Regina has a must-read post over at Weight of the Evidence.

In it, she talks about why the focus on “losing weight” completely misses the point and why looking at carb consumption in the diet is critical for people who have one or more of the following: obesity, high blood pressure, high triglycerides, low HDL cholesterol, or high fasting blood sugar. The presence of these symptoms may indicate something now being referred to as metabolic syndrome, a “cluster of conditions that occur together, increasing your risk for heart disease, stroke and diabetes.”

Some highlights from Regina’s post (emphasis mine):

Metabolic syndrome is one of those “chicken and egg” disorders - which came first, the metabolic dysfunction or the obesity, dyslipidemia, hypertension, insulin resistance, or high fasting blood sugars? The American Heart Association (AHA) apparently believes it is the obesity driving the disorder. Their recommendation - a low-fat diet to reduce weight coupled with increased physicial activity.

The problem with that recommendation? Data from numerous trials shows that a low-fat carbohydrate rich dietary pattern actually worsens the other risk factors for metabolic syndrome with increased triglycerides, decreased HDL. Without significant weight loss, such a diet may also increase insulin resistance and worsen fasting blood sugars due to the high carbohydrate intake required to achieve a fat intake less than 30% of total calories.

…

Folks, obesity is indeed contributing to the increase in metabolic syndrome. However, the answer to reverse the trend is not as simple as losing weight. The only way to reverse the trend is to identify the driving factor behind our obesity AND metabolic dysfunction issues - resolve the underlying reason for our weight gain and identify what is disrupting our metabolic pathways so negatively.

…

You don’t have to wait for the “experts” to finally “get it” - your long-term health depends on educating yourself about what the science says, what the research data shows us and making an informed decision about taking control of your diet to improve your risk factors. A controlled-carb approach offers improvements in weight, HDL cholesterol, blood pressure, triglycerides, insulin senstivity and glycemic control.

Regina may feel differently, but I don’t think there’s enough evidence yet to show that a very-low-carb diet is essential. I’ve been there, and while I’ve done well, I cannot fathom a long-term diet of double-digit carbs (e.g., 50 grams, the “amount advised in Protein Power and other enlightened books on carb restriction”) if it isn’t necessary. After using some online tools, I’ve found that I’ve been eating about 200 grams or so of carbs a day (that’s roughly the equivalent of a cup of whole grain or starchy veggie per meal; I avoid refined carbs like white rice or regular pasta).

Others, like Jimmy Moore, do wonderfully on low-carb, so I suspect that it’s really a matter of finding something that you can stick with.

So, if you’re like me, and the more refined carbs you eat, the more you want, you may want to consider controlling your carbs. I do the lazy person’s managed carb plan, but there are all sorts of others that run from very low-carb (Atkins, Protein Power) to managed carb (Zone, South Beach, any diet based on glycemic load).

Disclaimer: I don’t believe in dieting. Your mileage may vary, I’m not a doctor nor play one on TV, yada yada yada. But I do believe that folks like me, who compulsively overeat, can greatly benefit from cutting out or at least reducing the white stuff.