A Beginner's Guide To Low Carb Diets
Low carbohydrate diets have gained momentum over the last few years and have demonstrated real potential as therapeutic options for a number of chronic conditions such as managing insulin resistance, metabolic syndrome, type 2 diabetes, supporting cardiovascular health, weight loss / weight maintenance and more. Furthermore, very low carbohydrate diets such as the ketogenic diet are being studied in neurodegenerative conditions such as Alzheimer’s disease, some forms of cancer and type 1 diabetes. Ketogenic diets are not new, in fact they have been considered a potential therapeutic option in some forms of epilepsy since the 1920s, often a consideration when seizures are not controlled by anti-epileptic drugs (AEDs).
Whilst the concept of low carbohydrate diets is not new, both their popularity and potential scope of therapeutic application has expanded significantly in recent years. And as interest has increased, so too has the amount of information written and spoken on them. This is great news if you’re looking for resources, recipes and to dive into lots of emerging research and a wide range of thought-provoking viewpoints on the subject – but not so great if you’re looking for clear and simple answers (spoiler alert – there are no clear and simple answers)!
Still relatively new to the mainstream, low carb and ketogenic diets are a hotly-debated topic in the nutrition and medical worlds. Vibrant scientific debate is important for progress – science isn’t black and white and we must always be open to new ideas. The only way we ever really move forward is by continuing to cultivate questioning minds. And in a world where heavily refined and processed, nutrient-devoid, convenience foods typify the Western diet, and obesity and poor metabolic health are in urgent need of attention, it’s certainly important to stay curious to the potential benefits of a lower carbohydrate approach.
Here’s a closer look at some of the basics of a low carb diet, some additional factors to consider and links to useful resources if you’re ready to dig a bit deeper.
Low carb – the basics
• The main aim of a low carbohydrate approach is to minimise sugars in the diet. In simplified terms, this is because when we over-consume carbohydrates (particularly refined, processed and starchy carbs), and high levels of insulin are released, fat oxidation is turned off and fat storage is stimulated. Yet when we stop eating lots of carbs and insulin levels are lower, the opposite happens; fats come out of storage and can become fuel.
• If insulin levels are consistently elevated (chronic hyper-insulinaemia), this can cause weight gain, inflammation, high blood pressure and unfavourable changes in lipid profiles. Over time, hyper-insulinaemia can lead to insulin resistance, where the body’s cells become resistant to the actions of insulin, and this may eventually progress to type 2 diabetes. (Note type 2 diabetes is different to type 1 diabetes which is an autoimmune condition whereby the pancreas no longer produces insulin).
• Insulin is mainly released in response to carbohydrate consumption - the higher the carb levels in the diet, and the more refined and sugary they are - the more insulin is released. The aim of reducing carbohydrates is thus to support reduced insulin levels and improved associated health markers.
• Lower carbohydrate diets contain varying degrees of fewer carbohydrates and higher proportions of protein and fat. For example, some people choose a minimal reduction in carbohydrates, whereas a moderate low carb diet may aim for less than 100g carbs / day, a low carb diet less than 50g / day and a very low carb (keto) diet less than 20g / day.
• As you can see, levels of carbohydrate reduction are highly variable. And there is debate over the relative ratios of macronutrients; i.e. whether a low carb diet should be higher in protein or fat? Generally speaking, a lower carb higher protein (LCHP) diet may have the edge when it comes to optimal weight loss, whereas a lower carb higher fat (LCHF) diet may be preferential for an optimal way to fuel the body. What is more generally agreed upon is that a combination of high carb & high fat is best avoided. In reality, this wide-ranging variation simply demonstrates that we are all unique, that one size does not fit all and that a flexible, personalised approach is best.
Low carb – Additional factors to consider
Stay open and curious
Low carb diets have become increasingly popular in recent years. The aim of this article is to help you to stay informed and to encourage you to be open and curious to the potential benefits for some.
One size does not fit all
As with all aspects of diet and nutrition, there is no one size fits all approach to low carb; some people may do brilliantly on a ketogenic diet, others may benefit from a slight reduction in dietary carbohydrates and still others may thrive on something different. Everyone has a different starting point and unique health goals, and personalised nutrition is still key for optimal health outcomes.
Know when to refer
Specialist knowledge is certainly required in some areas, some examples include when there are blood sugar lowering medications, insulin therapy or blood pressure medications to take into account. As healthcare practitioners it is always important to know when to refer and low carb diets are no different in this respect.
Consider gut health
Some people experience improved gut health on a lower carbohydrate diet. Yet others are concerned that low carb and particularly ketogenic diets may impact the gut microbiome when carbohydrates are restricted. This is an area of intense debate, accelerated research and one to watch.
Diversity is key
Whether low carb or not, dietary diversity (especially of a wide range of plant foods) is a key tenet of any healthy diet, especially for nurturing a thriving internal ecosystem of gut microbes. And it remains important to pay attention to dietary diversity whatever diet you are following.
Fat is your friend
Prominent nutrition and obesity researcher and author Dr Zoe Harcombe has said, “the demonization of fat has had inevitable consequences for the consumption of carbohydrate”. After so many years of ‘fat is bad for you’ public health messages, it’s still taking time to re-educate people on the benefits of including good quality fats in their diets. In choosing ‘low fat’ options, many end up over-consuming carbohydrates, in part because many ‘low-fat’ options are loaded with refined sugar and sweeteners, and also because fat helps to fill you up. Whether low carb or not, fat needs to be put back on the menu.
Reducing refined & processed foods, sugary foods, drinks and snacks is a good idea for everyone
Similar to the sea change that is needed with fat, reducing or removing heavily refined and processed foods, and sugary foods, drinks and snacks is good advice for everyone. We’re long overdue the point where ‘a typical Western diet’ should mean something very different.
Dietary quality is key
And finally, this is the dietary message I share most often and it’s as relevant here as anywhere; that no matter what way of eating you choose, dietary quality is key. When natural, unprocessed foods are selected for their buoyant nutritional content and meals are cooked from scratch, not only do we get macronutrients, but a whole array of essential vitamins, minerals and incredible phytonutrients too. We can always make significant potential impact on health outcomes by choosing foods that deliver the most ‘bang for their buck’ in terms of nutritional content. Dietary quality is, and always will be, absolutely key.
Want to find out more? Here’s some useful resources:
Nutri Advanced Resources:
Natural Support For Blood Sugar Balance
The Art and Science of Low Carbohydrate Living by Jeff S. Volek & Stephen D Phinney
The Diabetes Weight Loss Cookbook by Katie & Giancarlo Caldesi with Jenny Phillips & Dr David Unwin
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