's pulse and blood pressure were normal.

His weight appeared normal. My history and physical examination were

unrevealing; therefore we conducted several laboratory tests to assess

his electrolytes, kidney function and general blood count.

 

The results were normal, except for his kidney function. It was slightly

off, suggesting recent damage. I was perplexed. He finally told me he

had lost 25 pounds during the previous six weeks. He wasn't really on a

diet, but his wife had started it for herself and he joined to support

her.

 

New disease

 

During the past few years, the obesity epidemic has become one of our

country's greatest health threats. We have discussed this in past

columns and I'm certain we will speak of it more. To combat the

explosion of our society's obesity, an enormous number of Americans are

turning to various diets for quick and easy weight loss.

 

However, my colleagues and I are seeing a new and unnamed disease of

general poor health that is caused by dieting and severe carbohydrate

restriction. In my practice, at least once each week, an exhaustive

evaluation leaves this new disease as the most likely diagnosis. We

don't yet have a name for this disease, but it is real and is becoming a

threat to our country's health.

 

Low-carb diets

 

Dr. Robert C. Atkins introduced the first low-carb diets in 1972. Since

then, many other diets have similarly called for severely restricting

carbohydrate intake. They include the high protein diet, the Hollywood

Diet, the South Beach Diet and several others.

 

These diets work by shutting off the most efficient fuel supply to our

bodies -- carbohydrates. The body first turns to the liver for a backup

source. After this is depleted, it starts breaking down muscle and

extracting proteins.

 

With continued carbohydrate deprivation, the body turns to fats for its

last-ditch source of metabolic fuel. The brain, which is highly

dependent on carbohydrates for its energy source, is forced to use fat

breakdown products -- ketone bodies -- as a poor fuel substitute. The

brain's dependence on ketone bodies causes it to function well below its

normal capacity.

 

Ketosis also causes a phenomenon called metabolic dehydration. This is a

type of dehydration that has nothing to do with how much you drink but

is responsible for the enormous total body-fluid loss associated with

the depletion of normal carbohydrate and protein stores.

 

Weight loss

 

You might say to me that you know these diets work. You have tried one

of these diets or know someone who has. Well, let's review the data.

Low-carbohydrate diets clearly result in weight loss, but the real

questions are for how long and at what health cost.

 

A review published in the May 2004 edition of the American Journal of

Clinical Nutrition found there is no weight-loss advantage over diets

with an equal number of calories that include carbohydrates. This review

shows that one of the principal features of carbohydrate-deprivation

diets is that they restrict total calories.

 

In a large national patient registry, it is reported that less than one

out of 100 dieters who lose 30 pounds from a carbohydrate-restriction

diet are able to maintain this after one year.

 

Many experts report the true reason for the sudden large weight losses

often seen are total body water losses from metabolic dehydration and

not actual shedding of fat.

 

The costs

 

At a public news conference June 22 in Washington D.C., national leaders

in nutrition issued a public warning about health risks associated with

low-carb diets. In this warning, it was described that these diets have

a number of short-term side effects, which include headaches, difficulty

concentrating, gastrointestinal problems and loss of energy. However,

compelling information has now been uncovered that these diets

eventually hurt the kidneys, liver, heart and brain.

 

The American Heart Association, the American Cancer Society, the

National Academy of Sciences, the American Kidney fund and the American

Diabetes association are just a few of the groups raising caution about

health risks of low-carb diets.

 

What to do

 

Research information is beginning to substantiate what we see every day

in our clinical practices. Severe restriction of carbohydrates can be

risky and unhealthful and seems to be a new disease. Although weight

loss is an important goal for many, experts state the best way to lose

weight is to choose a healthy program that includes a sustainable

balance of nutritional diversity.

 

For more information, see www.essentialnutrition.org.

 

Joe Pellicer and Tom Burke are physicians at Providence St. Peter

Emergency Department. Send your medical questions, comments or stories

to Notes from the ER, Olympia Emergency Services, Providence St. Peter

Hospital, 413 Lilly Road, Olympia, WA 98506.

_________________

JoAnn Guest

mrsjo-

DietaryTi-

www.geocities.com/mrsjoguest/Genes

 

 

 

 

AIM Barleygreen

" Wisdom of the Past, Food of the Future "

 

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