Laura Schoenfeld wrote a guest post for my blog called “Is a Low-Carb Diet Ruining Your Health.” Perhaps not surprisingly, it caused quite a stir. For reasons I don’t fully understand, some people identify so strongly with how many carbohydrates they eat that they take offense when a suggestion is made that low-carb diets may not be appropriate for everyone, in all circumstances.
In these circles low-carb diets have become dogma (i.e. a principle or set of principles laid down by an authority as incontrovertibly true). Followers of this strange religious sect insist that everyone should be on low-carb or even ketogenic diets; that all carbohydrates, regardless of their source, are “toxic”; that most traditional hunter-gatherer (e.g. Paleolithic) societies followed a low-carb diet; and, similarly, that nutritional ketosis—which is only achievable with a very high-fat, low-carb, and low-protein diet—is our default and optimal physiological state.
Cut through the confusion and hype and learn what research can tell us about low-carb diets. #lowcarbdiets #myths #truths
On the other hand, I’ve also observed somewhat of a backlash against low-carb diets occurring in the blogosphere of late. While I agree with many of the potential issues that have been raised about low-carb diets, and think it’s important to discuss them, I also feel it’s important not to lose sight of the fact that low-carb diets can be very effective therapeutic tools for certain conditions and in certain situations.
With this in mind, here are 7 things I think everyone should know about low-carb diets.
#1: Paleo Does Not Equal Low-Carb, and Very Low-Carb/Ketogenic Diets Are Not Our “Default” Nutritional State, as Some Have Claimed.
Some low-carb advocates have claimed that most traditional hunter-gatherer societies consumed diets that were very low in carbohydrates. I’ve even seem some suggestions that nutritional ketosis was “the norm” for these cultures.
These claims are false.
The majority of studies have shown that traditional hunter-gatherer (HG) societies typically consume between 30–40% of their total calories from carbohydrate, though the range can vary between 3–50% depending on the population studied and the latitude at which they live. (2, 3) The only HG societies observed to eat fewer than 20% of calories as carbohydrate were those living at latitudes quite distant from the equator, often in marginalized environments where fruits, vegetables, starches, and honey were not readily available.
Yet even these cultures—such as the traditional Inuit—often made an effort to obtain carbohydrates from berries, corms, nuts, seaweed, and tubers whenever they could, as Richard Nikoley has recently detailed on his blog. What’s more, contrary to popular claims, studies have shown that it’s unlikely the Inuit spent much time—if any—in nutritional ketosis. Their high protein intake would have prevented ketosis from occurring. (5)
So, while ancestral diets were certainly lower in carbohydrate than the diet currently recommended by the USDA (45–65% of calories), they were not typically “very low” in carbohydrate (<15% of calories). With virtually no historical examples of human beings following ketogenic diets for any significant length of time, and few examples of very low-carb diets, it’s difficult to imagine how these diets could be considered our “default” nutritional state or the optimal approach for most people.
#2: Low-Carb Diets Are Incredibly Effective in Certain Situations
Lest low-carb advocates think that I am anti-low-carb, I’d like to reiterate that both the research and my clinical experience suggest that low-carb diets can be incredibly effective therapeutic tools for certain conditions.
These conditions include (but aren’t limited to):
- Overweight and obesity
- High blood sugar, metabolic syndrome, diabetes (both type 1 & type 2)
- Traumatic brain injury
- Epilepsy
- Parkinson’s disease
- Alzheimer’s disease
- Other neurological conditions
- PCOS
I have personally witnessed some remarkable transformations using ketogenic diets therapeutically in my practice. I recall an 84 year-old woman who came to see me complaining of dementia and early-onset Alzheimer’s. She was losing her memory and cognitive abilities at an alarming rate. After just two weeks on a ketogenic diet, this progression not only halted, it reversed: her memory returned, her mind was sharper, and she was far less confused and disoriented. Her family (and her doctor) were stunned, and could hardly believe the changes they were seeing.
Yet as impressive as very low-carb (VLC) and ketogenic diets can be in certain situations, that does not mean that these diets may not have some undesirable side effects over the long term—some of which we’re only beginning to understand. For example, as I discussed with Jeff Leach from the American Gut project in a recent podcast, some preliminary research suggests that long-term ketogenic/VLC diets may cause adverse changes to the gut microbiota. (6) In addition, a new paper soon to be published in the journal Cell by two Stanford microbiologists indicates that diets low in “microbiota-accessible carbohydrates (MACs)” contribute to modern, inflammatory disease. (7)
The phrase “microbiota-accessible carbohydrates” refers to the various fibers found in fruits, vegetables, starchy plants, nuts, seeds, legumes, and other foods that are poorly absorbed by us, but can be utilized as a food source by our intestinal bacteria. It’s worth noting that many of these fibers are found in foods with moderate to high carbohydrate content—foods that would typically be excluded on very low-carb diets.
It’s important to note, however, that the beneficial bacteria-starving effects of ketogenic/VLC diets can be at least partially offset by consuming non-digestible, fermentable fibers like resistant starch and non-starch polysaccharides that don’t count toward daily carbohydrate intake. This is something I recommend to all of my patients following low-carb diets)
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#3: The Fact That Ketogenic/Vlc Diets Work Therapeutically for Certain Conditions Does Not Make Them Appropriate in All Circumstances, for All People
This assumption is a basic failure of logic, but it’s remarkable to see how often it happens. A person has a life-changing experience with a VLC diet, so they assume that their friend will have a similar experience. Or a clinician that works primarily with people suffering from neurological conditions has great success with ketogenic diets, and then makes the assumption that all people (regardless of their health complaints) will benefit from them.
This is akin to saying that since people with hemochromatosis (a genetic condition that causes iron overload) need to limit their iron intake, everyone should consume foods that are low in iron.
The belief that “everyone” will benefit from one particular dietary approach—no matter what it is—ignores the important differences that determine what is optimal for each person. These include variations in genes, gene expression, the microbiome, health status, activity levels, geography (e.g. latitude and climate), and more.
When it comes to diet, there is no one-size-fits-all approach.
#4: Some People Do Better with Low-Carb Diets Than Others
If you understand #3 above, then this should not come as a surprise.
Some people may thrive on a long-term, low-carb diet. I have patients and even a family member in this category. And maybe you’re one of them too. But that doesn’t mean everyone will have this experience. If you talk to practicing clinicians who work with patients on a daily basis, or spend any amount of time in internet forums or the comments sections of nutrition blogs, you’ll find numerous reports from people who either experienced no benefit from or were even harmed by following a low-carb diet.
What blows my mind is that the “low-carb zealots” seem completely incapable of accepting these reports at face value. Instead, they’ll argue that anyone who doesn’t succeed with low-carb is either doing it wrong, cheating, or somehow imagining their symptoms.
What’s the more likely explanation here? That everyone who gets worse with a low-carb diet is either incapable of following directions, weak-willed, or delusional? Or that a low-carb diet simply does not work for everyone? You be the judge.
#5: If a Low-Carb Diet Works as a Therapy in a Given Condition, That Doesn’t Mean Too Many Carbs Caused That Condition in the First Place
This is another error of logic that is often made. Here’s an example:
“A low-carb diet is effective for treating type 2 diabetes. Therefore, eating too many carbohydrates led to this condition in the first place.”
This is like saying:
- Restricting iron is helpful in hemochromatosis patients. Therefore, consuming too much iron is what caused hemochromatosis in the first place.
- A low-FODMAP diet helps patients with Irritable Bowel Syndrome (IBS). Therefore, eating FODMAPs caused IBS in the first place.
- A low-histamine diet alleviates the symptoms of histamine intolerance. Therefore, histamine intolerance is caused by eating too many histamine containing foods.
Or, more ridiculously, since wearing a cast on your arm will help the broken bone heal, the reason you broke your arm in the first place is because you weren’t wearing a cast.
It’s true that VLC/ketogenic diets are effective for improving the metabolic markers associated with type 2 diabetes. But that doesn’t mean that eating too many carbohydrates led to the condition in the first place. It is certainly possible (and indeed likely) that eating too many refined and processed carbohydrates, in the form of flour and sugar, contributes to diabetes. But I have not seen a single study suggesting that eating whole-food carbohydrates (e.g. fruit or starchy plants) leads to diabetes or other metabolic problems. On the contrary, reviews of prospective studies looking at the relationship between fruit intake and diabetes have found that those with the highest intake of fruit had the lowest incidence of diabetes. (8, 9)
It is also worth pointing out that virtually all studies performed so far showing benefits of the Paleo diet in conditions like type 2 diabetes and obesity have used moderate carbohydrate (not low or very-low carb) versions of the Paleo diet.
#6: If a Low-Carb Diet Is an Effective Therapy for a Condition, That Doesn’t Mean It’s the Only Therapy for That Condition
There’s little doubt, as I said above in #2, that low-carb diets can be remarkably effective in certain situations. For example, there are numerous studies showing that low-carb and ketogenic diets can help with weight loss and metabolic problems. (10)
However, that doesn’t mean it’s not possible to lose weight and reset your metabolism through other means. Studies have also shown that calorie-restricted diets, protein-sparing modified fasts, and even low-fat diets can also be effective treatments. (11, 12, 13)
This means that it’s not necessarily true, for example, that everyone with type 2 diabetes should be on a low-carb diet. They may be able to reverse their condition by following a high-protein, moderate-carbohydrate, moderate-fat diet (such as the Paleo diet with 32% of calories from carbohydrate in this study), or any of the methods I just mentioned.
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#7: Whole-Food Carbohydrates Do Not Affect the Body in the Same Way as Processed and Refined Carbohydrates
This should be obvious to anyone with a basic understanding of nutrition and human physiology, so I’m amazed at how often I see experts talk about all carbohydrates as if they’re the same.
In #1 above, I referenced studies indicating that most hunter-gatherer societies consumed about 30–40% of calories from carbohydrate. These carbohydrates came from starchy tubers and plants, whole fruit, and in some cases, honey. We also have evidence of specific ancestral populations—such as the Kitava, traditional Okinawans, and Tukisenta—that consumed between 70–95% of calories from whole-food carbohydrate. (14)
Yet despite this liberal consumption of carbohydrates, these people were remarkably lean, fit, and free of chronic, inflammatory diseases like diabetes, cardiovascular disease, and neurological conditions. (15) If carbohydrates cause these conditions, regardless of their source, why don’t we see such conditions in these groups?
What we do see is that these cultures acquire modern disease when they adopt a modern diet and lifestyle, complete with the highly processed and refined foods that characterize it.
When it comes to macronutrients, quality is much more important than quantity for most people.
Final Thoughts
I hope this helps to clarify some of the confusion that has surrounded this issue. Low-carb diets are an effective therapeutic tool in certain situations and one that I (and many other clinicians) use in my clinical practice. That said, it’s equally true that low-carb—and especially VLC and ketogenic—diets are not appropriate in all circumstances, and they are certainly not our “default” or optimal nutritional state.
Sadly, it doesn’t seem to matter how much scientific evidence, clinical experience, and common sense is brought to bear on this question: those who preach and follow low-carb dogma will not be swayed. Ah, well. As they say: “You can’t fight faith with facts.”
I tried the paleo diet when it first became “all the rage”. I am a small 100lb female. I was pretty strict for a month, ate absolutely no grains or sugar, but still ate sweet potatoes. Guess what happened? I lost my menstrual cycle. I don’t deny that a low carb diet can help some, but for me it obviously wasn’t healthy. It took me a few months of eating good ol’ white potatoes, brown rice, beans, quinoa, corn, and even (gasp!) bread and sugar to get my menstrual cycle back. I unashamedly eat carbs.
I’ve also found that I do better with a higher carb intake. On low carb I had very little energy, blood sugar crashes, problems with attention and focus, and adrenal issues. I am more functional and productive when I eat more carbs, able to think more easily, and feel happier and more positive to boot!
I always worry that the crabs are killing me and I’ll get dementia….because of books like Grain Brain…
Dr. Perlmutter has some valid points about grains.
Maybe you can aim for those grains lower in gluten than the intensely changed wheat now sold in the grocery store.
Plus grains are NOT the only carbs out there.
Thanks for writing this post Chris,
I’m very happy more people are starting to come out against the extreme low-carb approach. I was on a low carb paleo diet for two years untill its downsides finally caught up with me. In the beginning I had a lot more energy and my focus was increased tremendously (I have ADHD). But I found out that there IS such a thing as too low carb. I started having pain in my thyroid and liver and I lost a lot of hair. I finally found Danny Roddy’s blog and purchased “Hair like a fox” which also has some extreme advice, but it did put the whole low carb issue into a different perspective for me. I still have some thyroid and liver issues, but my hair is back to normal 😉
In short, yes, I believe that the ‘pro-low-carbers’ are taking things over board and things can be dangerous if taken to extremes. I also vote for a balanced approach. Everything in moderation.
Warmest,
L.
Here we go again! There’s is no end to theorizing about diet. Paleo is “out” and carbs are back in.
Anybody think that maybe we are just omnivorous and just eat a little bit of everything?
I have been following a low-carb, whole-foods diet since 2006 and it has turned my life around. Prior to that, for most of my adult life, I was eating a high-carb, ultra low-fat, low-protein diet with lots of processed foods. After years on that diet, I was in a lot of pain and diagnosed with Fibromyalgia. I also had lots of “female” problems (surgery for endometriosis, amenorrhea, infertility, low progesterone, high prolactin, 3 miscarriages after fertility treatment, 2 surgeries for ovarian cysts, early and rough menopause).
My pain, insomnia, and hormone problems kept getting worse until an integrative doctor suggested I try an elimination diet. I did, and within 10 days I was shocked at how much better I felt. After trying to add foods back in, I determined that carbs (even complex ones) do not agree with me.
Now I eat lean meat/fish/poultry, egg whites, olive oil, nuts low in Omega 6 (e.g., raw walnuts, macadamia nuts) , and lots of low-starch vegetables (e.g., Brussels sprouts, broccoli, asparagus, leafy greens). I eat no sugar, dairy, grains, soy, fruit, or processed foods. I eat a total of about 50 grams of carbs/per day.
Whenever I try to add more carbs (e.g., an apple or a slice of cantaloup) or even veggies that aren’t low-starch (e.g., yam or sweet potato), the old fibromyalgia symptoms return (extremely painful, knotted muscles; insomnia; fatigue).
I also get symptoms that seem to be related to insulin/blood sugar and hormones (sleepy during the day, especially about an hour after eating lunch; irritability; ravenous hunger if I go longer than 2-3 hours without eating; weight gain around waist that is disproportionate to the calories ingested; oily hair and oily skin plus pimples; increased facial hair; hair around nipples).
No one ever diagnosed the cause of my “female” problems, but I wonder if I had/have PCOS. I’ve read that low-carb helps PCOS, and it certainly helps me. I’ve never read WHY low-carb helps PCOS, though, and I wish I knew that.
Amen Cris! And Laura Schoenfeld for her article “Is a Low-Carb Diet Ruining Your Health”
Finally some sanity in the low carb debate! I too have witnessed these dogmatic beliefs on Paleo blogs including the mistaken idea that nutritional ketosis is the default nutritional state, and many of these beliefs are being promoted by MD’s.
Too high a carb diet and I don’t do well at all. But too low and I do just as poorly. Had to find the right level for me.
I’m ready to give up here…..everyone seems to have the “scientific evidence” on their side of the argument…..everyone I read has many impressive letters after their names……I eat a vlc diet and I lost the weight etc…and I get the difference between natural occurring carbs and the processed variety, but I’ve read from other “authorities” about carb intake and the effects on cholesterol and fat in the body……ie. cholesterol and fat only become an issue when combined with a diet high in carbohydrates…..regardless of the source….I’ve been reading and tinkering with my diet for years because I want to be healthy, but all this conflicting “evidence” makes me just want to give up on the whole thing!…….:P
Why not just eat and live like the oldest-living traditional cultures? They must be doing something right.
http://en.wikipedia.org/wiki/Blue_Zone
Thanks for this reminder. I loved the previous article that caused so much uproar as well. Personally, I have many reasons to keep my carbs a bit higher: I have secondary adrenal insufficiency, I am trying to get pregnant, AND I found out last spring that I am ApoE 3,4! I was eating lots of saturated fat and not paying a ton of attention to my carb intake prior to that, and since I found out my ApoE status I have really made a conscious effort to trade out some of that fat for carbs.
Let me tell you, it’s hard to do after eating low-carb for so many years! I find that I absolutely have to work in white rice or potatoes ever day (which feels “wrong” if not working out), and I still eat more fruit than I’d like. Veggies (even squash) just don’t have enough carbs to add up. Any other ideas?
My way of eating is real food and low carb. And I like South Africa Prof Tim Noake’s take on LCHF, as he recognizes it needs to be individualized. Eating fat helps with satiety, but I also find when I restrict carbs too much, my appetite seems to increase. The Jaminet’s Perfect Health Diet helped me dial in “safe carbs,” and the result for me is better satiety with the occasional apple and cheese, rice and sushi, sweet potato, and my favorite- banana egg pancakes with yogurt. Intentionally adding in such real carbs is a much better plan than dipping into a bag of corn chips or chocolate due to being hungry. Chris, thanks, your blog and Personal Paleo book has helped me greatly. The reset dramatically reduced an alcohol habit, and I am sleeping better and am more conscious of my relationships.
I believe that low carb diets work well for me, but I think I follow a low carb diet inadvertently out of lack of creativity in my own paleo diet. What are your suggestions for the best sources of paleo carbs other than sweet potatoes and fruit?
A year ago I was diagnosed with both cancer and diabetes. My A1C was almost 14, my fasting glucose was tested 311–discovered when I tried to have a Pet Scan to see if the cancer had spread beyond the lymph nodes.
So, that changed the way I eat dramatically, and I’m still working things out. I started out on insulin to get the diabetes under control and because I was going to be starting chemo. I started out with the recommendations of my Diabetes educator–losing weight was a side effect, but I noticed that as I lost weight my insulin dose was going down. (I’d lose 70 pounds over the next 9 months.) Next changes came with meeting with a nutritionist connected with the cancer treatment center who recommended 50 to 55 grams of carbs for each meal and 15 grams for snacks–she recommended one or two snacks a day. My endocrinologist feels that much carbs is to high for a diabetic and recommended 35 to 45 grams per meal, 15 for one to two snacks, for a total of 130 to 165 grams per day, and typically–I’ve been keeping a food diary for several months, I’ve been keeping to that recommendation.
This would be considered at the low end of a moderate carb diet. By the time the full course of chemo ended about 4 months later I was off insulin. My next A1C was 4.8 and I was taken off Januvia, my one oral. Three months after that I was at 5.1–but without meds. My fasting glucose has only gotten better (particularly after going off statins), Typically it’s in the mid 80s. My endocrinologist encouraged me to take readings one hour post-meals and I’ve been tweaking my meals accordingly to get them under 140. (Often reducing carbs, upping protein and fiber in a meal to reach the “safe” range.)
I’m not (yet) doing Paleo, although I have been using some ideas and recipes and am considering trying it for 30 days. I have dairy, I have grains and legumes (although in careful amounts) and I have about three servings of fruit every day–and not always “low glycemic.” I’d say the one major change I’ve made from the standard American diet is that I avoid sugar, refined flours and juices and try to eat foods as “whole” and unprocessed as possible, though I don’t bother with organic or non-GMO. And i have tons more veggies and fish than I used to.
And I’ve done very very well so far. Could I do better? Maybe. Which is why I picked up The Paleo Code and have been browsing this site. And it hasn’t even been a year since my diagnosis, But I’d note I have “reversed” diabetes–and without eating low carb–or paleo.
Yeah, I followed Paleo lifestyle for 2-3 years with good and best result in my life at almost 40 year old. Many instances when I wanna shred the last 2-3 kgs for the sake of super leanest belly 6-pack, I experiences tingly toes and fingers, cramps, and etc. Googling the net, I found it could be one of the case called euthyroid sickness syndrome. Last time I experimented 1 clean month of VLC with all the supplements mentioned in the low carb community, the symptom apparently reoccurred clearing my understanding to what Chris laid out right here. Thanks, Chris! for all info/analyzing/reasoning/clearing. Love your site and this lifestyle!
I used to be strict Paleo. After all of my neurological symptoms cleared up, the amount of animal protein in the Paleo diet started making me jittery (like too much caffeine). I felt much better after I reduced my animal consumption by 25% (roughly a meal) and replaced them with low-moderate glycemic index unrefined carbohydrates. My carbohydrate consumption is a little less than half of my total calories, with increased high quality fats replacing the lost protein.
Never felt better in my life than now. Being a doctor myself, I have seen remarkable results with people who are chronically ill go on a Paleo or neo-Paleo diet. IMHO, once a person is healthy with a strong nervous system, it is no longer necessary to go strict Paleo, although limiting the carbs to the percentage and types in the article keeps people healthy.
Can you give me examples of what your carbohydrate sources are on a regular basis? (See my comment below.) I have had to increase my carbs but find it hard to get enough.
I am an example of low-carb/ketogenic diets doing harm, so I would like to share my personal experience in the hope it may be helpful to others.
I read a book by one of the most respected writers in the Paleosphere, which unequivocally promotes a ketogenic diet as the only solution to repair adrenal fatigue and the concomitant leptin/insulin etc. dysregulation. It all made logical sense and had science to back it.
As a sufferer of 16 years of severe CFS type illness, I thought “this is it!” So I excitedly commenced my low carb/starch diet. I was not to eat anything that grew “underground”! No fruit, only a few organic berries here and there, not a skerrick of sugar! I ate loads of non starchy veg, whilst proudly congratulating myself on sticking to my healthy diet, knowing that soon all the benefits would kick in and I’d feel amazing.
Around this time I saw a new practitioner who also started me on some new treatment, which unfortunately muddied the waters. As I got sicker and sicker with the passing months, I didn’t even CONSIDER that it was my perfect diet, it must be the new treatment! I was so ill I became bedridden, so weak I could barely stand for a minute or two, yet somehow doggedly persisted in hauling myself into the kitchen to prepare my nutritionally dense food. I’m no stranger to hair falling out (chronic iron deficiency) but now I was losing handfuls at a time! My confidence was shattered. I started adding in sweet potatoes and fruit, with no change. So 7 months in, in desperation I made myself some congee with chicken broth, carrots (gasp!) and basmati rice (double gasp!)and within 2 days I had the most energy I’d had in months. I have since discovered that white potatoes are my friend and a necessary addition to my diet; I realise now I am so energy deficient my body needs simple starches in the form of whole foods as an easy energy source.
Unfortunately, by the time I came to my senses I was experiencing tenderness in the thyroid area and difficulty swallowing. A recent ultrasound revealed thyroid inflammation and nodules which led to a diagnosis of Hashimoto’s. It’s probable I have had hashimotos for a long time, but I am in no doubt the low carb diet caused this acute flare, and after months of a better diet I am still experiencing a level of fatigue I never had before. I dont think I yet understand fully how my body systems have been affected.
So it’s going to be a long road to recovery.
I’m now seeing a new practitioner who better understands the role of diet and a healthy gut, and I really appreciate writers like Chris Kresser who emphasise BIOINDIVIDUALITY! For me, this is key now, and I will in the future put more focus on how I am feeling on any given diet/treatment. And in the meantime, I am hoping to see the aforementioned keto-advocate soon acknowledging it is not for everyone. She is amazing-smart and I have so much respect for her, but I’m pretty disillusioned that her advice was so harmful to me personally.
So I’m really thankful to Chris, and others like him, for having the courage in bringing this important issue to the fore. Hopefully this will prevent other vulnerable ones from taking the same harmful course as I did, and will still take some time to correct.
Thanks Chris!
Interesting reading – soooo much information! I have no idea what carbs I eat – I flatly refuse to count! I don’t often eat junk, I am NOT a cook or a foodie (nor is my partner), my family was big so food was fuel not a big social affair and we never over ate (portion size). So, we eat basic & boring and food is about as important to me as putting fuel in my car!
The moral of this story is that I DO think my food intake can be very much improved and may help my hormonal peri-menopausal issues (dumping coffee will help too, but thats a hard one!) As to obsessively counting carbs? TOO HARD! Unsustainable (I did it once for 3 months body building trial – ate more than I ever had in my life, lost weight – I don’t have much to lose either! and get terrible). I have enough trouble trying to remember to eat at all!!!!!
Great article Chris. I would like to see you have a discussion/debate with Nora Gedgaudas( Primal Body Primal Mind) Overall her book is the best health, diet/nutrition book I’ve read. She claims to be open minded, but seems pretty dogmatic on the low carb ketogenic diet. I start experiencing leg cramps, low body temp, slow transit time of stools, and sluggishness on strict very low carb diet. Maybe even less than 125 grams of carbs.
I meant, low carbo
One thing you din’t mention is, that people who have suffered of gout should not follow a low cargo diet. If they do, they, sooner or later, are going to have a gout attack. That for sure
I see several people on here claiming that a LC diet “reversed” their T2D. I don’t think this is possible. It’s possible to control T2D with diet, but not to reverse it. If you’ve really reversed it then you can eat like an average ordinary person and not have BS issues.
Also, someone above claimed that overeating carbs causes diabetes. They must’ve not even read Chris’ article. Sheesh.
Laurel,
“If you’ve really reversed it then you can eat like an average ordinary person and not have BS issues.”
The average ordinary person in the United States (70%) is overweight and over 100 million people have diabetes or prediabetes according to the CDC.
This means almost no one should be eating like the average ordinary person regardless of whether they have diabetes or not.
When I weighed 260 pounds and was a complete couch potato, I had full blown type two diabetes.
Since my pancreas was still producing insulin, when I lost 100 pounds, began vigorous exercising and went from 35% body fat down to 12%, I found I could eat more carbs and even an occasional high carb junk food meal without pushing blood sugar levels outside normal ranges.
Does that mean my type 2 diabetes is reversed. I think so by any definition. My fasting blood glucose is never over 90 and rarely over 120 following meals. I can and have passed a glucose tolerance test. There isn’t a doctor in the country, who based on lab tests, could diagnose me today with type 2 diabetes.
However, I have zero doubts that if I go back to eating like an “ordinary” person and stop exercising, I will again develop full blown diabetes.
It’s also possible that I may have damaged my pancreas to the point that I will develop diabetes in the future regardless of what I do. I’m keeping my fingers crossed.
As to whether too many carbs can cause diabetes, it may be a matter of semantics but Chris is simply wrong about this.
Carbs don’t cause diabetes in the same way alcohol does not cause alcoholism. Some people have a genetic predisposition for type 2 diabetes in the same way there are people with a predisposition for alcoholism.
You feed an eight year old kid a two liter bottle of coke every day of his life and odds are you will eventually have a metabolically damaged fat kid or adult with a very good chance of developing diabetes.
It is exactly the same for a person who is drinking two quarts of vodka every day damaging their liver.
Too much alcohol causes fatty liver disease in an alcoholic in the same way too much sugar causes non fatty liver disease in someone with diabetes.
Everyone has different levels of how much alcohol or sugar they can tolerate before it metabolically damages them.
The best way not to become an alcoholic is to never start drinking alcohol.
Does this mean everyone should refrain from drinking a glass of wine or having alcohol in moderation? Of course not. It’s the dose and a person’s tolerance to alcohol that is relevant.
The best way to not become a type 2 diabetic (which like alcoholism is an entirely preventable disease) is to not eat highly processed manufactured carbohydrate foods.
One of the problems in discussing this is that the definition of carbs is too broad. There is a huge difference between a natural whole food carb and a highly processed carbohydrate Frankenfood.
There is a strong correlation between too much sugar, Frankenfoods and chronic preventable illness. Not so much for natural whole food carbs eaten by healthy adults.
Hi Blaine – I’m glad you were able to get healthy.
One of my grandmothers who was always a skinny little person had a very bad case of T2D to the point where she lost her eyesight and both legs. How can we say that her disease was “entirely preventable”?
Most people, eating the SAD, do not develop T2D. How can we reconile the two sides of this seeming paradox?
Don’t underestimate the genetic component. Should we blame the victim? Should we blame my old granny, who never overate that I could see, for her horrendous T2D?
Laurel,
There is a misconception that you have to be fat to develop type 2 diabetes.
In fact all you need is a fatty liver and pancreas to develop type 2 diabetes and you can do that even if you are relatively “skinny.”
There is an explosion in type 2 diabetes and heart disease in India right now with people who have a much lower BMI than the average American with heart disease and diabetes.
It’s the junk food vegetarian, high carb, high sugar, high fried foods diet that is causing Indians to have the highest heart disease rate in the world along with an explosion in type 2 diabetes.
There are two things that can explain why a “skinny” old person can develop type 2 diabetes. One is that it is actually misdiagnosed late onset type 1 diabetes which is an autoimmune disease where the pancreas is no longer producing insulin.
The other is that an older person is not eating enough calories to gain or maintain weight. However, what they are eating is an unhealthy high carbohydrate, low protein diet and because they have no muscle mass to burn off the elevated levels of blood glucose this diet causes, the excess glucose is turned to fat and stored in the liver and pancreas diminishing normal function and causing diabetes.
In other words, many older people are “skinny fat,” meaning they look skinny but they have low muscle mass. Because they are frail with no muscle mass, their body composition has a very high percentage of fat including a fatty liver and pancreas that is impairing insulin production normal liver function.
Getting enough protein and maintaining enough muscle mass is a real challenge for older people. Mainstream medicine just exacerbates the problem by prescribing diets and nutritional supplements like Ensure which is a high carbohydrate, high sugar drink which just makes the problem worse… and as the problem worsens, the doctors just go on increasing the diabetes medication as their patients go blind and body parts get amputated.
If I sound cynical, it’s because this is what happened to my parents. If I knew then what I know now, it never would have happened.
The mainstream medical approaches to treating type 2 diabetes today is equivalent to physicians who used to bleed patients or more recently cut out their stomachs to treat ulcers because it wasn’t understood that bleeding made a patient weaker and ulcers were caused by a virus and surgery could not cure.
Hope this answers your questions.
“If you’ve really reversed it then you can eat like an average ordinary person and not have BS issues.”
Laurel, I’m sure you don’t mean it, but you’ve made several remarks implying that people with diabetes aren’t normal, or like ordinary people.
I’m a Type2 and I can assure you I’m very normal and ordinary.
Low carb has given me great control over my diabetes, but I realize it hasn’t been reversed, nor have I been cured. I will have to maintained this type of eating in order to keep my BG in check.
Please choose your words in describing diabetics with a bit of forethought. We already have enough issues to deal with.
In good health. Thanks
Bill – You’re reading something that isn’t there or wasn’t posted by me.
Have been Paleo for 4 years and ketogenic (<100g/day) for 1 year. The latter resulted in a dramatic reset of my lipid panel results (dropped triglycerides and VLDL, raised HDL and LDL) but aside from another few pounds of water weight (which I no longer care about) has largely inconsequential. Was easy enough to drop the last few high GI starches, so happy to believe I've improved my risk of a host of neurological disorders. And I am eating well.