Originally published in The Ottawa Citizen November 4, 2003
Original Title: A guilt free review of dining at your favourite eatery

A growing number of people are adopting a low-carbohydrate lifestyle. Indeed, a few studies support the Atkins diet, in the short-term, as a safe way to lose weight (the diet is contraindicated for some medical conditions). The Atkins diet can be difficult to follow over the long-term. Atkins recommends vitamin supplements but many forget to take them leading to an increased risk of vitamin deficiencies.

How does the diet work? One hypothesis is the quantity and quality of carbohydrate intake will affect insulin levels. Insulin enables the transfer of glucose (sugar) into cells and promotes fat storage. When eating a high-fat high-carbohydrate meal, insulin levels will spike in response to the high sugar load. Consequently, most of the fat within the meal will be stored in the fat cells whilst the body preferentially uses the easily metabolized sugar as its energy source.

The choice of dietary lifestyle should not be a chore (the death knell of any diet) but integrate itself seamlessly into daily life. What is the rationale for food combinations?

The proposed system promotes three food categories. Category A includes red meat, fish, chicken, fatty and processed meats, cheeses, oils and other fats. Category B includes fruits, vegetables, legumes and beans, and category C, pasta, potatoes, rice and bread.

The goal is to reduce insulin secretion after a meal. Combining A + B minimizes the sugar load and hence no insulin increase. The body uses fat as its energy source of choice. B +C limits fat intake and storage. A + C, the meat and potatoes diet, is assumed to be partially responsible for weight gain.

How would these categories help select dishes from a restaurant menu? The following exercise outlines an approach to menu selection and is intended for illustration purposes only. This is not a critique of the menus or an endorsement of any establishment over another.

Wendy’s fare offers hamburgers, chicken sandwiches, fries, chili and salads. A review of their nutrition/ingredient guide available for the asking can help you select an A+B meal. You can choose a hamburger with mustard, pickles, lettuce tomatoes and onions or their grilled (not breaded) chicken fillet with some side condiments without the bun. Add a side salad with either low fat honey mustard or fat-free French Style dressing, water or a diet soda and you now have a meal.

East Side Mario’s offers a broad range of appetizers, entrees and desserts. Fried mozzarella aside, there are several appetizers to choose from: the Sizzling Calamari Al Diavolo (sautéed in white wine, garlic, lemon, red, green and hot cherry peppers), steamed mussels, Baked Garlic Shrimp or Chicken Garden Salad (no croutons).

Many of their entrees come with unlimited soup or garden salad and garlic bread. Push the garlic bread away from the table and stick to the salad. Choose pasta dishes that do not have meat, cream sauces or cheese. Any pasta with Arrabbiatta or Napolitana sauce with primavera vegetables fits the bill. Meat lovers can choose from Hell’s Kitchen Chicken, Rack of Ribs or New York Steak all without fries, potatoes or pasta. Dessert: fuggedaboudit

The Kam Fung Chinese buffet is popular. The 30 or so items offer many choices and combinations. The dishes to avoid include any breaded meats, noodle dishes, spring and egg rolls and won ton soup. This still leaves a variety of tasty dishes: Hot and sour soup, beef or chicken with broccoli, beef with green pepper and onion, beef, shredded pork or chicken with garlic sauce, beef or shrimp with mixed vegetables, Kung Pao chicken and the salad and fruit bar.

For non-diabetics who wish to have noodles and plain white rice with their meal, select the meatless vegetable dishes.

All these selections lead to a net reduction in caloric intake. This in itself is a likely reason for weight loss. Marie Hebert, a dietitian with the Diabetes Clinic of the Ottawa Hospital has some concerns with this choice of diet. Indeed, she states this type of diet “may lead to an overconsumption of protein and a restriction in food choices and may have long term negative impact on health.” She asks where milk fits into this system.

One should not eliminate grains and other complex carbohydrates that form part of a healthy diet. Indeed, the glycemic index (http://diabetes.about.com/library/mendosagi/nmendosagi.htm) is a useful measure to select healthful carbohydrates.

There are indeed other factors to consider when choosing a weight reduction method: saturated and hydrogenated fats, protein load, quality and quantity of food, exercise and eating habits.

Hurrying through any meal does not allow the natural feedback mechanism of the body to signal satiety leading to overeating. It is imperative to combine diet and exercise. A dietician can help you select the proper meal plans and provide professional lifestyle advice based on your food preferences.

---

© Dr. Barry Dworkin 2003