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Nutritionist and dietician
We believe that a low carb diet is the key to combating some of the biggest health threats of our time, including obesity and type 2 diabetes. This view is supported by scientific evidence.
In a low-carb diet, the consumption of carbohydrates - such as those found in cereal products and starchy fruit and vegetables - is limited and protein- and fat-rich foods are eaten instead. Many different low-carb diet concepts have now been developed. Each diet differs in terms of the type and amount of carbohydrates allowed.
Normally, a low-carb diet is aimed at weight loss. However, some people can not only reduce their weight, but also lower certain risk factors associated with type 2 diabetes and metabolic syndrome. A low-carb diet can therefore also be beneficial for your health.
Most people opt for a low-carb diet because they:
Be sure to talk to your doctor or naturopath before starting a weight loss diet. This is particularly important if you suffer from certain illnesses, such as diabetes or heart disease.
Carbohydrates are contained in foods in simple or complex form and provide the body with the energy it needs.
Carbohydrates can be divided into:
The most important and best sources of natural carbohydrates are:
Food manufacturers often add refined carbohydrates to their products in the form of sugar or white flour with a low type number. Examples of foods that contain refined carbohydrates are white bread, pasta, cookies, cakes, sweets and sugar-sweetened soft drinks and beverages.
Carbohydrates are the main source of energy for our body. Complex carbohydrates (e.g. starch) are converted into simple sugars during the digestive process. They are then released into the bloodstream. From then on, it is referred to as blood sugar (glucose).
This means that there is a big difference in energy production between eating a piece of white bread and wholemeal bread. Whole grains contain polysaccharides, which first have to be broken down into simple sugars, so digestion takes longer. Wholemeal products therefore keep you full for longer and have less of an effect on blood sugar levels. White bread, on the other hand, provides the body with energy immediately, causes blood sugar levels to rise rapidly and is also broken down again quickly. Simple sugars only keep you full for a short time.
An increased blood sugar level triggers the release of insulin. Insulin enables glucose to enter the cells. The body uses some of the glucose as energy for all bodily processes - be it an endurance run or breathing in and out. Excess glucose is normally stored in the liver, muscles or other cells for later use or converted into fat.
The idea behind a low-carb diet is that a lower carbohydrate intake reduces insulin levels and the body has to obtain energy from stored fat. As a result, we lose weight.
Most people automatically lose weight when they limit their calorie intake and exercise more. To lose between 0.5 and 0.7 kg per week, you need to reduce your daily calorie intake by 500 to 700 calories.
It is quite normal to lose a lot of weight very quickly on a diet. This phenomenon is related to the way our glycogen stores are stored, namely together with three to four grams of water per gram of glycogen. If your body uses up its glycogen stores due to the reduction in carbohydrates in your diet, the water bound to glycogen also disappears. So we lose water (or the corresponding weight) and not fat. Not yet. At least not until the glycogen and its water have disappeared from the muscles and liver.
Incidentally, this is also the explanation for why many people who are on a ketogenic diet and go overboard once notice an alarming weight gain the next day. Even if the carbohydrates consumed are at a moderate level (i.e. a grilled cheese instead of a giant birthday cake), your greedy liver and muscles will grab as much glycogen as possible and the corresponding water as well.
Zack! Immediate weight gain.
But that's no reason to panic - water comes and goes. However, if you want to burn excess fat, you simply have to stick to your diet over a longer period of time. Then your body will automatically go into fat-burning mode.
People who don't think much of ketogenic diets and dispute their effectiveness repeatedly emphasize that you will put on weight again as soon as you stop the diet.
Of course, any weight loss from water will quickly be reversed as soon as you consume more than 100 grams of carbohydrates - this is the nature of glycogen storage. Any weight gain beyond that is just a result of excess calories and has nothing to do with quitting the ketogenic diet.
Low-carb diets, especially those that severely restrict carbohydrate intake, may lead to greater short-term weight loss than diets that restrict fat intake. Most studies came to the conclusion that the benefits of a low-carb diet are not particularly great after 12 or 24 months. A 2015 review found that a diet with a higher protein intake and limited carbohydrate intake had slight benefits in terms of weight loss and lowering body fat mass compared to a normal protein diet.
Presumably, it is not only limiting calorie and carbohydrate intake that contributes to weight loss. Some studies show that we also lose weight because the higher protein and fat intake makes us feel fuller for longer and we therefore eat less.
Serious diseases can be prevented or improved with a low-carb diet.
In fact, any diet that helps you lose weight will reduce or even reverse risk factors for cardiovascular disease and diabetes. Most diets - not just low carb diets - can at least temporarily lower blood cholesterol and blood sugar levels.
Low-carb diets are slightly better at lowering HDL and triglyceride levels than diets with a moderate carbohydrate intake. This is probably not only due to the quantity of carbohydrates consumed, but also to the quality of the other foods you eat. Lean protein (fish, poultry, legumes), healthy fats (monounsaturated and polyunsaturated fatty acids) and unprocessed carbohydrates (whole grains, legumes, vegetables, fruits and low-fat dairy products) are generally considered healthy foods.
A conflicting report by the American Heart Association, the American College of Cardiology and the Obesity Society states that there is not yet enough evidence to say whether low-carbohydrate diets have a positive effect on heart health.
In general, a low carb diet focuses on protein intake and includes meat, poultry, fish, eggs and some non-starchy vegetables. It also excludes most cereals, bread, sweets, pasta and starchy vegetables and sometimes nuts and seeds. Some low carb diets allow small amounts of certain fruits, vegetables and whole grains.
A limit of 20 to 60 g of carbohydrates per day usually applies. This amount provides between 80 and 240 kcal. In some low-carb diets, carbohydrate intake is drastically restricted at the beginning and then slowly increased again as the diet progresses.
In contrast, the dietary recommendations for Americans are that carbohydrates make up between 45 and 60 percent of the total calorie intake. With 2000 kcal a day, between 900 and 1300 should come from carbohydrates.
If you suddenly restrict your carbohydrate intake drastically, you may experience temporary side effects. The reason for this is the low-carb flu.
Symptoms of the low-carb diet:
In addition, some low-carb diets limit carbohydrate intake in such a way that vitamin or mineral deficiencies, bone loss and gastrointestinal disorders can occur in the long term. The risk of various chronic diseases also increases.
As low-carb diets do not provide the necessary nutrients, they are not suitable for children and young people who want to lose weight. During growth, the body absolutely needs the nutrients contained in wholegrain products, fruit and vegetables.
Drastically limiting carbohydrates - less than 20 g per day - leads to a process called ketosis. Ketosis occurs when the body does not have enough sugar (glucose) available as energy and therefore breaks down stored fat. As a result, ketones are deposited in the body. The side effects of ketosis include nausea, headaches, mental and physical exhaustion and bad breath.
So far, the possible long-term risks of a low-carb diet have not been researched, as most studies have lasted less than a year. Some health experts believe that consuming large amounts of animal fat and protein leads to an increased risk of heart disease and certain cancers.
If you (want to) eat a low-carb diet, choose foods that contain healthy unsaturated fats and healthy proteins. Limit your intake of foods that contain saturated and trans fats, such as some meats, high-fat dairy products and industrially produced crackers and pies.
Why do many people feel tired and listless and experience flu-like symptoms when they start a low-carb diet?
To understand this, you first have to understand the process behind it.
Glycogen is a sugar compound (more precisely, a polysaccharide) that our body uses to store energy as glucose, mainly in the liver and muscles. High-intensity physical exertion (such as sprinting) draws on the glycogen stored in the muscles as a kind of fuel - which is why marathon runners, for example, consume a lot of carbohydrates before major competitions.
The glycogen stored in the liver ensures that certain endogenous systems such as the brain, kidneys and red blood cells work throughout the day. For example, the body needs at least 100 grams of glucose a day to maintain the basic functions of the brain.
So what happens if someone eats significantly less than 100 grams of carbohydrates in a day? And what happens when the body runs out of glucose?
To find this out, the hierarchy of energy sources must first be understood.
Your body is actually as lazy as you are when you're munching on potato chips on the living room couch on a Sunday afternoon. It will always get its energy with as little effort as possible - i.e. from the most readily available source. The quickest energy comes from carbohydrates in the diet, especially the simple ones that can be quickly converted into sugar. (Think white bread, sweets, fructose, etc.) For someone with normal Western eating habits - and we are talking about an average of at least 300 grams of carbohydrates per day - the body will most likely not (be able to) burn all the energy potential supplied. Instead, it sweeps it under the carpet and turns it into what we generally refer to as "waistline gold" and find less attractive.
So if you limit your daily carbohydrate intake to less than 100 grams, something interesting happens: the body first draws on the carbohydrates consumed and then on the glycogen reserves in the liver so that it can maintain its basic functions. When these stores are exhausted - which is usually the case after a day - things get really exciting.
The body may be a lazy fellow, but it still has a few tricks up its sleeve. When it runs out of both glucose and glycogen, it starts a process called gluconeogenesis (which can be translated as "making new glucose"), which begins in the liver.
Gluconeogenesis is the reason why you don't actually need to eat any carbohydrates to ride your bike down the road. This is because in this case the liver switches into gluconeogenesis mode and produces the glucose required for the brain simply with the help of non-carbohydrates such as glycerol from fats or amino acids from proteins.
However, producing glucose through gluconeogenesis is a lengthy process that puts a lot of strain on your sluggish body. Think of marathon runners when they suddenly seem to hit a wall and a state of total exhaustion sets in where - as a result of the glycogen in the muscles being used up - there is no energy left. For non-marathon runners, the end of glycogen stores comes as they consume less carbohydrates in their diet, which corresponds to a change in eating habits that results in a very similar situation during the first few days.
This condition has many names -Atkins flu, induction flu, keto flu or "low carb flu".
Similar to a real flu. This is due to the fact that the body is used to obtaining its energy from easily and quickly utilizable carbohydrates and protests when it is suddenly forced to switch to other fuel sources.
The pleasant flip side of the coin (especially for those who want to shed excess pounds): Now that carbohydrates are no longer available, fat stores are the best alternative source of energy for the body to cope with the change in energy production as quickly as possible.
Congratulations! You are now in fat burning mode.
Your personal choice of food depends on your state of health, how much sport you do and how much weight you want to lose.
The following list therefore only serves as a general guideline and is not set in stone. Please consult your naturopath before starting a low-carb diet.
Your diet should consist mainly of these non-processed foods with a low carbohydrate content:
If you want to lose weight, pay attention to the quantities you eat.
Include plenty of low-carb vegetables in your diet. If you want to eat less than 50 g of carbohydrates per day, you still have the option of eating a piece of fruit and plenty of vegetables every day.
If you are healthy and active and do not need/want to lose weight, you can increase your carbohydrate intake a little.
But you can also enjoy these foods in moderation:
Dark chocolate contains many antioxidants and can provide health benefits when consumed in moderation. However, remember that dark chocolate and alcohol will affect your success if you consume too much.
Again, if you are healthy, slim and active, you can eat tubers such as potatoes and sweet potatoes in moderation, as well as healthy grains such as oats.
You should avoid these six food groups in order of importance.
Be sure to read the list of ingredients of products that are declared as "healthy".
For health reasons, you don't need to eat more than three meals. If you do get hungry between meals, try these healthy low-carb snacks that are quick to prepare:
In most restaurants, it should be easy to turn your meal into a low-carb menu.
There is no clear definition of what exactly counts as low carb. Some consider 100 - 150 g of carbohydrates per day to be low carb. This amount is considerably lower than the standard diet in industrialized countries. Most people would achieve impressive results with this amount if they were to eat unprocessed foods.
However, if you want to reach the state of ketosis and flood your body with lots of ketones as an energy source, this amount is clearly too much.
You will probably have to experiment a little until you find the optimal amount for you. For most people, however, this means that they can consume less than 50 g of carbohydrates per day to achieve full ketosis.
With this amount, you don't have many options left, apart from a few vegetables and a few berries.
CONCLUSION: If you want to achieve ketosis and reap the full benefits of a low-carb diet, you must limit your carbohydrate intake to less than 50 g per day. Nevertheless, check your state of health with your naturopath beforehand.
Proteins are important macronutrients. Most people consume too little of them. Proteins can improve satiety and boost fat burning compared to other macronutrients.
In general, a higher protein intake leads to weight loss and an improved body composition. However, as part of a low carb diet, there is a risk that you will consume too much lean meat or other animal foods. When you eat more protein than your body needs, it converts some of the amino acids it contains into glucose in a process called gluconeogenesis.
This can be a problem, especially with extreme low-carb and ketogenic diets, as you will not achieve full ketosis.
According to Volek and Phinney, a "balanced" low-carb diet should consist of few carbohydrates, plenty of fat (lots of omega 3) and protein in moderation.
A good guideline is 1.5 to 2 g of protein per kg of body weight.
CONCLUSION: Proteins can be converted into glucose by the body as part of gluconeogenesis. An excessively high protein intake prevents you from reaching the state of ketosis.
Most people meet their calorie needs with carbohydrates, especially from sugar and grains. If you cut out this source of energy, you have to replace it with another, otherwise you will starve.
Unfortunately, some people believe that it is even better to eat a low-fat AND low-carb diet. But this is a big mistake.
Your body needs some source of energy. Therefore, if you do not consume carbohydrates, you MUST increase your fat intake in return. If you don't do this, you will be hungry, feel really bad and sooner or later give up.
From a scientific point of view, there is no reason to fear fats as long as you choose healthy fats, i.e. monounsaturated, saturated and omega-3 (polyunsaturated) fats. At the same time, you should keep certain vegetable oils to a minimum and exclude trans fats altogether.
As part of a low-carb diet, fats should provide at least 50 to 60 percent of calories. Volek and Phinney even recommend a fat content of 70 percent.
To consume this much fat, you need to eat fatty meats and include generous amounts of healthy fats such as butter, sour cream, coconut oil and olive oil in your diet.
CONCLUSION: A low-carb diet with a severely restricted carbohydrate intake must be high in fat in order to meet the body's energy requirements.
One of the main mechanisms of action of a low-carb diet is that insulin levels are lowered. Insulin performs numerous functions in the body and, for example, signals fat cells to store fat. It also signals the kidneys to store sodium.
As part of a low-carb diet, insulin levels drop and the body begins to excrete large amounts of water and sodium. This is why people lose so much weight in the first day of a low-carb diet.
However, sodium is a vital electrolyte. If the kidneys excrete too much sodium, this causes problems in the body. This is the main reason why people suffer from side effects of a low carb diet such as drowsiness, fatigue, headaches and even constipation.
The best way to prevent these side effects is to increase your sodium intake. To do this, add more salt to your food or drink a cup of broth every day. For example, simply dissolve a stock cube in a cup of hot water and drink the broth. Not only does it taste good, but it also provides 2 g of sodium.
CONCLUSION: A low-carb diet leads to a reduction in insulin levels. As a result, the kidneys excrete more sodium. This can lead to a slight sodium deficiency and consequently to side effects. You should therefore prevent a deficiency at an early stage.
Our body is designed to primarily burn carbohydrates, as long as they are available. Therefore, if carbohydrates are constantly available, the body only burns these.
If you suddenly reduce your carbohydrate intake, your body has to switch to another source of energy - fat. This fat is either stored body fat or fat that you add to your diet. The body needs a few days to cope with this change. During this time you will probably not feel completely fit.
This condition is also known as "low-carb flu". Most people are affected by it. It usually lasts around three to four days. However, it can take several weeks for the body to fully adapt. For this reason, you need to be patient and stick to your diet plan from the start so that this metabolic adjustment can take place.
CONCLUSION: It takes a few days to get over the "low-carb flu" and up to several weeks for your body to fully adapt to your changed eating habits. You just have to be patient.
However, it is not enough to simply eat fewer carbohydrates to achieve optimum results. You must adhere strictly to the guidelines in order to achieve the desired effect and not fall into a yo-yo effect.
Consult your naturopath before starting a low-carb diet. In any case, your health status should be measured so that the foods and permitted amount of carbohydrates can be determined. Make follow-up appointments to monitor your progress.
Sources (in English):
Westerterp-Plantenga, M. S., Nieuwenhuizen, A., Tomé, D., Soenen, S. & Westerterp, K. R. (2009). Dietary protein, weight loss, and weight maintenance. Annual Review of Nutrition, 29:21-41, doi: 10.1146/annurev-nutr-080508-141056
Veldhorst, M. A., Westerterp-Plantenga, M. S. & Westerterp, K. R. (2009, September). Gluconeogenesis and energy expenditure after a high-protein, carbohydrate-free diet. The American Journal of Clinical Nutrition, 90(3):519-26, doi: 10.3945/ajcn.2009.27834
Hernandez, T. L., Sutherland, J. P., Wolfe, P., Allian-Sauer, M., Capell, W. H., Talley, N. D. et al. (2010, March). Lack of suppression of circulating free fatty acids and hypercholesterolemia during weight loss on a high-fat, low-carbohydrate diet. The American Journal of Clinical Nutrition, 91(3):578-85, doi: 10.3945/ajcn.2009.27909
Tiwari, S., Riazi, S. & Ecelbarger, C. A. (2007, October). Insulin's impact on renal sodium transport and blood pressure in health, obesity, and diabetes. American Journal of Physiology Renal Physiology, Volume 293, Issue 4, doi: 10.1152/ajprenal.00149.2007
Hession, M., Rolland, C., Kulkarni, U., Wise, A. & Broom, J. (2008, December). 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, Volume 10, Issue 1, doi: 10.1111/j.1467-789X.2008.00518.x
Westman, E. C., Feinman, R. D., Mavropoulos, J. C., Vernon, M. C., Volek, J. S., Wortman, J. A. et al. (2007, August). Low-carbohydrate nutrition and metabolism. The American Journal of Clinical Nutrition, 86(2):276-84, doi: 10.1093/ajcn/86.2.276
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