Low Carbohydrate Diets

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There is no established definition of what constitutes a low carbohydrate diet beyond the idea that they all have some type of restriction on carbohydrate intake. Therefore I will classify low carbohydrate diets as "Carbohydrate Optimization Diets", "Non-Ketogenic Low Carbohydrate Diets", "Ketogenic Diets", and "Extreme Calorie Restriction Diets", as well as the baseline "Standard American Diet". The specific diets can then be mapped into these categories.

1 The Diet Classifications

  • Standard American Diet (SAD). This is the baseline from which the diets can generally be compared. The SAD is generally high in carbohydrates, and includes carbohydrate sources such as refined sugars and refined grains.
  • Carbohydrate Optimization Diets. This is a broad category of diets that don't restrict the overall quantity of carbohydrate, but do restrict particular types of carbohydrate. Examples would be Paloelithic diets, and nutrient timing.
  • Non-Ketogenic Low Carbohydrate Diets (NKLCD). A NKLC diet restricts overall carbohydrate level, typically to around 50-150g of net carbohydrate, but does not elevate ketone levels sufficiently to be considered a Ketogenic Diet. A diet that restricts net carbohydrate intake to below 50g may still be Non Ketogenic if protein intake is not also sufficiently restricted.
  • Ketogenic Low Carbohydrate Diets (KLCD). A ketogenic diet restricts both carbohydrate and protein intake so that the body metabolizes fat to produce ketones. There is no established definition of what level of ketones are required for a diet to be considered ketogenic. (Fasting ketone levels are typically ~0.3 on the SAD [Effects of a high-protein ketogenic diet on hunger, appetite, and weight loss in obese men feeding ad libitum].) Also, because it takes time to adjust to a ketogenic diet, I do not consider a diet to be a 'ketogenic diet' even if it elevates ketone levels for less than two weeks. A ketogenic diet should only be started under medical supervision. A Ketogenic diet is sometimes referred to as a Low Carbohydrate Ketogenic Diet or LCKD.
  • Extreme Calorie Restriction Diets. These diets are intended to treat severe obesity by dramatically reducing calorie intake.

1.1 Diets

Diet SAD (High Carb) Carbohydrate Optimization NKLCD KLCD ECR
S.A.D. Yes
Food Avoidance Yes Possible
Slow Carb Possible Possible Possible
Nutrient Timing Possible Possible
Paleolithic Yes Possible Possible
Atkins Yes Possible
High Protein Yes
Cyclic Ketogenic Diet (CKD) Yes
MCT Possible Possible
MAD Possible Possible
Ketogenic Ratio Diet Yes
Fasting Yes

2 The DIetns

  • Standard American Diet (SAD). This is the baseline from which the diets can generally be compared. The SAD is generally high in carbohydrates, and includes carbohydrate sources such as refined sugars and refined grains.
  • Food Avoidance Diets. There are a number of dietary modifications that avoid the specific types of food. Examples would be a gluten-free diet, or diet that avoids sugars such as fructose. These specific Food Avoidance Diets can be combined with other types of diet. For instance, a Low Glycemic Index Diet could also be gluten-free.
  • Low Glycemic Index Diet (Slow carb diet). This approach limits carbohydrate intake based on their Glycemic Index. A slow carb diet provides a relatively normal percentage of calories as carbohydrate, but avoids any high Glycemic Index foods such as those that include refined flour or sugars. (Note that this diet is different from the Low Glycemic Index Treatment discussed below.)
  • Nutrient Timing. The Nutrient Timing is similar to the Slow Carb diet, but uses high Glycemic Index carbohydrates during and immediately after exercise, then only low Glycemic Index foods the rest of the time.
  • Paleolithic Diets. There are a number of diets that aim to re-create the food intake of our caveman ancestors, whose food sources predate the birth of agriculture. Because our ancestors lived in many different geographical areas that provided radically different food sources, there is some variation in what is considered a Paleolithic diet. However, Paleolithic diets always avoid cereals and grains, as well as refined sugars, dairy products[1]. Some studies have estimated the modern hunter gatherer societies get 22–40% of their energy from carbohydrate sources[2][3]. However, modern interpretations of the Paleolithic diet can vary widely in their carbohydrate intake, and some can be ketogenic (see below for details.)
  • Atkins Diet. The Atkins diet is probably the best-known low carbohydrate diet. This diet has four phases, and the initial "induction phase" can be a Ketogenic Diet, but overall the Atkins diet does not maintain elevated blood Ketones.
  • High Protein Diet.
  • Cyclic ketogenic diets (and others from that book?).
  • MCT Diet. This is a variant of the traditional diet that uses Medium Chain Triglycerides (MCT) that produces more ketones than other oils. The MCD Diet is typically only used for the treatment of epilepsy.
  • Modified Adkins Diet (MAD). The MAD started by accident, when a child was put onto the Adkins diet prior to starting the traditional Ketogenic Ratio Diet, and their seizures stopped[4]. The MAD is similar to the induction phase of the Adkins diet, though children are allowed only 10 grams/day of carbohydrate rather than the 20 grams/day allowed for adults.
  • Low Glycemic Index Treatment (LGIT). The LGIT restricts the carbohydrate intake to only those foods with a Glycemic Index of less than 50[5]. However, the LGIT is more than just restricting the glycemic index, and requires a fat intake of 60% with a Ketogenic Ratio of 1:1. The LGIT is similar to the MAD and restricts carbohydrates to 40-60 grams/day.
  • Ketogenic Ratio Diet. The Ketogenic Ratio is commonly used to construct a diet to treat drug resistant epilepsy. The ketogenic diet measures the ratio of grams of fat to the grams of protein plus net carbohydrates. For example a 4:1 diet has 4 grams of fat to each gram of carbohydrate or protein. However, this ratio is slightly misleading, as there are other constraints on the diet. By tightly controlling the overall calorie intake and XXXXX
  • Protein Sparing Modified Fast (PSMF). The use of complete fasting to reduce body fat in the severely obese can be effective, but also tends to result in unwanted loss of muscle. By supplementing the fast with a small amount of protein, the diet can still result in rapid weight loss while sparing muscle. A PSMF should only be used under medical supervision as it can be dangerous and people have died from badly formulated PSMF.
  • Fasting. Complete fasts are sometimes used to reduce body fat in the severely obese. Many of the studies of ketosis come from studies of fasting subjects.
  • Starvation. This is not actually a diet so much as a condition. During extreme calorie intake diets the body will burn the stores of body fat and produce ketones. However, once those body fats become depleted then the body will change to burning the protein from muscle and other tissues. At this point ketosis will end and the protein will be converted to glucose. This is sometime seen in children on the Ketogenic diet who have insufficient body fat; if they get too few calories from fat they may drop out of ketosis and suffer breakthrough seizures.

3 See Also

4 References

  1. Staffan Lindeberg, Loren Cordain, S. Boyd Eaton, Biological and Clinical Potential of a Palaeolithic Diet, Journal of Nutritional and Environmental Medicine, volume 13, issue 3, 2003, pages 149–160, ISSN 1359-0847, doi 10.1080/13590840310001619397
  2. L. Cordain, JB. Miller, SB. Eaton, N. Mann, SH. Holt, JD. Speth, Plant-animal subsistence ratios and macronutrient energy estimations in worldwide hunter-gatherer diets., Am J Clin Nutr, volume 71, issue 3, pages 682-92, Mar 2000, PMID 10702160
  3. L. Cordain, SB. Eaton, JB. Miller, N. Mann, K. Hill, The paradoxical nature of hunter-gatherer diets: meat-based, yet non-atherogenic., Eur J Clin Nutr, volume 56 Suppl 1, pages S42-52, Mar 2002, doi 10.1038/sj.ejcn.1601353, PMID 11965522
  4. Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 2926
  5. Eric. Kossoff, Ketogenic diets : treatments for epilepsy and other disorders, date 2011, publisher Demos Health, location New York, isbn 1-936303-10-8, Kindle Offset 3230