101 Cooking For Two - Everyday Recipes for Two: Thoughts about Low Carb Diets

Friday, January 1, 2010

Thoughts about Low Carb Diets

While internal medicine is not may area of expertise, my training as a physician and years of experience gives me some ability to evaluate matters of medicine, nutrition and science. So here I go.

Almost any diet can succeed if followed completely. Almost all depend on calories in vs. calories out. The trouble comes in following them.

The Traditional Low Fat Diet seems to make a lot of sense, at less superficially.
Fats have high caloric density. 9 calories per gram vs. 4 calories/gram for carbs and protein. Help in the calorie in side of the equation.
Fats will obviously go directly to fat on your body. No not really. Lots of metabolism to go on first.
Lower fat foods frequently are very high in carbs. Many of these carbs simple in their composition. Not a good thing. They stimulate your appetite and make you hungry.

Low carb diets work though control of insulin levels. Simple carbohydrates are digested rapidly and leads directly to increase serum glucose levels. The natural response by the body is the release of insulin. This drives the glucose levels down. Evolution has designed us to have a more nature type diet that would be much lower in these simple carbs (read low glycemic load), so our bodies is programmed to respond to a diet of more complex carbs/protein/fats. This would require a higher insulin response than responding to just simple carbs. So the body responds like it was programed. Too much insulin is released for the simple carbs. The blood sugar level drops rapidly and too far. Now your hungry again. You eat more. Over and over. Problem #1.
Now for problem #2, the insulin acts as a key letting the sugar into to cells that will ultimately lead to fat production to store those calories for the long cold winter. You eventually have persistently high insulin levels, markedly elevated body fat deposits and lots of other effects. This is what we physicians now call metabolic syndrome. This is the epidemic sweeping America and what will ultimately lead to decreased life expectancy in the USA along with the back breaking cost to society. And I have not even mentioned the personal costs to you and your family. By keeping simple carbohydrates to a minimum, blood glucose levels don't peak. You don't get hungry nor "graze". A good thing. See my glycemic discussion for more.

Back to the calorie in/out issue. Long term studies in real journal are now showing that low carb diets lead to less total caloric intake and longer long term weight loss. Good things also.

Now I will probably insult some people. The low carb community seems to frequently connect to a lot of alternative medicine wackiness. If it is against organized medicine, it must be right and all organized medicine is only about profit and is a massive conspiracy. If you believe this, GO AWAY. I'm busy. I will not respond to your messages, your comments will not be posted. Having spent over 30 years in organized medicine, I will tell you that the vast majority of physicians and medical organizations are interested in doing the right thing. Yes, they (including me) make a living from our work. Your get paid for your work also.

Yes, I'm a doctor. But as my daughter states in her blog "but I'm not your doctor". Don't ask me medical questions. If I respond, I will only refer you back to your primary care provider(PCP).

I can't recommend any "good sites". The more commercial the site, the more wacky some of them seem to be.

If you are considering a significant change in your diet, my general recommendation is to talk with your PCP. If you want to read something, I like the new South Beach book. And reading the Atkins book has only a little value due to the  wackiness there.

This blog is for my entertainment and that of others. Eating my caloric heavy Chicago style deep dish pizza every day will not make you healthy. But I enjoyed the exercise of modifying a recipe and seeing how it works. Hopefully you will find these posts entertaining. That is why they are here.

Briefly put, this blog is for entertainment only. Any health discussions will be about me. Any dietary recommendations are about what I'm doing for me. Not about you. You need to have a PCP and follow their recommendations. I have one and I follow his recommendations.



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