|Monday, July 19th 2004|
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The controversy and the craze surrounding the low-carb revolution continue to rage, while low-fat believers try to hold their ground.
Kraft, which satisfied dieters counting fat grams in the
90s with SnackWell cookies, now has added a CarbWell line. They are just
a few of the hundreds of "carb-cutter" products.
High-protein, high-fat diets aren't safe, they say. Cutting out whole groups of foods -- such as most fruits and vegetables -- makes it difficult to get enough vitamins, while extra protein and fat can tax the kidneys and gall bladder.
Eating more red meat and fewer vegetables increases the risk of cancer, especially of the colon. But dietitians do see the need for Americans to reduce the amount of refined carbohydrates they eat -- and to lose weight.
There are good and bad pieces in all diets, said Ann Hoffman, a registered dietitian and certified diabetes educator with Covenant HealthCare in Saginaw. Hoffman teaches "Lean on Me" weight-loss classes for the hospital.
"Atkins is helpful for some people, but I would advise people to eat a moderate amount of carbohydrates. They don't have to be cut back so drastically that you compromise nutrients."
The most recent national statistics indicate 64 percent of adults are overweight or obese, and many continue to turn to diets to fight fat. While carb counting is the rage, many dieters considered low-fat snacks the solution a few years ago.
Hoffman said she is talking to doctors about the popular diets -- and won't recommend any of them.
She likes that Atkins has made people aware of the different kinds of carbohydrates and of their sugar consumption -- which often is excessive. But diets should include carrots and wheat bread, she said.
"I don't promote Atkins at all," said Laura A. Hegenauer, a registered dietitian and certified diabetes educator at Saint Mary's hospital in Saginaw. "Low-carb diets work because of lower calorie content. If you limit a major food group, you won't eat as much. But low-carb diets are inadequate in nutrients."
The Atkins plan does include the use of vitamin and mineral supplements, which its creator considers a must for everyone.
Hegenauer considers Atkins unsafe and unproven, but generally thinks all "diets" are doomed to fail.
"Most last about six weeks, regardless. Some people are successful longer."
The key is changing behavior for life, she said.
"We know the answers, but we want the easy solution. I give them a plan to modify quantity -- eating half of what they normally eat for some."
Atkins boosters say much of the diet's effectiveness is based on the fact that followers aren't hungry as they lose weight. Hegenauer argues that many people don't eat out of hunger, but are driven by emotions.
"They have to learn to feel hungry. Any program has to take a psychological view to work."
Instead of simply counting calories, many popular diets use more complicated systems such as tracking digestible carbohydrates and the "glycemic load" of a food. It sounds pretty technical, but most dietitians don't give the calculations a lot of weight.
The glycemic index tells you how fast glucose enters the blood stream. Pure glucose rates 100, and fat is at zero. At the high end are highly refined foods such as instant white rice at 91 and cornflakes at 84, followed by jelly beans at 80, a banana at 52 and peanuts at 14. Fiber-rich foods are lower on the index because fiber slows the passage of foods through the digestive system.
Higher numbered foods are digested rapidly and can cause sharp increases in blood sugar after eating. The resulting surge of insulin -- a hormone made in the pancreas that helps the body use sugar for energy -- causes a drop in blood sugar to relatively low levels several hours later. That "sugar crash" creates a sensation of hunger and may stimulate overeating.
While a lot of best-selling diet books are based on these ideas, the index isn't very useful for the average person because it looks at how individual foods raise blood sugar, Hoffman said. Most people eat a mixed meal -- if you put peanut butter on a bagel, you can balance out the carb load of the bread, she said.
"People are thinking all carbs are bad, and that's the wrong message," said Peggy S. Crawford, associate professor of health and wellness at Delta College. "The problem is that we eat too many and too much of the wrong carbs, like enriched breads and flours.
"Enriched means the manufacturers took the natural germ of the grain out, beat it up and then had to put back the nutrients they took out."
That's a basic definition of "highly processed," which means most fiber is removed and the food will break down easily in your digestive tract.
It's not easy to find products without the word "enriched" on the label, Crawford said, but human bodies work better when they have to break down foods without help. Brown rice and sweet potatoes are better choices.
Crawford teaches a class on nutrition that covers the most popular diets -- and their problems.
"There are more than 33,000 diet books out there; if one really worked, there wouldn't be so many," she said.
One hundred percent of her students say they make diet changes after the class, such as reducing the amount of soda they drink and trying new foods, she said.
Atkins is dangerous for people with diabetes who might have decreased kidney function, said Michele Bernreuter, a registered dietitian and diabetes educator with the East Central Diabetes Outreach Network based in Saginaw. All that extra protein can put strain on the kidneys as they work to eliminate waste, she said. The extra fat may cause gall bladder problems, such as gallstones, she said.
"Atkins is the backlash to the low-fat everything and Snackwells. People who ate low-fat ate too many carbs, but with no carbs you eat only meat and fat. You can't just eat all the prime rib you want. You need a balanced diet."
Proponents of low-carb eating say the relatively quick drop in pounds in the first weeks is a great motivator for people who need to combat a major health crisis -- obesity.
The most recent national statistics indicate 64 percent of adults are overweight, with a body mass index of 25-29, or obese, with a BMI of 30 or higher. More than 15 percent of children and teens 6-19 are overweight.
Body mass index is a measurement of body weight relative to height, which usually correlates with body fat. To determine your number, multiply weight in pounds by 703, divide by height in inches, then divide again by height in inches. BMI of 18.5 to 24.9 are considered normal.
Dietitians and fitness experts don't offer easy answers to weight loss, but they do help people find ways to lose weight for good, they said.
"My message till the day I die is that it's not what you look like, it's what you live like," said Crawford, who competes in women's fitness contests. "If you want to be healthy, you have to eat that way and exercise. Make small changes; you can't overhaul your whole diet. You'll never stick to it every day."
Hoffman agrees. Even more than diet, the answer to fighting obesity is increased activity, she said.
She likes to see fast food restaurants such as McDonald's offering a stepometer and more salads.
"We have to have options," Hoffman said. "I don't think people are going to be cooking more at home, but you can pack and take fruits and vegetables with you. That is very basic."
Our ways of thinking about food change all the time, with new research and with the whims of the marketers. Nutrition experts are trying to find a middle ground.
The U.S. Department of Agriculture, which in 1992 created the Food Guide Pyramid that most nutritionists follow, is working on revising the guide -- including changes in portion sizes and calorie levels. Weight control and exercise likely will get greater focus.
The advisory panel working on changes has decided people should pay more attention to counting calories than to counting carb or fat grams. Final release of the new pyramid is scheduled for early 2005.
"Changes will come, but it will take time,"
Hoffman said. "There's a lot of influence on this from science and
Coarsely chop washed drained cranberries and nuts in food processor. Add orange zest and Steviva Blend to taste. Cover and put in refrigerator at least 2 hours before eating with turkey, chicken or ham.
Carbohydrates per Serving : 1.02 - Carbohydrates per Serving minus Fiber: .92
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