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The Down Low On Low-Carb Diets
You've cleaned out those pantry closets, gone food shopping, and made the commitment. It's official: you're on a low-carb diet!
But while the road to a slimmer new you may be paved with high-protein foods, if you're like most low-carbers it's likely you've also encountered a few potholes along the way.
"Any time you make a fundamental change in your diet your body is going to react -- and when it does you are bound to experience certain symptoms or problems," says Stephen Sondike, MD, director of the Nutrition, Exercise, and Weight Management Program (NEW) at Children's Hospital of Wisconsin.
When that change involves reducing carbs, he says, among the most common problems is constipation.
"One of the primary places where you are going to see metabolic changes on any kind of diet is in your gastrointestinal tract -- and that can include a change in bowel habits often experienced as constipation," says Sondike, who is also credited with conducting the first published, randomized clinical trial on low-carb diets. The reason, Sondike tells WebMD, is that most folks get whatever fiber they consume from high-carb foods such as bread and pasta. Cut those foods out, and your fiber intake can drop dramatically, while the risk of constipation rises.
"However, if you really follow a low-carb diet correctly, you will be replacing those starchy foods with low-carb, high-fiber vegetables -- which should help counter the constipation by providing as much, if not more fiber, than you had before," says Sondike.
Doctors say that eating up to five servings of low-carb vegetables daily -- foods such as broccoli, cauliflower, and lettuce -- can keep your bowels healthy without interfering with weight loss.
If it's still not doing the trick, Sondike says a fiber supplement -- such as Metameucil or FiberCon can help.
"The one thing I would not do is start taking laxatives -- adding more fiber to your diet is definitely a smarter and healthier way to deal with the problem," says Doris Pasteur, MD, director of the Nutrition Wellness program at Mt. Sinai Medical Center in New York City.
A low-carb diet can help you lose weight because it turns on fat-burning processes, known as "dietary ketosis." These ketones are also thought to have an appetite suppressant effect.
However, Pasteur says that when large amounts of ketones are produced, your body can become quickly dehydrated -- another problem faced by those on a low-carb diet.
The solution: Drink more water.
"The lower your carb intake, the greater your risk of dehydration and subsequently the greater your need for water," says Pasteur. Most low-carb diet experts suggest drinking at least 2 quarts of water daily.
In addition to keeping you adequately hydrated -- which can also help alleviate constipation -- drinking lots of water can also help offset still another low-carb diet problem: bad breath. The ketones produced during the diet can lead to what is sometimes described as a fruity odor although it is often described as having an almost "chemical" odor similar to acetone or nail polish remover.
Now if you're thinking you'll just handle the problem by brushing and flossing a little more often, guess again. Since the breath odor is coming from metabolic changes and not necessarily a dental-related condition, traditional breath products are not likely to provide long-lasting relief. On the other hand drinking more water intake can do the trick.
"The water helps dilute the ketones in your system, and while that won't affect weight loss, it will help with the bad breath," says Sondike.
The lower your intake of carbohydrates, the greater your need for a vitamin supplement. That's the mantra that most doctors now recommend that everyone on a low-carb diet should never forget.
The reason? Any time you restrict your diet, particularly in terms of certain food groups, your nutrient levels can drop. But when your diet is low carb, experts say you may be in even greater need for certain key vitamins and minerals, particularly folic acid.
"If you're cutting out cereals, fruits, vegetables, fortified grains, then you are cutting out your major source of folic acid, a B vitamin that is not only important when you are pregnant, but important to everyone's overall health," says NYU nutritionist Samantha Heller.What's more, says Heller, folic acid is key to controlling levels of homocysteine, an inflammatory factor linked to heart disease. If you're already at risk for cardiovascular problems, she says, dropping folic acid levels too low could put your health at serious risk.
One way to protect yourself, she says, is to take a B vitamin supplement -- with at least 400 micrograms of folic acid daily.
"All of the B vitamins work together in a very complicated metabolic pathway and they need each other -- so if you are not going to get your source in foods, then a vitamin supplement is a must," says Heller.
Sondike agrees and says that, "Any time you are on a weight-loss diet you need a good multivitamin, regardless of whether you are limiting your carbohydrate intake or not," he says.
Although there has been some evidence that a low-carb diet can also take its toll on calcium levels, Sondike says that fortunately, this is usually only on a short-term basis.
"Your body will often shift metabolism when you do something different to it -- but it equalizes -- you see a rapid shift and a return to normal -- and the longer-term studies show normal results in this area," says Sondike. Still, he tells WebMD it's a "smart idea" to take a calcium supplement beginning at the start of your low-carb diet to safeguard against a possible deficiency. Tofu can also be a good source of calcium.
Another mineral you may want to supplement is potassium. While there is no concrete evidence that a dramatic potassium loss occurs on a low-carb regimen, Sondike says to ensure against problems he recommends patients use Morton's Light Salt -- a potassium chloride product that he says can add back any of this important mineral that's lost. Eating a few almonds is also a good way to supplement this mineral without adding carbs to your diet.
Finally, if you stick to your low-carb diet via the use of prepackaged foods, experts say read the label carefully to avoid ingredients that are notoriously responsible for gastrointestinal upsets, and especially excess gas. Among the worst offenders: sugar alcohol, found in sweeteners such as sorbitol.
"Anything above 10 grams or more of sorbitol at a time has been shown to cause gastrointestinal upset -- and some of these low-carb diet foods have as much as 30 grams a serving," says Heller. While it won't make you violently ill, she says, it can make you -- and those in the same room -- pretty uncomfortable.
Sondike agrees and also cautions us to "read the labels."
"If a product is advertised as having 3 net carbs but the label says 35 grams of carbs, then it's likely that 32 grams are sugar alcohol -- and it's probably going to upset your stomach," says Sondike.
12 Fast Foods You Can Eat On A Low Carb Diet
Though most items at fast food restaurants are high in carbs, there are several options that can fit into a low carb diet, including salads, bunless sandwiches, and burrito bowls.
Sticking to a low carb diet when dining out can be hard, especially at fast food restaurants.
That's because these meals are often based on bread, tortillas, rice, and other high carb items.
Still, most fast food restaurants offer some good low carb options, and many items can easily be modified to fit your lifestyle.
Here are 12 fast foods you can eat on a low carb diet.
Submarine sandwiches are very high in carbs. A typical sub has at least 50 grams (g) of carbs, most of which come from the bun.
Some restaurants allow you to order your sub in a bowl rather than on a bun, which can significantly reduce the carb content of your meal.
You can order your meal this way from many other sub sandwich shops as well, including Subway.
Simply request that it be prepared as a salad with olive oil and vinegar for the dressing.
Fried chicken is high in fat because the chicken absorbs a large amount of oil during frying.
Heating vegetable oils to high temperatures also produces harmful compounds that may increase oxidative stress and your risk of heart disease, cancer, and other health problems.
In addition, fried chicken from restaurants like Kentucky Fried Chicken (KFC) contains about 3 to 11 g of carbs, depending on the specific cut.
Grilled chicken is a lower carb option, which is available at many fast food franchises. Each piece of grilled KFC chicken contains 0 g of carbs.
As for side dishes, green beans contain 5 g of carbs per serving, 3 g of which are fiber. Coleslaw is another low carb choice, with 14 g of carbs per serving, 4 g of which are fiber.
Coffee and tea are carb-free beverages.
They're also high in caffeine, which may help improve metabolic rate, brain health, and physical performance while reducing your risk of many chronic health conditions.
If you like milk in your coffee or tea, many places offer half-and-half. A single-serving container (15 g) has about 0.5 g of carbs.
Heavy cream has slightly fewer carbs and is sometimes available. However, it contains about 50 calories per tablespoon (tbsp), or 15 milliliters (mL), compared to 20 calories for half-and-half.
Some coffee houses also offer soy or almond milk. Unsweetened versions of these milk substitutes provide minimal carbs per 2-tbsp (30-mL) serving.
Chipotle is a popular Mexican fast food restaurant.
Many people consider it to be healthier than other chains, as it uses high quality ingredients and emphasizes animal welfare and sustainable farming practices.
A salad with meat or chicken, grilled vegetables, fresh tomato salsa, and guacamole contains 18 g of total carbs, 8 g of which are fiber. This meal also provides about 35 g of high quality protein.
Protein and fiber play key roles in appetite management. For instance, they can increase the production of the gut hormones peptide YY (PYY) and cholecystokinin (CCK), which tell your brain you're full and help prevent overeating.
Though vinaigrette is available, generous servings of guacamole and salsa make salad dressing unnecessary.
Additionally, Chipotle has a helpful online nutrition calculator that allows you to see the exact carb content of your meal.
A bunless burger wrapped in lettuce is a standard low carb, fast food meal. It's high in protein, essentially carb-free, and available at many fast food burger establishments.
If lettuce wraps are unavailable, you can ask to omit the bun instead.
You can further customize your burger by adding the following low carb toppings or additions, depending on availability and personal preferences:
Depending on how they're prepared, buffalo wings can be a low carb option at pizza places and sports bars.
Traditionally, buffalo wings are covered in a spicy red sauce made from vinegar and hot red peppers.
An order of three drummettes (105 g) typically has just 2.6 g of carbs.
By contrast, other sauces can add a significant number of carbs, especially sweet types, such as barbecue, teriyaki, and anything made from honey.
Sometimes the wings are breaded or battered and fried, which is especially common for boneless wings. Therefore, be sure to ask how the wings are made and order yours with no breading or batter.
Buffalo wings are also usually served with carrots, celery, and ranch dressing.
Although they're higher in carbs than many other vegetables, carrots are fine to eat in small quantities. A half-cup (61 g) of carrot strips contains about 6 g of carbs, 2 g of which are fiber.
Is any fast food keto-friendly?Many fast food items like burrito bowls, salad bowls, and Buffalo chicken wings can fit a keto-friendly diet.
A ketogenic diet focuses on eating plenty of fats and protein while limiting carb intake between 20 and 50 grams (g) per day.
Sometimes the simplest breakfast option can be the most delicious, such as bacon or sausage and eggs.
This traditional breakfast combination is available at most fast food restaurants and contains a minimal amount of carbs.
A 2015 study in young women with overweight found that eating sausage and eggs for breakfast helped reduce appetite, lower blood sugar and insulin, and reduce calorie intake at lunch compared to a low protein, higher carb breakfast.
However, keep in mind that cured bacon and sausages are processed meat products, which have been linked to an increased risk of heart disease and cancer.
For this reason, most health professionals advise against a high intake of these foods.
Fast food Italian restaurants are best known for high carb foods like pizza, pasta, and subs.
Antipasto salad offers a delicious, low carb alternative.
This salad is traditionally served as an appetizer, consisting of assorted meats, cheese, olives, and vegetables topped with an olive-oil-based dressing. However, it can be ordered in a larger portion as an entrée.
An entrée-size serving (402 g) of antipasto salad with ham, cheese, fish, and vegetables is rich in protein and contains 15.6 g of carbs per serving, 4.4 g of which are fiber.
Subway is one of the most popular fast food sandwich shops worldwide.
In recent years, the chain has been offering chopped salads that can be customized with the protein and vegetables of your choice.
The salads all include peppers, tomatoes, onions, olives, and cucumbers.
Consider adding avocados, which are rich in heart-healthy monounsaturated fat and fiber. Eating them at lunch may even lead to lower calorie intake at your next meal.
Many people regard burritos as a favorite food.
They typically contain meat, vegetables, rice, and beans wrapped in a large flour tortilla. This results in a meal that can easily pack more than 70 g of carbs.
However, almost every Mexican restaurant allows you to leave out the tortilla and other high carb items.
This is known as a burrito bowl or "bare" burrito.
A burrito bowl from Qdoba made with ground beef, guacamole, lettuce, fajita vegetables, and fresh salsa is a delicious and satisfying meal that provides just 13 g of carbs.
McDonald's is the most popular fast food chain in the world, with more than 38,000 restaurants worldwide as of 2025.
Though it's best known for burgers like the Big Mac and Quarter Pounder, its Egg McMuffin and Sausage McMuffin breakfast sandwiches are also very popular.
These breakfast entrées consist of an English muffin with one egg, a slice of American cheese, and ham or sausage.
Each sandwich contains around 30 g of carbs. However, ordering either of these items without the muffin will reduce the carb content to 3 g or less.
It's also a good idea to order two low carb sandwiches, as each one will only provide about 9 to 12 g of protein.
The Low-Carb Craze Continues
Low-carbohydrate foods are the hot trend in the food industry. Manufacturers, restaurants, and grocery stores have raced to keep pace with consumer demand, offering everything from beer and ice cream to breads and chocolates. For example, Albertson's grocery store used to carry just a few low-carbohydrate items; today, they offer more than 200 low-carb products.
So what does this proliferation of low-carb foods mean? Can these products really help you lose weight and get healthier? Read on, and we'll help you answer these questions and sort out the confusion surrounding our national obsession to lose weight the low-carbohydrate way.
First of all, if you buy a food labeled "low carb," there's no guarantee that it's much lower in carbohydrates than foods that don't carry such a label. Since there are no nutrition labeling guidelines or legal definitions for low-carbohydrate foods, it's totally up to the manufacturer.
It makes little sense to pay more for a so-called ultra-low-carbohydrate light beer containing 2.6 grams of carbohydrate and 95 calories, when a basic light beer has 3.2 grams of carbohydrate and 96 calories! So buyer beware: Read that label before you hit the checkout line. After all, most foods with the low-carb label are certainly not lower in price than their regular counterparts.
But the bigger question in all this is: Should you be cutting carbs at all?
In some circles, carbohydrates have been declared the new dietary villain. But most dietitians don't agree -- and even research has shown mixed results. It's also important to keep in mind that not all carbohydrates are alike.
Carbohydrates are your body's preferred form of fuel. You need them every day to give you energy. The National Academy of Sciences' Institute of Medicine recommends that 45%-65% of your total calories come from carbohydrates.
Carbohydrates basically come in two forms: Simple carbohydrates are found in fruits, non-starchy vegetables, sugars, and dairy products; and complex carbs in grains, legumes, and starchy vegetables like potatoes and corn.
The carbs that tend to be the culprits in weight gain are mostly refined, like white flour (a complex carb) and sugars (a simple carb). Americans have a passion for sweets and refined foods, which often contain added fats and lots of extra calories. These are the carbohydrates to limit in your diet.
But don't just eliminate those carbs. Replace them with the healthier carbs: fruits, vegetables, whole grains, low-fat dairy, and legumes. Along with their calories, these carbs have fiber, vitamins, and minerals to give you energy while helping you feel satisfied.
Its not the carbs but the calories that cause folks on diets like Atkins to lose weight: That was the headline generated last spring from a study published in The Journal of the American Medical Association. Many nutritionists rejoiced as their predictions were confirmed by this study that demonstrated people lose weight on low-carb diets because they eat fewer calories. The bottom line for weight loss is that you must burn more calories than you consume, regardless of where those calories come from -- or so we thought.
But then another study was presented at a North American Association for the Study of Obesity meeting. Lead author Penelope Green, of Harvard University, suggested that people who ate a low-carbohydrate diet could actually consume more calories -- 300 more -- than people on a low-fat diet, yet lose the same amount of weight.
Even the study's authors cautioned that these results were preliminary, based on a very small study (of 21 adults), and that more research was needed. It's also noteworthy that this study was not published, and that the Robert Atkins Foundation (the same Atkins of low-carb diet book fame) was its sponsor.
Other studies have had similar results.
At the same time, some dieters who have followed low-carbohydrate regimes have reported health problems ranging from constipation to heart problems, according to the activist group Physicians Committee for Responsible Medicine.
What all this comes down to is that we need to learn more about how carbs work in weight loss. An ongoing, government-funded study may supply some answers. Almost 200 people will be closely monitored while they follow the diet for two years. But in the meantime, we need to be skeptical.
"It does take a little more energy to digest protein than carbs or fat," says Julie Walsh, MS, RD, spokeswoman for the American Dietetic Association. But she firmly believes that at the end of the day, it's the total number of calories you eat that determines whether you lose weight.
"The only good thing that has come from the low-carb craze is that it has served to educate Americans that there are good and bad carbs, and we are definitely over-consuming refined carbohydrates such as sodas and white bread" says Walsh. "As a nation, we need to eat more whole grains and fewer refined carbohydrates if we are going to be successful at weight loss."
Which brings up another important point: Low-carb diets don't do much to teach you how to make good food choices once you go off the low-carb wagon. And, after days or weeks of low-carb dieting, many people find themselves craving carbohydrates more than ever.
Further, while it's possible to lose weight quickly when you begin a high-protein diet, experts believe much of that loss is water. So low-carb still is not the diet of choice for lifetime weight loss.
My crystal ball shows signs that the low-carb trend is headed for the same fate as the low-fat craze did in the '90s. A decade ago, shelves were packed with fat-free products. But these items did little to stem the tide of the growing obesity epidemic. While they were fat free, they were loaded with calories.
Besides, when you're trying to lose weight, you should not be focused on products like cookies, chocolate, beer, etc. Whether they're low-carb, low-fat, or whatever. These simply are not the kinds of foods that help you take off pounds. So the next time you're at the grocery store, walk on by those low-carb foods and right into the fresh produce section.
The WebMD Weight Loss Clinic advocates a healthy, balanced diet that you can live with forever. Our eating plan is in accordance with guidelines from all the leading health authorities and government. So stick with us. We'll help you learn about the healthy carbs while you lose weight and improve your overall health and well-being.
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