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Low Carbohydrate Renaissance

December 29, 2010 Written by JP       [Font too small?]

One of my favorite Christmas gifts this year came in the form of an article that my wife sent me via e-mail. The piece, “A Reversal on Carbs”, was written by Marnia Jameson and appeared in December 20th online edition of the Los Angeles Times. It features the voices of many of the leading nutritional scientists the world over. The general thrust of the publication is best summarized by Dr. Walter Willet, the chairman of the department of nutrition at the Harvard School of Public Health. He emphatically states that, “If Americans could eliminate sugary beverages, potatoes, white bread, pasta, white rice and sugar snacks, we would wipe out almost all of the problems we have with weight and diabetes and other metabolic diseases”. I would’ve added a few additional foods to that list, but otherwise I agree wholeheartedly. (1)

Anyone who regularly reads my columns knows that I frequently criticize foods and food products that contain high glycemic and/or refined carbohydrates. What’s more, many of you already know that I’ve lost over 90 lbs primarily by restricting my overall carbohydrate intake. But you may not be aware of the physiological underpinnings behind my general recommendation to follow suit. Here’s a brief overview of the importance of moderating carbohydrate consumption:

In the body, carbohydrates are converted into blood sugar. Certain carbs such as those rich in starches (grains, potatoes) and sugar (candy, fruit juice) lead to quicker and more dramatic elevations in blood glucose. In order to deal with this rapid rise in blood sugar, the pancreas must release insulin in order to transport sugar from the blood into cells to provide a form of stored energy known as glycogen.

The problem is that the human body isn’t well adapted to handle the estimated 250 to 300 grams of carbohydrates that are commonly consumed in the modern diet. Over time, our cells become tired of trying to keep up with this unnatural burden. This leads to a dangerous situation referred to as insulin resistance. In essence, the insulin the body produces becomes less effective. Then the pancreas attempts to compensate for this abnormality by producing excessive amounts of insulin.

The result of this destructive cycle is typically diabetes, obesity and several risk factors pertaining to heart disease known collectively as metabolic syndrome. The specific threats involved include abdominal obesity, high blood pressure and blood sugar, high triglycerides and low HDL (“good”) cholesterol. It is estimated that approximately 25% of the US population has at least three of these symptoms – the benchmark for establishing metabolic syndrome.

That’s the bad news. The good news is that a large body of research indicates that making modest changes in your diet can help reverse the danger that a high carbohydrate diet presents. Several recent studies attest to the safety and value of making this very shift. For instance, the latest issue of the British Journal of Nutrition reports that an egg-rich, high protein/high cholesterol diet improved antioxidant levels, blood sugar control and cardiovascular risk factors in a group with type 2 diabetes and impaired glucose tolerance. Another trial using a very low carbohydrate (ketogenic) diet found that this dietary intervention improved memory performance and reduced waist circumference and weight in a group of 23 older adults with mild cognitive impairment. The authors noted that chronic inflammation, high insulin (hyperinsulinemia) and problems relating to energy metabolism are frequently present in those most at risk for Alzhmeimer’s disease and other neurocognitive diseases. Ketogenic diets are documented as addressing all of these issues and more. (2,3)

Body Composition and Blood Marker Responses of Subjects at Baseline and Following the Two Low Carbohydrate Diets

Characteristic Baseline CRD-Saturated Fat
CRD-Unsaturated Fat
hs-CRP (mg/dl) 2.7 ± 2.3 1.8 ± 0.9 2.7 ± 1.8
IL-6 (pg/ml) 1.3 ± 1.1 0.9 ± 0.9 1.1 ± 1.2
IL-8 (pg/ml) 1.7 ± 0.6 1.5 ± 0.9 1.9 ± 1.1
TNF-a (pg/ml) 3.8 ± 1.5 3.4 ± 1.4 3.6 ± 1.6
MCP-1 (pg/ml) 251 ± 81 234 ± 94 269 ± 123
8-iso PGF2a (pg/mg creatinine) 629 ± 262 524 ± 146 425 ± 61

Source: Lipids. 2010 October; 45(10): 947–962. (link)

The question I’m most often asked in reference to carbohydrate restricted diets is: Are they really safe? The answer in most instances is ‘yes’. This point of view is increasingly shared by clinicians, as evidenced by the growing number of studies utilizing lower carbohydrate diets in vulnerable populations including pregnant women and young children. The general consensus is that higher protein diets that emphasize low sugar source carbohydrates tend to protect against obesity and the health concerns that accompany the current epidemic of overweight. I’m convinced that this is the trend of the future. If you haven’t already done so, I strongly suggest that you take a look at the number and type of carbs in your own diet. If you’re like most people, you’d do well to reduce the number of total carbohydrates and replace some of them with healthy sources of fat, fiber, low glycemic fruits, non-starchy vegetables and protein. (4,5,6)

Be well!

JP

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16 Comments to “Low Carbohydrate Renaissance”

  1. Mark Says:

    I practice a low starch diet, actively eating more fresh veggies and fruits. But I’m confused on potatoes. What’s the difference between a white potato and a sweet potato. Is it a difference in nutrition or fiber? I read a lot of articles about the benefits of sweet potatoes.

  2. Tiffany Says:

    I’m pregnant, and a big advocate of a low carb diet. I’m still overweight, and I’m not sure how low I should go. The doctor and nurses kinda flip out when they find ketones in my urine. My main concern during this time is the health of my unborn child, and me- I can deal with me later. If you have any of these studies regarding pregnancy, I’d love to read them. I have yet to dig up any truly valuable information.

    Thanks for the info – great read.

  3. JP Says:

    Mark,

    There’s a pretty significant difference in terms of their glycemic index, load and nutrient density:

    http://nutritiondata.self.com/facts/vegetables-and-vegetable-products/2770/2 (potato)

    http://nutritiondata.self.com/facts/vegetables-and-vegetable-products/2667/2 (sweet potato)

    Sweet potatoes are clearly superior, IMO. They’re still too high in carbs for some low carbohydrate diets. But they can be enjoyed in moderation by many people.

    Be well!

    JP

  4. JP Says:

    Tiffany,

    I think your judgment is right on the money. Right now, you need to focus on your overall health and the health of your baby to come, IMO. I’d consider focusing on eating a low glycemic, whole food diet that contains a fair share of healthy fats, fiber and protein. Lots of non-starchy vegetables. I would also stay as active as your doctors will allow. Movement helps – not only in relation to weight but also re: insulin sensitivity. A few studies for you:

    http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=7835434

    http://www.ajcn.org/content/92/6/1306.abstract

    http://tde.sagepub.com/content/35/6/1004.abstract

    http://jcem.endojournals.org/cgi/content/full/88/8/3554

    http://www.ncbi.nlm.nih.gov/pubmed/9540949

    Be well!

    JP

  5. Tiffany Says:

    Thank you JP –
    I felt like I was doing the right thing, but then yesterday I read a horrible tale of low birth weights and the mother starving her unborn child, but I really don’t think I’m in any danger of that!

    I’ll make my way through the links you posted – THANK YOU!

  6. JP Says:

    Tiffany,

    You’re most welcome! :)

    This is purely anecdotal … My sister-in-law recently gave birth to twin boys. She actually needed to modify her typical diet during the course of her pregnancy due to elevated blood sugar readings. For her, adopting a diet that contained fewer carbohydrates helped her stay well and avoid gestational diabetes. It wasn’t necessarily a low carbohydrate diet. But she did avoid many of the higher GI & GL foods and emphasized better options.

    Be well!

    JP

  7. Tiffany Says:

    JP-
    Perfect – I know I’m at a higher risk for GD. However, I think I’ll be fine, eating low enough to avoid GD, but high enough to avoid ketosis. I really think that’ll be the perfect balance and certainly a lot lower in carbs than the standard American diet. I’ve just been seeking that affirmation that I’m on the right track. Now I’m off to read more on the links.

  8. Bill Says:

    The LA Times article is significant. There is now a critical mass of respected nutritionists and researchers speaking up about the dangers of high-carb diets such that the media is starting to take notice.

    Gary Taubes really got the ball rolling in 2007 with “Good Calories, Bad Calories.” I’ve been allowing 10 years until 2017 before we see public policy revised to reflect reality. In the meantime, there will be many scientists, etc. that made their names by “proving” that fat is the enemy who will fight low-carb to the death.

    The real issue for people going low-carb is what to eat instead of white flour. The correct answer in my mind is to increase the consumption of high-quality fats, and because of the nature of our food supply, that is no easy task.

    As usual, thanks, JP, for sharing this.

    Good luck,

    Bill

  9. Pradip Gharpure Says:

    Though low carb diet has its relevance it is unfair to always that kind of diet. We need to take all sorts of diet and not only low carb diet.

  10. JP Says:

    Thank you, Bill. I tend to agree. But I think it can be done – provided we have resolve and the necessary resources. I’m all about making this dietary shift practical.

    A practical example: I just brought over some gluten-free, low carb cookies to a holiday party. They were well accepted and didn’t have a grain of flour in them. Plenty of healthy fats as well. I’ll add a link to the recipe once it’s posted tomorrow.

    Be well!

    JP

  11. JP Says:

    Pradip,

    I don’t think low carb diets are for everyone. But I do believe that high carb diets that are rich in starch and sugar do not promote health. Any movement away from the latter dietary trend would be a positive development, IMO.

    Be well!

    JP

  12. Bill Says:

    If your body responds to rapid glucose infusions by overproducing insulin, you will be a person who tends to easily put on weight from eating carbs, and you will be in danger of suffering from all the chronic maladies now being associated with chronic high insulin levels.

    If you are one of the unusual people who tolerates a high-carb diet well, I suspect you are a slender high-energy person.

    Good luck,

    Bill

  13. Adriana Says:

    Even when low carbs diet do have excelent results on weight loss, I do have some concerns about high protein diets and the probably kidney failure ( If we think that Obeses have more risk to suffer high blodd pressure).
    Greetings from Venezuela.

  14. JP Says:

    Adriana,

    Please keep in mind that many low-carbohydrate diets are not high in protein. The variety of low-carb eating I advocate is: high in healthy fats, fiber, non-starchy vegetables and select low-glycemic fruits; moderate in protein; and devoid of added sugar, refined carbohydrates and starches.

    I think you might enjoy my three-part interview with Dr. Richard Feinman. In that exchange, he explains away many misconceptions about what healthy low-carb dieting is and is not:

    http://www.healthyfellow.com/588/dr-richard-feinman-interview-part-one/

    http://www.healthyfellow.com/595/dr-richard-feinman-interview-part-two/

    http://www.healthyfellow.com/616/dr-richard-feinman-interview-part-three/

    Be well!

    JP

  15. Iggy Dalrymple Says:

    “Low-carbohydrate diet scores and risk of type 2 diabetes in men”

    Results: We documented 2689 cases of T2D during follow-up. After adjustments for age, smoking, physical activity, coffee intake, alcohol intake, family history of T2D, total energy intake, and body mass index, the score for high animal protein and fat was associated with an increased risk of T2D [top compared with bottom quintile: hazard ratio (HR): 1.37; 95% CI: 1.20, 1.58; P for trend < 0.01]. Adjustment for red and processed meat attenuated this association (HR: 1.11; 95% CI: 0.95, 1.30; P for trend = 0.20). A high score for vegetable protein and fat was not significantly associated with the risk of T2D overall but was inversely associated with T2D in men aged <65 y (HR: 0.78; 95% CI: 0.66, 0.92; P for trend = 0.01, P for interaction = 0.01).

    Conclusions: A score representing a low-carbohydrate diet high in animal protein and fat was positively associated with the risk of T2D in men. Low-carbohydrate diets should obtain protein and fat from foods other than red and processed meat.
    http://www.ajcn.org/content/early/2011/02/09/ajcn.110.004333.abstract?papetoc

  16. JP Says:

    Thanks for posting that, Iggy. I’d like to see the full text of the study to get a better handle on what they considered “low carbohydrate diets”.

    Be well!

    JP

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