Low Carbohydrate Diet Might Be Better for Losing Weight and Improving Heart Health.

For a long time we have been told that the best way for us to maintain our weight or lose some is to go low fat and restrict our calorie intake. The calories in, calories out paradigm has been the harsh reality and for many people a source of constant frustration. No matter how hard they try, they can’t seem to make it.
Finally we seem to be finding our way back to a more varied way of looking at our metabolism and understanding what our bodies actually thrive of. It’s not only the calories, it matters what source they have. This is knowledge we’ve had for a long time, but in the well meaning attempt to make us “heart healthy” during the last 40 years, it has been lost. Normal, nutrient dense food (meats and organ meats, good fats etc) that we can easily cook on our own has been put to shame and we’ve been guilted by the medical society for not caring enough about our health. The more the “heart-healthy” advice seem to have been followed, the more sick we seem to get.
More and more evidence, both scientific and experiential, is showing that the human race might be doing better with lowering their carbohydrate intake.

The “Annals of Internal Medicine” recently published this randomized study – “The effects of Low-Carbohydrate and Low-Fat Diets“.
They followed 148 subjects for a year, randomly assigned to a low-carbohydrate or a low-fat group (119/80% completed the intervention). There were overweight, men and women, white and black, in the ages between 22-75. The participants did not have Diabetes or cardiovascular disease at the start of the study.
Both groups were tested for a multiple of markers in the beginning of the study and after 3, 6 and 12 months, at which time two 24-hour dietary recalls (one reflecting a week day and one a weekend day) were also collected.
They were given weekly individual dietary counseling sessions from a dietician for the first 4 weeks, then in small groups every second week for the next 5 months and after that in the groups monthly for the rest of the year.
They also got shopping lists, recipes, sample menus for a week, meal planners and guides on how to count macro-nutrients and read nutrition labels, as well as a low-carb/low-fat meal replacement a’ day throughout the study.

The low-carbohydrate group was instructed to eat a diet with less than 40 g of digestible carbohydrates/daily.
The low-fat group was told to have less than 30 % of their food intake from fat (less than 7 % from saturated fat) and about 55 % carbohydrates.
The low-fat diet follows the National Cholesterol Education Program Guidelines.
There was no specific calorie or energy goal, but the participants were instructed not to change their physical activity levels during the study. Both groups received the same information on dietary fiber (25 g/day) and dietary fats (including education on the different kinds of fats and emphasis on benefits of monounsaturated fats and avoiding trans fats).

After a year the participants in the low-carbohydrate group had significantly reduced in weight and fat mass and had also increased their levels of HDL-cholesterol compared to the low-fat group. The levels of triglycerides changed significantly in both groups, the change being bigger for the participants in the low-carbohydrate one.
The low-carbohydrate group also had lower CRP levels (an indicator of overall inflammation) and the estimated 10-year risk for cardiovascular disease (Framingham risk score) than in the low-fat group.

The levels of LDL-cholesterol or blood glucose and the blood pressure didn’t change significantly in any of the groups.

It seems that a low-carbohydrate diet is beneficial for weight loss, especially since people following this diet tend to lose mostly fat mass.
The cholesterol levels have been the main worry for the medical collective when discussing LCHF and other low-carbohydrate diets and this study actually showed beneficial effects on markers for cardiovascular health, especially improving the total cholesterol – HDL-cholesterol ratio.
That should make your doctor/internist/cardiologist happy.

The average low-carbohydrate diet usually aims for 20 % or less of the daily intake to be from carbohydrates, and in this diet the average intake landed on 30% over the year. So of course, we can’t extrapolate the numbers from the study to diets with lower carbohydrate content.
My personal experience in both personal and clinical life does gravitate towards that a the lower the carbohydrate (especially the refined, processed ones) intake, the better.
But if you can experience health benefits like the ones described in the study and not going to extremes, that is good news for us all.

In this study they did their best to keep the activity-level the same, to be able to asses the changes more correctly.
The best way of losing weight and keeping healthy is of course to combine dietary changes with being more active, especially in daily life.

I’m sure that there are more interesting studies to come on this subject, especially since the researchers and the medical society has become aware of the possible benefits of a low carbohydrate diet and need to keep up with the changes that people make themselves in their lives as they start reaping the benefits. Read more of how you can start today here!

Courtesy to: http://dgeneralist.blogspot.se/2013/11/the-low-carb-high-fat-diet.html

What an exciting future!

 

 

 

 

 

 

 

To the abstract: http://annals.org/article.aspx?articleid=1900694

Ketogenic diet – a remedy for Diabetes?

So far, diabetics have had to resolve to getting insulin through multiple injections daily (or through a insulin pump). All diabetics have been taught to eat a “heart healthy” low-fat diet, with a lot of carbohydrates and they learn to adjust the amount of insulin needed to keep their blood sugar within reasonable limits. They never get to the same blood sugar control as a person with a functioning pancreas of course, but with practice many get really good at keeping it in check.
Having diabetes also automatically raise the risk for comorbidity – that is having other diseases. The most commonly associated ones are cardiovascular diseases – i.e myocardial infarction, micro-vascular dysfunction that leads to kidney failure, poor eye sight because of bad circulation in the retina and poor leg circulation leading to difficulties healing wounds and sometimes needing to amputate toes, feet or a whole leg because of ischemia (oxygen deficiency).  These diseases occur because sugar have tendency to react with proteins and make them dysfunctional. The more of the changed proteins you have, the more inflammation, because that’s how the body tries to deal with them. Inflammation is good when it’s kept in check, but it is also damaging for the tissues.

Of course, not everyone with diabetes will succumb to these diseases, but the risk a lot higher than for an average person without diabetes.
It’s pretty easy to understand that having a normal regulation of blood sugar is the pivotal point here. If you don’t have diabetes or any problems with blood sugar regulation you never have to worry about what will happen to the sugar, your body just handles it. But when having diabetes you have to become your pancreas and figure out just how much insulin is needed to get the sugar into the cells, but not lower it too much, a tricky balance.

I find it really interesting that diabetics are told to eat a diet high in carbohydrates and low in fat, since it is the sugar that is the problem. It doesn’t matter if you eat a spoon of sugar or a “low-GI” carbohydrate, it will all become glucose in your blood.
There is a bunch of different versions of insulin for injections, and they all have their different profiles of how they affect blood sugar. Most of the ones taken with a meal are fast and short acting, with an effect that lasts for two to five hours. It can be tricky to know just how much insulin is needed to end up in a good range.

A case study (that is one person has been studied) has been published in the International Journal of Case Reports and Images (1). It shows how a young 19-year old man, newly diagnosed with diabetes, goes from a standard, conventional diabetes diet – 6 meals daily, containing about 240 grams of carbohydrates. He had a hard time keeping his glucose levels in check, fluctuating between 68 to 267 mg/dL (normal is considered below 140 two hours after a meal, but most healthy people are lower than that).
20 days after being diagnosed he shifted to a low carbohydrate diet, in this case a paleolithic ketogenic one. He consumed meat, organ meat, fish, fowl, eggs and fat and very small amount of vegetables. He did not eat oils of plant origin, milk products, sugars or artificial sweeteners.
From the first meal he discontinued insulin, because his glucose levels never went high enough to take it! As he continued the diet the pancreas seemed to restore it self and insulin was continuously being produced. This was measured through a protein called C-peptide, which is cut of from the insulin as it is released into the blood stream and it correlates to insulin levels in the body.

He had been on a ketogenic diet for 6,5 months when the report was published, and he was still doing well, with low/normal glucose levels and he was not experiencing any side effects.
When having diabetes in a young age, there is usually auto-antibodies, directed towards the cells producing insulin in the pancreas, and so was the case for this man as well. It seems his diet has not only kept him of insulin but also halted the auto-immune process, because the levels were unchanged four months after starting the diet.

This is a case study and you can’t draw to many conclusions from it when it comes to looking at the whole community of diabetics. Some might not have any insulin production left for example.
From my clinical experience and from other observational studies, it seems that lowering the carbohydrate intake does help people with diabetes to manage their blood glucose levels and also get off blood sugar regulating drugs and lower their need for insulin.
And that’s all we want in the medical profession. We want our patients to have a well regulated blood sugar and with as little insulin as possible, because we know that’s how they can stay healthy for as long as possible.

I actually have a type 1 diabetic patient in my clinic that just have made the shift from a standard diabetic diet to a low carbohydrate one, and she’s experiencing some amazing results! How about getting of insulin completely three days into the diet, after being on both a long- and short-acting one for 25 years?
Keep a look out on my blog for more about her!

I think we are moving towards a big shift in how we look at diseases like diabetes. There is so much more that can be done than just resorting to insulin injections!
Hopefully this and other case studies will push the science towards a more open mindset and allowing individualized treatment that might, or might not contain insulin or other drugs.
I am convinced that what we eat affects our bodies, and cases like this make it pretty apparent.

From my perspective it also feeds my conviction that we all are best of with as little sugar (that includes all carbohydrates) as possible in our diets. Type 2 diabetes is on the rise, and it is seems to be connected with our high carbohydrate, low fat and no exercise life styles.
I’m not going to wait for the medical community to catch up. Do your own research, read up on the human physiology and it will speak for itself!

1) Tóth C, Clemens Z. Type 1 diabetes mellitus successfully managed with the paleolithic ketogenic diet. Int J Case Rep Images 2014;5(10):699–703. http://www.ijcasereportsandimages.com/archive/2014/010-2014-ijcri/CR-10435-10-2014-clemens/index.php