I believe that what represents an ideal diet varies from person to person, but one thing I’m clear about is that many health professionals and even our Governments advise intakes of carbohydrate that are greater than is good for us. In particular, while starchy carbohydrates such as bread, potatoes, rice, pasta and breakfast cereals have for a long time been promoted as wholesome, nutritious and healthy, the reality is that they tend to be disruptive for blood sugar and insulin levels in a way that can predispose to all sorts of problems including weight gain, type 2 diabetes and cardiovascular disease.
Those who traditionally criticise low carbohydrate diets have often done this on the basis of safety. This is ironic because there is actually quite a stack of evidence which shows that lower-carb diets generally lead to significant improvement in certain markers for disease including blood fat levels and measures of blood sugar status.
One such study was published this very day in the on-line journal Nutrition and Metabolism. This study took 50 overweight or obese individuals (average body mass index 33.6) and randomised them to eat one of two test diets [1]. One of these diets was relatively low in protein and rich in carbohydrate. The other was higher in protein (1.6 g of protein per kg of body weight) and lower in carbohydrate (less than 170 g of carbohydrate compared to more than 240 g in the other diet). Both diets were calorie-restricted, supplying 500 calories less per day than the amount estimated to be required to maintain stable weight. The study lasted for four months.
At the end of the study, the higher protein, lower carb eaters had lost more weight (9.1 per cent compared to 7.3 per cent of those eating more carb and less protein), though the difference was not statistically significant. The group eating less carb lost more fat than the higher carb consumers, and this difference was statistically significant (8.7 per cent v 5.7 per cent).
The improved fat loss is important here, because it serves to remind us that gross weight loss tells us nothing about what actually has been lost. For individuals who are carry extra fat, fat is the thing that is what needs shifting, and the higher protein, lower carb diet was the clear winner here. Why? Well part of the explanation may lie in the fact that the lower carbohydrate diet, in theory at least, should have led to lower levels of the hormone insulin, which happens to be the chief hormone responsible for fat deposition in the body.
Evidence which supports this concept comes from the finding in this study that the lower carb diet led to lower insulin levels after eating compared to the higher carb diet. The difference was statistically significant. Less insulin might not only mean less fat, it may well mean lower risk of type 2 diabetes in time too.
Other statistically significant benefits of the higher protein, lower carb diet were seen in the levels of triglycerides, HDL-cholesterol and LDL-cholesterol.
The authors of this study conclude: A weight loss diet with moderate carbohydrate, moderate protein results in more favorable changes in body composition, dyslipidemia, and post-prandial INS [insulin] response compared to a high carbohydrate, low protein diet suggesting an additional benefit beyond weight management to include augmented risk reduction for metabolic disease.
Common sense dictates that a generally healthy diet will be one that is similar to the diet we ate for longest in terms of our evolution on this planet. Why? Because that’s the diet we evolved to eat, and it’s therefore the diet we’re most likely to be best adapted to. It is perhaps interesting to note that primitive diets have been found to considerably less carbohydrate and more protein than the sort of diet we typically eat now [2]. It is perhaps no wonder that rates of obesity and type 2 diabetes are rising like they are. And there’s certainly an argument for returning our diet to something more primal in nature
References:
1. Walker Lasker DA, et al. Moderate carbohydrate, moderate protein weight loss diet reduces cardiovascular disease risk compared to high carbohydrate, low protein diet in
obese adults: A randomized clinical trial. Nutrition & Metabolism 2008, 5:30
2. Cordain L, et al. Plant-animal subsistence ratios and macronutrient energy estimations in worldwide hunter-gatherer diets. Am J Clin Nutr. 2000 Mar;71(3):682-92
Worryingly this mis-information (high carb, low fat) is being fed to our children through our education system – my daughter has even been encouraged to use ‘low sugar’ (half sugar half saccharine!!).
Anyone have any ideas for change?
Carol, I am also anutritionist and cannot understand where this high carb diet comes from. If you look at the huge posters they have in hospitals it is not high carb it is MAINLY Carb as all the fruits and vegetables are also carbs. Dieeticians are not allowed to think for themselves or rock the boat but why do none of them even try?
Soz53 – part of the problem is the sheer time it takes for people to change their minds along with the power of habit. When a doctrine has fundamentally entrenched itself in the consciousness of society it sometimes requires a whole generation to actually die before a truly open minded approach can pervade.
Dr John – as an aside, where do you stand on the question of grains? Having just read Michael Eades’ Protein Power Life Plan I am left wondering whether there have been any trials that have shown that they can have a detrimental effect on the health of people who are eating them….
I concur with everything you say, John, but I fail to understand why the government still propounds the low-fat and calorie counting theory as the only way to lose weight. Can you enlighten me?
For the first time in my life, I am now getting my eating pattern in order and with little effort and no feelings of hunger. I used to eat toast and marmalade or marmite compulsively; likewise, sausage rolls, cheese and onion bread and all the high carb, low value savories. I felt bloated and lethargic. I’m 58 so I’m talking about a life-time of digestive abuse.
I enjoy my food now; I eat when I’m hungry not when I think I might be hungry. I can live without the bad carbohydrates that caused me pain but will eat them without fear when out with friends when it would be churlish of me not to accept the food offered; but no guilt attached because such an occasional amount is acceptable to my body.
Thank you so much for your wonderful insight into this increasing problem of obesity( horrid word ) I would really like your opinion on why we have been so misled.
Best wishes,
Susie.
As a biochemist and nutritional therapist, I’m in agreement with you on the carbs issue and weight loss, and my clinical experience proves it. However, the majority of diabetics are being advised to “eat plenty of carbohydrates”. Moreover, the British Dietetic Association have recently posted an item on their website extolling the virtues of carbs for weight loss, under the banner “dieticians give carbs the all clear”.
The people who benefit most from the ‘plenty of carbs’ advice are the food industry, notably breakfat cereal and baked goods manufacturers, and the pharmaceutical manufacturers of diabetic drugs.
Thank you Methuselah.
Am I alone in not following the fourth paragraph of this message? Is something missing? I can’t understand it.
Kay
Word “lost” was missing there (how ironic) before “more fat” and is corrected now. Thanks.
Mesuthelah : See the book ‘Dangerous Grains’ by Brady. It is very good and connects grains with autoimmune diseases.
I agree whole heartedly with Carol, the drugs companies do rather well from diabetics being told to eat a high carb diet as I was. Now we have obesity drugs to lose the weight but still eat ‘high carb diet’. As a type 1 diabetic my excellent nutritional consultant doesn’t get any thanks for reducing my insulin intake to very little through low carb eating. from the NHS. Surprisingly I’ve lost the weight I first put on through high carb eating and I am now exactly the weight I should be for my height.
Any comment on today’s news about the statin held to be suitable for eveyone with a cholesterol count (sorry don’t know the unit of measure) greater than 4? Why would it be considered better than taking soluble aspirin 75 micro grammes daily as per Bradford Hill and Court Brown, Univ of Edinburgh research c 1944? Is there really this direct link between cholesterol and heart-attacks and strokes that makes the media and health service so excited about this latest product? Confused. EA
Elspeth
See here: http://www.drbriffa.com/blog/2008/11/10/statins-reduce-cardiovascular-disease-in-health-people-and-why-this-study-is-a-poke-in-the-eye-for-the-cholesterol-hypothesis/
I would be grateful for clarification about the type of carbohydrates referred to in this article. Does it make any difference if these are wholegrain? I understand that this slows down their digestion so that blood sugar levels do not suddenly peak. I cannot at present make out whether your views apply equally to wholegrain sources of carbohydrate.