low carbohydrate

Low-carbohydrate diets or low-carb diets are dietary programs that restrict berries) are often allowed. The amount of carbohydrate allowed varies with different low-carbohydrate diets.

Such diets are sometimes [3] is ketogenic.

The term “low-carbohydrate diet” is generally applied to diets that restrict carbohydrates to less than 20% of caloric intake, but can also refer to diets that simply restrict or limit carbohydrates.[4]

Low-carbohydrate diets are used to treat or prevent some chronic diseases and conditions including: polycystic ovarian syndrome.

Contents

[edit] History

[edit] Prehistory

See also: Paleolithic: Diet and nutrition

As with the [15]

Primatologist Katherine Milton, however, has argued that the survey data on which this conclusion is based inflates the animal content of typical hunter-gatherer diets; much of it was based on early [17]

The invention of agriculture brought about a rise in carbohydrate levels in human diets.[18] The industrial age has seen a particularly steep rise in refined carbohydrate levels in Western societies as well as urban societies in Asian countries like India, China,Japan etc.

[edit] Early dietary science

In 1797 Dr. John Rollo reported on the results of treating two diabetic Army officers with a low-carbohydrate diet and medications. A very low-carbohydrate, ketogenic diet was the standard treatment for diabetes throughout the 19th century.[20]

In 1863 [22]

In 1888, Salisbury steak as part of his high-meat diet, which limited vegetables, fruit, starches, and fats to one-third of the diet.

[edit] Modern low-carbohydrate diets

In 1967, Dr. Irwin Stillman published [26] However, it was hardly noticed in the English-speaking world.

In 1972, [29]

The concept of the starch, which is efficiently absorbed as glucose), despite differences in glycemic index.

[edit] 1990s – present

A pack of pork from Carbs per serving”. This is aimed at people on a low-carbohydrate diet.

In the 1990s Atkins published Dr. Atkins New Diet Revolution and other doctors began to publish books based on the same principles. This has been said to be the beginning of the “low carb craze”.low-carbohydrate diet medical research).

The popularity of the low-carb diet trend waned somewhat in the late 2000s.[[42] Other popular low-carb diets focus on the removal of certain foods from the diet, such as sugar and grain.

[edit] Practices and theories

Today, the term “low-carbohydrate diet” is most strongly associated with the Atkins Diet and other diets that share similar principles. The American Academy of Family Physicians defines low-carbohydrate diets as diets that restrict carbohydrate intake to 20 to 60 grams per day, typically less than 20 percent of caloric intake.[43] Some low-carbohydrate diets may exceed one or more of these definitions, notably the maintenance phase of the Atkins Diet. There is no consensus definition of what precisely constitutes a low-carbohydrate diet. Medical researchers and diet advocates may define different levels of carbohydrate intake when specifying low-carbohydrate diets. For the purposes of this discussion, this article focuses on diets that reduce (nutritive) carbohydrate intake sufficiently to significantly reduce insulin production and to encourage ketosis (production of ketones to be used as energy in place of glucose).

The body of research underpinning low-carbohydrate diets has grown significantly in the decades of the 1990s and 2000s.beta cells and glucagon from alpha cells.

In western diets (and many others), most meals are sufficiently high in nutritive carbohydrates to evoke insulin secretion. The primary control for this insulin secretion is glucose in the blood stream, typically from digested carbohydrate. Insulin also controls ketosis; in the non-ketotic state, the human body stores dietary fat in fat cells (i.e., adipose tissue) and preferentially uses glucose as cellular fuel. Diets low in nutritive carbohydrates introduce less glucose into the blood stream and thus evoke less insulin secretion, which leads to longer and more frequent episodes of ketosis. Some research suggests that this causes body fat to be eliminated from the body, although this theory remains controversial, insofar as it refers to excretion of lipids (i.e., fat and oil) and not to fat metabolism during ketosis.[47]

Low-carbohydrate diet advocates in general recommend reducing nutritive carbohydrates (commonly referred to as “net carbs,” i.e. grams of total carbohydrates reduced by the non-nutritive carbohydrates)[52]

Low-carbohydrate diets often differ in the specific amount of carbohydrate intake allowed, whether certain types of foods are preferred, whether occasional exceptions are allowed, etc. Generally they all agree that processed sugar should be eliminated, or at the very least greatly reduced, and similarly generally discourage heavily processed grains (white bread, etc.). Low-carbohydrate diets vary greatly in their recommendations as to the amount of fat allowed in the diet. The Atkins Diet does not limit fat. Others recommend a moderate fat intake.

Although low-carbohydrate diets are most commonly discussed as a weight-loss approach, some experts have proposed using low-carbohydrate diets to mitigate or prevent diseases including diabetes, metabolic disease and epilepsy.unreliable source?]

There is also a category of diets known as low-glycemic-index diets (low-GI diets) or low-glycemic-load diets (low-GL diets), in particular the Low GI Diet by Brand-Miller et al.[58] In reality, low-carbohydrate diets can also be low-GL diets (and vice versa) depending on the carbohydrates in a particular diet. In practice, though, “low-GI”/”low-GL” diets differ from “low-carb” diets in the following ways. First, low-carbohydrate diets treat all nutritive carbohydrates as having the same effect on metabolism, and generally assume that their effect is predictable. Low-GI/low-GL diets are based on the measured change in blood glucose levels in various carbohydrates – these vary markedly in laboratory studies. The differences are due to poorly understood digestive differences between foods. However, as foods influence digestion in complex ways (e.g., both protein and fat delay absorption of glucose from carbohydrates eaten at the same time) it is difficult to even approximate the glycemic effect (e.g., over time or even in total in some cases) of a particular meal.

Another related diet type, the low-insulin-index diet, is similar except that it is based on measurements of direct insulemic responses (i.e., the amount of insulin in the bloodstream) to food rather than glycemic response (the amount of glucose in the bloodstream). Although such diet recommendations mostly involve lowering nutritive carbohydrates, there are some low-carbohydrate foods that are discouraged as well (e.g., beef).[59] Insulin secretion is stimulated (though less strongly) by other dietary intake. Like glycemic index diets, there is difficulty predicting the insulin secretion from any particular meal, due to assorted digestive interactions and so differing effects on insulin release.

[edit] Ketosis and insulin synthesis: what is normal?

At the heart of the debate about most low carbohydrate diets are fundamental questions about what is a normal diet and how the human body is supposed to operate. These questions can be outlined as follows:

The diets of most people in modern [63]

People who eschew low carbohydrate diets cite citation needed]

A diet very low in starches and sugars induces several adaptive responses. Low blood glucose causes the pancreas to produce glucagon,[64] which stimulates the liver to convert stored glycogen into glucose and release it into the blood. When liver glycogen stores are exhausted, the body starts utilizing fatty acids instead of glucose. The brain cannot use fatty acids for energy, and instead uses ketones produced from fatty acids by the liver. By using fatty acids and ketones as energy sources, supplemented by conversion of proteins to glucose (gluconeogenesis), the body can maintain normal levels of blood glucose without dietary carbohydrates.

Most advocates of low-carbohydrate diets, such as the Atkins Diet, argue that the human body is adapted to function primarily in ketosis.trans fat).

On a high-carbohydrate diet, glucose is used by cells in the body for the energy needed for their basic functions, and about 2/3 of body cells require insulin in order to use glucose. Excessive amounts of blood glucose are thought to be a primary cause of the complications of diabetes; when glucose reacts with body proteins (resulting in glycosolated proteins) and change their behavior. Perhaps for this reason, the amount of glucose tightly maintained in the blood is quite low. Unless a meal is very low in starches and sugars, blood glucose will rise for a period of an hour or two after a meal. When this occurs, beta cells in the pancreas release insulin to cause uptake of glucose into cells. In liver and muscle cells, more glucose is taken in than is needed and stored as glycogen (once called ‘animal starch’).[68] Diets with a high starch/sugar content, therefore, cause release of more insulin and so more cell absorption. In diabetics, glucose levels vary in time with meals and vary a little more as a result of high carbohydrate content meals. In non-diabetics, blood sugar levels are restored to normal levels within an hour or two, regardless of the content of a meal.

While there are [71]

[edit] Studies on health effects

Main article: Medical research related to low-carbohydrate diets

Because of the substantial controversy regarding low-carbohydrate diets and even disagreements in interpreting the results of specific studies, it is difficult to objectively summarize the research in a way that reflects scientific consensus.[84]

[edit] Weight loss

A 2003 [82]

A July 2009 study of existing dietary habits associated a low carbohydrate diet with obesity, although the study drew no explicit conclusion regarding the cause: Whether the diet resulted in the obesity or the obesity motivated people to adopt the diet.[88]

One theory is that one of the reasons people lose weight on low carbohydrate diet is related to the phenomenon of spontaneous reduction in food intake.[89]

[edit] Blood lipids

Potential favorable changes in triglyceride and high-density lipoprotein cholesterol values should be weighed against potential unfavorable changes in low-density lipoprotein cholesterol and total cholesterol values when low-carbohydrate diets to induce weight loss are considered.[91]

[edit] Mortality

A study of more than 100,000 people over more than 20 years within the [94]

[edit] Opinions from major governmental and medical organizations

Although opinions regarding low-carbohydrate diets vary greatly throughout the medical and nutritional science communities, major government bodies as well as major medical and nutritional associations have generally opposed this nutritional regimen. In recent years, however, some[citation needed]. The following are official statements from some of these organizations.

American Academy of Family Physicians

The AAFP released a discussion paper on the Atkins Diet specifically in 2006. Although the paper expresses reservations about the Atkins plan they acknowledge it as a legitimate weight loss approach.[95]

American Diabetes Association

The [101]

American Dietetic Association

As of 2003 in commenting on a study in the Journal of the American Medical Association, a spokesperson for the [103]

American Heart Association

The official statement from the [105]

Australian Heart Foundation

The position statement by the Heart Foundation regarding low-carbohydrate diets states that “the Heart Foundation does not support the adoption of VLCARB diets for weight loss.”[106] Although the statement recommends against use of low-carbohydrate diets it explains that their major concern is saturated fats as opposed to carbohydrate restriction and protein. Moreover, other statements suggest that their position might be re-evaluated in the event of more evidence from longer-term studies.

Food Standards Agency (UK)

The consumer advice statements of the FSA regarding low-carbohydrate diets state that “rather than avoiding starchy foods, it’s better to try and base your meals on them.”[107] They further state concerns regarding fat consumption in low-carbohydrate diets.

Heart & Stroke Foundation (Canada)

The official position statement of the Heart & Stroke Foundation states “Do not follow a low carbohydrate diet for purposes of weight loss.”[108] They state concerns regarding numerous health risks particularly those related to high consumption of “saturated and trans fats”.

National Board of Health and Welfare (Sweden)

In 2008, the [110] Although formal endorsement of this regimen has not yet appeared, the government has given its formal approval for using carbohydrate-controlled diets for medically supervised weight loss.

In recommendation for Diets suitable for diabetes patients published in 2011 a moderate low-carb option (30-40%) is suggested.

U.S. Department of Health and Human Services

The HHS issues consumer guidelines for maintaining heart health which state regarding low-carbohydrate diets that “they’re not the route to healthy, long-term weight management.”[111]

[edit] Criticism and controversies

[edit] Water-related weight loss

In the first week or two of a low-carbohydrate diet a great deal of the weight loss comes from eliminating water retained in the body (many doctors say that the presence of high levels of insulin in the blood causes unnecessary water retention in the body).[[113]

[edit] Exercise

John McDougall, a physician, diet book author, and advisory board member of the [119]

[edit] Vegetables and fruits

Many critics[[125]

Contrary to the recommendations of most low-carbohydrate diet guides, some individuals may choose to avoid vegetables altogether in order to minimize carbohydrate intake. Low-carbohydrate vegetarianism is also practiced.

Raw fruits and vegetables are packed with an array of other protective chemicals like vitamins, flavonoids and sugar alcohols. Some of those molecules help safeguard against the over-absorption of sugars in the human digestive system[129]

[edit] Micronutrients and vitamins

The major low-carbohydrate diet guides generally recommend multi-vitamin and mineral supplements as part of the diet regimen which may lead some to believe that these diets are nutritionally deficient. The primary reason for this recommendation is that if the switch from a high-carbohydrate to a low-carbohydrate, ketogenic diet is rapid, the body can temporarily go through a period of adjustment during which the body may require extra vitamins and minerals (the reasons have to do with the body’s releasing excess fluids that were stored during high-carbohydrate eating).[citation needed] In other words, the body goes through a temporary “shock” if the diet is changed to low-carbohydrate dieting quickly just as it would changing to a high-carbohydrate diet quickly. This does not, in and of itself, indicate that either type of diet is nutritionally deficient.[citation needed] While it is true that many foods that are rich in carbohydrates are also rich in vitamins and minerals, there are many low-carbohydrate foods that are similarly rich in vitamins and minerals.[130]

[edit] Glucose availability

A common argument in favor of high-carbohydrate diets is that most carbohydrates break down readily into glucose in the bloodstream and, therefore, the body does not have to work as hard to get its energy in a high-carbohydrate diet as a low-carbohydrate diet. This argument, by itself, is incomplete. Although many dietary carbohydrates do break down into glucose, most of that glucose does not remain in the bloodstream for long. Its presence stimulates the beta cells in the pancreas to release insulin which has the effect of causing about 2/3 of body cells to take in glucose, and to cause fat cells to take in fatty acids and store them. As the blood glucose level falls, the amount of insulin released is reduced; the entire process is completed in non-diabetics in an hour or two after eating.[132]

In addition, this claim neglects the nature of the carbohydrates ingested. Some are indigestible in humans (e.g., cellulose), some are poorly digested in humans (e.g., the amylose starch variant), and some require considerable processing to be converted to absorbable forms. In general, uncooked or unprocessed (e.g., milling, crushing, etc.) foods are harder (typically much harder) to absorb and so do not raise glucose levels as much as might be expected from the proportion of carbohydrate present. Cooking (especially moist cooking above the temperature necessary to expand starch granules), and mechanical processing, both considerably raise the amount of absorbable carbohydrate and reduce the digestive effort required. Analyses which neglect these factors are misleading and will not result in a working diet, or at least one which works as intended. (See Catching Fire, Richard Wrangham)

In fact, there is some evidence that the human brain – the largest consumer of glucose in the body – can operate more efficiently on ketones.[133][not in citation given]

[edit] Other controversies

In 2004, the Canadian government ruled that foods sold in Canada could not be marketed with reduced or eliminated carbohydrate content as a selling point because reduced carbohydrate content was not determined to be a health benefit, and that existing “low carb” and “no carb” packaging would have to be phased out by 2006.[citation needed]

Some variants of low carbohydrate diets involve substantially lowered intake of citation needed] For example, this has been a criticism of the Induction phase of the Atkins diet (the Atkins diet is now clearer about recommending a fiber supplement during Induction). Most advocates today argue that fiber is a “good” carbohydrate and encourage a high-fiber diet.

It has been hypothesized that a diet-related change in blood acidity can lead to bone loss through a process called ketoacidosis, as mentioned earlier in this article. However ketoacidosis, which is often confused with ketosis, is an acute medical condition caused by extreme fasting or as a symptom of untreated diabetes, and is not likely to be induced by an otherwise adequate low-carbohydrate diet.

One of the occasional side effects of a ketogenic diet is a noticeable smell of ketones in the urine, perspiration, and breath.[134] This is caused by the presence of larger than usual amounts of the three ketone bodies normally produced during fat metabolism. One of the ketone bodies, acetone, is released via the lungs and has a characteristic smell of overripe fruit or nail polish remover. In most cases, periodic ketosis (as occurs between widely separated meals) does not cause a noticeable odor.

[edit] See also

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    Cutting out starchy foods, or any food group, can be bad for your health because you could be missing out on a range of nutrients. Low-carbohydrate diets tend to be high in fat, and eating a diet that is high in fat (especially saturated fat from foods such as meat, cheese, butter and cakes) could increase your chances of developing coronary heart disease.
    …
    So, rather than avoiding starchy foods, it’s better to try and base your meals on them, so they make up about a third of your diet.
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    Do not follow a low carbohydrate diet for purposes of weight loss. These diets tend to be high in saturated and trans fats.
    …
    Based on what is known about nutrition and health, some of the concerns with low carbohydrate diets include an increased risk of heart disease, stroke, high blood pressure, bone mineral loss, gout (a type of arthritis), and kidney stones.
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[edit] Further reading

  • Gary Taubes: Good Calories, Bad Calories: Challenging the Conventional Wisdom on Diet, Weight Control, and Disease (US title), Knopf (2007), ISBN 978-1-4000-4078-0.
  • Eades, Michael R.; Eades, Mary Dan: Protein Power: The High-Protein/Low-Carbohydrate Way to Lose Weight, Feel Fit, and Boost Your Health—in Just Weeks!, Bantam Books, 1999, ISBN 978-0-09-192428-7.
  • Bowen, R.: The Endocrine Pancreas, Colorado State University: Hypertexts for Biomedical Sciences, 8 December 2002.
  • Johns Hopkins Medicine, Epilepsy Center: Ketogenic Diet Center
  • Banting, William: Letter On Corpulence, Addressed To The Public, 4th, London, England: Harrison, 1869.
  • Bowden, Jonny: Living the Low Carb Life: From Atkins to the Zone, Sterling Publishing, February 2004, ISBN 978-1-4027-1398-9, 352pp.
  • Carr, Timothy P.: Discovering Nutrition, Blackwell Publishing, October 2002, ISBN 978-0-632-04564-8.
  • Freeman, John M., Kossoff, Eric H., Freeman, Jennifer B.: The Ketogenic Diet: A Treatment for Children and Others with Epilepsy, Fourth edition, Demos Medical Publishing, October 4, 2006, ISBN 978-1-932603-18-7.
  • v
  • t
  • e
Diets
Basic types
  • No-carbohydrate (carnivore)
  • Omnivore
  • Vegan
  • Vegetarian
Religious diets
  • Kashrut (Jewish)
  • Buddhist
  • Hindu
  • Islamic
  • Ital (Rastafari)
Specific restrictions
  • Calorie restrictions
  • Gluten-free
  • Gluten-free and casein-free
  • Low-carbohydrate
  • Low-fat
  • Low-sodium
  • Very-low-calorie
  • Low-glycemic
Other diets
  • Atkins
  • Fruitarian
  • Macrobiotic
  • Paleolithic
  • Raw foodist
  • Raw vegan
  • Semi-vegetarian
  • Slow carb
List of diets

 

Source: Wikipedia


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