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Sunday, 8 October 2017

Low-Carb, High-Fat Is What We Physicians Eat. You Should, Too

We have adopted this diet for ourselves and our families, for health and well-being reasons. And we continue to eat this way because we love what we eat.

Èvelyne Bourdua-Roy Family doctor at Coop de santé-solidarité de Contrecoeur

As physicians, we are concerned when we see misinformation circulating in the media, especially when it comes from health-care professionals. Therefore, we would like to rectify some points raised recently by a few nutritionists and dietitians in a letter of opinion published in a daily newspaper in Quebec

Not a 'fad diet'

First, the low-carbohydrate, high-fat diet (LCHF) is not a "fad diet." It's a way of eating that is as old as the world. Human beings evolved by eating this way for hundreds of thousands of years. In fact, humans have only been eating an abnormally high quantity of carbohydrates (bread, pasta, potatoes, rice, fruits and sweets) for about four decades.

The "restrictive" nature of this diet is often cited as a reason not to offer it to patients. It will supposedly be so difficult to sustain it that the majority of people will give up in the short or medium term.

People who choose to be vegetarians face restrictions and make choices for their own health, just like people who are intolerant to gluten. Let's not forget that people who are following a low-fat diet, the fad diet of the last few decades, also face many food restrictions, such as: avoiding whole dairy products, fatty cheeses, full cream, butter, eggs and certain cuts of meat. When it comes to health, we all make choices. The low-carb diet is no exception, and is not any more restrictive than other diets. It deserves to be offered.

The main objective of LCHF isn't rapid weight loss. LCHF is a way of eating, a way of life.

Following a low-carbohydrate diet often makes counting grams or calories unnecessary. This practice, which is so common in many approaches in the field of nutrition, can trigger an eating disorder. Rather, patients are taught to listen to their bodies, and to stop eating when they feel full. Weight loss has been shown to be more effective with low-carb diets than with the standard low-fat diet, and this occurs while feeling satiated.

One must understand that in order to get the energy required to properly function, assuming protein intakes are constant, carbohydrates must be increased if fats are drastically reduced. We favour an approach that is lower in carbohydrates and higher in natural fats than the current dietary guidelines recommend. Natural fats are present in butter, cream, cuts of whole meat, fatty cheeses, olive oil, avocados and coconut, for example.

The experience of thousands of doctors and other health professionals

Our personal and clinical experience shows that this diet is more varied, tasty and satiating than the low-fat diet proposed by the Canadian Food Guide. We are thousands of doctors across the country and around the world who have adopted this way of eating for ourselves and our families, for health and well-being reasons. And we continue to eat this way in part because we love what we eat.

The main objective of LCHF isn't rapid weight loss. LCHF is a way of eating, a way of life. Weight loss is one of the side-effects of this way of eating, and it is not always rapid. We offer this diet to our patients because it can help reverse several lifestyle chronic diseases, such as type 2 diabetes, metabolic syndrome, chronic pain and chronic fatigue, hypertension, etc.

What we see in our clinics: blood sugar values go down, blood pressure drops, chronic pain decreases or disappears, lipid profiles improve, inflammatory markers improve, energy increases, weight decreases, sleep is improved, IBS symptoms are lessened, etc. Medication is adjusted downward, or even eliminated, which reduces the side-effects for patients and the costs to society. The results we achieve with our patients are impressive and durable.

With the current recommendations, on the other hand, patients remain diabetic and still need medication, usually in increasing dosages over time. Don't we say that type 2 diabetes is a chronic and progressive disease? It doesn't have to be this way. It can actually be reversed or put into remission. Of the patients that we treat with a low-carb diet, most will be able to get off the majority or all of their medications.

Where does energy come from?

The human body mainly draws its energy from ingested carbohydrates, protein and lipids. However, carbohydrates are not essential for providing fuel. Lipids can play this role in the human body, often more efficiently. There are essential fatty acids and essential amino acids. But there are no essential carbohydrates. According to the National Academies of Science, Engineering and Medicine (U.S.), "The lower limit of carbohydrates compatible with life is apparently zero, provided that adequate amounts of protein and fat are consumed."

One of the most common myths is that carbohydrates are essential to brain function. This is false. Certain parts of the brain need glucose, possibly around 130 grams per day, but that glucose does not need to come from ingested carbohydrates. The liver can effortlessly produce the required glucose from protein and fat: it is called gluconeogenesis. However, reducing carbohydrate intake to 130 gram per day would already be a step in the right direction over what many patients are currently eating, and would correspond to a liberal form of low-carb/LCHF, resulting in real health benefits for the majority of patients.

Many of us doctors, as well as our patients, are doing perfectly well with 20 to 50 grams of carbohydrates per day, with a stable energy and mental clarity that we didn't know existed. Many high-level athletes have now also adopted this way of eating for enhanced endurance and performance, after an adequate period of adaptation.

It is true that carbohydrates can contribute to the pleasure of eating, but they are not essential to make food tasty. That being said, a well-designed low-carb diet allows for plenty of high-quality whole food sources of carbohydrates, such as vegetables, whole milk products, nuts, seeds, berries, legumes and smaller amounts of whole grains. People with diabetes can choose to eat less of them, while others without metabolic problems may choose to eat more. It's a choice. The pleasure of eating is important, indeed, but the pleasure of living a healthy life is even more important in our view.

Let's briefly mention that people who adopt a low-carb diet very frequently report a significant reduction or disappearance of their IBS symptoms, including less cramps, flatulence and bloating. We believe that it is likely, therefore, that their microbiota (intestinal flora) improves.

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Sue (this n that) said...

Thanks for this article Graham.

only slightly confused said...

It's nice to hear physicians corroborate what so many of us believe.

Valerie-Jael said...

Very interesting article. Hugs, Valerie

Carol Blackburn said...

Personally I have found all of these claims to be true. Having Fibromyalgia and Lyme disease I used to be in terrible pain constantly. Retirement and rest, stress reduction and being able to move at my own pace and not that of being in the workforce made some improvement but it wasn't until I started eating Ketogenic LCHF that I really noticed changes in my body. 1st the weight loss without doing exercise was beneficial since most exercising was out of the questions for me. Next I found that the continuous ringing in my ears disappeared, as well as most of the skin issues of sensitivity and pain when touched. I have increased mental clarity and stamina. I can say nothing bad at all about eating this way. It has been so much fun learning new recipes and even eating in restaurants is not difficult. This diet has been a blessing to me and I hope that others I know will someday try it for themselves and see.
Thanks for your post. Great!

baili said...

wonderful article and very usefully informative

RO said...

This is a wonderfully informative article that makes sense. Thanks so much! Hugs...and Happy Monday! RO

Betsy Banks Adams said...

I love pound cake --and that one looks delicious... Thanks for sharing and for the info.

I have a good blog post today about our visit to a Slot Canyon in Arizona recently... You all would enjoy seeing the pictures I think..

~Lavender Dreamer~ said...

This is so interesting. Most people react when I say I don't eat sugar...they say, oh I could NEVER do that! But we all have to find what makes us healthy and gives us energy. I can not tolerate sugar so I don't have a choice as far as that goes. I eat fruit in moderation and it tastes so much sweeter. Veggies taste well as a good glass of wine. For a 'pick me up' I eat nuts or a cheese stick. And I feel GREAT! Thanks for sharing such good information! We need to get back to basics!

DeniseinVA said...

Another very interesting read Graham, thank you!

Pat @ Mille Fiori Favoriti said...

We try to eat LCHF as much as possible. It is a healthier way to eat.

I do admit I miss potatoes, and my husband misses pasta, so we do indulge in them from time to time, but not as much as we used to years ago.

Magic Love Crow said...

This is very interesting, thank you!