A no-carbohydrate diet (no-carb diet) excludes dietary consumption of all carbohydrates and suggests fat as the main source of energy with sufficient protein. A no-carbohydrate diet is ketogenic, which means it causes the body to go into a state of ketosis, converting dietary fat and body fat into ketone bodies and using them to fuel the entire body and up to 95% of the brain. The remaining 5% still runs on glucose which is adequately supplied by converting dietary protein via gluconeogenesis or by converting glycerol from the breakdown of fat. It uses mainly animal source foods and requires a high saturated fat intake.
An early proponent of an all animal-based diet was Icelandic-Canadian explorer Vilhjalmur Stefansson (1879–1962), who lived with the Inuit for some time and witnessed their diet as essentially consisting of meat and fish, with very few carbohydrates—just berries during the summer. However, the accuracy of his analysis has been since called into question, as the Inuit diet has not been shown to be a ketogenic diet and roughly 15-20% of its calories are from carbohydrates, largely from the glycogen found in the raw meats. Stefansson and a friend later volunteered for a one year experiment at Bellevue Hospital Center in New York City to prove he could thrive on a diet of nothing but meat, meat fat, and internal organs of animals. His progress was closely monitored and experiments were done on his health throughout the year. At the end of the year, he did not show any symptoms of ill health; he did not develop scurvy, which many scientists had expected to manifest itself only a few months into the diet due to the lack of vitamin C in muscle meat. However, Stefansson and his partner did not eat just muscle meat but also fat, raw brain, raw liver (a significant source of vitamin C and others), and other varieties of offal.
One of the first registries on low-carbohydrate diets was in 1860 when English casket maker William Banting was prompted to lose weight and decided to write "Letter on Corpulence", which aimed to completely avoid starch and sugar. Banting lost 45 pounds on a diet composed by lean meat, dry toast, soft boiled eggs, and a few drinks a day. Thus, the Banting diet became a very well known method during that period of the 19th century, promoted also for weight loss and diabetes control.
More than a century after this, carbohydrate-restricted diets gained great popularity, particularly in the case of the Atkins Diet which emerged in 1972, thanks to Robert Atkins. While his diet is not a zero-carbohydrate diet, it does reduce carb intake to a ketogenic level in its initial stages (20 grams daily in Induction; weekly increase of 5 thereafter), allowing followers to take advantage of the fat-burning mechanism that is ketosis. According to Atkins, this nutritional approach is more effective for weight loss than a low-fat, "high carbohydrate diet," although there has always been much controversy and great dispute amongst healthcare professionals concerning drastic carbohydrate restriction.
Low carbohydrate foods
Foods that are low in carbohydrates include:
- Meats: beef, pork, venison, chicken, etc.
- Seafood: tuna, trout, flounder, sardines, scallops herring, etc.
- Cheeses: cheddar, goat cheese, Gouda, blue cheese, etc.
- Fats: butter, cream, suet, lard, marrow, etc.
- Nuts and Legumes
Research on effects of no-carbohydrate diet
According to observational and prospectively designed studies from physicians and nutrition scientists, impaired physical performance is a common but not an obligate result of a low carbohydrate diet or no-carbohydrate diet. However, therapeutic use of ketogenic diets should not require restriction of any physical labor or recreational activity, with the particularity that only anaerobic performance is limited, such as weight lifting. In this case, due to the low glycogen levels in the ketogenic diet, competitive athletes cannot follow this kind of diet.
In 1939 two Danish scientists, Christensen and Hansen, made a study of low carbohydrate, moderate carbohydrate and high carbohydrate diets, each one lasting at least one week. At the end of each diet, the subjects' endurance time to exhaustion on a stationary bicycle was measured, and they found that with the low carbohydrate they lasted only 81 minutes, while they were able to ride for 206 minutes after the high carbohydrates diet.
In 1946, another experiment was made by Kark, Johnson and Lewis to determine effects of pemmican (a mixture of fat and dry meat) as an emergency ration for infantry troops in winter training in the Canadian Arctic. Results on this study showed that in 3 days, soldiers were unable to complete their assigned tasks. Then, in the 1960s, with the resurgence of biomedical science, new research revealed that fat had limited utility as fuel for high intensity exercise, and that humans are physically impaired if they are given a low carbohydrate or no-carbohydrate diet.
In 1980, Stephen Phinney performed an experiment in which subjects' physical performance was tested while eating a zero carb diet, over a longer period of time. In the first week they showed the same degradation of performance as the earlier studies. After six weeks, though, their endurance performance had fully recovered suggesting that it takes some time to adapt to a ketogenic diet.
At the Center for Obesity Research and Education at Temple University, Philadelphia, researchers found recently that after a two-year comparison, a low carbohydrate diet is almost similar to low-fat diet in terms of weight loss, but low-carbohydrate improves cardiovascular risk factors more, such as blood pressure and blood lipid levels. This study would suggest that low-carbohydrate diet protects individuals from potential coronary heart diseases in a more effective way. 307 patients were randomly assigned to either one of the two diets and researchers found 2 years later that good cholesterol levels were higher among the low-carbohydrate group compared to the low-fat group, 23% and 11% respectively.
On the other side, a study by the Beth Israel Deaconess Medical Center (BIDMC), a teaching hospital of Harvard Medical School, revealed after a study made on mice with different diets that with a low-carbohydrate there is a significant impact on atherosclerosis, even though it didn't affect cholesterol levels. Anthony Rosenzweig, a professor of Medicine at Harvard Medical School, found that the increase in plaque build-up in the blood vessels and the impaired ability to form new vessels were associated with a reduction in vascular progenitor cells, which some researchers claim could play a protective role in keeping vascular health.
Alexander Ströhle, Maike Wolters and Andreas Hahn, with the Department of Food Science at the University of Hanover, rely on Bjerregaard et al. (2003) to argue that hunters like the Inuit, who traditionally obtain most of their dietary energy from wild animals and therefore eat a low-carbohydrate diet, seem to have a high mortality from coronary heart disease, but the study did not control for carbohydrate consumption or smoking, which is significant, considering it was a "westernized" Inuit population of which 79% were current smokers and more than likely ate a non-traditional diet.
There are still some questions about the long-term effects on health adopting a no-carbohydrate diet. In 2005, the British Heart Foundation recommended not to follow diets of this kind, for those individuals who want to lose weight and take care of their heart. Working together with the Oxford University team, they found that the energy stored in the heart was reduced by an average of 16% among those who followed a high-fat, low-carbohydrate diet.
When the Beth Israel Deaconess Medical Center (BIDMC) found in their investigation that this diet is associated with serious artery damage in animals, The Stroke Association in the UK added that foods such as red meat and dairy products, containing high levels of saturated fat, are the ones that cause the buildup in the arteries. Researchers suggested having a moderate and balanced diet, coupled with regular exercise.
The restriction of starchy plants, by definition, severely limits the dietary intake of microbiota-accessible carbohydrates (MACs) and may negatively affect the microbiome in ways that contribute to disease. Starchy plants, in particular, are a main source of resistant starch — an important dietary fiber with strong prebiotic properties. Resistant starches are not digestible by mammals and are fermented and metabolized by gut flora into short chain fatty acids, which are well known to offer a wide range of health benefits. Resistant starch consumption has been shown to improve intestinal/colonic health, blood sugar, glucose tolerance, insulin-sensitivity and satiety. Public health authorities and food organizations such as the Food and Agricultural Organization, the World Health Organization, the British Nutrition Foundation and the U.S. National Academy of Sciences recognize resistant starch as a beneficial carbohydrate. The Joint Food and Agricultural Organization of the United Nations/World Health Organization Expert Consultation on Human Nutrition stated, "One of the major developments in our understanding of the importance of carbohydrates for health in the past twenty years has been the discovery of resistant starch."
- Carbohydrate metabolism
- Country food / Inuit diet, the traditional diet of the Inuit and First Nations
- Ketogenic diet
- Low-carbohydrate diet
- Rabbit starvation
- Vilhjalmur Stefansson
- Peter Heinbecker (1928). "Studies on the Metabolism of Eskimos" (PDF). J. Biol. Chem 80 (2): 461–475. Retrieved 2014-04-07.
- A.C. Corcoran, M. Rabinowitch (1937). "A Study of the Blood Lipoids and Blood Protein in Canadian Eastern Arctic Eskimos". Biochem J. 31 (3): 343–348. PMC 1266943. PMID 16746345.
- Kang-Jey Ho, Belma Mikkelson, Lena A. Lewis, Sheldon A. Feldman, and C. Bruce Taylor (1972). "Alaskan Arctic Eskimo: responses to a customary high fat diet" (PDF). Am J Clin Nutr. 25 (8): 737–745. Retrieved 2014-04-07.
- McClellan WS, Du Bois EF (1930). "Clinical calorimetry. XLV. Prolonged meat diets with a study on kidney function and ketosis" (PDF). J. Biol. Chem. 87 (3): 651–668.
- 1860s: first low-carb diet CBS Money Watch. Retrieved 2010-08-26
- "No Carb Diet Plan". CBS Money Watch. Retrieved 2010-08-26.
- Phinney, Stephen D. (2004-08-17)Ketogenic diets and physical performance Nutrition and Metabolism. Retrieved 2010-08-26
- Low Carb Better for Cardiovascular Health than Low Fat Diet Medical News Today. Retrieved 2010-08-26
- Prescott, Bonnie. (2009-08-24)Low-carb diets linked to atherosclerosis and impaired blood vessel growth Harvard Science. Retrieved 2010-08-26
- Bjerregaard P, Young TK, Hegele RA (February 2003). "Low incidence of cardiovascular disease among the Inuit--what is the evidence?". Atherosclerosis 166 (2): 351–57. doi:10.1016/S0021-9150(02)00364-7. PMID 12535749.
- Ströhle A, Wolters M, Hahn A. (January 2007). "Carbohydrates and the diet-atherosclerosis connection--more between earth and heaven. Comment on the article "The atherogenic potential of dietary carbohydrate"". Prev Med. 44 (1): 82–4. doi:10.1016/j.ypmed.2006.08.014. PMID 16997359.
- Low-carb diets 'cut heart energy' BBC News. Retrieved 2010-08-26
- Low carb diets 'damage arteries' BBC News. Retrieved 2010-08-26
- Sonnenburg, Erica D.; Sonnenburg, Justin L. (2014). "Starving our Microbial Self: The Deleterious Consequences of a Diet Deficient in Microbiota-Accessible Carbohydrates". Cell Metabolism. doi:10.1016/j.cmet.2014.07.003. ISSN 1550-4131.
- Langkilde AM, Champ M, Andersson H (January 2002). "Effects of high-resistant-starch banana flour (RS(2)) on in vitro fermentation and the small-bowel excretion of energy, nutrients, and sterols: an ileostomy study". Am. J. Clin. Nutr. 75 (1): 104–11. PMID 11756067. Retrieved 2014-07-17.
- Bird AR, Brown IL, Topping DL (March 2000). "Starches, resistant starches, the gut microflora and human health". Curr Issues Intest Microbiol 1 (1): 25–37. PMID 11709851.
- Sajilata, M.G.; Singhal, Rekha S.; Kulkarni, Pushpa R. (2006). "Resistant Starch—A Review". Comprehensive Reviews in Food Science and Food Safety 5 (1): 1–17. doi:10.1111/j.1541-4337.2006.tb00076.x. ISSN 1541-4337.
- Birt DF, Boylston T, Hendrich S, et al. (November 2013). "Resistant starch: promise for improving human health". Adv Nutr 4 (6): 587–601. doi:10.3945/an.113.004325. PMID 24228189. Retrieved 2014-07-18.
- Topping DL, Clifton PM (July 2001). "Short-chain fatty acids and human colonic function: roles of resistant starch and nonstarch polysaccharides". Physiol. Rev. 81 (3): 1031–64. PMID 11427691. Retrieved 2014-07-17.
- Brouns, Fred; Kettlitz, Bernd; Arrigoni, Eva (2002). "Resistant starch and "the butyrate revolution"". Trends in Food Science & Technology 13 (8): 251–261. doi:10.1016/S0924-2244(02)00131-0. ISSN 0924-2244.
- Ahmed, R.; Segal, I.; Hassan, H. (2000). "Fermentation of dietary starch in humans". The American Journal of Gastroenterology 95 (4): 1017–1020. doi:10.1111/j.1572-0241.2000.01848.x. ISSN 0002-9270.
- Shen L, Keenan MJ, Raggio A, Williams C, Martin RJ (October 2011). "Dietary-resistant starch improves maternal glycemic control in Goto-Kakizaki rat". Mol Nutr Food Res 55 (10): 1499–508. doi:10.1002/mnfr.201000605. PMID 21638778. Retrieved 2014-07-17.
- Raben A, Tagliabue A, Christensen NJ, Madsen J, Holst JJ, Astrup A (October 1994). "Resistant starch: the effect on postprandial glycemia, hormonal response, and satiety". Am. J. Clin. Nutr. 60 (4): 544–51. PMID 8092089. Retrieved 2014-07-17.
- Robertson MD, Bickerton AS, Dennis AL, Vidal H, Frayn KN (September 2005). "Insulin-sensitizing effects of dietary resistant starch and effects on skeletal muscle and adipose tissue metabolism". Am. J. Clin. Nutr. 82 (3): 559–67. PMID 16155268. Retrieved 2014-07-17.
- Carbohydrates in human nutrition (Report of a Joint FAO/WHO Expert Consultation, Rome, Italy, 14-18 April 1997). FAO food and nutrition paper 66. World Health Organization. 1998. ISBN 9251041148.
- Nugent A.P. (2005). "Health properties of resistant starch, British Nutrition Foundation". Nutrition Bulletin 30 (1): 27–54. doi:10.1111/j.1467-3010.2005.00481.x.
- National Research Council (2005). Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. National Academies Press. ISBN 0309085373.
- Not Eating Enough: Overcoming Underconsumption of Military Operational Rations (1995) "Chapter 16: The Functional Effects of Carbohydrate and Energy Underconsumption" Institute of Medicine (IOM)
- Phinney SD (2004). "Ketogenic diets and physical performance". Nutr Metab (Lond) 1 (1): 2. doi:10.1186/1743-7075-1-2. PMC 524027. PMID 15507148.