But in school lunch lines — and at the national meeting of the school food service association this week — bread isn't a bad word.
School lunch menus are dictated by recommendations from the U.S. Department of Agriculture. It's the creator of the Food Guide Pyramid, which is currently under review but for now still recommends six to 11 servings of breads and grain, an amount discouraged by some low-carb diets.
While food service administrators are looking for healthier choices than Tater Tots and fish sticks, low-carb options aren't common in schools.
Some doctors say such diets aren't appropriate for growing children and active teenagers. But as America's struggle with childhood obesity continues, schools may be increasingly fielding requests from parents to add low-carb options.
Dr. Mary Vernon, a member of the Atkins Physicians Council, has several teenage patients following the Atkins diet.
Vernon, who practices in Kansas and also is vice president of the American Society of Bariatric Physicians, said she'd like to see more low-carb options — such as nuts, fruit and cheeses — available on school a la carte menus or in vending machines. And she'd like students going through school lunch lines to be able to request second helpings of protein.
Although Vernon prefers her clients snack on fresh, whole fruit, she said low-carb candy bars are better than the regular variety because they contain less sugar. Her clients bring low-carb options to school, tucked away in lockers and backpacks, because they aren't available in vending machines.
Of hundreds of vendor exhibits at the American School Food Service Association conference, few if any mention carbohydrates. But vendors promoting healthier foods — including fresh fruit, raisins, turkey and yogurt — dotted the Indiana Convention Center and were quick to point out nutritional information.
Dietitian Dayle Hayes of Billings, Mont., warns against putting children on low-carb diets.
She said parents in some school districts have requested bunless hamburgers on a la carte menus, and that school officials who lose weight on Atkins may think it's wise to incorporate low-carb alternatives without realizing such diets may not be healthy for growing children.
"It has become an issue for some school districts," she said. "It's inappropriate."
She said huge portions and lack of exercise are the real causes of American obesity, not an occasional cookie or snack.
While demand for healthy foods has increased, low-carb items aren't offered or even requested in most schools, said Marcia Smith, a past president of the school food association.
Smith said low-carb foods could pop up on a la carte menus in the future if parents start asking for it, but she doesn't predict a change in the lunch line any time soon.
"Some of these things (regarding USDA guidelines) would take an act of Congress to change," she said.
However, some of the same food options recommended by the Atkins diet are showing up in schools. The availability of more fresh fruit is a priority, and lower-sugar items are being added in some areas because of their health benefits. Salad bars have become popular at many schools.
"Right now we're focused on increasing the number of healthy choices at schools," said ASFSA spokeswoman Nancy Stiles.
By Deanna Wrenn