Thursday, August 25, 2016

What Docs read about low carbohydrate diets


I paid $500 to get the latest information on medical science.  
This is what I got for my money on Low Carbohydrate Diets. 
Obesity in adults: Dietary therapy
All topics are updated as new evidence becomes available and our peer review process is complete.
Literature review current through: Jul 2016. | 
   This topic last updated: Jun 15, 2016.


Low-carbohydrate diets —  

Proponents of low-carbohydrate diets have argued that the increasing obesity epidemic may be in part due to low-fat, high-carbohydrate diets. 
But this may be dependent upon the type of carbohydrates that are eaten, such as energy dense snacks and sugar or high fructose containing beverages.
The carbohydrate content of the diet is an important determinant of short-term (less than two weeks) weight loss.

Low- (60 to 130 grams of carbohydrates) and

very-low-carbohydrate diets (0 to less than 60 grams) <60 grams="" span=""> have been popular for many years [20].

Restriction of carbohydrates leads to glycogen mobilization

 and, if carbohydrate intake is less than 50 g/day, ketosis will develop.

 Rapid weight loss occurs, primarily due to
1- glycogen breakdown and
2-fluid loss
rather than fat loss.


Low- and very-low-carbohydrate diets are more effective for short-term weight loss than low-fat diets,
 although probably not for long-term weight loss. 

A meta-analysis of five trials found that the difference in weight loss at six months, favoring the low-carbohydrate over low-fat diet,
was not sustained at 12 months [27]. (See 'Choice of diet' below.)

I looked up this (27)reference and found this chart:


 Then I looked up the original Brehm trial which went out to 2 years:

 I then went to a more recent head to head 2 year Shai Trial:




 I must say I don't think I am getting my $500 worth of UP TO DATE material.

Back to UP TO DATE article:

Low-carbohydrate diets may have some other beneficial effects with regard to
1- risk of developing type 2 diabetes mellitus,
2- coronary heart disease, and
3-some cancers,
particularly if attention is paid to the type as well as the quantity of carbohydrate.

A low-carbohydrate diet can be implemented in two ways,
 either by
1-reducing the total amount of carbohydrate or by
2- consuming foods with a lower glycemic index or glycemic load (table 3).

Glycemic index and load are reviewed separately.
 (See "Dietary carbohydrates", section on 'Glycemic index'.)

If a low-carbohydrate diet is chosen,
healthy choices for fat (mono- and polyunsaturated fats) and protein (fish, nuts, legumes, and poultry) should be encouraged because of the association between saturated fat intake and risk of coronary heart disease.

During 26 years of follow-up of women in the Nurses' Health Study and

20 yrs of follow-up of men in the Health Professionals’ Follow-up Study,

low carbohydrate diets in the highest versus lowest decile for vegetable proteins and fat
were associated with
1- lower all-cause mortality  and
2-cardiovascular mortality  [28].

 In contrast, low-carbohydrate diets in the highest versus lowest decile for animal protein and fat were associated with
1- higher all-cause and
2-cardiovascular  mortality.
(See "Dietary fat" and "Overview of primary prevention of coronary heart disease and stroke", section on 'Healthy diet'.)


ADA guideline 2013  

Jackie Boucher, MS, RD, LD, CDE, Vice President for Education, Minneapolis Heart Institute Foundation,  noted that the scientific evidence is still limited related to various eating patterns and their impact on health outcomes in individuals with diabetes. Current evidence does not strongly support one eating pattern over another. “Whether you prefer a Mediterranean, vegetarian or lower-carbohydrate eating plan is less important than finding an eating pattern that fits your food preferences and lifestyle, can be consistently followed  and that provides you with the nutrition you need for good health,” she said.
In choosing an appropriate eating plan, people with diabetes should be sure to consider individual metabolic goals, such as their glucose and lipid levels and blood pressure, the statement notes.
The new guidelines also note that there is no conclusive evidence of an ideal amount of carbohydrate intake for people with diabetes. However, the authors suggest that whatever carbohydrates are eaten should come from vegetables, whole grains, fruits, legumes and dairy products, over other sources that contain added fats, sugar or sodium. Likewise the evidence remains inconclusive for an ideal amount of total fat intake. Fat quality (eating monounsaturated and polyunsaturated fats and avoiding trans fats and saturated fats) appears to be  more important than quantity, the authors note. Although individuals working to manage their weight should still eat  even good fats in moderation.
- See more at: http://www.diabetes.org/newsroom/press-releases/2013/american-diabetes-association-releases-nutritional-guidelines.html?referrer=https://www.google.com/#sthash.rWP7ahS2.dpuf
Jackie Boucher, MS, RD, LD, CDE, Vice President for Education, Minneapolis Heart Institute Foundation,  noted that the scientific evidence is still limited related to various eating patterns and their impact on health outcomes in individuals with diabetes. Current evidence does not strongly support one eating pattern over another. “Whether you prefer a Mediterranean, vegetarian or lower-carbohydrate eating plan is less important than finding an eating pattern that fits your food preferences and lifestyle, can be consistently followed  and that provides you with the nutrition you need for good health,” she said.
In choosing an appropriate eating plan, people with diabetes should be sure to consider individual metabolic goals, such as their glucose and lipid levels and blood pressure, the statement notes.
The new guidelines also note that there is no conclusive evidence of an ideal amount of carbohydrate intake for people with diabetes. However, the authors suggest that whatever carbohydrates are eaten should come from vegetables, whole grains, fruits, legumes and dairy products, over other sources that contain added fats, sugar or sodium. Likewise the evidence remains inconclusive for an ideal amount of total fat intake. Fat quality (eating monounsaturated and polyunsaturated fats and avoiding trans fats and saturated fats) appears to be  more important than quantity, the authors note. Although individuals working to manage their weight should still eat  even good fats in moderation.
- See more at: http://www.diabetes.org/newsroom/press-releases/2013/american-diabetes-association-releases-nutritional-guidelines.html?referrer=https://www.google.com/#sthash.rWP7ahS2.dpuf



Jackie Boucher, MS, RD, LD, CDE, Vice President for Education, Minneapolis Heart Institute Foundation,  noted that the scientific evidence is still limited related to various eating patterns and their impact on health outcomes in individuals with diabetes. Current evidence does not strongly support one eating pattern over another. “Whether you prefer a Mediterranean, vegetarian or lower-carbohydrate eating plan is less important than finding an eating pattern that fits your food preferences and lifestyle, can be consistently followed  and that provides you with the nutrition you need for good health,” she said.
In choosing an appropriate eating plan, people with diabetes should be sure to consider individual metabolic goals, such as their glucose and lipid levels and blood pressure, the statement notes.
The new guidelines also note that there is no conclusive evidence of an ideal amount of carbohydrate intake for people with diabetes. However, the authors suggest that whatever carbohydrates are eaten should come from vegetables, whole grains, fruits, legumes and dairy products, over other sources that contain added fats, sugar or sodium. Likewise the evidence remains inconclusive for an ideal amount of total fat intake. Fat quality (eating monounsaturated and polyunsaturated fats and avoiding trans fats and saturated fats) appears to be  more important than quantity, the authors note. Although individuals working to manage their weight should still eat  even good fats in moderation.
- See more at: http://www.diabetes.org/newsroom/press-releases/2013/american-diabetes-association-releases-nutritional-guidelines.html?referrer=https://www.google.com/#sthash.rWP7ahS2.dpuf
Jackie Boucher, MS, RD, LD, CDE, Vice President for Education, Minneapolis Heart Institute Foundation,  noted that the scientific evidence is still limited related to various eating patterns and their impact on health outcomes in individuals with diabetes. Current evidence does not strongly support one eating pattern over another. “Whether you prefer a Mediterranean, vegetarian or lower-carbohydrate eating plan is less important than finding an eating pattern that fits your food preferences and lifestyle, can be consistently followed  and that provides you with the nutrition you need for good health,” she said.
In choosing an appropriate eating plan, people with diabetes should be sure to consider individual metabolic goals, such as their glucose and lipid levels and blood pressure, the statement notes.
The new guidelines also note that there is no conclusive evidence of an ideal amount of carbohydrate intake for people with diabetes. However, the authors suggest that whatever carbohydrates are eaten should come from vegetables, whole grains, fruits, legumes and dairy products, over other sources that contain added fats, sugar or sodium. Likewise the evidence remains inconclusive for an ideal amount of total fat intake. Fat quality (eating monounsaturated and polyunsaturated fats and avoiding trans fats and saturated fats) appears to be  more important than quantity, the authors note. Although individuals working to manage their weight should still eat  even good fats in moderation.
- See more at: http://www.diabetes.org/newsroom/press-releases/2013/american-diabetes-association-releases-nutritional-guidelines.html?referrer=https://www.google.com/#sthash.rWP7ahS2.dpuf
Jackie Boucher, MS, RD, LD, CDE, Vice President for Education, Minneapolis Heart Institute Foundation,  noted that the scientific evidence is still limited related to various eating patterns and their impact on health outcomes in individuals with diabetes. Current evidence does not strongly support one eating pattern over another. “Whether you prefer a Mediterranean, vegetarian or lower-carbohydrate eating plan is less important than finding an eating pattern that fits your food preferences and lifestyle, can be consistently followed  and that provides you with the nutrition you need for good health,” she said.
In choosing an appropriate eating plan, people with diabetes should be sure to consider individual metabolic goals, such as their glucose and lipid levels and blood pressure, the statement notes.
The new guidelines also note that there is no conclusive evidence of an ideal amount of carbohydrate intake for people with diabetes. However, the authors suggest that whatever carbohydrates are eaten should come from vegetables, whole grains, fruits, legumes and dairy products, over other sources that contain added fats, sugar or sodium. Likewise the evidence remains inconclusive for an ideal amount of total fat intake. Fat quality (eating monounsaturated and polyunsaturated fats and avoiding trans fats and saturated fats) appears to be  more important than quantity, the authors note. Although individuals working to manage their weight should still eat  even good fats in moderation.
- See more at: http://www.diabetes.org/newsroom/press-releases/2013/american-diabetes-association-releases-nutritional-guidelines.html?referrer=https://www.google.com/#sthash.rWP7ahS2.dpuf
Jackie Boucher, MS, RD, LD, CDE, Vice President for Education, Minneapolis Heart Institute Foundation,  noted that the scientific evidence is still limited related to various eating patterns and their impact on health outcomes in individuals with diabetes. Current evidence does not strongly support one eating pattern over another. “Whether you prefer a Mediterranean, vegetarian or lower-carbohydrate eating plan is less important than finding an eating pattern that fits your food preferences and lifestyle, can be consistently followed  and that provides you with the nutrition you need for good health,” she said.
In choosing an appropriate eating plan, people with diabetes should be sure to consider individual metabolic goals, such as their glucose and lipid levels and blood pressure, the statement notes.
The new guidelines also note that there is no conclusive evidence of an ideal amount of carbohydrate intake for people with diabetes. However, the authors suggest that whatever carbohydrates are eaten should come from vegetables, whole grains, fruits, legumes and dairy products, over other sources that contain added fats, sugar or sodium. Likewise the evidence remains inconclusive for an ideal amount of total fat intake. Fat quality (eating monounsaturated and polyunsaturated fats and avoiding trans fats and saturated fats) appears to be  more important than quantity, the authors note. Although individuals working to manage their weight should still eat  even good fats in moderation.
- See more at: http://www.diabetes.org/newsroom/press-releases/2013/american-diabetes-association-releases-nutritional-guidelines.html?referrer=https://www.google.com/#sthash.rWP7ahS2.dpuf

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