The low-carb conundrum: can environmentalists "go Atkins" and still eat healthfully?

Last week, my favorite health-food supermarket was invaded with little red-and-blue circular signs. They read "Low-Carb" and appeared on everything from tomatoes to bulk cashews to reformulated bread and pasta. I've been trying to ignore the carb-counting craze, but those ubiquitous signs were missing from some of my favorite foods, and it bothered me. Was I eating less healthily than half the people I know who seem to be on one of the many low-carb diets?

From an Atkins-obsessed co-worker to the publisher of this magazine, it seems that everyone is trying it, and many are losing weight. In a recent survey by the Grocery Manufacturers of America, 74 percent of respondents said they were following some form of low-carb diet. E's publisher lost about 20 pounds over several months.

Many of these plans call for increased protein and fat, often in the form of meat and other animal products, which would seem to run contrary to my long-time commitment to a vegetarian diet. In fact I began to wonder if it is possible to eat a low-carb diet and still eat healthily.

Is it Healthy?

A host of medical professionals, not to mention vegetarian activists, have sounded off about low-carb diet plans. Mainstream news outlets, from the New York Times to Time magazine, have quoted experts opining that low-carb diets are likely to be unhealthy. Rob Walters, the chairperson of Australia's Division of General Practice, joined the Australian Medical Association in launching a major campaign against low-carb diets, which he says are "fad diets that engender undesirable eating patterns." One of the major complaints of critics is the shift toward promoting saturated fat and animal protein, which years of research have linked to cancer, diabetes and heart disease.

On the other hand, several reports have come out supporting low-carbohydrate diets as a valuable weight-loss tool. Some are heralding a new "low-carb lifestyle." A study at the University of Pennsylvania Medical School recently reported that the Atkins plan "may be safe," at least in the short term (no sizable long-term studies have yet been conducted on a low-carb lifestyle).

The Physicians Committee for Responsible Medicine (PCRM), which promotes vegetarian and vegan diets, has been an outspoken critic of Atkins, in particular, because of the plan's reliance on meat. The group argues, "Despite press accounts of seemingly dramatic weight loss, the effect of high-protein diets on body weight is similar to other weight-reduction diets." The American Heart Association states, "High-protein diets are not recommended. Individuals who follow these diets are at risk for compromised vitamin and mineral intake, as well as potential cardiac, renal, bone and liver abnormalities overall."

In the face of an obesity epidemic, Atkins supporters argue that the traditional medical recommendation to eat less fat often doesn't work, since people either give up their diet or overcompensate later because they miss fat. The Atkins theory is that normally, the body burns carbohydrates before it burns fat. By eating fewer carbs, the body burns them much more quickly and then immediately starts burning fats, leading to the rapid weight loss commonly associated with the diet.

Dr. Pamela Peeke, a professor at the Maryland School of Medicine and author of Fighting Fat After 40, argues, "This theory is nothing but conjecture. It's really important that we burn a mix of carbohydrates and fats, since different parts of the body need different fuels. For example, the brain needs glucose, which comes from carbohydrates." Peeke points to a 1995 study that found diets like Atkins impair cognitive performance in higher-order mental processing after only one week.

However, not all low-carbohydrate diets preach a simple more-meat, less-vegetables gospel. The low-carb diet universe is pretty diverse, and also includes the Scarsdale diet, the Protein Plan, the South Beach Diet (to some extent), and whole-foods, low-carb eating plans exemplified by the eponymous Low-Carb Dieting for Dummies book from John Wiley and Sons.

According to industry icon Atkins Nutritionals, "Animal proteins are a vital component of doing Atkins and it is difficult to follow the program without them. Limited options would make it boring and most vegetarians do not stay with it long term." But vice president of education and research for Atkins, Collette Heimovitz, says vegetarians can follow Atkins, as long as they eat cheese and eggs. "Vegans shouldn't really do this program, but there are other low-carb plans they could follow," says Heimovitz.

Of course, many observers argue that most vegans don't need to go on a diet. According to the American Dietetic Association, if you avoid all animal products, you are likely to have a lower body mass index and lower rates of heart disease, prostate and colon cancers and diabetes. But it's also true that many vegetarians and partial-vegetarians (not to mention the general public) may want to lose a few pounds.

Toeing a hard line, PCRM insists no one should consider increasing their intake of such high-fat and cholesterol foods as eggs, cheese and butter, regardless of dieting theories. But the debate isn't all black and white. E's publisher, a long-time vegetarian, has been losing weight the "low-carb" way while still following the bulk of more traditional diet recommendations. He avoids carbs but hasn't added any saturated fats and cholesterol. He fills up on leafy greens and less-starchy vegetables while consuming a reduced number of calories overall.

Many scientists have in fact suggested that low-carb diets work simply because reducing or eliminating any major food group is likely to result in a lower total caloric intake, as long as the person doesn't overcompensate too much with other foods. Perhaps certain carbohydrates are easier to give up than fats.

Atkins, in particular, has drawn the ire of many natural health advocates because it excludes many fruits, some vegetables, grains and even legumes, especially in the first leg of the plan, called induction. Peeke argues, "When in doubt, eat all the veggies you want!" Some supporters of the diet counter that one needn't necessarily abstain from fruits and vegetables for a lifetime, just for a weight-losing period.

Even if Atkins doesn't sound appealing, there are a wide variety of weight-loss plans for those of us who have had one too many slices of tofu cheesecake. To lose a few pounds, Peeke suggests,"Watch your servings of bread, choose cooked whole grains, eat the majority of your starchy foods before evening, and avoid eating after 8 p.m." CONTACT: Atkins Nutritionals, (800) 2-ATKINS, http://atkins.com; Physicians Committee for Responsible Medicine, [phone], www.pcrm.org; South Beach Diet Online, www.south beachdiet.com.

JULIA FAWKES STUART is a freelance writer specializing in health topics.