Tuesday, 2 December 2014
Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets.
Some extracts from this remarkable paper my bold text.
Although Hellerstein31 has recently reported that de novo lipogenesis contributes only ~20% of new triglycerides, this greater conversion of dietary carbohydrate into fat, much of it entering the circulation as saturated fat, is a metabolic abnormality that significantly increases risk for diabetes and heart disease. Thus, insulin resistance functionally manifests itself as ‘carbohydrate intolerance’. When dietary carbohydrate is restricted to a level below which it is not significantly converted to fat (a threshold that varies from person to person), signs and symptoms of insulin resistance improve or often disappear completely.
In studies that have evaluated well-formulated very-low-carbohydrate diets and documented high rates of compliance in individuals with T2D, results have been nothing short of remarkable. Bistrian et al.32 reported withdrawal of insulin and major weight loss in a matter of weeks in T2D individuals who were fed a very-low-calorie and -carbohydrate diet.
Although significant reductions in fat mass often results when individuals restrict carbohydrate, the improvements in glycaemic control, haemoglobin A1c and lipid markers, as well as reduced use or withdrawal of insulin and other medications in many cases, occurs before significant weight loss occurs. Moreover, in isocaloric experiments individuals with insulin resistance showed dramatically improved markers of metabolic syndrome than diets lower in fat.27 It is interesting in this respect that a recent extremely large epidemiological study reported that diabetes risk is directly correlated, in an apparently causative manner, with sugar intake alone, independently of weight or sedentary lifestyle.
The link to this paper is here.