What about “less carb” instead of “low carb”?

What about a “less carb” eating plan?  Wouldn’t that be a good bet if you still have safety concerns about low carb eating plans?  This page:  about.com low carb for kids provides a nice summary of this viewpoint.  What’s wrong with this logic?  At least three things.

1)  A less carb eating plan may not be low carb enough to get the metabolic benefits of low carb–to switch your child’s body over to primarily burning fat, rather than carbohydrates, for fuel.  (Westman, Dr. Eric C.; Phinney, Dr. Stephen D.; Jeff S. Volek (2010-02-17). The New Atkins for a New You (p. 8-). Simon & Schuster, Inc.. Kindle Edition).

2)  A less carb eating plan may not be low carb enough to eliminate carbohydrate cravings, making it much harder for the child to follow.  On a very low carb diet, cravings disappear.  That kid who can’t seem to get enough mac and cheese, muffins, cookies, bread with dinner, potato chips and so forth will disappear.

As you approach your goal weight, you gradually add carbs back in a defined order–but if a given carbohydrate food stops weight loss or causes cravings to return, you eliminate it again.  If you don’t do that, it’s very hard to stay on the eating plan.  (Westman, Dr. Eric C.; Phinney, Dr. Stephen D.; Jeff S. Volek (2010-02-17). The New Atkins for a New You (p. 116-144). Simon & Schuster, Inc.. Kindle Edition.

3) On a less carb eating plan, your child may be hungry even while consuming the same number of calories as on a low carb eating plan that does not result in nagging hunger.  Why?    Carbohydrates stimulate hunger in a way that fat and protein do not.  As Gary Taubes describes in “Good Calories, Bad Calories,” a diet of 1200 calories of fat and protein is satiating.  People find compliance relatively easy, without hunger, and they lose weight.  But a diet of 800 calories of fat and protein and 400 calories of carbohydrate is the classic semi-starvation diet that is successful in perhaps 1 of 100 people.  And a major reason for the low success rate is people can’t tolerate the constant hunger such a diet produces.  (Taubes, Gary (2007-09-25). Good Calories, Bad Calories (Kindle Location 6884-6924). Random House, Inc.. Kindle Edition).

Nor is it necessary to consume only 1200 calories of fat and protein to lose weight on a low carb eating plan.  Taubes summarizes:

“The last decade has witnessed a renewed interest in testing carbohydrate-restricted diets as obesity levels have risen and a new generation of clinicians have come to question the prevailing wisdom on weight loss. Six independent teams of investigators set out to test semi-starvation diets of the kind recommended by the American Heart Association in randomized control trials against “eat as much as you like” Pennington-type diets, now known commonly as the Atkins diet, after Robert Atkins and Dr. Atkins’ Diet Revolution. Five of these trials tested the diet on obese adults, one on adolescents. Together they included considerably more than six hundred obese subjects. In every case, the weight loss after three to six months was two to three times greater on the low-carbohydrate diet—unrestricted in calories—than on the calorie-restricted, low-fat diet.”

Taubes, Gary (2007-09-25). Good Calories, Bad Calories (Kindle Locations 6868-6875). Random House, Inc.. Kindle Edition.

See also:  Westman, Dr. Eric C.; Phinney, Dr. Stephen D.; Jeff S. Volek (2010-02-17). The New Atkins for a New You (p. 49-58). Simon & Schuster, Inc.. Kindle Edition.

We enroll in a kids weight control program

After Juliana hit 168 pounds at a height of 5′ 4″, I went looking for a kids weight control program. I found one at Lucile Packard Children’s Hospital at Stanford University. It was near my house, and started at the end of January. It was expensive and not covered by insurance, but I wanted help. Juliana was in the habit of asking my permission to eat things–usually sweets or seconds. I never said no, but would try to guide her choices–”I wouldnt have the cookie because we are going to a party later and you’ll probably want something there.” I wanted to cut myself out as the middleman. I wanted her to be in charge and empowered to control her own intake. The Packard program is designed to do that. Juliana met with the Packard staff, learned about the program, and we both agreed to try it together.

The Packard program is based on the standard calories in/ calories out model.  Kids are taught to switch to lower calorie foods, control their portion sizes, and increase their physical activity level.  Children are thereby supposed to burn more calories than they consume and lose weight.  The Packard program first ramps down on higher calorie foods. Then it ramps up on physical activity.

Foods are evaluated for their caloric density, that is calories over grams of weight: c/g. Foods with caloric density over a certain threshold are red. Below a lower threshold are yellow, and below the lowest threshold are green.

Green foods are things you may eat in virtually unlimited quantities. It’s a short list, and includes things like broccoli, romaine lettuce, and spinach. Yellow foods are go-slow foods–usually still healthy, but watch your portion size. Whole wheat bread, pasta, chicken, starchy vegetables like sweet potatoes, eggs. Red foods are junk foods, like soda or candy, or fast food, but also meats if they aren’t low in fat, full fat cheese, and nut butters.

Eating more than two servings per meal of a yellow food also makes the third portion into a red, to try to control for meal size. The kids were taught the visual cue of a serving being equal to what would fit in the palm your hand.

Some of the kids started out eating 100 or more red foods per week. They had fast food, soda, and juice regularly. Juliana topped out at 35, the week she was on a trip with her school and had no control over her food. Even so, we reduced the number of reds she ate. We eliminated maple syrup on her whole wheat French toast, substituting applesauce. She cut out the 100 calorie fudge bars she liked for dessert. I started cooking with almost no oil–a teaspoon for six servings was a “yellow”, more than that a red. I started making mostly vegetarian bean soups and stews, carefully using my teaspoon of oil to sauté garlic and onion. In a few weeks, she was down to eating only 4 or 5 reds a week.  (The Packard program didn’t recommend even trying to go below 18 reds per week, because they wanted goals to be challenging but doable—they didn’t think 18 reds or fewer was doable enough).

After six weeks, the Packard program starts to ramp up on exercise. Different activities have different point values, and you try to increase your exercise points while you decrease your red foods. Juliana had always exercised, but she began to do even more.

Did she lose weight? Yes, she lost 6 pounds in 10 weeks.   I didn’t find that rate of weight loss very impressive, considering how few reds she was eating and how much she exercised.  Then she stalled, gaining back half a pound at the weekly weigh-in. And meanwhile, she was almost always hungry, despite eating every few hours. I would pick her up from school, and before she said hello, she would gasp, “do you have a snack?”

The Packard program confirmed for me what I had been saying to anyone I thought could help–compared to the other overweight and obese kids in the program, her eating habits had been super healthy, and now were even healthier, and she exercised. If the Packard program was going to work for her, shouldn’t she be steadily dropping weight eating only 4 reds a week and exercising a minimum of 30 minutes a day at a medium intensity? But she wasn’t. She was also having a hard time because she was frequently hungry.   I went looking for something better.

Maybe she’ll grow into it?

I hoped she would “grow into her weight.” I had been a bit pudgy as a child and suddenly grew and slimmed out at age eleven–I thought the same growth spurt might happen to her.

But the signs weren’t good. Juliana seemed to have no internal satiety control. If she were eating pasta (whole wheat) she could not get enough. At the end of her kindergarten year, I learned that she had been routinely eating her entire lunch (healthy, packed by me), and then consuming one of the leftover school hot lunches of a child who was absent that day (unhealthy, from a pizza place). She would often be hungry again just a few hours after a large meal.