Vidyya Medical News Service
Volume 6 Issue 50 Published - 14:00 UTC 08:00 EST 19-Feb-2004 Next Update - 14:00 UTC 08:00 EST 20-Feb-2004
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Dieters beware: Hidden carbs in familiar OTCs may hinder weight-loss efforts

Millions of Americans have made carb counting a central tenet of their weight-loss efforts, but while the increasing number of low-carb foods, beverages and restaurant menu items trumpet their carb contents, undisclosed or "hidden" carbs in products such as over-the-counter medications risk undermining the weight-loss efforts of even the most-fervent carb-counters.

"People often assume that over-the-counter medications contain no carbs, simply because nutrition facts are not listed on their labels," says Pamela Peeke, M.D., M.P.H., a nationally renowned nutrition expert and author of Fight Fat After Forty (Viking Penguin). "But some of these products do contain sugar and starch. Fortunately, there are low-carb options available for many of the over-the-counter remedies out there."

Fiber Therapy

Because many high-fiber foods, such as fruits, vegetables and grains, are limited on low-carb diets, it is common for low-carb dieters to experience a change in regularity, which includes infrequent elimination, constipation or diarrhea. In fact, a recent study by Citrucel(R) found that more than one- third of low-carb dieters and nearly half of consumers on the Atkins and South Beach diets reported a change in regularity.

To help prevent regularity problems, the Atkins and South Beach diets both recommend that dieters use bulk-forming fiber. Fiber helps to normalize bowel activity by adding bulk and texture to food so that it passes through the body at a constant rate, rather than too slowly or quickly.

"In the best of all worlds, a healthy lifestyle would include a balanced diet rich in fruits, vegetables and whole-grains, giving people adequate fiber and helping to prevent serious gastrointestinal problems like diverticular disease, hemorrhoids or Irritable Bowel Syndrome," says Peeke. "Since low- carb diets provide only a fraction of the fiber we need, people who choose this way of eating should use a bulk fiber therapy product, which can be just as effective as high-fiber foods at maintaining regularity and comfort."

Many over-the-counter medicines aimed at restoring regularity, however, contain enough carbohydrates to derail even the most dedicated low-carb dieter. And while some of the lowest-carb options come in caplet form, even those are not equal. For example, Metamucil(R) capsules contain three carb grams per dose. If taken up to three times daily as directed, this can amount to nearly half the daily carb intake of 20 grams allowed during the Atkins induction phase. Citrucel caplets, on the other hand, contain zero carbs per dose.

Besides containing no hidden carbs, Citrucel caplets help low-carb dieters stay regular without excess gas or bloating that can make them feel fat. The product's main ingredient, methylcellulose, is naturally derived from plant sources and doesn't ferment in the digestive tract like psyllium, which is found in other fiber products.

Calcium Supplements

Many doctors also recommend that people on low-carb diets supplement their calcium intake.

"Typically, low-carb diets are also low in calcium, because dairy products like milk and yogurt are usually restricted due to their carbohydrate count. In fact, one cup of whole milk has approximately 11 carb grams and 291 mg of calcium," says Dr. Peeke. "Because of this, I encourage people using the low- carb diet approach to take a calcium supplement."

But some calcium supplements can also add unwanted carbs. Viactiv(R) Soft Calcium Chews, for example, contain four carb grams per chew, primarily from corn syrup, high fructose corn syrup and sugar. Each tablet of regular TUMS, however, provides 200 mg of calcium, with less than one carb gram.

Adults can get the recommended 1,000 to 1,500 mg of daily calcium from TUMS with fewer than half the carbs they would if they took Viactiv. A swallowable supplement like Os-Cal(R) is also a nutritional value with zero carb grams per tablet.


Other dietary changes that can occur on low-carb diets, especially liberal consumption of high-fat foods, may cause heartburn and indigestion.

To put out the fire without loading in the carbs, dieters can opt for Gaviscon(R) Regular or Extra Strength Liquids, which contain zero carb grams per dose. Compared to a dose of liquid Maalox(R) Max or Mylanta(R) Extra Strength Original, which contain up to four carb grams per dose, Gaviscon Extra Strength Liquid can save low-carb dieters up to 12 carb grams, if the maximum dosage of each of the products is taken daily.

Tums(R) Regular and Sugar Free are also good choices - both at less than 1 carb gram per tablet.

Cold and Flu Remedies

With cold and flu season in full swing, relief from fever, cough and congestion is top-of-mind for many. But some of the most popular over-the- counter remedies for these symptoms are also packed with sugar, which significantly increases carb content.

Both TheraFlu(R) Hot Liquid Formula and Robitussin(R) contain about nine carb grams per dose, while NyQuil(R) Original Formula has an eye-popping 19 carb grams per dose. Diet-friendly alternatives for relieving a variety of cold and flu symptoms include Contac(R) Day & Night and Contac(R) Severe Cold & Flu, each of which contain zero carb grams per dose.

"Even if you're not following a low-carb diet, it's a good idea to know what's in the medications you and your family are taking," says Dr. Peeke. "If the ingredients are not listed on the label, search the product's website or call the toll-free number on the package. Most companies have this information readily available upon request."

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