The Facts About Low Carb
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Dear Low Carb Eaters and 'Concerned Corporations' (see below),
I have some VERY important and timely things to talk to you about today.
No doubt you have been exposed to the recent press coverage of statements made by an organization called "Partnership for Essential Nutrition". (You can read their full press release on their website at: http://www.essentialnutrition.org/pr1.php ) You probably heard about this group through your local Annoying Co-Worker, who made sure to bring the "big news" to your attention (loudly) in the middle of the company lunchroom. "I told you that diet was going to kill you," he or she gloated, as you tried to eat your chicken and green salad in peace. "The evidence is mounting!"
You may be interested to know that "Partnership for Essential Nutrition" was founded by Dr. Koop's people at Shape Up America! and consists of various "consumer, nutrition and public health groups". Shape Up American's non-profit statement with the FTC says they "will receive grants from concerned corporations". (Which "concerned corporations" is the question, isn't it? WEIGHT WATCHERS happens to be one of them.)
I would like to address some of the points in their release and on their website in this space. I know that this is going to be a fairly long read, but I am writing it in the hope the information will be helpful as you speak to Annoying Co-Workers or - more importantly - as you try to sort through this whole thing in your own mind. You may still decide low carb isn't for you, which is fine. But at least I'll have given you some other facts to think about. (If you want to discuss any of the points I make below or add points of your own, please visit the special section of our message board that I've set up for the purpose of discussing this.)
In fact, while I have certainly found some success with a low carb diet, I absolutely don't think low carb is for everyone.
This is not about me wanting everyone to be low carb - it's about wanting to answer the people who are determined that NO ONE should be doing low carb! It seems very clear to me - based on my personal experience, on the experience of the hundreds of thousands who have visited this site since its inception, and on the SCIENCE - that low carb can be a SAFE and EFFECTIVE method for losing weight, controlling hunger, and alleviating a multitude of physical ailments, from PCOS to IBS to high blood pressure. Why would we NOT use it as ONE of the tools to fight the current obesity epidemic? Why, indeed.
1. The press release states that the organization has "announced the findings of a comprehensive review of the scientific literature".
What does this mean? It means that they looked over a bunch of studies and have come to the conclusion that low carb is bad for you based on their take on the studies they reviewed.
Researchers are doing this kind of thing all the time. (Many of the references below are of the same ilk!) But it certainly doesn't mean "evidence is mounting" against low carb, as the media reported.
That's just spin, plain and simple.
2. They say that "this review concludes that losing weight on these extreme low-carb diets can lead to such serious health problems as kidney stress, liver disorders and gout".
Question: DID PARTICIPANTS IN ANY OF THE LOW CARB DIET STUDIES DONE IN RECENT YEARS HAVE ACTUAL KIDNEY, LIVER OR GOUT PROBLEMS in statistically significant numbers????
Now, I think this point is very, very important. 'Concerned corporations' - um, I mean, nutritionists and dieticians, are always going around saying things like,"You could have kidney problems on Atkins".
Why? Read this:
These researchers from the University of Texas concluded, after their six week study of 10 subjects, "Consumption of an LCHP diet for 6 weeks delivers a marked acid load to the kidney, increases the risk for stone formation, decreases estimated calcium balance, and may increase the risk for bone loss." (For more on this study, read this analysis by author Laura Richard .)
And yet, despite the fact that these guys say "increases the risk" for kidney stones (not enough space to deal with the bone loss issue, but when you have time, check these studies out ), researchers never actually produce any evidence that people in controlled low carb studies DO end up with kidney problems.
On the contrary, it seems that healthy kidneys adjust pretty well to a high protein diet. Take a look at this six month (vs the six WEEK ) study.
The researchers' conclusion? "Moderate changes in dietary protein intake cause adaptive alterations in renal size and function without indications of adverse effects."
Ok, you say, maybe you don't get kidney problems after six months or a year. We need long-term studies!
How's this one funded by the National Institutes of Health: eleven years of data analyzed and the researchers concluded "We observed no significant adverse renal effects of high protein consumption in women who had normal renal function at baseline. In addition, when we separately analyzed nondairy animal, dairy, and vegetable protein intake, we found no evidence of a detrimental effect of animal protein compared with vegetable protein."
Yet low carb critics keep saying, "Low Carb leads to kidney problems."
It "might" be true, it sure sounds scary, but it's just not FACT based on the results so far!
(Caveat: as Dr. Atkins ALWAYS said, if you have any type of kidney problems, low carb is NOT for you. Which is why you SHOULD get checked out and medically cleared before you start the diet. But you knew that, because you read the book, right?)
3. Their press release also states, "These diets also increase the risk for coronary heart disease, diabetes, stroke and several types of cancer." This statement is so preposterous that they should be ashamed of themselves. Let's go through each claim separately.
a. coronary heart disease
Low Carb Diets have been shown over and over again to DECREASE the markers for coronary disease risk in the majority of cases.
From Duke University: "WHILE OVERALL CHOLESTEROL LEVELS DROPPED A LITTLE MORE IN LOW-FAT DIETERS, THE LOWCARB GROUP SAW THEIR GOOD CHOLESTEROL GO UP 5 POINTS AND THEIR TRIGLYCERIDES WERE CUT NEARLY IN HALF, COMPARED TO ONLY A 15 PERCENT DROP IN THE LOW-FAT GROUP. THAT WAS PROBABLY THE MOST SHOCKING FINDING."
(This quote comes from a transcript of a video piece about the recent Duke University study on the Duke website. The transcript can be viewed here .
or you can view a high bandwidth clip by clicking here
or the low bandwidth clip here .)
The findings that HDL goes up and Triglycerides go down MARKEDLY on a low carb diet have been repeated so often that I'd have a huge list if I put all the references below. But here are a few points to think about:
Effects of low-fat, high-carbohydrate diets on risk factors for ischemic heart disease in postmenopausal women
This team found that women placed on high carb diets had higher VLDL (very low density lipoprotein the actually BAD part of "bad cholesterol"), lower HDL (high density lipoprotein or "good cholesterol"), higher total cholesterol, higher insulin levels, and higher blood glucose levels than the women who ate a lower carbohydrate, higher fat diet.
Conclusion:"Because all of these changes would INCREASE risk of ischemic heart disease in postmenopausal women, it seems reasonable to question the wisdom of recommending that postmenopausal women consume low-fat, high-carbohydrate diets."
Carbohydrate-Induced Hypertriglyceridemia: An Insight into the Link between Plasma Insulin and Triglyceride Concentrations
"The results indicated that the 60% CHO (carbohydrate) diet resulted in higher fasting plasma TG (Triglyceride) concentrations associated with higher day-long plasma insulin and TG concentrations, and lower FFA concentrations."
Effect of protein and methionine intakes on plasma homocysteine concentrations: a 6-mo randomized controlled trial in overweight subjects
Homocysteine levels where 25% LOWER in the group following a high protein diet. (A high plasma homocysteine concentration is an independent risk factor for cardiovascular disease.)
Comparison of a Low-Fat Diet to a Low-Carbohydrate Diet on Weight Loss, Body Composition, and Risk Factors for Diabetes and Cardiovascular Disease
"These data suggest that energy restriction achieved by a very LC diet is equally effective as a LF diet strategy for weight loss and decreasing body fat in overweight and obese adults." "only the LC group had a significant decrease in circulating insulin concentrations.""Group results indicated that the diets were equally effective in reducing systolic blood pressure by about 10 mm Hg and diastolic pressure by 5 mm Hg ".
Ok, you say. What of the group of folks in the recent Duke study who found bad cholesterol going UP while on low carb?
AH HA! We got you there, I hear you thinking.
This is certainly something to watch for, though it was no big news to people familiar with the diet.
Dr. Atkins had advised that some patients would be "fat sensitive" and might have to do a lower fat version of the diet. I've spoken with folks myself who found that they had to do just that. But it is good that the study brought it to the attention of those who hadn't read the book - and it does bring out the point that you should be getting monitored by your doctor while on the diet, especially in the beginning!
In addition, although long considered the "bad" cholesterol, recent research indicates that some sub-fractions of LDL are actually heart protective! Therefore, unless a special test is done to determine which sub-type of LDL went up, we don't have the WHOLE picture, do we?
Nevertheless, I'm not downplaying anything. Like I said at the beginning, low carb isn't for everyone. Get checked out, get monitored, and see if it works for you. Do a lower fat version if you need to. Anyone doing low carb right will be eating less fat and more carbs as they progress through the various levels anyway. You may just need to adjust your diet sooner than someone else, or in the most extreme case, do something else besides low carb. Whatever works and keeps you healthy!
Not exactly a smoking gun, is it?
HOW IN THE WORLD DID THEY COME TO THE CONCLUSION THAT LOW CARB INCREASES THE RISK OF DIABETES???
Conclusion: "Addition of saturated fat and removal of starch from a high-monounsaturated fat and starch-restricted diet improved glycemic control and were associated with weight loss without detectable adverse effects on serum lipids."
Diabetics Improve Health With Very High-Fat, Low Carb Diet
"By the end of the one-year study...90 percent of the patients had achieved ADA (American Diabetes Association) targets for HbA1c, HDL, LDL and triglycerides."
Or this study : "Severely obese subjects with a high prevalence of diabetes or the metabolic syndrome lost more weight during six months on a carbohydrate-restricted diet than on a calorie- and fat-restricted diet, with a relative improvement in insulin sensitivity and triglyceride levels, even after adjustment for the amount of weight lost."
Or how about this:
Compound in meat prevents diabetes
Or this: Extra Sugar Can Cause Insulin Resistance In Cells
"Our experiments show that increasing O-GlcNAc on proteins is, by itself, a cause of insulin resistance, rather than an effect or a coincidence," says Vosseller. In the body, sugar (glucose) is changed into glucosamine, which is changed into O-GlcNAc. Other scientists have shown that giving cells or animals excessive amounts of sugar or glucosamine, along with extra insulin, leads to insulin resistance. "
Or this: Lipids, Carbohydrates, and Heart Disease
"Recent studies of carbohydrate intake and its relationship to the development of type 2 diabetes and CHD (coronary heart disease) have been very revealing and their findings rather unexpected, showing that an increase in carbohydrate intake is related to an increase in both conditions. The result has been a shift from the traditional focus on fats and CHD to a more critical consideration of carbohydrate intake. These recent large studies show that increased carbohydrate intake is related to an increase in both conditions."
c. increased risk of stroke.
"The association between insulin resistance and risk for stroke has been examined in four case-control studies and five prospective observational cohort studies. Six of the nine studies are methodologically sound and provide evidence that insulin resistance is associated with risk for stroke."
Prospective Study of Fat and Protein Intake and Risk of Intraparenchymal Hemorrhage (a type of stroke) in Women
Conclusion: "LOW intake of saturated fat and animal protein was associated with an INCREASED risk of intraparenchymal hemorrhage."
And if you can find ONE good study that shows that a low carb diet raises your blood pressure, be sure to email me.
d. increased risk of cancer.
Studies have shown a slightly higher risk for people who consume a lot of red meat or for people who don't get enough fiber. But let me remind you of what I hope you already know:
NEITHER A HIGH CONSUMPTION OF RED MEAT NOR A LOW INTAKE OF FIBER IS REQUIRED ON ANY LOW CARB DIET.
A few points here:
- You should be getting your protein from a wide variety of sources.
- If you are eating the recommended amount of vegetables, and adding other high fiber foods such as flax seed, nuts, low glycemic fruit and whole grains at the appropriate time, you are NOT going to be lacking in fiber. In fact, you'll probably be eating MORE fiber than the average American!
- We do not know if the association with cancer risk and red meat has to do with chemicals in the food chain, or the properties of red meat itself. Eating meat sourced from organic/free range animals *may* be a solution.
- I always have to ask, what else did the "high red meat" group eat? Take this example:
Major Dietary Patterns and the Risk of Colorectal Cancer in Women
In this study, researchers made the distinction between two types of diets, "prudent" and "Western". (Very objective those terms are, eh? No value judgement there.) "The prudent pattern was characterized by higher intakes of fruits, vegetables, legumes, fish, poultry, and whole grains, while the Western pattern, by higher intakes of red and processed meats, sweets and desserts, french fries, and refined grains." And the 'Western' group was found to have a higher incidence of cancer.
Well, duh, of course the "Western" group was not as healthy! But was it the red meat, the sweets and french fries, or the combination of it all? I'm not a doctor or scientist, but it seems to me that in this study (as in many others) red meat isn't given a fair chance. Not if it's lumped in with french fries!!!
And again, if you're following a low carb diet properly you're eating LOTS of high fiber veggies, some fruit, some legumes and some whole grains!
Believe me, I'm not being flip here. Like you, I take this issue very seriously indeed. Both my parents died of (smoking related) cancer, and I took care of them through their horrible illnesses. I saw what it's like. And I've lost several other close relatives to cancer, including colon cancer.
But I also think about information like this:
High Carbohydrate Diet Implicated in Pancreatic Cancer
Dietary Fat Intake and Endogenous Sex Steroid Hormone Levels in Postmenopausal Women
Conclusion: "We observed an inverse association between total fat intake averaged over 4 to 5 years and estradiol levels. This result is inconsistent with the hypothesis that fat intake predisposes to breast cancer risk by raising endogenous estrogen levels."
Meat, fish and egg intake and risk of breast cancer "There was no evidence of a positive association between intake of any type of fat and ovarian cancer risk, even after adjustment of fat subtypes (ie. saturated vs unsaturated) for one another."
Bottom line: if you're concerned about red meat DON'T EAT IT. You can do the diet without it!
And if you're not getting enough fiber and you're past induction: EAT MORE VEGGIES! If you're lacking fiber you have only yourself and not the diet to blame! (HINT: skip the 'low carb processed junk food' - you can eat way more veggies and other healthy foods for the same carbs and calories, with much more fiber!)
Can you see that saying a low carb diet "increases the risk of certain types of cancer" is not telling the whole story?
4. "Of key concern is that extreme low-carb diets produce dehydration, which can stress the kidneys and increase the potential for bone loss contributing to osteoporosis."
And what, there's NO WHERE in any of the low carb diet books where it says, "Be sure to drink lots of water. Check with your doctor before starting if you take diuretics, because your doctor may need to decrease your dosage"? If this is a key concern of theirs, we're in good shape, Low Carb America. Again I have to ask, which study of low carb diets ( and there have been several six month and one year studies) showed that bunches of people got horrid metabolic imbalances from dehydration? HAS THIS ACTUALLY HAPPENED IN THE CONTROLLED SETTING?
5. "Citing new findings that consumers now spend an average of $85 a month on these products, the coalition called on FDA to quickly issue an interim policy about the use of carbohydrate claims and then enforce it."
I'm in complete agreement with them here. The FDA needs to make a ruling quickly. We all know that consumers are being taken advantage of with false label claims and confusing net carb calculations.
But that doesn't make the low carb diet a rip-off, does it? Of course not. You can do a healthy low carb diet very successfully without any processed "low carb" fast food, thank you very much. They're certainly nice for a once in a while treat, or as a fill-in for times when you can't or don't want to cook. I have a low carb candy bar or ice cream once every so often myself! But we all know that whole foods - quality proteins, veggies, nuts, seeds, whole grains and low glycemic fruit - are the basis for a healthy low carb diet.
So don't blame the diet if you don't like the products. Or you don't like the fact that consumers are spending money on them instead of something else you'd rather they bought. Either way, the diet works.
There are quite a few other myths that the Essential Nutrition website tries to keep alive - most notably the idea that low carb dieters lose water weight not fat. "In fact, a classic study reported in the Journal of Clinical Investigation found that although people tended to lose weight more quickly on low-carbohydrate diets, the additional weight loss was not fat loss but water loss due to metabolic dehydration." (http://www.essentialnutrition.org/lowcarb.php)
That's not what the Duke Study found. "Along with losing an average of 26 pounds, dieters assigned to the low-carbohydrate plan lost more body fat. "
And I have a hard time believing I've lost over 100lbs of water weight. But silly me, I'm not a scientist. What do I know?
Anyway, I've written more than I started out to - but this is such an important topic. I may write more as time allows, or I may just append to this in the forums.
Either way, I hope you got something of benefit from it, and I hope you add your comments .
(She has a pic of herself here, click on original link to view it)
Note: it's all water, I have no muscle left, I'm dying of dehydration, I can't think because I don't eat 140g of carbs a day, and I have bad breath. On the flip side, I can fit in airline seats, walk without getting winded, control my eating, don't think about food all day long, went from a size 28 to a size 14/16, and I run a website where I hear stories like mine, or better, all the time.
Poor, poor deluded me.
How cool is this lady, such a good article and huge effort!
I posted the whole thing here to make sure people read it