Is a Low-Carb Diet Right for You?

Low-carb or keto diets seem to be a hot topic in today’s world of health and nutrition. You may have tried this way of eating or are curious as to what it means exactly. A low-carb diet keeps carbohydrates to 30-40% of your daily calories, whereas a very low-carb diet (VLCD), is 21-70 grams of carbohydrates per day1.

What Does a Low-Carb Diet Look Like?

So, what do these numbers look like when translated into food? Let’s consider a 170 lb female who keeps to a 2100 calorie/day diet. On the low end of a low-carb diet, that would be 158 grams of carbs daily (or 30% of calories). On a VLCD, let’s say 53 grams of daily carbs; somewhere in between 21-70 grams (that’s 10% of total calories).

Assuming she’s eating three meals with one snack a day, that’s 15 grams of carbs for each meal. That could be either:

• a small fruit
• ½ sandwich
• 9 oz glass of milk
• 10 wheat crackers

Any one of these provides about 8 grams of carbs left for a snack, which could be one Greek yogurt cup.

Who Is a Low-Carb Diet Right for?

Is this way of eating for everyone? Certainly not. But who exactly would this type of diet be recommended and not recommended? It’s recommended for:

• People who have diabetes or other forms of insulin resistance such as women with PCOS (polycystic ovarian syndrome)
• People who are metabolically unwell (high blood sugar, high blood pressure, excess weight around the midsection, and elevated cholesterol or triglycerides)
• People who are looking to lose weight
• Those limited to what they can do physically

However, a keto diet isn’t suggested for individuals with:

• Lipid metabolism disorders
• A history of heart attack or stroke in the past year
• Women who are pregnant or breastfeeding
• People with kidney or liver disease
• Anyone with alcohol or substance abuse
• Those with eating disorders
• Those with type 1 or type 2 diabetes with beta-cell dysfunction or those taking SGLT2 inhibitors (eg empagliflozin and canagliflozin) due to increased risk of diabetic ketoacidosis2

What Are the Pros and Cons of a Low-Carb Diet?

There have been a handful of benefits indicated in some studies with regards to a very low-carb diet. The American Diabetes Association 2019 consensus found that “very low-carbohydrate eating patterns have been shown to:

• Reduce A1c and the need for antihyperglycemic medications”3.
• Lower blood pressure and triglyceride levels
• Increase in HDL, or good cholesterol

However, due to severely limiting an entire food group, there may be nutritional impacts such as:

• Vitamin and mineral deficiencies
• Impaired bone health
• Kidney stones
• Gout from high uric acid levels
• Fatty liver as shown in some mice studies

Another area of impact is in the gut microbiome. Overall health and immunity corresponds with a diverse microbiota and what we eat influences that diversity. A high-fiber diet rich in fruits, non-starchy vegetables, and other plant-based foods promotes a diverse gut microbiome. Where antibiotics completely wipe out our gut microbiome, our gut environment changes pretty quickly in response to a change in diet.

Major Takeaways

So, what are the takeaways? Well, anyone who wants to start a low-carb diet to improve their metabolic health will likely have best results by reaching out to their primary care provider or working with a dietitian. Meal planning should focus on foods the person is already eating and enjoys, keeping in mind diversity, variety, avoiding GI symptoms, and meeting vitamin and mineral needs. Trendy diets will always be part of life. The most important thing is being able to rely on fact over fiction and utilize professionals, like dietitians, to help make and maintain sustainable eating habits that last.

Sources:

1, Warshaw, H., & Smithson, T. (2018, November). Very Low-Carbohydrate Diets - An Evaluation of Efficacy in Type 2 Diabetes Prevention and Management, and Considerations for Translating Research to Practice. Today's Dietitian. Retrieved December 2022, from https://www.todaysdietitian.com/newarchives/1118p28.shtml.

2,3, Danahy, A. (n.d.). Web exclusive: Guiding Clients Following Very Low-Carb Diets for Diabetes. Today's Dietitian. Retrieved December 30, 2022, from https://www.todaysdietitian.com/news/exclusive0820.shtml