Chewing the fat: the low-carb diet phenomenon

Townsend Letter for Doctors and Patients, August-Sept, 2003 by Stephen Byrnes

Richard Allen knew something was very wrong. In the late 1980s, the graphic designer and father of two suffered a heart attack at the age of 35. Thankful that he survived, Richard followed his doctor's instructions to the letter to avoid another heart attack and to avoid making a widow of his wife.

"I did everything they told me. I took my medications religiously. I exercised more. And I followed a low-fat, low-cholesterol diet. I stopped eating eggs (too much cholesterol). I cut back on meat and trimmed all the fat off what little meat I did allow myself. I started eating more fruits, vegetables, and whole grains and avoided butter. It was not exactly the tastiest diet, but I figured I was helping to preserve my health, so it was worth it."

In 1995, however, something unexpected happened: "I went in for a routine check-up and some blood was drawn for some tests. I was stunned to find out that my blood sugar levels were extremely high and I was subsequently diagnosed with adult-onset diabetes. I was dumbfounded. I had done everything they told me. I thought I was living and eating healthy and here I was a diabetic who now needed to take a new set of medications for a new disease."

Several years later, his blood sugar elevated and recalcitrant, Richard was taken off the oral diabetes meds and put on injection insulin--all the while following the dietary advice he'd been told would make and keep him healthy. Frustrated, confused, and overweight, Richard ran into an old friend who had recently changed her diet to include more animal fats and meat and exclude most grains, starchy vegetables, sugar and junk food. The friend had seen marked improvements in her and her family's health and invited Richard to a picnic near Sydney, Australia, put on by people following the "Optimal Diet," a high-fat, low carbohydrate diet developed by a Polish medical doctor.

Intrigued, Richard attended and met several of the diet's devotees, as well as a visiting naturopath who successfully utilised low-carb diets in his practice, and Dr. Bogdan Sikorski, a pharmacologist/ toxicologist. Collectively, they answered Richard's questions and testified enthusiastically as to the diet's effectiveness for a number of conditions, including heart disease and diabetes. After meeting with a Polish medical doctor who was on the Optimal Diet himself, Richard decided to abandon his low-fat/high carb diet ("What good had it done me anyway?" Richard exclaimed) and adopt a completely different way of eating.

Not Just for Weight Loss

Richard's story is not unusual. In recent years, there has been an explosion of lay and professional interest in low-carb diets. The public, disillusioned with the supposed effectiveness of low-fat diets and facing ever-climbing rates of obesity and diabetes, have been embracing starch-free diets in droves. Though the diet has been mostly associated with weight loss, practitioners and scientists alike are discovering the benefits of low-carb diets for a number of diseases--from multiple sclerosis to diabetes.

Low-carb diets are nothing new. Throughout history writers such as Anthelme Savarin, (1) William Banting, (2) Vilhjamur Stefansson, (3) and Weston Price, (4) in one way or another, all advocated lower carb diets. In more recent times, Drs. Richard Mackarness (5) and John Yudking both authored books espousing a lower carbohydrate intake. It is only in recent years, however, that the low-carb diet has achieved such wide and sustained popularity.

Myths about low-carb diets abound and this article will deal with several of them. It is important for readers to know that the low-carb craze is a true phenomenon, encompassing many writers and many approaches. Though each differs from the other in slight ways, the bottom line is this: To be healthy, humans need to reduce their intake of carbohydrates in any form and increase their intake of protein and fats, especially animal fats. The following is a summary survey of the various approaches to low-carb nutrition. Despite their critics, low-carb proponents stand by their nutritional recommendations as healthy and vibrant.

Dr. Robert Atkins

The most famous popularizer of low-carb diets has been American medical doctor, Robert Atkins. His book, Dr. Atkins' Diet Revolution, was first published in 1970 and has sold millions of copies. The latest revision was released in 2002 under the title Dr. Atkins' New Diet Revolution (Avon Books; 2002). Unlike earlier versions of the book, the latest revision is heavily referenced, thus ending frequent criticisms that his diet theories have no scientific basis.

Atkins' approach to weight loss is simple: Reducing your carbohydrate intake to less than 40 gms a day will induce ketosis/lipolysis in the body, a condition where the body breaks down fat instead of glucose for energy, resulting in weight loss. The allowable foods are unlimited amounts of meats, fats, cheeses, non-starchy vegetables, and limited amounts of nuts and low-carb fruits such as strawberries and blueberries. Off-limits are honey, sugar in any form, breads, grains, and all starchy vegetables like potatoes.