Low Carbohydrate Diet, how healthy is it?
December 22 2015 by
Ray Sahelian,M.D.


Low carb diets are based on the premise that a diet very low in carbohydrate leads to a reduction in the body's insulin production, resulting in fat and protein (muscle) stores being used as its main energy source. Please keep in mind that there are many different types of carbohydrates, they are all not the same.

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Low Carb Diet and Heart Disease
Eating a low-carb, high-fat diet for years doesn’t raise the risk of heart disease which indicates the popular Atkins diet and similar low carb regimens are heart healthy after all. A study of thousands of women over two decades found that those who got lots of their carbohydrates from refined sugars and highly processed foods nearly doubled their risk of heart disease. At the same time, those who ate a low-carb diet but got more of their protein and fat from vegetables rather than animal sources cut their heart disease risk by 30 percent on average, compared with those who ate more animal fats.


Cutting down on carbs may help people lose weight, but it may not be so good for lowering cholesterol. People who ate a diet low in carbohydrates but relatively high in fat lost the same amount of weight over six weeks as those who consumed a high-carb diet. But levels of low-density lipoprotein (LDL) or "bad" cholesterol increased significantly in the low-carb group, while they fell in the high-carb group. American Journal of Clinical Nutrition, 2010.

Low Carbohydrate diet and Obesity
Low-carbohydrate diets for the treatment of obesity are currently receiving widespread popularity. Several controlled trials have demonstrated larger weight loss (3-6 kg) during these diets compared to conventional low-fat diets. The weight differences between these diets were statistically significant after 6 months but not any more after 12 months. Possible reasons for the increased weight loss may be the initial loss of body water, later on the diminishment of food choices, the satiating properties of proteins and the anorectic effect of ketosis. Controlled studies have not demonstrated any increase in LDL-cholesterol but a favorable increase in HDL-C and a lowering of serum triglycerides. Even if these diets "work" in selected patients, they are problematic because the increase in protein ingestion may lead to increased intake of saturated fat, and intake of water soluble antioxidants, vitamins and of fiber may be too low. For these reasons, their protective effect on the "major killers " atherosclerotic diseases, hypertension, diabetes type 2 and some forms of cancer is questionable. Moreover, these diets are unpleasant on the long run, and social eating is impaired. For all these reasons a low carb diet should not be generally recommended for long term use.


Nutr Metab Cardiovascular Dis. 2013. Long term weight maintenance after advice to consume low carbohydrate, higher protein diets - A systematic review and meta analysis. The short term benefit of higher protein diets appears to persist to a small degree long term.


Low Carbohydrate Diet and Diabetes

In motivated people who are overweight and have type 2 diabetes, a low-carbohydrate diet with some caloric restriction has lasting benefits on body weight and blood sugar control.


Do Low Carb Diets Work?
Low-carbohydrate diets have re-emerged into the public spotlight and are enjoying a high degree of popularity as people search for a solution to the population's ever-expanding waistline. The current evidence though indicates that low-carbohydrate diets present no significant advantage over more traditional energy-restricted diets on long-term weight loss and maintenance. Furthermore, a higher rate of adverse side-effects can be attributed to low-carbohydrate dieting approaches. Short-term efficacy of low-carbohydrate diets has been demonstrated for some lipid parameters of cardiovascular risk and measures of glucose control and insulin sensitivity, but no studies have ascertained if these effects represent a change in primary outcome measures. Low-carbohydrate diets are likely effective and not harmful in the short term and may have therapeutic benefits for weight-related chronic diseases although weight loss on such a program should be undertaken under medical supervision. While new commercial incarnations of the low-carbohydrate diet are now addressing overall dietary adequacy by encouraging plenty of high-fibre vegetables, fruit, low-glycaemic-index carbohydrates and healthier fat sources, this is not the message that reaches the entire public nor is it the type of diet adopted by many people outside of the world of a well-designed clinical trial.


Low Carb Diet and Bones
Contrary to concerns raised by animal studies, people eating this way don't seem run a risk of weakening their bones. Scientists had suspected that such diets might leach calcium out of the bones by causing the kidneys to excrete more acid, and research in animals had supported this possibility. But a study in humans by Dr. John D. Carter and colleagues from the University of South Florida in Tampa had 15 people follow a low-carb diet for three months, comparing them to 15 age- and sex-matched "controls" who ate a normal diet. There was no difference between the two groups in bone turnover, but the men and women on the low-carb diet lost an average of 6 kilograms (14 pounds) compared to 1 kg (2.3 pounds) for the controls. "Although the relatively short observation period does challenge the generalizability of these findings, we suggest that a low-carbohydrate diet used for weight loss does not increase bone turnover in humans," Carter and his colleagues conclude. Osteoporosis International, 2006.


The only option?
It is unlikely that one diet is optimal for all overweight or obese persons. Both low-fat and low-carbohydrate diets have been shown to induce weight loss and reduce obesity-related comorbidities. Low-carbohydrate diets cause greater short-term (up to 6 months) weight loss than low-fat diets, but the long-term clinical safety and efficacy of these diets has not been studied.


High Protein Low Carbohydrate Diet

The high protein low carbohydrate diet was popular in the 1970s, before saturated fat was confirmed to have a negative influence on heart disease Now, high protein low carbohydrate diets are once again popular, mostly due to the popularity of the Atkins diet, due to the faster initial weight loss they can achieve. However, many doctors retain doubts about the long term health effects of a high protein low carbohydrate diet. However, a high protein low carbohydrate diet may be acceptable for a brief period of a few weeks and then more complex carbohydrates can be introduced..

Food low in carbohydrate
Foods low in carbohydrate include meat, fish, poultry, and dairy.


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