Low Carb Is Alive and Well

Who says the low-carb lifestyle is dead? You would never believe that after spending a weekend with experts in the field.

Indeed, most of the presentations at the Carbohydrate Restriction Conference held January 20 to 22, 2006, in Brooklyn, New York, sounded the alarm for changes to the modern high-carb diet. According to prominent scientists and physicians present, restricting carbohydrates would go far in mitigating worldwide epidemics of obesity, diabetes, cardiovascular disease and other aspects of insulin dysfunction.

Research Supports Carb Restriction

Thirty presentations covered carbohydrate restriction from all angles, including diet, food composition, satiety, exercise, enzymes and genetics. By conference end, the connection was unequivocally established between low-carb diets and metabolic health.

The scientific paradigm of this meeting was not in support of the low-fat, high-carb diets that have been in vogue over the last few decades and that are associated with the recent health crisis. Jeff Volek of the University of Connecticut called for more recognition of the tremendous volume of research showing metabolic improvement with carb-restricted diets. His research group has clearly shown the superiority of very low carbohydrate diets over low-fat diets for improving features of metabolic syndrome and nontraditional risk factors related to inflammation and circulatory disorders.

Limited Storage Space Leads to Trouble

The problem is that only a limited amount of carbohydrate can be stored in the liver and muscles. Athletes burn off the excess, but in sedentary individuals, it is converted to fat. Increased insulin production in response to high-carb diets interferes with fat burning and promotes fat deposition, thus contributing to obesity. Fat, our major energy reserve, is used only sparingly on a high-carb diet. Eventually, obesity interferes with insulin production and contributes to insulin resistance, and diabetes soon follows. Fatty blockage of blood vessels also leads to cardiovascular disease. Without regular exercise and proper nutrition, most people fare poorly on high-carb diets.

Conversely, low-carb diets can reverse metabolic problems associated with diabetes. Fat burning dominates on a low-carb diet, with needed blood glucose created from stored or dietary protein by a process called gluconeogenesis (GNG). Eventually carbohydrate cravings and appetite abate, and weight loss occurs rapidly.

Many Prestigious Attendees

This three-day meeting was organized by Richard D. Feinman and colleagues at the State University of New York (SUNY) Downstate Medical Center. Physician attendance was impressive. Mary Vernon, MD, FAAFP, CMD, of the University of Kansas at Lawrence and other clinicians extolled the beneficial effects of low-carb diets in clinical trials, including decreased triglycerides, improved insulin and blood glucose levels and increased HDL (“good”) cholesterol. Striking case studies were presented on diabetes patients who reduced or eliminated medications simply by embracing lower-carb diets. As a word of caution, diabetic patients should not switch to a lower-carb diet without first consulting with their physician, who will evaluate and likely reduce their current medication regimen.

Several well-known attendees were present at the conference. Pioneers of enzyme research were present, such as Richard W. Hanson, PhD, of Case Western Reserve University in Cleveland, Ohio, who illuminated some of the processes involved in GNG. Craig Warden, PhD, of the University of California, Davis, who studies the regulation of metabolism, presented scientific cornerstones for this largely clinical conference. Barry Sears, author of “The Zone” (Regan 1995), was in the audience. Sears believes that metabolic disorders derive from increased inflammation from unbalanced diets.

Two notable physicians present were Michael Eades, MD, and Mary Dan Eades, MD, authors of the popular book “Protein Power” (Bantam 1996). Mary Dan Eades was pleased to see such a serious gathering.

“It seems miraculous to see this many hard scientists and clinical researchers from so many countries verifying something so highly vilified. Twenty years ago, you would never have seen this. The general public needs to know that low-carb is not just a fad.”

Validation for Dr. Atkins’ Legacy

Many people still equate the low-carb approach with the Atkins diet. Indeed, Veronica Atkins, widow of Robert C. Atkins, was present at the meeting, and funds from her foundation made the conference possible. Clearly, her chief concern is in carrying on her deceased husband’s legacy.

“To see presentations from a wide array of researchers and clinicians support what Dr. Atkins experienced in his medical practice for decades was a wonderful tribute to him and his years of perseverance,” said Mrs. Atkins, who feels that her husband was vilified and should get due credit as a pioneer in the low-carb movement. For practitioners struggling to help their patients at risk, the research supporting Dr. Atkins’ clinical experience is now building. The optimism shared by participants at this meeting was palpable.

Some have expressed concern about the safety of low-carb diets. Richard K. Bernstein, MD, author of “The Diabetes Diet” and “Dr. Bernstein’s Diabetes Solution” (Little, Brown, 2005, 2003) suggested the reverse may be true:

“Low-carb diet safety has already been proven by the history of humanity,” says Bernstein. “High-carb diets are new to our history, and are suspect with regard to safety. Our human ancestors had little access to carbohydrates. There are pockets of civilization today that live successfully on fat and protein. The Inuits thrived on whale blubber and seal meat.”

Bernstein adds that low-carb diets have also been proved safe and reduced seizures in people with epilepsy. Even athletes can adapt to a low-carb diet. The recent move of the Pima Native American people from a hunter–gatherer society to a “Western” diet has taken a terrible toll on their population. The Pima people are experiencing an epidemic in obesity, diabetes and heart disease attributable directly to a diet rich in processed carbohydrates.

Getting the Public to Take Low-Carb Seriously

Many experts at the conference believe that the current epidemic of metabolic disorders results from insulin overproduction and inflammation from chronic excessive carbohydrate intake. Compiling the enormous body of data on low-carb diets and establishing clinical guidelines were noted future goals for this group.

However, the big hurdle remains getting the public, the medical establishment and public health agencies to learn more about the benefits of a lower-carb diet and to start taking lower carb eating seriously.

More Than Just Atkins

Several popular diets feature the lower-carb approach, including the Atkins Diet, the South Beach Diet, the Protein Power Life Plan, the Hampton’s Diet and the Rosedale Diet. Other diets, such as the Zone Diet and low glycemic index–based diets, recommend foods that are lower in refined carbohydrates and suggest reductions in portion size.

Many of these diets are conducted in phases: First is the induction period, where carbs are maximally restricted, followed by a maintenance phase allowing for low to moderate carbohydrate intake. Studies comparing these approaches to high-carb diets convincingly show their superiority for weight loss, improvements in glucose and insulin regulation and overall health.

Compliance and staying power are the difficulties with carbohydrate-restricted diets, which are devoid of such “comfort foods” as bread, pasta, rice, cereal and sweets. However, lower-carb diets allow a number of tasty, rich foods, such as nuts, avocados, eggs, cheese, beef, chicken and fish, and most vegetables.

Micronutrients and Lower-Carb Eating

Certain vitamins and minerals are antioxidants or anti-inflammatory agents and contribute greatly to metabolic health. However, some argue that micronutrients are more important on a high-carb than on a low-carb diet. Barry Sears contends that omega-3 fatty acids contribute greatly to reduce inflammation, while omega-6 fats are largely proinflammatory. The essential mineral chromium, which is a co-factor for insulin, can significantly reduce insulin resistance in the treatment of obesity and diabetes and consequently reduces carbohydrate cravings. Studies are underway to assess supplementation with chromium picolinate and other important micronutrients as nutritional support for lower-carb diets. The level of micronutrients needed for a lower-carb diet needs better definition.

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