Tag Archives: low carbohydrate diet

Should you eat like a caveman? What you need to know about paleo and keto diets.

Which diet is the best? This is one of the most common questions about nutrition and health, with implications for weight control, chronic disease prevention and treatment, and exercise performance. Unfortunately, this is no simple answer to this question. While there are certain eating patterns and aspects of specific diets that are considered to be beneficial, there is no single diet that has been shown to be the “best.”

As a general rule, healthy eating should be informed by nutrition science, not determined by the latest trends. Many fad diets raise concerns because they restrict or over-emphasize certain foods or nutrients, rely on meal replacements or supplements instead of real food, or are supported by limited evidence.

The Paleo and ketogenic (Atkins) diets are examples of popular diets that are at odds with traditional nutrition recommendations, going against the poor “low-fat” advice we have long been provided. Given the popularity of these low-carbohydrate diets, it is worth exploring the benefits and drawbacks of each to help you decide which is right for you.

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Forget about low-carb, go smart carb.

Nutrition advice tends to be complicated and contradictory, making simple answers to the question, “What should I eat?” anything but simple (but you still need to do it!). This is particularly true when it comes to carbohydrates. On one hand, current recommendations call for carbohydrates to be the major part of your diet. On the other hand, low-carbohydrate diets are at odds with these recommendations but are still very popular.

For example, the Atkins diet restricts all carbohydrates, including refined grains and sugars. The Paleolithic diet emphasizes minimally processed foods that may have been consumed by our ancient ancestors including lean meat, eggs, fruit, and vegetables while restricting the consumption of grains and added sugars. Both have been shown to promote weight loss better than traditional low-fat diets.

Proponents of low-carbohydrate diets claim that restricting carbohydrates promotes fat loss and eating carbohydrates leads to fat storage and weight gain. It is also likely that people who follow low-carbohydrate diets find them easier to stick to than other diets, so they may actually end up eating fewer calories.

But the problem may not be carbohydrates in general, it might be eating too few of the right carbohydrates. Given that September is Whole Grains Month, this seems like a good time to explore the benefits of going smart-carb instead of low-carb. This is the topic of my Health & Fitness column in the Aiken Standard this week.

Food grains


Sources of carbohydrates include whole grains (such as whole wheat bread), refined grains (white bread), and sugars. Both refined grains and sugars tend to raise blood glucose rapidly, called the glycemic index, which leads to an increase in certain hormones, including insulin. Insulin stimulates the uptake of nutrients into cells, including the storage of fat in adipose tissue. This is one reason why carbohydrates are linked to fat gain and why restricting carbohydrates leads to fat loss.

But carbohydrates from whole grains don’t raise either blood glucose or insulin as much. This “low and slow” response has several benefits, including improved blood glucose regulation, lower triglycerides, and, potentially, reduced fat storage. For these reasons, complex carbohydrates from whole grains are called “good carbs,” in contrast to refined grains and sugars, known as “bad carbs.”

Considering that the typical American diet contains too much carbohydrate from sugars and refined grains and not enough whole grains, restricting carbohydrates may have some benefits. But there is another approach: be smart about your carbohydrate choices. Instead of cutting out all carbohydrates, focus on reducing refined grains and sugars and emphasizing whole grains.

You can meet this goal by limiting your intake of sugars, especially added sugars, and refined grains while increasing your consumption of whole grains, fruits, and vegetables that are high in fiber. When comparing food labels, look for foods that contain whole grains (the first ingredient should be something like “whole wheat flour”) and higher levels of fiber. But be aware that some foods, like many breakfast cereals, contain whole grains but are also high in added sugar. The best advice is to get the majority of your carbohydrates from real food, including vegetables, fruits, whole grains, and legumes, rather than from processed foods.

Something to keep in mind is that although low-carbohydrate diets are associated with weight loss and good health, they are not the only way to achieve these benefits. Indeed, people who are considered to be fit and healthy have a wide range of eating patterns, from vegetarian and low-fat diets to extreme low-carbohydrate diets and everything in between. The one factor they have in common is that they are active. It may be that regular exercise is just as important as what you eat when it comes to promoting health.


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Fat still matters

Last week I wrote about some recent research suggesting that low-carbohydrate diets may be better for weight loss that low-fat diets. For many, this study reinforced the notion that traditional recommendations are wrong and that the key to good health is to eliminate carbohydrates from your diet. This couldn’t be further from the truth.

The recent study did show that people lost more weight and experienced beneficial changes in blood lipids when they followed a low-carbohydrate diet compared to those who ate a low-fat diet. However, this does not mean that low-fat diets aren’t effective for weight loss or that they are “unhealthy.”

In fact, low-fat diets have long been used effectively to promote weight loss, reduce heart disease risk, and lead to healthier eating in general. This is supported by the results of hundreds of research studies as well as the practical experience of health professionals and real people. Here are two reasons why fat still matters when it comes to health.

First, reduced-fat diets have been shown to improve blood cholesterol and lower the risk for heart disease. Eating a diet low in fat, especially saturated and trans fat, has been the foundation of nutrition recommendations for decades. The fact is that these diets are effective for weight loss, reducing cholesterol, and otherwise improving heart health.

One famous study demonstrated that following a low-fat diet contributed to a reduction in the severity of atherosclerosis, the narrowing of arteries that leads to many heart attacks. Literally hundreds of other studies have shown similar beneficial results.

This isn’t some magical effect of eating less fat, though. The health benefits are likely due to eating more vegetables, fruits, and whole grains as much as they are to reducing fat intake. The point is that adopting a low-fat diet can lead to better nutrition overall.

Second, reducing fat intake is a good way to reduce calories. This is true because fat contains nine calories per gram, more than twice that of carbohydrates and protein, so cutting fat is an effective way to cut calories. Limiting fat intake also reduces calories indirectly because many high fat foods are also high in sugar and calories (think of most desserts).

It is important to mention that simply reducing fat intake won’t always lead to weight loss; total calories must be lower, too. This is a mistake many make when they reduce fat intake, but increase the amount of calories from other sources, typically carbohydrates. Many low-fat foods are actually relatively high in calories due to added sugar or people tend to eat more of them (the SnackWell Effect).

The effectiveness of low-fat diets for weight loss has been demonstrated in research studies (like this one) and countless weight loss programs. In one notable study, a diet low in fat even led to weight loss in people who weren’t trying to lose weight. And don’t forget that in the recent study about low-carbohydrate diets, the subjects that followed the low-fat diet also lost weight.

For some people, cutting carbohydrates as a way to lose weight is reasonable; for others, reducing fat intake makes sense. For most people, though, doing both to some extent is the best option, but going to extremes is unnecessary.

Eating less added sugar and avoiding foods with added fats (such as French fries) are good recommendations for almost everyone. That said, there is little evidence for the benefit of limiting carbohydrates in the form of whole grains, legumes, vegetables, and fruits or the fat in meat and dairy.

The bottom line is that the quality of food we eat is more important than the specific amounts of the nutrients it contains. Eating low-carbohydrate or low-fat diets can help steer you toward making healthier choices, but so can avoiding processed foods in favor of wholesome, nutrient-dense “real” food.

Good sources of protein for your low-carb diet

Thanks to a recent study and media coverage (including me), low-carbohydrate diets are a popular topic of discussion. For many people, cutting back on carbohydrates is a good way to reduce calories to promote weight loss.

Most low-carbohydrate diets also emphasize protein intake. But finding healthy protein sources is important for promoting weight loss and good health.

This recent discussion about the best protein for optimal weight loss  on the Train Your Body show on RadioMD should help.

The diet wars continue

If you are confused or frustrated by the conflicting claims about whether a low-fat or low-carbohydrate diet is the best, you are forgiven. First we were told that eating a low-fat diet was the best way to lose weight and improve heart health. Then, research suggested that low-carbohydrate diets were better. And back and forth it has gone for years.

During this time, the prevailing recommendations have suggested that a diet low in fat and high in carbohydrates was best. But more and more research has supported the notion that cutting carbohydrates, not fat, would lead to greater weight loss. Although this has been supported by some research, critics pointed out that eating more fat would raise blood cholesterol and other risks for heart disease.

According to a recent study, though, low-carbohydrate diets seem to have benefits for promoting weight loss and improving some indicators of heart health over low-fat diets. But you should hold off on shunning fruits and vegetables in favor of cheeseburgers! Here is a practical interpretation of the research and some common sense recommendations, taken from my Health & Fitness column in the Aiken Standard this week.

The study, published last week in the Annals of Internal Medicine, reported on 150 men and women who either restricted the amount of carbohydrates or fat they ate. After one year, the group that ate a low carbohydrate diet lost over 7 pounds more than the subjects on the low-fat diet. Additionally, the low-carbohydrate diet promoted greater improvements in blood lipids than the low-fat diet.

This is important for two reasons. First, this wasn’t a weight loss study; the researchers were simply following the subjects to see what would happen as they followed either diet. The fact that the low-carbohydrate group lost more weight suggests that it is relatively easier to cut calories following this type of diet.

This is consistent with other research showing that eating more carbohydrates, especially refined carbohydrates and sugar, can actually make people feel hungrier and eat more. Indeed, other studies have shown low-carbohydrate diets to be more effective for weight loss than low-fat diets (although a more recent study suggests there isn’t such a difference).

Second, the greater decrease in triglycerides and “bad” LDL cholesterol and increase in “good” HDL cholesterol in the low-carbohydrate group were different from what might be expected. Conventional wisdom holds that a low-fat diet should have a greater effect on blood lipids. Since weight loss can have a big effect on blood lipids, the improvement in the low-carbohydrate group may be due to losing more weight, not a direct effect of the diet.

It is important to note that the low-fat diet also led to weight loss in this and numerous other studies. The critical component of any weight loss diet is that it is relatively low in calories, regardless of what nutrients supply those calories. Really, almost any diet will lead to weight loss as long as it contains less energy than what is expended, but a low-carbohydrate diet may be more effective for weight loss than the traditional low-fat diet.

The bottom line is that the best diet is one that emphasizes eating wholesome foods, not on cutting carbohydrates or fat. That said, limiting carbohydrates in the form of refined grains and added sugar is an excellent way to reduce calorie intake and improve the overall nutritional value of what you eat. And shifting toward more monounsaturated fats (think olive oil and nuts) rather than worrying about the total amount of fat you eat is also a good idea.