Low-carbohydrate diet

From Wikipedia, the free encyclopedia
  (Redirected from Low carbohydrate diet)
Jump to: navigation, search

Low-carbohydrate diets or low-carb diets are dietary programs that restrict carbohydrate consumption. Foods high in easily digestible carbohydrates (e.g., sugar, bread, pasta) are limited or replaced with foods containing a higher percentage of fats and moderate protein (e.g., meat, poultry, fish, shellfish, eggs, cheese, nuts, and seeds) and other foods low in carbohydrates (e.g., most salad vegetables such as spinach, kale, chard and collards), although other vegetables and fruits (especially berries) are often allowed. The amount of carbohydrate allowed varies with different low-carbohydrate diets.[1]

Such diets are sometimes 'ketogenic' (i.e., they restrict carbohydrate intake sufficiently to cause ketosis). The induction phase of the Atkins diet[2][3][4] is ketogenic.

The term "low-carbohydrate diet" is generally applied to diets that restrict carbohydrates to less than 20% of caloric intake, but can also refer to diets that simply restrict or limit carbohydrates to less than recommended proportions (generally less than 45% of total energy coming from carbohydrates).[5][6]

Definition and classification[edit]

Low-carbohydrate diets are not well-defined.[7] The American Academy of Family Physicians defines low-carbohydrate diets as diets that restrict carbohydrate intake to 20 to 60 grams per day, typically less than 20% of caloric intake.[8] A 2016 review of low-carbohydrate diets classified diets with 50g of carbohydrate per day (less than 10% of total calories) as "very low" and diets with 40% of calories from carbohydrates as "mild" low-carbohydrate diets.[9]

Used for weight loss, low-carbohydrate diets are classified as fad diets.[10][11]

Adoption[edit]

The U.S. Institute of Medicine recommends a minimum intake of 130 g of carbohydrate per day.[12] The FAO and WHO similarly recommend that the majority of dietary energy come from carbohydrates.[13][14]

A popular misconception driving adoption of the diet for weight loss, is that by reducing carbohydrate intake dieters can in some way avoid weight gain from the calories in other macronutrients.[15] However any weight loss resulting from a low-carbohydrate diet comes from a reduced overall calorie intake not from "metabolic hocus pocus".[15]

Although low-carbohydrate diets are most commonly discussed as a weight-loss approach, some experts have proposed using low-carbohydrate diets to mitigate or prevent diseases, including diabetes, metabolic disease.[16]

A category of diets is known as low-glycemic-index diets (low-GI diets) or low-glycemic-load diets (low-GL diets), in particular the Low GI Diet.[17] The low-insulin-index diet, is similar, except it is based on measurements of direct insulemic responses i.e., the amount of insulin in the bloodstream to food rather than glycemic response the amount of glucose in the bloodstream. Although such diet recommendations mostly involve lowering nutritive carbohydrates, some low-carbohydrate foods are discouraged, as well (e.g., beef).[18]

Health effects[edit]

Weight loss[edit]

People following a low-carbohydrate diet can lose weight, but the diet is no more effective for this than a low-fat diet.[19] Although weight loss may be rapid, initially as a result of water loss, when the diet stops weight is regained just as quickly.[20][21] Any weight loss from following the diet is merely a result of reduced calorie intake.[10] Overweight people pursuing a low-carbohydrate diet experience no superior benefit to cardiovascular health compared to those following a balanced weight-loss diet.[6]

Diabetes[edit]

Limiting carbohydrate consumption is a traditional treatment for diabetes – indeed, it was the only effective treatment before the development of insulin therapy – and when carefully adhered to, it generally results in improved glucose control, usually without long-term weight loss.[22][23] Some experts recommend a low-carbohydrate diet as the first, default treatment for people with diabetes.[24] There is mixed evidence to support the use of low-carbohydrate diets for people with diabetes in the short-term, but no good evidence of long-term benefit or safety.[25] Safety is a concern if the diet is taken without expert monitoring.[25]

Blood lipids[edit]

Potential favorable changes in triglyceride and high-density lipoprotein cholesterol values should be weighed against potential unfavorable changes in low-density lipoprotein cholesterol and total cholesterol values when low-carbohydrate diets to induce weight loss are considered.[26] A 2008 systematic review of randomized controlled studies that compared low-carbohydrate diets to low-fat/low-calorie diets found the measurements of weight, HDL cholesterol, triglyceride levels, and systolic blood pressure were significantly better in groups that followed low-carbohydrate diets. The authors of this review also found a higher rate of attrition in groups with low-fat diets, and concluded, "evidence from this systematic review demonstrates that low-carbohydrate/high-protein diets are more effective at six months and are as effective, if not more, as low-fat diets in reducing weight and cardiovascular disease risk up to one year", but they also called for more long-term studies.[27]

Mortality[edit]

It is not known whether low-carbohydrate diets have any effect on mortality or morbidity associated with cardiovascular disease.[20]

Opinions from major governmental and medical organizations[edit]

American Dietetic Association

As of 2003 in commenting on a study in the Journal of the American Medical Association, a spokesperson for the American Dietetic Association reiterated the association's position that "there is no magic bullet to safe and healthful weight loss."[28] The Association specifically endorses the high-carbohydrate diet recommended by the National Academy of Sciences.[28] As part of the National Nutrition Month "Fact vs. Fiction" campaign in 2008, the ADA stated: "Calories cause weight gain. Excess calories from carbohydrates are not any more fattening than calories from other sources."[29]

American Heart Association

As of 2015 the AHA stated categorically that it doesn't recommend high-protein diet. It states: "The American Heart Association doesn't recommend high-protein diets for weight loss. Some of these diets restrict healthful foods that provide essential nutrients and don't provide the variety of foods needed to adequately meet nutritional needs. People who stay on these diets very long may not get enough vitamins and minerals and face other potential health risks."[30] A science advisory from the association further states the association's position that these diets may be associated with increased risk for coronary heart disease.[31] Robert H. Eckel, past president, noted that a low-carbohydrate diet could potentially meet AHA guidelines if it conformed to the AHA guidelines for low fat content.[32]

Australian Heart Foundation

The position statement by the Heart Foundation regarding low-carbohydrate diets states: "the Heart Foundation does not support the adoption of VLCARB diets for weight loss."[33] Although the statement recommends against use of low-carbohydrate diets, it explains their major concern is saturated fats as opposed to carbohydrate restriction and protein. Moreover, other statements suggest their position might be re-evaluated in the event of more evidence from longer-term studies.

National Health Service (UK)

The consumer advice statements of the NHS regarding low-carbohydrate diets state that: "eating a high-fat diet could increase your risk of heart disease" and advises: "try to ensure starchy foods make up about a third of your diet".[34]

Research[edit]

Low-carbohydrate diets became a major weight loss and health maintenance trend during the late 1990s and early 2000s.[35][36][37] While their popularity has waned recently from its peak, they remain popular.[38][39] This diet trend has stirred major controversies in the medical and nutritional sciences communities and, as yet, there is not a general consensus on their efficacy or safety.[40][41] Many in the medical community remain generally opposed to these diets for long term health[42] although there has been a recent softening of this opposition by some organizations.[43][44]

Synopsis[edit]

Because of the substantial controversy regarding low-carbohydrate diets, and even disagreements in interpreting the results of specific studies, it is difficult to objectively summarize the research in a way that reflects scientific consensus.[45]

Although there has been some research done throughout the twentieth century, most directly relevant scientific studies have occurred in the 1990s and early 2000s and, as such, are relatively new and the results are still debated in the medical community.[45] Supporters and opponents of low-carbohydrate diets frequently cite many articles (sometimes the same articles) as supporting their positions.[46][47][48] One of the fundamental criticisms of those who advocate the low-carbohydrate diets has been the lack of long-term studies evaluating their health risks.[49][50] This has begun to change as longer term studies are emerging.[51]

Meta-analytic summaries[edit]

A 2012 systematic review studying the effects of low-carbohydrate diet on weight loss and cardiovascular risk factors showed the LCD to be associated with significant decreases in body weight, body mass index, abdominal circumference, blood pressure, triglycerides, fasting blood sugar, blood insulin and plasma C-reactive protein, as well as an increase in high-density lipoprotein cholesterol (HDL). Low-density lipoprotein cholesterol (LDL) and creatinine did not change significantly. The study found the LCD was shown to have favorable effects on body weight and major cardiovascular risk factors (but concluded the effects on long-term health are unknown). The study did not compare health benefits of LCD to low-fat diets.[52]

A meta-analysis published in the American Journal of Clinical Nutrition in 2013 compared low-carbohydrate, Mediterranean, vegan, vegetarian, low-glycemic index, high-fiber, and high-protein diets with control diets. The researchers concluded that low-carbohydrate, Mediterranean, low-glycemic index, and high-protein diets are effective in improving markers of risk for cardiovascular disease and diabetes.[53]

Criticism and controversies[edit]

Exercise[edit]

Advocates of low-carbohydrate diets generally dispute any suggestion that such diets cause weakness or exhaustion (except in the first few weeks as the body adjusts), and indeed most highly recommend exercise as part of a healthy lifestyle.[54]

Arctic cultures, such as the Inuit, were found to lead physically demanding lives consuming a diet of about 15–20% of their calories from carbohydrates, largely in the form of glycogen from the raw meat they consumed.[55][56][57][58] However, studies also indicate that while low-carb diets will not reduce endurance performance after adapting, they will probably deteriorate anaerobic performance such as strength-training or sprint-running because these processes rely on glycogen for fuel.[54]

Vegetables and fruits[edit]

Some critics imply or explicitly argue that vegetables and fruits are inherently all heavily concentrated sources of carbohydrates (so much so that some sources treat the words 'vegetable' and 'carbohydrate' as synonymous).[59] While some fruits may contain relatively high concentrations of sugar, most are largely water and not particularly calorie-dense. Thus, in absolute terms, even sweet fruits and berries do not represent a significant source of carbohydrates in their natural form, and also typically contain a good deal of fiber which attenuates the absorption of sugar in the gut.[60] Lastly, most of the sugar in fruit is fructose, which has a reported negligible effect on insulin levels in obese subjects.[61]

Most vegetables are low- or moderate-carbohydrate foods (in the context of these diets, fiber is excluded because it is not a nutritive carbohydrate). Some vegetables, such as potatoes and carrots, have high concentrations of starch, as do corn and rice. Most low-carbohydrate diet plans accommodate vegetables such as broccoli, spinach, cauliflower, and peppers.[62] The Atkins diet recommends that most dietary carbs come from vegetables. Nevertheless, debate remains as to whether restricting even just high-carbohydrate fruits, vegetables, and grains is truly healthy.[63]

Contrary to the recommendations of most low-carbohydrate diet guides, some individuals may choose to avoid vegetables altogether to minimize carbohydrate intake. Low-carbohydrate vegetarianism is also practiced.

Raw fruits and vegetables are packed with an array of other protective chemicals, such as vitamins, flavonoids, and sugar alcohols. Some of those molecules help safeguard against the over-absorption of sugars in the human digestive system.[64][65] Industrial food raffination depletes some of those beneficial molecules to various degrees, including almost total removal in many cases.[66]

Glucose availability[edit]

Some evidence indicates the increasingly large percentage of calories consumed as refined carbohydrates is positively correlated with the increased incidence of metabolic disorders such as type 2 diabetes.[67]

In addition, this claim neglects the nature of the carbohydrates ingested. Some are indigestible in humans (e.g., cellulose), some are poorly digested in humans (e.g., the amylose starch variant), and some require considerable processing to be converted to absorbable forms. In general, uncooked or unprocessed (e.g., milling, crushing, etc.) foods are harder (typically much harder) to absorb, so do not raise glucose levels as much as might be expected from the proportion of carbohydrate present. Cooking (especially moist cooking above the temperature necessary to expand starch granules) and mechanical processing both considerably raise the amount of absorbable carbohydrate and reduce the digestive effort required.

Analyses which neglect these factors are misleading and will not result in a working diet, or at least one which works as intended. In fact, some evidence indicates the human brain – the largest consumer of glucose in the body – can operate more efficiently on ketones (as efficiency of source of energy per unit oxygen).[68]

Other controversies[edit]

In 2004, the Canadian government ruled that foods sold in Canada could not be marketed with reduced or eliminated carbohydrate content as a selling point, because reduced carbohydrate content was not determined to be a health benefit. The government ruled that existing "low carb" and "no carb" packaging would have to be phased out by 2006.[69]

Some variants of low-carbohydrate diets involve substantially lowered intake of dietary fiber, which can result in constipation if not supplemented.[citation needed] For example, this has been a criticism of the induction phase of the Atkins diet (the Atkins diet is now clearer about recommending a fiber supplement during induction).

History[edit]

Early dietary science[edit]

In 1797, John Rollo reported on the results of treating two diabetic Army officers with a low-carbohydrate diet and medications. A very low-carbohydrate, ketogenic diet was the standard treatment for diabetes throughout the 19th century.[70][71]

In 1863, William Banting, a formerly obese English undertaker and coffin maker, published "Letter on Corpulence Addressed to the Public", in which he described a diet for weight control giving up bread, butter, milk, sugar, beer, and potatoes.[72] His booklet was widely read, so much so that some people used the term "Banting" for the activity usually called "dieting".[73]

In the early 1900s Frederick Madison Allen developed a highly restrictive short term regime which was described by Walter R. Steiner at the 1916 annual convention of the Connecticut State Medical Society as The Starvation Treatment of Diabetes Mellitus.[74]:176–177[75][76][77] People showing very high urine glucose levels were confined to bed and restricted to an unlimited supply of water, coffee, tea, and clear meat broth until their urine was "sugar free"; this took two to four days but sometimes up to eight.[74]:177 After the person's urine was sugar-free food was re-introduced; first only vegetables with less than 5g of carbohydate per day, eventually adding fruits and grains to build up to 3g of carbohydrate per kilogram of body weight. Then eggs and meat were added, building up to 1g of protein/kg of body weight per day, then fat was added to the point where the person stopped losing weight or a maximum of 40 calories of fat per kilogram per day was reached. The process was halted if sugar appeared in the person's urine.[74]:177–178 This diet was often administered in a hospital in order to better ensure compliance and safety.[74]:179

Modern low-carbohydrate diets[edit]

In 1958, Richard Mackarness M.D. published Eat Fat and Grow Slim, a low-carbohydrate diet with much of the same advice and based on the same theories as those promulgated by Robert Atkins more than a decade later. Mackarness also challenged the "calorie theory" and referenced primitive diets such as the Inuit as examples of healthy diets with a low-carbohydrate and high-fat composition.

In 1967, Irwin Stillman published The Doctor's Quick Weight Loss Diet. The "Stillman diet" is a high-protein, low-carbohydrate, and low-fat diet. It is regarded as one of the first low-carbohydrate diets to become popular in the United States.[78] Other low-carbohydrate diets in the 1960s included the Air Force diet[79] and the drinking man's diet.[80] Austrian physician Wolfgang Lutz published his book Leben Ohne Brot (Life Without Bread) in 1967.[81] However, it was not well known in the English-speaking world.

In 1972, Robert Atkins published Dr. Atkins Diet Revolution, which advocated the low-carbohydrate diet he had successfully used in treating patients in the 1960s (having developed the diet from a 1963 article published in JAMA).[82] The book met with some success, but, because of research at that time suggesting risk factors associated with excess fat and protein, it was widely criticized by the mainstream medical community as being dangerous and misleading, thereby limiting its appeal at the time.[83] Among other things, critics pointed out that Atkins had done little real research into his theories and based them mostly on his clinical work. Later that decade, Walter Voegtlin and Herman Tarnower published books advocating the Paleolithic diet and Scarsdale diet, respectively, each meeting with moderate success.[84][not in citation given]

The concept of the glycemic index was developed in 1981 by David Jenkins to account for variances in speed of digestion of different types of carbohydrates. This concept classifies foods according to the rapidity of their effect on blood sugar levels – with fast-digesting simple carbohydrates causing a sharper increase and slower-digesting complex carbohydrates, such as whole grains, a slower one.[85] The concept has been extended to include the amount of carbohydrate actually absorbed, as well, as a tablespoonful of cooked carrots is less significant overall than a large baked potato (effectively pure starch, which is efficiently absorbed as glucose), despite differences in glycemic indices.

1990s – present[edit]

In the 1990s, Atkins published an update from his 1972 book, Dr. Atkins New Diet Revolution, and other doctors began to publish books based on the same principles. This has been said to be the beginning of what the mass media call the "low carb craze" in the United States.[86] During the late 1990s and early 2000s, low-carbohydrate diets became some of the most popular diets in the US. By some accounts, up to 18% of the population was using one type of low-carbohydrate diet or another at the peak of their popularity,[87] and this use spread to many countries.[citation needed] Food manufacturers and restaurant chains like Krispy Kreme noted the trend, as it affected their businesses.[88] Parts of the mainstream medical community has denounced low-carbohydrate diets as being dangerous to health, such as the AHA in 2001,[31] the American Kidney Fund in 2002,[89] Low-carbohydrate advocates did some adjustments of their own, increasingly advocating controlling fat and eliminating trans fat.[90][91]

Proponents who appeared with new diet guides at that time like the Zone diet intentionally distanced themselves from Atkins and the term 'low carb' because of the controversies, though their recommendations were based on largely the same principles .[92][93] The 1990s and 2000s saw the publication of an increased number of clinical studies regarding the effectiveness and safety (pro and con) of low-carbohydrate diets (see low-carbohydrate diet medical research).

In the United States, the diet has continued to garner attention in the medical and nutritional science communities, and also inspired a number of hybrid diets that include traditional calorie-counting and exercise regimens.[94][95][96][97] Other low-carb diets, such as the Paleo Diet, focus on the removal of certain foods from the diet, such as sugar and grain.[98] On 2 September 2014 a small randomized trial by the NIH of 148 men and women comparing a low-carbohydrate diet with a low fat diet without calorie restrictions over one year showed that participants in the low-carbohydrate diet had greater weight loss than those on the low-fat diet.[99] The low-fat group lost weight, but appeared to lose more muscle than fat.[100]

See also[edit]

References[edit]

  1. ^ Schwarzfuchs, Dan; Golan, Rachel; Shai, Iris (4 October 2012). "Four-year follow-up after two-year dietary interventions". The New England Journal of Medicine. 367 (14): 1373–1374. doi:10.1056/NEJMc1204792. ISSN 1533-4406. PMID 23034044. 
  2. ^ "Weight Loss: High-Protein, Low-Carbohydrate Diets". Women.webmd.com. Retrieved 18 December 2011. 
  3. ^ Stefanov, Sebastien: Do Low-Carb Diets Work?, AskMen.com
  4. ^ Hanlon, Kathie: The Low-Down on Low-Carbohydrate Diets, Vanderbuilt University, 25 April 1997
  5. ^ Dolson, Laura: What is a Low Carb Diet?, About.com: Low Carb Diets, retrieved 11 March 2008
  6. ^ a b Naude, CE; Schoonees, A; Senekal, M; Young, T; Garner, P; Volmink, J (2014). "Low carbohydrate versus isoenergetic balanced diets for reducing weight and cardiovascular risk: a systematic review and meta-analysis". PLOS ONE. 9 (7): e100652. doi:10.1371/journal.pone.0100652. PMC 4090010Freely accessible. PMID 25007189. 
  7. ^ Westman EC, Feinman RD, Mavropoulos JC, Vernon MC, Volek JS, Wortman JA, Yancy WS, Phinney SD (2007). "Low-carbohydrate nutrition and metabolism". Am. J. Clin. Nutr. (Review). 86 (2): 276–84. PMID 17684196. 
  8. ^ Last AR, Wilson SA (June 2006). "Low-carbohydrate diets". American Family Physician. 73 (11): 1942–8. PMID 16770923. 
  9. ^ Hashimoto Y, Fukuda T, Oyabu C, Tanaka M, Asano M, Yamazaki M, Fukui M (2016). "Impact of low-carbohydrate diet on body composition: meta-analysis of randomized controlled studies". Obes Rev (Review). 17 (6): 499–509. doi:10.1111/obr.12405. PMID 27059106. 
  10. ^ a b Alters S, Schiff W (22 February 2012). "Chapter 10: Body Weight and Its Management". Essential Concepts for Healthy Living (6th ed.). Jones & Bartlett Publishers. p. 326. ISBN 978-1-4496-3062-1. 
  11. ^ "How to diet". NHS Choices. 9 December 2015. 
  12. ^ "Dietary Reference Intakes (DRIs):" (PDF). National Academy of Medicine. Retrieved 31 August 2015. 
  13. ^ Food and Nutrition Board (2002/2005). Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. Washington, DC: The National Academies Press. Page 769. ISBN 0-309-08537-3
  14. ^ Joint WHO/FAO expert consultation (2003). "Diet, Nutrition and the Prevention of Chronic Diseases" (PDF). who.int. Geneva: World Health Organization. pp. 55–56. ISBN 92-4-120916-X. Archived from the original (PDF) on 4 April 2003. 
  15. ^ Yancy WS, Foy M, Chalecki AM, Vernon MC, Westman EC (2005). "A low-carbohydrate, ketogenic diet to treat type 2 diabetes". Nutrition & Metabolism. 2 (1): 34. doi:10.1186/1743-7075-2-34. PMC 1325029Freely accessible. PMID 16318637. 
  16. ^ Brand-Miller et al. (2005). The Low GI Diet Revolution: The Definitive Science-based Weight Loss Plan. Marlowe & Company. New York, NY
  17. ^ SH Holt; JC Miller; P Petocz (1 November 1997). "An insulin index of foods: the insulin demand generated by 1000-kJ portions of common foods". American Journal of Clinical Nutrition. 66 (5): 1264–1276. PMID 9356547. 
  18. ^ Alexandraki I, Palacio C, Mooradian AD (2015). "Relative Merits of Low-Carbohydrate Versus Low-Fat Diet in Managing Obesity". South. Med. J. (Review). 108 (7): 401–16. doi:10.14423/SMJ.0000000000000308. PMID 26192936. 
  19. ^ a b Westman EC, Feinman RD, Mavropoulos JC, Vernon MC, Volek JS, Wortman JA, Yancy WS, Phinney SD (1 August 2007). "Low-carbohydrate nutrition and metabolism". The American Journal of Clinical Nutrition. 86 (2): 276–84. PMID 17684196. 
  20. ^ Freedman MR, King J, and Kennedy E (2001), Popular Diets: a Scientific Review Obesity Research, Volume 9, Supplement 1, Pages 1S-5S. Retrieved on 15 August 2013.
  21. ^ Meng, Yan; Bai, Hao; Wang, Shijun; Li, Zhaoping; Wang, Qian; Chen, Liyong (September 2017). "Efficacy of low carbohydrate diet for type 2 diabetes mellitus management: A systematic review and meta-analysis of randomized controlled trials". Diabetes Research and Clinical Practice. 131: 124–131. doi:10.1016/j.diabres.2017.07.006. ISSN 1872-8227. PMID 28750216. 
  22. ^ Noakes, Timothy David; Windt, Johann (January 2017). "Evidence that supports the prescription of low-carbohydrate high-fat diets: a narrative review". British Journal of Sports Medicine. 51 (2): 133–139. doi:10.1136/bjsports-2016-096491. ISSN 1473-0480. PMID 28053201. 
  23. ^ Feinman, Richard D. (April 2011). "Fad diets in the treatment of diabetes". Review. Current Diabetes Reports. 11 (2): 128–135. doi:10.1007/s11892-011-0178-y. ISSN 1539-0829. PMID 21234818. Far from faddish, diets based on carbohydrate restriction have been the historical treatment for diabetes and are still supported by basic biochemistry, and it is argued that they should be considered the "default" diet, the one to try first, in diseases of carbohydrate intolerance or insulin resistance. 
  24. ^ a b Subhan FB, Chan CB (2016). "Review of Dietary Practices of the 21st Century: Facts and Fallacies". Can J Diabetes (Review). 40 (4): 348–54. doi:10.1016/j.jcjd.2016.05.005. PMID 27497150. 
  25. ^ Hu, T; Mills, KT; Yao, L; Demanelis, K; Yancy Jr, WS; Kelly, TN; He, J; Bazzano, LA (2010). "Effects of Low-Carbohydrate Diets Versus Low-Fat Diets on Metabolic Risk Factors: A Meta-Analysis of Randomized Controlled Clinical Trials". American Journal of Epidemiology. 176 (Suppl 7): S44–S54. doi:10.1093/aje/kws264. PMC 3530364Freely accessible. PMID 23035144. 
  26. ^ Hession, M.; Rolland, C.; Kulkarni, U.; Wise, A.; Broom, J. (2009). "Systematic review of randomized controlled trials of low-carbohydrate vs. Low-fat/low-calorie diets in the management of obesity and its comorbidities". Obesity Reviews. 10 (1): 36–50. doi:10.1111/j.1467-789X.2008.00518.x. PMID 18700873. 
  27. ^ a b "American Dietetic Association Says New Studies of Low-Carb Diets 'Confirm What We Already Know'". American Dietetic Association via PR Newswire. 22 May 2003. "The findings confirm what we already know," said registered dietitian and American Dietetic Association spokesperson Kathleen Zelman. "There is no magic bullet to safe and healthful weight loss." Zelman added: "In the short term, these studies show, you can achieve weight loss with low-carb diets. But in the long term, success rates were not different from people who are on a more 'traditional' diet. These results don't change ADA's recommendations for achieving healthful weight that can be sustained over a lifetime." ADA's advice is based on the National Academy of Sciences' recommendations that adults obtain 45 percent to 65 percent of their calories from carbohydrates, 20 percent to 35 percent from fat and 10 percent to 35 percent from protein. 
  28. ^ "Nutrition: Fact vs. Fiction" (PDF). American Dietetic Association via University of California Irvine. March 2008. 
  29. ^ "High-Protein Diets". American Heart Association. 18 March 2014. Archived from the original on 2 February 2015. 
  30. ^ a b St. Jeor, Sachiko T., RD, PhD; Howard, Barbara V., PhD; Prewitt, T. Elaine, RD, DrPH; Bovee, Vicki, RD, MS; Bazzarre, Terry, PhD; Eckel, Robert H., MD (2001). "Dietary Protein and Weight Reduction: A Statement for Healthcare Professionals From the Nutrition Committee of the Council on Nutrition, Physical Activity, and Metabolism of the American Heart Association" (Science Advisory). American Heart Association. Retrieved 1 March 2014. These diets are generally associated with higher intakes of total fat, saturated fat, and cholesterol because the protein is provided mainly by animal sources. ... Beneficial effects on blood lipids and insulin resistance are due to the weight loss, not to the change in caloric composition. ... High-protein diets may also be associated with increased risk for coronary heart disease due to intakes of saturated fat, cholesterol, and other associated dietary factors. 
  31. ^ Associated Press (16 July 2008). "Low-carb diet beats other diets in study". CNN. Archived from the original on 29 August 2008. 
  32. ^ Position Statement on Very Low Carbohydrate Diets, Heart Foundation, retrieved 19 July 2008. It states
    Based on current available evidence, the Heart Foundation does not support the adoption of VLCARB diets for weight loss.
    ...
    The Heart Foundation found that subjects in research studies achieved more weight and fat loss on the VLCARB diets than on the conventional low fat diets, but this was only in the short term.
    The Heart Foundation's major concern with many VLCARB [Very Low Carb] diets is not their restriction of carbohydrate or increase in protein, but their high and unrestricted saturated fat content, which may contribute to cardiovascular risk.
  33. ^ Starchy foods, National Health Service, retrieved 5 December 2013. It states
    Low-carbohydrate (low-carb) diets usually involve cutting out most starchy foods. These diets tend to be high in fat, and eating a high-fat diet (especially saturated fat from foods such as meat, cheese, and butter) could increase your risk of heart disease. Low-carb diets could also restrict the amount of fruit, vegetables, and fibre you eat, so try to ensure starchy foods make up about a third of your diet.
  34. ^ Low Carb - US - May 2004, The InfoShop.com by Global Markets, 2004.
  35. ^ ZERNIKE, KATE; BURROS, MARIAN: Low-Carb Boom Isn't Just for Dieters Anymore, New York Times, 19 February 2004.
  36. ^ History of the Dr. Atkins Diet Plan, Atkins Diet Advisor. Retrieved 10 March 2008.
  37. ^ WARNER, MELANIE: Is the Low-Carb Boom Over?, New York Times, 5 December 2004.
  38. ^ Low-Carb Diet Effective for Teens Trying to Lose Weight, Cincinnati Children's Hospital, 6 May 2007.
  39. ^ Bernstein, Richard: Why the Low Carb Diet is Best, Diabetes Health, 24 April 2007.
  40. ^ Warshaw, Hope: [1], Diabetes Health, 24 April 2007.
  41. ^ Karra, Cindy: Shape Up America! Reveals The Truth About Dieters, Shape Up America! (by former U.S. Surgeon General C. Everett Koop), 29 December 2003.
  42. ^ ADA Issues New Clinical Practice Recommendations, Bio-Medicine, 28 December 2007, Alexandria, VA.
  43. ^ Exclusive Interview: Dr. Annika Dahlqvist Gets Swedish Government To Promote Livin’ La Vida Low-Carb! (Episode 107), The Livin La Vida Low-Carb Show, 28 January 2008
  44. ^ a b Warner, Jennifer: Jury Still Out on Low-Carbohydrate Diets, WebMD.com, 8 April 2003.
  45. ^ Low-Carb Experts Drs. Michael and Mary Dan Eades Offer Rebuttal to Recent 'Report' Suggesting Low Carb Diets Are Unhealthy According to LowCarbiz, Business Wire, 26 November 2003.
  46. ^ AtkinsExposed: References 1 - 1160, AtkinsExposed.org. Retrieved 12 March 2008.
  47. ^ Research Supporting a Low-Carb Diet, Wilstar. Retrieved 12 March 2008.
  48. ^ BURROS, MARIAN: EATING WELL; The Post-Atkins Low Carb Diet, The New York Times, 21 January 2004.
  49. ^ Low Carbohydrate - How Do Low Carb Diets Work?, WeightLossResources.co.uk. Retrieved 12 March 2008.
  50. ^ Shai, Iris; Schwarzfuchs, Dan; Henkin, Yaakov; Shahar, Danit R.; Witkow, Shula; Greenberg, Ilana; Golan, Rachel; Fraser, Drora; et al. (2008). "Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet". New England Journal of Medicine. 359 (3): 229–41. doi:10.1056/NEJMoa0708681. PMID 18635428. 
  51. ^ Santos, F. L., Esteves, S. S., da Costa Pereira, A., Yancy, W. S. and Nunes, J. P. L. (12 August 2008). "Systematic review and meta-analysis of clinical trials of the effects of low carbohydrate diets on cardiovascular risk factors". Obesity Reviews. 13: 1048–1066. doi:10.1111/j.1467-789X.2012.01021.x. 
  52. ^ Ajala O.; English P.; Pinkney J. (2013). "Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes". The American Journal of Clinical Nutrition. 97 (3): 505–516. doi:10.3945/ajcn.112.042457. 
  53. ^ a b Phinney SD (2004). "Ketogenic diets and physical performance". Nutrition & Metabolism. 1 (1): 2. doi:10.1186/1743-7075-1-2. PMC 524027Freely accessible. PMID 15507148. 
  54. ^ Phinney, Stephen (2004). "Ketogenic diets and physical performance". Nutrition and Metabolism. 1 (1): 2. doi:10.1186/1743-7075-1-2. PMC 524027Freely accessible. PMID 15507148. 
  55. ^ Peter Heinbecker (1928). "Studies on the Metabolism of Eskimos" (PDF). J. Biol. Chem. 80 (2): 461–475. Retrieved 7 April 2014. 
  56. ^ 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 1266943Freely accessible. PMID 16746345. 
  57. ^ Kang-Jey Ho; Belma Mikkelson; Lena A. Lewis; Sheldon A. Feldman; C. Bruce Taylor (1972). "Alaskan Arctic Eskimo: responses to a customary high fat diet" (PDF). Am J Clin Nutr. 25 (8): 737–745. Retrieved 7 April 2014. 
  58. ^ Nutrition: Carbohydrates, Women's Health Channel, retrieved 13 March 2008
  59. ^ Weickert MO, Pfeiffer AF (March 2008). "Metabolic effects of dietary fiber consumption and prevention of diabetes". The Journal of Nutrition. 138 (3): 439–42. PMID 18287346. 
  60. ^ Teff, K. L.; Grudziak, J.; Townsend, R. R.; Dunn, T. N.; Grant, R. W.; Adams, S. H.; Keim, N. L.; Cummings, B. P.; et al. (2009). "Endocrine and Metabolic Effects of Consuming Fructose- and Glucose-Sweetened Beverages with Meals in Obese Men and Women: Influence of Insulin Resistance on Plasma Triglyceride Responses". Journal of Clinical Endocrinology & Metabolism. 94 (5): 1562–1569. doi:10.1210/jc.2008-2192. 
  61. ^ Dolson, Laura: Vegetables on a Low-Carb Diet: The Best and Worst, About.com: Low Carb Diets, 3 March 2008
  62. ^ Jennifer Warner: Fiber-Rich Fruits and Cereals Protect Heart, Web MD, 23 February 2004. Cites 2004 study in The Archives of Internal Medicine showing that fiber from cereals and fruits is more beneficial than fiber from vegetable sources.
  63. ^ Kwon, O.; Eck, P.; Chen, S.; Corpe, C. P.; Lee, J.-H.; Kruhlak, M.; Levine, M. (2007). "Inhibition of the intestinal glucose transporter GLUT2 by flavonoids". The FASEB Journal. 21 (2): 366–77. doi:10.1096/fj.06-6620com. PMID 17172639. 
  64. ^ Song, J; Kwon, O; Chen, S; Daruwala, R; Eck, P; Park, JB; Levine, M (2002). "Flavonoid inhibition of sodium-dependent vitamin C transporter 1 (SVCT1) and glucose transporter isoform 2 (GLUT2), intestinal transporters for vitamin C and Glucose". The Journal of Biological Chemistry. 277 (18): 15252–60. doi:10.1074/jbc.M110496200. PMID 11834736. 
  65. ^ Miller, Kenneth B.; Hurst, William Jeffery; Payne, Mark J.; Stuart, David A.; Apgar, Joan; Sweigart, Daniel S.; Ou, Boxin (2008). "Impact of Alkalization on the Antioxidant and Flavanol Content of Commercial Cocoa Powders". Journal of Agricultural and Food Chemistry. 56 (18): 8527–33. doi:10.1021/jf801670p. PMID 18710243. 
  66. ^ Gross LS, Li L, Ford ES, Liu S (May 2004). "Increased consumption of refined carbohydrates and the epidemic of type 2 diabetes in the United States: an ecologic assessment". The American Journal of Clinical Nutrition. 79 (5): 774–9. PMID 15113714. 
  67. ^ Veech RL, Chance B, Kashiwaya Y, Lardy HA, Cahill GF (April 2001). "Ketone bodies, potential therapeutic uses". IUBMB Life. 51 (4): 241–7. doi:10.1080/152165401753311780. PMID 11569918. 
  68. ^ Joel Ceausu (26 November 2004). "CANADA: Low-carb products could be barred with new labelling rules". just-food.com. Aroq Ltd. Retrieved 12 February 2014. 
  69. ^ Morgan, William (1877). Diabetes mellitus: its history, chemistry, anatomy, pathology, physiology, and treatment. 
  70. ^ Einhorn, Max (1905). Lectures on dietetics. 
  71. ^ William Banting (1869). Letter On Corpulence, Addressed to the Public (4th ed.). London, England: Harrison. Retrieved 2 January 2008. 
  72. ^ Barry Groves (2002). "William Banting Father of the Low-Carbohydrate Diet". The Weston A. Price Foundation. 
  73. ^ a b c d Steiner, Walter R., M.D., The Starvation Treatment of Diabetes Mellitus in Proceedings of the Connecticutt State Medical Society 1916, 124th Annual Convention (1916, Published by the Society) paged 176-184. https://archive.org/details/starvationtreat00steigoog
  74. ^ Allen, Frederick M; Fitz, Reginald; Stillman, Edgar (1919). Total dietary regulation in the treatment of diabetes. New York: The Rockefeller Institute for Medical Research. 
  75. ^ Another publication of similar regimen was Hill, Lewis Webb, M.D., & Eckman, Rena S., The Starvation Treatment of Diabetes with a series of graduated diets as used at the Massachusetts General Hospital (1915, Boston) 72 pageshttps://archive.org/details/starvationtreatm00hilliala . This was so well received that it went into revised editions, eventually becoming The Allen (Starvation) Treatment of Diabetes with a series of graduated diets (4th ed., 1921, Boston) 140 pages https://babel.hathitrust.org/cgi/pt?id=hvd.hc368d;view=2up;seq=4.
  76. ^ Also see "Discussion on the Modern Treatment of Diabetes (Oct. 24, 1921)" in Transactions of the Medical Society of London, vol. 45, (1923, London, printed for the Society) pages 3-16 https://babel.hathitrust.org/cgi/pt?id=umn.319510003249606;view=2up;seq=58
  77. ^ 1967: the Stillman diet – History Of Diets, Part 12 – protein diet Men's Fitness. June 2003
  78. ^ Air Force Diet. Toronto, Canada, Air Force Diet Publishers, 1960.
  79. ^ Gardner Jameson and Elliot Williams (1964) The Drinking Man's Diet. San Francisco: Cameron. (2004) Revised Ed. ISBN 978-0-918684-65-3. See also Alan Farnham (2004) "The Drinking Man's Diet", Forbes.com.
  80. ^ Lutz, Wolfgang; Allan, C.B. Life Without Bread. McGraw-Hill; 2000. ISBN 978-0-658-00170-3. English language, 1st Ed.
  81. ^ Gordon, Edgar; Goldberg, Marshall; Chosy, Grace (October 1963). "A New Concept in the Treatment of Obesity". JAMA. 186 (1): 50–60. doi:10.1001/jama.1963.63710010013014. Retrieved 19 January 2015. 
  82. ^ A critique of low-carbohydrate ketogenic weight reduction regimens. A review of Dr. Atkins' diet revolution., Journal of the American Medical Association, 1973
  83. ^ Voegtlin, Walter L. (1975). The stone age diet: Based on in-depth studies of human ecology and the diet of man. Vantage Press. ISBN 0-533-01314-3. 
  84. ^ Jenkins, DJ; Wolever, TM; Taylor, RH; Barker, H; Fielden, H; Baldwin, JM; Bowling, AC; Newman, HC; et al. (1981). "Glycemic index of foods: A physiological basis for carbohydrate exchange". The American Journal of Clinical Nutrition. 34 (3): 362–6. PMID 6259925. 
  85. ^ "PBS News Hour: Low Carb Craze". Pbs.org. Retrieved 18 December 2011. 
  86. ^ Americans Look for Health on the Menu: Survey finds nutrition plays increasing role in dining-out choices [2]
  87. ^ Morning Edition (22 June 2004). "Low-Carb Diets Trim Krispy Kreme's Profit Line". Npr.org. Retrieved 18 December 2011. 
  88. ^ The American Kidney Fund: American Kidney Fund Warns About Impact of High-Protein Diets on Kidney Health: 25 April 2002
  89. ^ BBC (19 January 2004) Atkins diet boss: 'Eat less fat'. BBC News. Retrieved on 12 September 2007.
  90. ^ The Atkins Essentials: A Two-Week Program to Jump-start Your Low Carb Lifestyle, ISBN 978-0-06-059838-9, page 23
  91. ^ Sears, Barry; Lawren, Bill: Enter the Zone, Regan Books, 1995, 352 pp, ISBN 0-06-039150-2
  92. ^ Brand-Miller, Jennie; Foster-Powell, Kaye; McMillan-Price, Joanna: The Low GI Diet Revolution: The Definitive Science-Based Weight Loss Plan, Marlowe & Company, 30 November 2004, 336 pp, ISBN 978-1-56924-413-5
  93. ^ Diabetes Group Backs Low-Carb Diets, HealthDay News on U.S. News and World Report, 28 December 2007
  94. ^ Kossoff, Eric: Do ketogenic diets work for adults with epilepsy? Yes!, Epilepsy.com, updated 22 February 2008
  95. ^ Rosen, Evan David: Weighing In On the Low Carb Diet Controversy, Defeat Diabetes Foundation, 18 June 2003
  96. ^ Burros, Marian (21 January 2004). "Eating Well; The Post-Atkins Low Carb Diet". The New York Times. Retrieved 19 December 2010. 
  97. ^ "The Paleo Diet Simplified – The Three Food Groups to Avoid". Better Mind Body Soul. 
  98. ^ Lydia A. Bazzano; Tian Hu, Kristi Reynolds; et al. (2 September 2014). "Effects of Low-Carbohydrate and Low-Fat Diets: A Randomized Trial". Annals of Internal Medicine. 16 (5): 309–318. doi:10.7326/M14-0180. Retrieved 1 February 2015.  (subscription required)
  99. ^ ANAHAD O’CONNOR (1 September 2014). "A Call for a Low-Carb Diet That Embraces Fat". New York Times. Retrieved 1 February 2015.