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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 discuss in detail what the keto-adapted (fat adapted) state is; how this comes about, including increased beta oxidation of fat, decreased hyperinsulinemia, and a reorchestration of substrate utilization in the body, including the use of ketones to fuel brain function. 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. The latest and most talked about nutritional development is the trend of endurance athletes experimenting with high fat, low carb (HFLC) diet. The basic idea behind the diet, is that fat as an energy source yields more energy than carbohydrates, therefore prolonging our aerobic performance level. Quality high intensity training requires higher CHO intake (although endurance events are primarily aerobic, there will always be periods of the race completed at higher intensity, and also high intensity performance gains in training will require CHO), for this I would and always advise the main component of the diet to be CHO. While weight loss may be a factor in determining some level of performance gain, this should not be the primary goal of training and a balanced diet met with regularly prescribed exercise is more beneficial for the body. Also read between the lines in some HFLC articles, a lot of athletes who are claimed to use HFLC diet have often made alterations to their diet to become more efficient at utilising fat, or moving towards cleaner more refined form of carbohydrates. Ultimately performance gains should be driven by training and adaptations to progressively challenging loads, diet should be used to support this, not the other way around.
Either way, as research continues to delve into this diet you will find articles to support it, and for every one probably more to oppose it.
The verdict"The theory of the alkaline diet is that eating certain foods can help maintain the body's ideal pH balance (acidity levels) to improve overall health. 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.
This is true to an extent, but what this diet (in my opinion) does is sends athletes the wrong message about the types of training we should be doing in conjunction with HFLC. The plan recommends three snacks a day from an extensive list, including crisps and chocolate, two meal replacement shakes or bars and one regular meal, taken from a list of recipes on the Slim-Fast website.You can stay on the diet for as long as you want, depending on your weight loss goal. We’re concerned that this diet promises such a large weight loss, up to 13lb, in the first two weeks.
That paper concluded that as long as one sticks to low GI carbs and good quality fats dietary composition doesn’t matter that much. Not too long ago a similar study was done in adule male with acne and showed 296% higher insulin level in OGTT as compared to men with clear skin. 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. While research is being done, and numerous well-known athletes attest to the benefits of the diet, the science is not conclusive (opposed to a higher CHO diet). I find these athletes often then become very driven by volume and reduce the quality, higher intensity training that we all need to improve specific aspects of our performance. Look after your body and make sure training and diet are planned to support the specific changes you need to make in performance. Once reached, you’re advised to have one meal replacement shake a day, up to two low-fat snacks and two healthy meals. 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. You’re encouraged to eat food with 5% or less fat, with the exception of oily fish, porridge oats and lean meat.A network of local Rosemary Conley clubs offers weekly exercise classes, support and motivation.
Carbs are off limits except for a small amount of oat bran.The next three phases of the plan see the gradual introduction of some fruit, veg and carbs, and eventually all foods.

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