In search of low carb research


  • Health
  • Sunday, 15 Jun 2003

By RAJEN. M

The late Dr Robert Atkins was a firm believer in low carb diets and how such diets could lead to weight loss and other benefits.

DESCENDED from apes! My dear, let us hope that this is not true, but if it is, let us pray that it will not become generally known.”  

This was what the wife of the Bishop of Worcester said after she heard of Charles Darwin’s book, The Origin of Species. The book was sold out on the day of publication in 1859. Darwin was prosecuted and ridiculed. Yet, today Darwin remains the most important figure in the field of biology.  

Similarly, proponents of the low fat (hence high carbohydrate and low protein) movement have blasted proponents of the low carbohydrate diets, like the late Robert Atkins, for years. So, the April 9 issue of the Journal of the American Medical Association (JAMA) article entitled, Efficacy and Safety of Low-Carbohydrate Diets - A Systematic Review must have been really something to chew on.  

Review 

The primary author was Dena M. Bravata, MD, MS, from the Centre for Primary Care and Outcomes Research in Stanford. In the first review of its kind, authors searched for English-language diet studies that reported sufficient data.  

Initially, 2,609 potentially relevant articles were identified, with 107 of these meeting the given criteria. Finally, 94 different studies were included in the data sample. These involved a total of 3,268 participants. 

Of all the potential hazards of the low carbohydrate diet, one that is quoted most frequently is the “fat causes increase in your cholesterol” theme. This extensive review did not show that to be the case.  

Weight loss 

The review also noted that “of the 34 of 38 lower-carbohydrate diets for which weight change after diet was calculated, these lower-carbohydrate diets were found to produce greater weight loss than higher-carbohydrate diets ?”  

However, this data was largely ignored in the review since the large range of studies have very different characteristics that cannot be statistically compared.  

However, the raw data reveals a major difference in weight loss between the diets containing 60g or less of carbohydrate per day, and those containing more than 60g. Of the 34 various diets of 60g of carbs or less, the average weight loss was 16.9kg, or 37.2lb. Of 130 diets of more than 60g of carbs, the average weight loss was 1.9kg or 4.2lb.  

These higher carb diets were also too varied to be statistically compared. This suggests to me that if additional studies were done in a more controlled manner, the data comparisons could be significantly positive for the lower carbohydrate diets. 

This review has some positive outcomes that I believe are significant. It demonstrates that low carbohydrate diets had no significant adverse effect on serum lipids, refuting one of the major criticisms of these diets.  

It demonstrates that low carbohydrate diets had no significant adverse effect on serum glucose and insulin. 

Even though the authors cannot recommend the use of low carb diets, they also state that there is insufficient evidence to recommend against them. This is a new attitude, since previous expert advice has been definitely against low carbohydrate diets. .  

The review illustrates that weight loss did occur with low carb diets, even though it was noted to be principally associated with decreased caloric intake and increased diet duration (because nothing else was consistent enough to compare). 

This review reflects a new attitude toward research of low carb diets. The authors conclude that we need to investigate the long-term effects and consequences of low-carbohydrate diets.  

It will be exciting to finally see research being done that can truly make comparisons between low and high carbohydrate diets.  

More studies 

Adding to that are two new studies in The New England Journal of Medicine – one of the most respected medical literature in the world.  

The first was titled, A Randomised Trial Of A Low Carbohydrate Diet For Obesity that appeared in The New England Journal of Medicine (May 22, Volume 348).  

In that study, 132 severely obese subjects showed that those on the low carbohydrate diet lost significantly more than those on a low fat diet. Interestingly, there was a more significant drop on triglycerides in the low carbohydrate group. Insulin sensitivity also improved more significantly.  

The second study was also published in the same journal, entitled A Randomised Trial Of A Low Carbohydrate Diet For Obesity.  

It was a trial lasting a year for 63 obese men and women who also experienced superior weight loss in the low carbohydrate group.  

It was also a healthier weight loss as the low carbohydrate group also showed greater improvement of cardiovascular risk factors. Interestingly, the group also contained diabetics who showed improvement in insulin control.  

Basic biochemistry 

When you look at the basic biochemistry, you will quickly understand that the human body thrives on fats and protein – you have essential amino acids and essential fatty acids – meaning that you cannot live without them. 

You can well live without carbohydrates, especially the refined ones. You do not have essential carbohydrates. You body can make glucose from fats and proteins. However, you cannot make amino acids and fatty acids from glucose.  

Indeed, Eskimos live well for much of the year on a diet with almost no carbohydrate.  

Likewise, the Masai warrior tribe in Africa and the Australian aborigine live on diets very low in carbohydrate (zero refined carbohydrate) and do very well.  

Darwin’s close friend and renowned naturalist, Thomas Henry Huxley, read the Origin of Species and exclaimed “How extremely stupid to have not thought of that!” Perhaps, the opponents of the low carbohydrate movement will need to re-evaluate their stand in the face of such new data. 

Rajen. M is a pharmacist with a doctorate in Holistic Medicine. You can write to him at starhealth@thestar.com.my. The views expressed are those of the writer and readers are advised to always consult expert advice before undertaking any changes to their lifestyles. 

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