Are low Carbohydrate (Ketogenic) Diets the right way for weight loss?


A ketogenic diet is a high protein/ high fat diet with very low carbohydrate consumption. There are many claims that promote the diet leads to weight loss and reduction in cardiovascular diseases such as Atherosclerosis (hardening of arteries due to cholesterol deposition), Stroke and Myocardial infarction (Heart Attack) by reducing the overall cholesterol and triglyceride level. Popular diets such as Atkin’s diet, Modified Atkin’s diet, Zone diet, Protein powder diet work on the same principle which makes us wonder is carbohydrate really the villain here? Read on to find out.

Rationale behind low carbohydrate diets:

The main rationale behind the low carbohydrate diet is eating carbohydrates leads to insulin production which further makes us hungry and increases the triglyceride levels as well.

    People on low carbohydrate diet tends to lose weight because of two reasons:

a.            Reduced calorie intake: approximately 500 calories/day.

b.            Loss of water weight: Low carb diets mobilize liver glycogen stores with water and due to ketone bodies production, there is initial diuresis (loss of water through urine) which gives 2-3kg weight loss in first week.

 

What does evidence say about low carbohydrate diets?

1.                 The Coronary Artery Risk Development in Young Adults (CARDIA) study conducted among 2909 adults between 18-30 years of age found

a.   NO correlation between fat intake and cardiovascular diseases.

b.   High protein intake leads to high BMI, high insulin levels and decrease in triglycerides and also good cholesterol

c.   High Fiber intake leads to low insulin level, low BMI, low blood pressure, low Triglycerides and a high good cholesterol level.

 

2.                Another study following 42,524 women in Breast Cancer Detection demonstration project found that women who consumed low saturated fats with high carbohydrates and more fiber had a lower mortality rate due to heart disease and stroke.

3.                 The Nurses’ Health Study supports similar results suggesting women who consume a lot of fruits and vegetables (6 servings per day) are at lower risk of stroke and cardiovascular disease.

 

How does Fiber fights Obesity?

  • ·      It gives a sense of fullness.
  • ·      It is low in calories.
  • ·      It keeps down the glycemic index of food. Glycemic index is the rise of blood sugar that you get when you consume any food. A lower glycemic index helps with controlling blood sugar level.

 

What about High protein Diets?

  • ·      Keto diets are generally high protein with low fat diets.
  • ·      A problem with high protein is development of renal disease in the long run.
  • ·      Another problem is high protein diet leads to increase in urine calcium level (hypercalciuria) which further manifest as kidney stones and osteoporosis.

 

Is High Carbohydrate Diet the right way to go?

  • ·      Diets like Ornish diet support High carbohydrate and extremely low-fat intake.
  • ·      The main problem with this diet is with reduction of LDL (bad cholesterol) and Total Cholesterol, there is also reduction of HDL (good cholesterol) with increase in triglycerides unless there is weight loss.
  • ·      Thus, a high Carbohydrate Diet will NOT be the right way to go as well. Moderation plays an important role here.

 

Choosing an Optimum Diet

A balanced diet such as Mediterranean diet will be a good optimum diet for prevention of heart disease. It contains moderate amount of carbohydrates; proteins and it is low in saturated fats and simple sugars. It is high in unsaturated fats (PUFA) and High in fiber recommending more consumption of fruits and vegetables.

 

References:

  1. Ludwig DS, Pereira MA, Kroenke CH, et al. Dietary fiber, weight gain, and cardiovascular disease risk factors in young adults. JAMA. 1999;282:1539–1546.
  2. Liu S, Stampfer MJ, Hu FB, et al. Whole‐grain consumption and risk of coronary heart disease: results from the Nurses' Health Study. Am J Clin Nutr. 1999;70:412–419.
  3. Kant AK, Schatzkin A, Graubard BI, et al. A prospective study of diet quality and mortality in women. JAMA. 2000;283(16):2109–2115.
  4. Pickering, T. G. (2002). Diet wars: from Atkins to the Zone. Who is right?. The Journal of Clinical Hypertension, 4(2), 130. 

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