If you're on a strict high-protein, very low-carbohydrate diet, I have important news for you: You may be throwing the baby out with the bath water.

Starches and sugars are your body's main source of energy. You need them to fuel your muscles, and your brain needs 130 grams of carbs a day just to function properly! A carbohydrate-free diet, or a diet that's too low in carbs, can be both dangerous and low in nutrients.

If you're on a high-protein diet, you still need carbohydrates. The good ones.

Some carbohydrates support your health while others drag it down. Too many of the bad carbohydrates raise your triglycerides and make your blood thicker, putting you at risk for heart disease. They also contribute to carbohydrate cravings and diabetes. The trick is to eat enough good carbs and very few bad ones. It's a balancing act, but not too difficult once you understand the concept. So just which carbs are good and which are bad? And why?

Carbohydrates and insulin resistance

When you eat any carbohydrate — either a sugar or a starch — your pancreas releases insulin to help your body utilize it. When you eat a lot of carbohydrates, especially those that are refined and low in fiber, you run the risk of having high amounts of insulin that remain in your blood.

Over time, your body may stop using insulin properly. This is called insulin resistance. It often leads to diabetes, heart disease, obesity, hypertension, and blood clots. Good carbs are digested slowly. They rarely lead to insulin resistance when you eat them in moderation. In fact, they tend to stabilize your blood sugar.

The health food industry and bad carbs

Health food stores are filling up their shelves with junk foods. I'm disheartened with the amount of foods they're selling that contain bad carbs.

Here are a few to watch out for and avoid:

White rice. You may find organic white basmati rice in health food stores and think it's good for you. It's not! White rice has been stripped of its nutritious hull that contains B vitamins and magnesium. Eat it along with vegetables and protein and it isn't so bad. But I don't consider any white rice a "good carb." It's low in nutrients and turns to sugar too quickly.

Unenriched or enriched wheat flour. This is white flour, plain and simple. "Unenriched" wheat flour means the food contains white flour stripped of nutrients with none put back. Enriched flour is no better. Neither the fiber nor much of the nutrients that were removed is replaced. You may find white flour in organic breads, crackers, and cookies, but "organic" doesn't necessarily mean "nutritious." Treat refined flour like white rice – okay in very small quantities, but with little nutritive value.

Spinach and tomato pastas. Just because they look dark doesn't mean they're unrefined. Most spinach and tomato pastas are made from white flour dyed a darker color from the added vegetables. Vegetable juices just make white pasta look healthier than it is.

Pure cane sugar juice. I know a lot of it is organic and that's great for the environment. But pure cane sugar juice acts the same as plain old sugar. It contains a minimal amount of nutrients, feeds Candida and cancer cells, and causes insulin reactions just like white sugar.

Five years ago, a nutritionally minded doctor put out a line of instant cereals. I noticed that they contained organic pure cane sugar juice. "What's the difference between this sweetener and refined sugar?" I asked him. "Nothing," he answered. "I use it because people like the way it tastes."

Fructose and high fructose corn syrup. These don't raise blood sugar levels very much, but they raise total cholesterol levels and harmful LDL cholesterol. Worst of all, they contribute to a sluggish immune system. Fructose may be the single substance that's causing an increase in diabetes. It's found in soft drinks and many fruit drinks.

Honey and maple syrup. These sweeteners trigger an insulin response, contribute to inflammation, and can lower your immunity. Just because they're natural doesn't mean they're healthy. If you want a safe sweetener without any calories that won't affect insulin levels, stick to stevia, a powder made from the leaves of the stevia plant. You can find it in health food stores.

Net carbs: Pushing confusion to the limit

Read all product labels carefully. Some are very misleading. A growing number of snack foods now contain carbohydrates made from sugar alcohols called "net carbs." They make foods sound healthier and lower in calories than they are. Companies are saying these sugars "don't count." They do!

These sugar alcohols contain the same amount of calories as other sugars. If you're trying to control your weight, all carbs count! And some of them do raise blood sugar levels in spite of what you're told. They also can have side effects you want to avoid. You don't want to miss next month's revealing article on sugar alcohols.

Good carbs to eat:

Get 90 percent of your carbohydrates from whole foods. Beans, brown rice, corn tortillas, polenta, and starchy vegetables are all good carbs. Eat small amounts of them along with protein and vegetables rather than one large carbohydrate meal.

Some good carbs, such as potatoes, have gotten a bad rap because they're high on the glycemic index. This means they turn into sugar quickly. But Nancy Appleton, PhD, author of Lick the Sugar Habit, is furious about this.

"The glycemic index is a hoax," she told me. "If you eat any one of these foods alone that's high on the glycemic index, it will raise your blood glucose. But if you eat them with protein and fat, you won't. That's the way we should eat!"

Don't be afraid or reluctant to eat some carbohydrates with your meals if they are unprocessed and are eaten with plenty of vegetables, protein, and a little fat. Just make them the good carbs, and keep your portions small.

Appleton, Nancy. Lick the Sugar Habit, Avery Publishing, 1996.

Haas,Elson. Staying Healthy With Nutrition, Celestial Arts, 1992.

Tallmadge, Katherine. "Do Net Carbs Add Up?" Washington Post, February 25, 2004.

Nutrient in Meat and Spinach Can Help Prevent Cataracts

Cataracts are not an inevitable result of aging. We now know that a number of antioxidants may protect you from getting them. However, out of all antioxidants, one found in spinach and beef could be the most beneficial.

But don't think you can get enough of this super antioxidant from your food. You can't! You need too much of it.

This particular antioxidant is not only found in some common foods, it's also manufactured inside your body. The problem is that when you're young, your body makes enough to meet your needs. As you get older, your body makes less. At the same time, your need for it increases.

All antioxidants are considered to be anti-aging nutrients because they neutralize harmful free radicals that lead to a number of degenerative diseases. But some antioxidants are more protective for the eyes than others.

Most antioxidants are either soluble in water or in oil and fight free radicals on the surface of cells. This particular antioxidant is different. It is both oil-soluble and water-soluble. It can protect the cells in our eyes from both the inside and outside. It can get into the watery tissues of our eyes and destroy the free radicals that contribute to cataracts.

And preliminary research suggests that it also binds to metals in the eye that may be an additional factor in the formation of cataracts, especially in diabetics.

The antioxidant I'm talking about that appears to be a key nutrient in protecting us from cataracts is alpha lipoic acid (ALA). You may have heard that ALA is useful in treating diabetes, cancer, and heart disease. It's also been used to repair liver damage. Now we have studies showing that ALA can save our sight. It's an important preventive for all types of cataracts: those from aging, from exposure to chemicals, and from the progression of diabetes.

How ALA works

It finds and destroys free radicals: A defective antioxidant defense system inside the lens of the eye often leads to cataracts. ALA is a powerful antioxidant that hunts down free radicals in the eye and destroys them.

It regenerates antioxidants: After an antioxidant neutralizes a free radical, that antioxidant becomes oxidized and stops working. ALA turns it back into an active antioxidant that can continue to fight free radicals. ALA is particularly effective in regenerating some key antioxidants that protect your eyes from forming cataracts. These include vitamins C and E. The longer these anti-cataract antioxidants remain in the lens of your eye, the more protective they are. You don't necessarily need more antioxidants. You need the antioxidants you're taking to remain in your eyes longer.

It increases glutathione: Cataracts form when there's not enough glutathione in the eyes. If you aren't familiar with glutathione, it's a powerful immune booster and detoxifier. Like ALA, it's able to get into the cells of the eye, not just remain on their surface. ALA increases glutathione levels and helps it work better. This is particularly important since oral glutathione needs co-factors, such as N-acetyl-cysteine, to work best. When ALA was given to laboratory animals, it not only increased the quantity of glutathione in their lenses, it also decreased the amount of chemicals that help form cataracts.

It binds to heavy metals: We're beginning to see a connection between diabetic cataracts and the presence of heavy metals. Since heavy metals cause oxidation, I think we're going to find that they play an important role in forming all types of cataracts. ALA attaches itself to heavy metals and pulls them out of the body.

Antioxidants against cataracts

I think ALA is a particularly valuable and overlooked nutrient to protect our eyes. I say this because of its own antioxidant properties, as well as its ability to recycle and promote the production of other anti-cataract antioxidants.

A number of researchers share my opinion and see the value in boosting antioxidant levels to prevent cataracts even without conclusive evidence. Nearly 50 women, aged 53-73, were followed over 13 years and had their vitamin consumption carefully monitored. The women who took vitamin C supplements over the longest period of time had the least amount of cataracts. Since ALA extends the life of vitamins C and E in tissues, anything that helps keep these antioxidants in your eyes longer seems to help prevent cataracts. If vitamin C can prevent cataracts, just think of the added protection you'll get by adding ALA.

If you want to include ALA in your supplement program to protect your eyes, I'd suggest you take a minimum of 25-50 mg per day. How much is in your food? Not enough to flood your eyes with helpful nutrients. It's highest in organ meats, and three ounces of beef liver has just 14 mg of ALA. A cup of raw spinach contains five mg. And a large egg yolk has only 0.3 mg of ALA. Don't depend on your diet for adequate amounts. The formula I take, Women's Preferred Sharper Vision (800-728-2288), has 25 mg of ALA in a daily dose.

But you may need more. Before ALA can function as an antioxidant, you may need 50-400 mg per day (600 mg has been shown to be very safe). One study found that 600 mg/day for four months significantly reduced oxidative stress in healthy people. You can get 100 mg of ALA from ProThera (888-488-2488). Source Naturals, available in many health food stores, has ALA in various strengths, from 50 mg to 300 mg. Be sure to include a multivitamin high in other antioxidants, as well.

Hagen, T.M., PhD. "Alpha lipoic acid," Linus Pauling Institute, 2002-2003.

Head, K., ND. "Natural therapies for ocular disorders – Part Two: Cataracts and glaucoma," Alternative Medicine Review, 2001, vol. 6, no. 2.

Jacques, P.F., et al. "Long-term nutrient intake and early age-related nuclear lens opacities," Arch Ophthalmol, July 2001;119(7).

Kottler, U.B., et al. "Is a cataract avoidable? Current status with special emphasis on the pathophysiology of oxidative lense damage, nutritional factors, and the ARED study," Ophthalmologe, March 2003;100(3).

Maitra, I., et al. "Alpha-lipoic acid prevents buthionine sulfoximine-induced cataract formation in newborn rats," Rad Biol Med, 1995 April;18(4).

Oc, P., et al. "Thioctic (lipoic) acid: a therapeutic metal chelating antioxidant?" Biochemical Pharmacology, 1995, 50.

Little Know Remedy From Ancient Greece ...

... Can Relieve Your Stress and Fatigue

The ancient Greeks knew about this stress-relieving herb ever since physician Dioscorides included it in his giant book on herbal medicine 2,000 years ago.

Word of its value quickly spread throughout Europe and Asia where it's been used ever since for many health conditions. Yet chances are you haven't heard of it.

The Vikings used it to give themselves greater strength and endurance.

It was used to prevent altitude sickness and fatigue, and to promote longevity.

It was considered to be the most effective of all herbs for colds and flu during harsh arctic winters when respiratory problems were often fatal.

More recently, the Russians gave it to their astronauts and professional athletes to relieve fatigue and enhance their performance.

What is it? A root that grows high in the mountains of Europe and Asia called Rhodiola rosea (R. rosea). Russian families carefully guarded its locations for centuries. They harvested the root in secret and smuggled it down the mountains, where they traded it for rare foods and wines. Chinese emperors sent messengers to Russia to bring back this prized herb.

R. rosea was studied at length by Russian botanist G.V. Krylov in the mid-1900s. He found it protects against physical and emotional stress, toxins, and cold weather. Nearly 200 papers and studies over the past 30 years support R. rosea's effectiveness in a wide variety of conditions. It increases energy, alleviates depression, helps with weight loss, relieves mental fatigue, protects the heart during stress, and improves the function of the thyroid, thymus, and adrenal glands.

How can it do so much? Simple. Rhodiola rosea is an adaptogen. Adaptogens, as you may remember from past articles, are those herbs that help regulate and balance your body by normalizing its physiological functions. They increase your resistance to harmful physical, chemical, and biological stressors. For this reason, they are often called "anti-aging" herbs. Out of a group of adaptogens that have been extensively researched, R. rosea has the greatest positive effect on mental fatigue when someone is under stress.

R. rosea for stress and fatigue

Sometimes, recruiting the wrong participants deliberately skews a study. For instance, a group of healthy men were chosen to take vitamin C to lower their cholesterol. But their cholesterol was already low! This study was meaningless.

When it comes to stress, few people are under more physical and mental stress than professional athletes and doctors. R. rosea dramatically increased the endurance, performance, and mental clarity in a group of master level competitive skiers. It also shortened their recovery time.

Then there was a group of doctors on night duty at a hospital. Who could be more stressed and tired than these doctors? They took 170 mg of R. rosea extract just once a day for two weeks and reported significantly less fatigue than those who took a placebo.

But what about ordinary people like you and me?

A 50-year-old computer analyst suffered from extreme fatigue. Any of us who work at computers can understand how stiff and tired you can get sitting in front of a monitor day in and day out. Her doctor gave her 50 mg of R. rosea extract to take in her morning tea and her fatigue disappeared within a few days!

If you know anyone who has had chemotherapy, you know it can lead to exhaustion. A 62-year-old woman with breast cancer was forced to stop her chemotherapy treatment because of fatigue and low red and white blood cells. She took 150 mg of R. rosea extract twice a day. It normalized her red and white blood cells so she could continue her chemo. It also relieved her fatigue.

Last March, the results of a randomized, double-blind, placebo-controlled study of 161 stressed and tired cadets were published. Some of the cadets were given higher amounts of Rhodiola than others, but there was no difference in results between the two groups. R. rosea worked in smaller or larger quantities. This is good news to all of us, because it means that if you're extremely stressed, a larger dose is not necessarily more effective than a standard dose.

All of us are under a huge amount of stress. It's so much a part of our daily lives that we often ignore it, accept it, or adapt to it. Whether we pay attention to it or not, stress can lead to serious health problems, as I've explained in the past. (You can read these articles on my website: http://womenshealthletter.com.)

To handle stress, you need enough serotonin, the "fight-or-flight" chemical. Serotonin, you may remember, gives you the ability to run from danger at speeds you never knew were possible. It gives you the strength to lift things in an extreme emergency you could never have budged.

But stress decreases your body's production of serotonin. R. rosea "turns on" brain chemicals, such as norepinephrine, dopamine, and serotonin, that help you think and feel better. It also reverses the chemicals that block memory activity, improving your memory.

Caution! All Rhodiola is not the same

The problem with Rhodiola supplements is that they do not all work. There are more than 50 species of Rhodiola. The only one that's proven effective for the conditions I've described is Rhodiola rosea — the species used in every one of the studies. Any Rhodiola product you buy should be a standardized extract and say Rhodiola rosea.

R. rosea is an effective adaptogen whether it's dried or in a tincture. It works well alone or in combination with other herbs. Nature's Way (250 mg) and Planetary Formulas (327 mg) both sell a standardized Rhodiola rosea extract you can find in many health food stores. If you can't locate them, call Planetary Formulas at 800-606-6226 or e-mail at info@planetary. Herb Pharm, one of my favorite herb companies, makes an excellent R. rosea extract tincture from roots harvested in the Russian Arctic Circle (800-348-4372, or email at [email protected]).

The answer to stress and its side effects — memory loss and fatigue — is to reduce it with exercise, daily meditation or prayer, a healthy diet, and specific supplements. An adaptogen like R. rosea is an excellent addition to any stress-reduction program.

Brown, Richard P., MD, et al. "Rhodiola rosea: A phytomedicinal overview," HerbalGram 56, 2002.

Darbinyan, V., et al. "Rhodiola rosea in stress induced fatigue – A double-blind, cross-over study of a standardized extract SHR-5 with a repeated low-dose regimen on the mental performance of healthy physicians during night duty," Phytomedicine, vol. 7(5), 2000.

Monograph: "Rhodiola rosea," Alternatie Medicine Review, vol. 7, no. 5, 2002.

Shevtsov, V.A., et al. "A randomized trial of two different doses of a SHR-5 Rhodiola rosea extract versus placebo and control of capacity for mental work," Phytomedicine, March 2003.

Spasov, A.A., et al. "A double-blind, placebo-controlled pilot study of the stimulating and adaptogenic effect of Rhodiola rosea by stress during an examination period with a repeated low-dose regimen," Phytomedicine, vol. 7(2), 2000.

Nutrition Detective

Has the Ultimate Anti-Aging Supplement Been Found?

Human growth hormone (HGH) isn't a supplement at all. It's a prescription drug approved by the FDA to correct hormone levels in people who have a deficiency of it, and to slow down muscle wasting associated with AIDS. But now a lot of doctors are injecting HGH in healthy people to restore their libido, muscles, and bone loss. It's become the latest anti-aging craze.

Unfortunately, this expensive therapy can have side effects. In a six-month study of 131 older men and women, HGH injections did, in fact, give positive results. But half the men developed diabetes or other blood sugar problems and many of the women had edema (water retention).

Some supplement companies claim their HGH products increase blood levels of the hormone when taken orally or sprayed into the mouth. The truth is, swallowing HGH breaks the hormone down into amino acids that don't give the same effect as injections. Whether HGH is in tablets, capsules, liquid, or spray, there aren't any good studies I could find that show they work. Save your money. You can raise your HGH levels by doing resistance exercise (lifting weights or using the OsteoBall – both work) and getting a good night's sleep. It's effective and a lot cheaper.

Thomas, Paul R., RD. The Dietary Supplement, "Anti-aging supplements: Can they really turn back the clock?" January-February 2003, vol. 4, no. 1.

Ask Dr. Nan

Q: Last week, I had a silicone breast implant removed. It had not ruptured, but lost about half its silicone through bleeding. What can I do to detoxify my body? — G.K., via e-mail

A: I wish I had a better solution for you, but after talking with a number of doctors of integrative medicine, I don't. Silicone is a very sticky substance. When it escapes into the body, it doesn't just go away. It adheres to tissues and blood vessels.

The only answer these doctors could offer was to scrape the area as thoroughly as possible. It doesn't sound like your surgeon did this when your breast implant was removed. If you're worried about this and, personally, I would be, you may need additional surgery.

Meanwhile, you could take a good quality detoxification formula that can support your liver's ability to detoxify chemicals and drugs. One such formula that includes milk thistle, NAC, and alpha-lipoic acid (200 mg of each) is HepatoThera Forte from ProThera (888-488-2488). I'd take it for at least a year.

I'd also suggest you support your immune system. Since medicinal mushrooms help remove toxins as well as boost immunity, that's what I'd take. The strongest medicinal mushroom formula I know of is MycoPhyto Complex (800-728-2288), because all of its mushrooms are grown on immune-enhancing herbs.

Women who have silicone breast implants might want to have them removed before they leak. Unfortunately, over time, most of them do.

Q: A recent article from Tufts University says to prevent osteoporosis, women should take 1,200 mg of calcium a day. Your recommendations – to take less calcium, and more magnesium and vitamin D — make a lot more sense. I would like to know how you refute this lady's recommendations, so I can explain to my own doctor why the Tufts approach is no longer valid. — M.C., via e-mail

A: My job is not to refute, but to educate you so you can make your own decisions. Whenever possible, I suggest you work with your doctor to implement the suggestions that make the most sense to you. In this case, it may not be possible for you to do this with your present doctor.

I've read scientific studies over the past 25 years that point to a lower calcium, higher magnesium diet and supplementation to form bones that are less brittle. High calcium intake forms bones that may be denser, but more brittle as well. Brittle bones break more easily than bones that are flexible.

This is basic physiology your doctor should understand. In addition, numerous studies have found that taking oral calcium tablets does not prevent osteoporosis. For more information that you may want to share with your doctor, read my booklet, User's Guide to Calcium and Magnesium (to order, call 800-728-2288).

By the way, the doctor from Tufts who recommends high calcium and never mentions magnesium is quoted in the article you sent me as saying, "The statistics on osteoporosis treatment 'have run from horrible to dismal." This is with treatment using high calcium and lower magnesium. Clearly, the current protocol isn't working.