A second excellent review article was also published in Nutrition Today by Volek (again!) and Phinney, the low carb gurus. What I should be doing in this blog is simply drawing your attention to this good work and you can go and check it out for yourself. Let’s start with the Nutrition Today paper by Volek and Phinney, which is a nice synthesis of the available evidence for the biology of human energy regulation and homeostasis, and how a carbohydrate restricted diet operates. Saturated fat levels in the blood are not associated with dietary saturated fat intake, but dietary carbohydrate intake.
They show a nice little diagram, which I have reinterpreted and redrawn below, to show the role of dietary carbohydrate in metabolic (dys)function. Carbohydrate restricted diets are a legitimate and well documented approach to the treatment of a wide range of issues. There is now strong evidence to show that low carbohydrate diets are safe and effective treatments for several conditions, and have some likely positive effects for other conditions. Remember metabolic health is driven by diet, exercise, stress and the presence or absence of other toxins int he environment. The problem, I think, with that post is that you mostly talk about short-term studies that indeed show higher insulin load for carb meals.
For example, this systemic review looked at different dietary approaches to T2D and concluded that the Mediterranean diet works the best. I agree people do better on modest carb restriction especially compared with the standard American diet.
The major studies you quote a re all good but still have to be careful abotu what low carb means in these meta analyses.
Also that producing more ketones might have other beneficial effects on cognition, sleep, inflammation in general etc etc which all need further work. OK, perhaps best we can say at the moment is that there are no health harms in more severe carbohydrate restriction and that it may better for people with insulin resistance. I’m trying to reconcile accounts of the low carb diet that come from people using it to treat kids with epilepsy (about the only medically approved use as far as I can see and then used for a fraction of the kids it could benefit) and the account of sites like yours.
The epilepsy dieticians describe it as pretty challenging – lots of butter,cream, very restrictive, few vegetables, constipation, need for nutritional supplements, something that is hard to do but worth it because having dozens of fits a day is far worse. Seems to me one big difference is limit put on carb intake – the epilepsy lot say about 25 gm a day any more than that and you are likely to tip out of ketosis rapidly fill up glycogen stores and put on weight. All 66 subjects received a ketogenic diet consisting of less than 20 g of carbohydrates in the form of green vegetables and salad and 80–100 g of proteins in the form of meat, fish, fowl, eggs, shellfish and cheese.

All 83 subjects received the ketogenic diet consisting of 20 g to 30 g of carbohydrate in the form of green vegetables and salad, and 80 g to 100 g of protein in the form of meat, fish, fowl, eggs, shellfish and cheese.
However, one disappointing aspect is that we have only really lost 1-2kg each in the 6 weeks we have been doing this.
A new study that looked at which diets work best for kids found that compared to portion control and low-glycemic index (GI) diets, low-carb diets work just as well for weight loss, but are more difficult for kids to stick with long-term. The study also showed that low-GI diets, which promote foods like fruits, vegetables and whole grains yielded similar weight-loss success, but showed greater long-term compliance a year later.
Since long-term habits are the foundation of healthy living, Ludwig and his colleagues focus on choosing the right combination of foods to limit hunger and overeating, rather than encouraging people to eliminate entire classes of nutrients, like carbohydrates. But as the study’s findings show, there are plenty of obstacles that keep kids and families from sticking to healthy habits long-term. The challenge is even more intense for inner city and low-income families, who may live in “food deserts” where fast food restaurants and convenience stores prevail, and quick access to fresh fruits, vegetables and whole grains is limited. For more information on Boston Children’s Hospital’s work on preventing obesity and helping children achieve healthy weight, visit the New Balance Foundation Obesity Prevention Center Boston Children’s Hospital.
As these diets continue to rise in popularity, so does the number of people experiencing many of the potentially negative side effects. If you want more depth and how-to on this topic, we’ll be doing a complete master class on low carb diets in the Rebooted Body Inner-Circle. What happens is that guys like Volek and Phinney put in heaps of work, often that work is paid for by either public institutions, or by research grants gained through public funds. It is interesting that the majority of practicing dietitians, endocrinologists, cardiologists, and public health physicians have never heard of any of this. This is a comprehensive scientific review of the evidence and emerging evidence for the treatment and prevention of a range of chronic diseases with carbohydrate restricted (ketogenic) diets. Ive been doing my own low carb thing and have really noticed an improvement in overall energy levels and mood. I think this is not 100% in-line with longer studies that show improvements in metabolic health even in diets that are higher in carbohydrates.
Again the low-carb was still fairly high in carbs (<45%) and the results favored the lower carb diet. Especially keeping in mind that sticking to a ketogenic diet is probably much harder than sticking to a moderately carb restricted diet. The extent to which most people do better on a ketogenic diet to a lower carb one is debatable.

Polyunsaturated and mo- nounsaturated fats (5 tablespoons olive oil) were included in the diet. Price-trained GP where I live (who often recommended ketogenic diet to patients) to see if his methods could assist me.
The traditional way of eating as per the food Pyramid was not working for me, I was gaining weight while starving myself. I find a low carb higher fat diet makes me feel more energetic and is perfect for fat lose and muscle retention!
This diet is part of the innovative clinical research conducted by David Ludwig, MD, MPH, director of the New Balance Foundation Obesity Prevention Center Boston Children’s Hospital, and its Optimal Weight for Life (OWL) Clinic. Ultimately, this method makes it easier for a child to accommodate his or her personal and cultural preferences, allowing the diet to more easily become a lifestyle.
Boston Children’s Hospital’s OWL clinic does just that, by offering a multidisciplinary team to provide patients with customized, age-appropriate weight management at both the Children’s Hospital Longwood campus and its suburban location in Waltham, MA. That paper concluded that as long as one sticks to low GI carbs and good quality fats dietary composition doesn’t matter that much.
Gradually, the amount of carbohydrate is raised from the original 20 to 40 g in order to supply sufficient glucose to sustain the cells with few or no mitochondria such as erythrocytes, cornea, lens, renal medulla and leukocytes. Twelve weeks later, an additional 20 g of carbohydrate were added to the meal of the patients to total 40 g to 50 g of carbohydrate. When you find the right gear, however, suddenly that effort pushes you forward more efficiently.” The same is true for choosing the right weight-loss plan for a child. I’ve also read several studies comparing MUFAs to low GI carbs for insulin resistance. From analysis of my diet (on Foodworks) it looks like some days my carb intake was around 20g, other days around 50g.
It’s just pretty alarming that obesity rate  in here in the US sky rocketed this past few years.

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