Low-carbohydrate diet
[10] The UK National Health Service recommend that "carbohydrates should be the body's main source of energy in a healthy, balanced diet.
Carbohydrate has been wrongly accused of being a uniquely "fattening" macronutrient, misleading many dieters into compromising the nutritiousness of their diet by eliminating carbohydrate-rich food.
[20] Low-carbohydrate diet advocates including Gary Taubes and David Ludwig have proposed a "carbohydrate-insulin hypothesis" in which carbohydrates are said to be uniquely fattening because they raise insulin levels and cause fat to accumulate unduly.
[21][22] The hypothesis appears to run counter to known human biology whereby there is no good evidence of any such association between the actions of insulin, fat accumulation, and obesity.
[18][21] In 2017, Kevin Hall, a National Institutes of Health researcher hired to assist with the project, wrote that the carbohydrate-insulin hypothesis had been falsified by experiment.
[22][21] Hall wrote "the rise in obesity prevalence may be primarily due to increased consumption of refined carbohydrates, but the mechanisms are likely to be quite different from those proposed by the carbohydrate–insulin model.
"[21] It has been repeatedly found that in the long-term, all diets with the same calorific value perform the same for weight loss, except for the one differentiating factor of how well people can faithfully follow the dietary programme.
[25][18] The Endocrine Society stated that "when calorie intake is held constant ... body-fat accumulation does not appear to be affected by even very pronounced changes in the amount of fat vs. carbohydrate in the diet".
[26] Much of the research comparing low-fat vs. low-carbohydrate dieting has been of poor quality and studies which reported large effects have garnered disproportionate attention in comparison to those which are methodologically sound.
"[38] According to the ADA, people with diabetes should be "developing healthy eating patterns rather than focusing on individual macronutrients, micronutrients, or single foods."
They recommended that the carbohydrates in a diet should come from "vegetables, legumes, fruits, dairy (milk and yogurt), and whole grains", while highly refined foods and sugary drinks should be avoided.
[38] For individuals with type 2 diabetes who can't meet the glycemic targets or where reducing anti-glycemic medications is a priority, the ADA says that low or very-low carbohydrate diets are a viable approach.
[43] A low-carbohydrate diet causes extensive metabolism of fatty acids, which are used by the liver to make ketone bodies, which provide energy to important organs, including the brain, heart, and kidneys, in a condition called ketosis.
Looking at the diet composition the authors found that eating more animals foods was associated with an increased cancer risk while plant fat consumption was not.
[46] As of 2018[update], research has paid insufficient attention to the potential adverse effects of carbohydrate restricted dieting, particularly for micronutrient sufficiency, bone health and cancer risk.
[27] Significantly restricting the proportion of carbohydrate in diet risks causing malnutrition, and can make it difficult to get enough dietary fiber to stay healthy.
[50] 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.
[52] Physicians who advocated a low-carbohydrate diet consisting of large amounts of animal fat and protein to treat diabetes in the late 1800s include James Lomax Bardsley, Apollinaire Bouchardat and Frederick William Pavy.
[55][56] 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.
[70] Parts of the mainstream medical community have denounced low-carbohydrate diets as being dangerous to health, such as the AHA in 2001[71] and the American Kidney Fund in 2002.
[76] Children on this diet are at risk of broken bones, stunted growth, kidney stones, high cholesterol, and micronutrient deficiency.
The premise of the weight-loss ketogenic diet is that if the body is deprived of glucose obtained from carbohydrate foods, it will produce energy from stored fat.
However, concerns about serum sodium levels led researchers to propose the diet only be used in "selected" people, and under strict medical supervision.
