Dr. Lee, the Healthy Professor

Low Carb Diets

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In Defense of Reduced Carbohydrate Eating

Chronic criticism and reluctant acceptance of reduced carbohydrate eating plans prompted this column. Media and scientists supporting conventional wisdom continue to refer to low carbohydrate eating plans like the Atkins diet, the Protein Power diet, the South Beach Diet and the Zone diet as “fad” diets. When is a “fad” (dictionary defined as short-term, temporary, popular trend or behavior) no longer a fad? The Atkins program first appeared in a best selling book “Dr Atkins’ Diet Revolution” in 1972. When it was re-published in 1992 as “Dr. Atkins’ New Diet Revolution”, it once again became a best seller.

Actually reduced carbohydrate eating has a very long history. Not counting the original Inuit and Lapland eating plans of 75 – 80% mammalian fat, published versions appeared in 1825 by Jean Anthlene Brillant-Savin in his Essay on Preventative or Curative Treatment of Obesity.

Then there was famous “Banting Letter” that first appeared in 1862 and was re-published many times. The Salisbury steak was invented in the late 1800s when the Earl of Salisbury’s physician rediscovered the Banting letter and included it in a book “Eat and Grow Thin” that went through 113 printings by 1931.

These were all reduced carbohydrate eating plans designed to solve obesity and other selected health problems. There is also a very famous study done in 1929/30 when the arctic explorers Stefansson and Anderson saw Eskimos able to live healthy lives on Caribou meat only. They returned to New York and volunteered to be studied while hospitalized in a controlled environment for one year. They ate a meat diet 2500 Calories per day which was 75% fat. At the end of the year they lost six pounds, had normal cholesterol levels and had no ill health effects.

The critics, who make me very tired, continuously harp on the adverse effects of high fat/ protein diets on cholesterol, heart disease risk factors, the dangers of ketosis (the result of partially metabolized fat) and the alleged void in research on the long term effects of such diets.

Dr. Ancel Keys (known as Msr. Cholesterol at the University of Minnesota) has been quoted “... there’s no connection whatsoever between cholesterol in food and cholesterol in the blood. None. And we have known that all along. ”Dr. Calvin Ezrin an endocinologist at UCLA in his book “The Type II Diabetes Diet” (formerly The Endocrine Control Diet) has made it very clear that ketosis caused by very low carbohydrate diets is not dangerous (except to your social life because of bad breath and body odor).

The “long term research” criticism could also be applied to the conventional high carbohydrate, low fat, low-calorie diets. Not only is there no long term controlled research, they have met with dismal failure as obesity doubles every five years and type II Diabetes shows a three fold increase every five years.

Speaking of research, there have been at least five published papers in the last eighteen months demonstrating the effectiveness of the The Atkins’ diet on weight loss and blood lipid control. One very notable study was from Duke University and it showed the Atkins’ program was significantly more successful than the American Heart Association phase I program

I was particularly disturbed by a recent ‘scare tactic’ criticism of low carbohydrate eating levied by a director of a program at the Toronto Hospital for Sick Children. The suggestion was made that low carbohydrate eating “could trigger a sharp resurgence in devastating birth defects and childhood cancers ...”.

This is irresponsible speculation not supported with any data. The suggestion was that low carbohydrate programs are low in folic acid, necessary for fetal development and suggests that bread, pasta, breakfast cereals and orange juice (all reduced in consumption in low carb diets) are the key sources of folic acid.

Well, there are few OBGYN doctors who do not recommend full folic acid supplementation during pregnancy and there are many other colorful vegetables and fruit that carry folic acid. One does not need to create an “insulin disaster” (insulin control is the entire objective of reduced carbohydrate eating) to obtain enough folic acid or any other micronutrient. Responsible supplementation is a modern solution a modern problem. 

Please don’t take this column to be a blind endorsement of Atkins’ or other ketogenic programs. These programs can be a boon to getting the obese started on an insulin control program but they are not usually necessary for those seeking moderate weight management. I would look for an approach that controls insulin, and delivers adequate nutrition in a long-term lifestyle approach rather than a quick-fix approach.

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