Are people on a low-carb diet replacing starches and sugars with unhealthy high-fat foods? A new survey suggests they may do something radically different.

A recent study of an internet-based support group suggests that the major change in eating patterns for dieters on low-carbohydrate diets has been the addition of large amounts of vegetables and salads to replace carbohydrates removed from their diet. The report was published today in the open access journal Nutrition Journal (no subscription required: http:www.nutritionj.com).

Richard Feinman, PhD, principal author and a professor of biochemistry at SUNY Downstate Medical Center, notes that 54% of forum dieters increased salad greens and 34% increased green vegetables by "at least double their usual consumption" in response to removing starches and sugars from their diets.

Few of the 3,000 respondents reported that they had drastically increased consumption of such high-fat foods as beef, bacon, or butter, popularly portrayed as features of low-carbohydrate diets. This was especially true of the half of the respondents who had lost 30 lbs or more and kept the weight off for more than one year. A doubling of consumption of chicken, however, a lower-fat food, was reported by 34% of the dieters.

Other surprising results from the survey were attitudes of family practitioners. Half of the respondents reported consulting a health professional prior to or during dieting. Of these, 55% stated that their health professional was supportive, and another 30% found the physician had no opinion but was supportive after good results were reported.

"The real import of the work," says Dr. Feinman, "is that physicians can prescribe a diet for people who want to do low carb that involves replacing starch and sugar with green vegetables and salads, a diet that few could object to on conventional health- or nutrition-related grounds."

Dr. Feinman observed that people on the low-carb forum followed diets that had no portion control beyond their own natural responses to carbohydrate restriction, but he noted, "Those physicians who want to prescribe a fixed diet could use the actual behavior of this group as a model."

"Most people were happy with the diet and a section of narrative comments produced consistent responses of 'have more energy,' Dr. Feinman added.

The Active Low-Carber's Forum currently has more than 89, 000 members and and their site asserts, "1,229,589 lbs lost by 59,754 members."