Carbohydrate restriction as first response for obesity and diabetes:
The AHA permits 6 tsp of added sugar for women and 9 for men; yet, it is discussed that sugar consumption is
associated with perpetuation of metabolic disease
The WHO argues obesity must be addressed through correcting behavior: patients need to eat fewer calories
and exercise more
http://www.who.int/dietphysicalactivity/strategy/eb11344/strategy_english_web.pdf on November 1, 2017.
The American College of Sports Medicine reports that regular (30 minutes/day) moderate intensity physical
activity provides only modest weight loss.
Donnelly | Med Sci Sports Exerc. | 2009
WHY LOW CARB?
1. A low carbohydrate, high fat dietary pattern compares favorably to low calorie for amelioration of:
Cardiovascular risk markers:
Renal health markers:
2. The “nutritional ketosis” induced by a low carbohydrate dietary pattern suppress appetite, facilitating
decreased caloric intake and weight loss:
3. “The lower limit of dietary carbohydrate compatible with life apparently is zero, provided that adequate
amounts of protein and fat are consumed.”
4. Nutritional ketosis not the same as ketoacidosis:
5. Regardless of degree of glycemic control, insulin resistance is associated with cardiovascular disease:
6. The evidence for sugar, not salt as etiological in hypertension and cardiometabolic disease; we are worried
about “The wrong white crystals”
WHY HIGH FAT?
1. Dietary fat restriction has not been proven to reduce cardiovascular risk
2. Saturated fat consumption has not be proven to cause cardiovascular disease
meta-analysis of 4 RCTs, the most recent of which was published in 1983 and was conducted in a Finish
hospital for patients with psychiatric illness. Sacks | Circulation | 2017
3. Replacing dietary fat calories with carbohydrate calories is associated with lower HDL, and higher serum
triglycerides and small-dense LDL subfraction; this triad is called atherogenic dyslipidemia and is associated with
increased cardiovascular risk
4. Carbohydrates, not dietary fat, increase serum triglycerides:
5. Serum triglycerides, HDL and small-dense LDL subfraction predict 5 year myocardial infarction risk but LDL
does not; on the other hand, decreased LDL is a marker of treatment response to statin therapy and predicts
myocardial infarction risk reduction
6. It is “oxidized small-dense LDL”, that is pathogenic for atherosclerosis, not LDL-C:
In this section, useful books for further reading will be proposed.
1. Is a low carb dietary pattern safe in the setting of chronic renal failure?
Licensing: All work on MetabolicHealth.ca is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
- The content on MetabolicHealth.ca is for your information only, should not be taken as a medical prescription and does not replace the individualized care and direction provided by your doctor or nurse practitioner.
- Please consult your healthcare provider prior to making any significant lifestyle changes, especially if you are on medications that may be affected by a change in your dietary pattern like those that lower blood pressure or blood sugar.