By Stefan Ianev
The ‘Low Carb’ Diet. Does it still have its place with your clients?
Low carbohydrate diets first became popular in the early 1970s when it was brought to the public’s attention by Dr Robert Atkins and his bestselling book ‘Dr Atkins’ Diet Revolution’. Even before then, bodybuilders of the Golder Era like Arnold Schwarzenegger and Frank Zane were following low carbohydrate diets before anyone was talking about it.
The Rise & Fall of the ‘Low Carb’ Diet
In the early 1980s, low carbohydrate diets fell out of favour with the emergence of the ‘low fat’ craze. All of a sudden, dietary fat, especially saturated fats became the villain and were blamed for the rising rates of obesity as well as contributing to cardiovascular disease.
By the late 1990s, low carbohydrate diets were back in favour as obesity rates and cardiovascular disease had continued to increase.
Society’s Perception of Carbs & Fats
Fast forward another 20 years and today it is pretty well-established that it is indeed excess calories, not dependant of the macronutrients they are made up of, are the primary drivers of obesity and the associated health conditions (1).
Now, that doesn’t mean low carbohydrate diets still don’t have their place. In fact, it has been quite well documented that ‘low carb’ diets outperform ‘high carb’ diets in those presenting with insulin resistance and/or metabolic syndrome, especially in the first 6 months of the diet (2-7).
Low carbohydrate diets generally lead to greater improvement in markers associated with metabolic syndrome compared with high carbohydrate diets (2).
Insulin Resistant Populations
In these populations, low carb diets are especially effective for increasing satiety and improving dietary adherence (3-5). For example, it has been shown that overweight individuals are 53-81% more likely to overeat after a moderate or high GI versus low GI meal respectively (4).
That’s because insulin-resistant individuals have a blunted satiety response to insulin. Their brain doesn’t get the satiety signal, so they keep on eating (5).
There is also some evidence to suggest that a low carbohydrate diet may upregulate genes involved in energy expenditure in insulin-resistant individuals (6).
All this data along with empirical evidence seems to suggest that low carbohydrate diets may be more favourable for insulin-resistant individuals, whereas in those with normal insulin function it may not matter that much as long as calories are controlled.
What Constitutes A ‘Low Carb’ Diet?
There are many forms of ‘low carb’ diets such as Atkins, Keto, Paleo, South Beach etc., all with varying degrees of carbohydrate allowance. Generally, I consider a low carbohydrate diet with consuming under 100g of total carbohydrates per day, mostly from low glycemic fibrous carbohydrates. A very low carbohydrate diet, in my opinion, would be consuming below 50g of carbohydrates per day.
I would suggest experimenting with carbohydrates in those ranges while maintaining a steady calorie deficit of 30-35% and monitoring biofeedback markers such as hunger, energy, mood, and performance in the gym.
Keep in mind those suggestions are for overweight and insulin-resistant individuals only. For leaner individuals, I generally don’t recommend low carb diets unless they are trying to get that last little bit of stubborn fat off. In that case, I prefer a ketogenic diet because it may have protein-sparing effects. But that is a topic of discussion for another blog post.
The point I wanted to get across today is that low carbohydrate diets can indeed be more effective for overweight individuals, which is extremely important seeing as we have an obesity epidemic that makes up a very large percentage of the world’s population.
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Yours in health,
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- Sacks FM, Bray GA, Carey VJ, et al. (2009) Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. New England Journal of Medicine, 360(9): 859-873.
- Foster GD, Wyatt HR, Hill JO, McGuckin BG, Brill C, Mohammed BS, Szapary PO, Rader DJ, Edman JS, Klein S. A randomized trial of a low-carbohydrate diet for obesity. N Engl J Med. 2003;348(21):2082–2090.
- McClain A, et al. Adherence to a low‐fat vs. low‐carbohydrate diet differs by insulin resistance status. Diabetes, Obesity and Metabolism 2013;15(1), 87-90.
- Ludwig DS, et al. High glycemic index foods, overeating, and obesity. Pediatrics. 1999;103(3), e26-e26.
- Flint A, et al. Associations between postprandial insulin and blood glucose responses, appetite sensations and energy intake in normal weight and overweight individuals: a meta-analysis of test meal studies. British Journal of Nutrition. 2007 Jul;98(1):17-25.
- Cornier MA, et al. Insulin sensitivity determines the effectiveness of dietary macronutrient composition on weight loss in obese women. Obesity Research. 2005;13(4):703–709.
- Pittas AG, Das SK, Hajduk CL, Golden J, Saltzman E, Stark PC, Greenberg AS, Roberts SB. A low-glycemic-load diet facilitates greater weight loss in overweight adults with high insulin secretion but not in overweight adults with low insulin secretion in the CALERIE Trial. Diabetes Care. 2005 Dec;28(12):2939-41.