Low Carb in the UK

Disputed: "The 10 best reasons a Low Carb Diet is Wrong!"

There is a nutritional booklet currently circulating in the USA called "The 10 best reasons a Low Carb Diet is Wrong!"
One of my list members was really worried about it, but "Elaine in Cumbria" took time out to refute all of its claims. I think that she did it rather well, and so, I wanted to share it with you all!

Reason 1: Your Heart Disease Risk Increases:Risk of heart disease is increased greatly on a low-CHO, low-fiber diet that is high in animal protein, Cholesterol and saturated fat.
Elaine: May I refer you to three excellent sites! The articles are quite long, but the authors know more than I do about this, and it is worth reading them.
Second Opinions - FATS, Cholesterol AND HEART DISEASE
Uffe Ravnskov's Cholesterol Pages
Diet and Heart Disease -It is not what you think

Also, Dr Atkins, who wrote the book on the low carb diet is a cardiologist, and developed it as a TREATMENT for cardiac problems! He wasn't trying to drum up business, he was trying to save his patients - and succeeding. If you haven't read Dr Atkins' New Diet Revolution, I suggest you do so.

The site owner of Second Opinions, Barry Groves, has been living low carb since the 60's, with his wife, and is on the Concise-Low-Carb-UK Yahoo! Group. He is extremely knowledgeable, and his book, "Eat Fat, Get Thin!" is very good! He advocates a less stringent regimen that Dr A, but he is really writing for a healthy life, not for those of us who are already "sick" because of our diet. My doctor is astounded at the improvements he sees in my health.
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Reason 2: Your Cancer Risk Increases: Risk of many cancers is likely to increase when most fruits, vegetables,whole grains and beans are eliminated from the diet. The National Cancer Institute currently recommends, based on the bulk of scientific research, that you eat a plant-based diet that is high-fiber and low-fat.
Elaine:Once again, the doctor is using "conventional" arguments that have been discredited by research.
Second Opinions - POLYUNSATURATED OILS AND CANCER
Second Opinions - CLIMB DOWN FROM THE BRAN WAGON
Effects of a ketogenic diet on tumor metabolism and nutritional status in pediatric oncology patients: two case reports
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Reason 3:Poor Long Term Weight Control: There is no "metabolic magic" in low-CHO diets. Those who continue to lose weight after the first week do so because they decrease calorie intake. This can occur because of decreased dietary variety. Greatly limiting the number of foods that people are allowed to eat, reduces their food and calorie intake. But a reduction in variety most often leads to boredom and cravings over the long run. One recent study showed that a high protein meal leads to greater tendency towards bingeing later in the day on foods that are high in sugar and fat.
Elaine: I don't have a site to list on this one, just my personal story!
For many years before I discovered Atkins I was trying hard not to gain weight. That's right, I would have been happy just not getting any bigger.
I ate 2 slices of wholemeal or granary toast for breakfast - no butter, another 2 slices with a clear chicken or vegetable broth for lunch, and a baked potato with no butter or cheese, some peas or sweetcorn, and either a skinless chicken breast or some tuna in brine for dinner. No snacks, no treats, no fats. I stuck with this, never more than 900 cals daily, but still gained. The dietician I begged to see told me to leave out half of the potato, but couldn't seem to see that this left me ravenous a couple of hours later, and more likely to "cheat". I find it hard to think of a diet that is more restrictive as to variety, or one that is more boring. Yet still I gained.

On Atkins I eat many more calories, of a greater variety, and am never bored. I eat many more foods than I did before, and feel fitter, healthier and generally better. I take fewer pain killers (I have a couple of disabilities which include chronic pain) and do not "binge". However, I never did. I am losing weight.

The other point I'd like to make is that the Atkins diet is not high protein (except by comparison with low fat, low cal), it is adequate protein, higher fat. It is the fat that is our energy source, not carbs or protein. Thus it MAY be that, if a high protein, low fat, low cal meal is eaten, especially by someone who eats excessive carbs, it MAY cause that reaction. (I don't know, I haven't done the trials!)We are not eating in that way, so we don't have that problem.
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Reason 4: Reduced Athletic Performance: Athletic performance is reduced on a low-CHO diet. Since the 1930's it has been known that a high-CHO diet can enhance endurance during strenuous athletic events. Mountain climbers and skiers should be warned that a ketogenic diet greatly increases the risk of mountain sickness.
Elaine:I don't know about mountain sickness, which I believe is just an altitude/oxygen thing (but may be wrong!) but for athletes who are running long distances, a phenomenon exists known as "the Wall". This is where, after about 15 miles, they run out of steam, and come crashing to a halt.
I have read that several runners have commented that this does not occur if they eat a low carb diet - it happens because the body has used all its carbs and glycogen stores, and is having to switch over to burning fat in an emergency!
Second Opinions - Diet for Athletic Performance
Second Opinions - Feed your Brain to win
If you are already burning fat, then no problem, no wall. It MAY be that for short "burst" events, such as sprints, long/high jump, javelin etc. the high energy burst from "instant" carbs may be better, but for the sustained or endurance events, it is definitely better to burn fats rather than sugar.This process of "Fat-burning for energy" is described at the end of this article:
Your Liver and Fat loss

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Reason 5:Rising Blood Pressure with Age: Blood pressure will likely increase with age on a typical low-CHO diet. In part, this is because a high-CHO, high-fiber diet includes more fruits, vegetables, whole grains and nonfat dairy products. This diet was shown to lower blood pressure most likely due to its higher content of key minerals such as potassium, calcium and magnesium. Also low-CHO diets do not restrict salt intake, the main reason blood pressure rises with age.
Elaine: Hmmm, so they agree that the main reason that blood pressure rises is due to salt intake. So by their very words, it's not due to low carb, just to salt intake. I used to use lots of salt (and pepper) to make the bland, low fat, low cal foods palatable. I last filled my salt cellar up in November, and it's still mostly full today! I never put salt on anything these days, the mayo and butter I put on savoury meals suffice. Blood pressure is also effected by obesity. By lowering weight successfully, the BP also falls.

I found this interesting site on the web:
High Blood Pressure - by Ronald Hoffman, M.D

The Doctor who wrote it does not seem to be a great advocate of low carb specifically, but he writes:

"...... In fact, there are a probably a complex array of causes including genetic factors, stress, sodium intake, environmental pollution, excess production of insulin, overweight and other specific nutritional factors. All these factors may operate simultaneously in a given individual or only one or two may account for that person's high blood pressure."

".....Actually, an even more key factor in the development of high pressure may be the circulating level of insulin. In patients who suffer from carbohydrate craving associated with high Cholesterol and triglycerides, particularly with features of diabetes, high blood pressure can be reduced by minimizing carbohydrate intake. Hence, subtract the salt shaker, but also basta on the pasta, and hold the Hostess Twinkies." So, advocating losing weight, controlling insulin production, and minimising carb intake are all factors which could reduce high blood pressure. And which diet does all these? A "Low carbohydrate" one!
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Reason 6: Gout: An excess of uric acid in the body causes gout. This excess can be caused by an increased intake of foods high in purines, which are broken down into uric acid in the body. Meat, poultry, nuts, seeds, eggs and seafood are all fairly high in purines. Elevated levels of uric acid in the blood may lead to needle-like uric acid crystals in joints.
Elaine: Once again, a trawl of the net gives us the definition:
Gout
This states:
"....It follows that gout may develop in persons whose uric acid is higher than normal. There are many causes of this. The following are some of the more common causes: Therefore the following foods which are high in Purines should be restricted or avoided:
So,looking first at the foods, we are not eating large quantities of offal,as these are the meats that contain carbs. Shellfish are also "carby" so we are careful about our intake of those. Peas, lentils and beans are a no-no, and as for alcohol, well, we all know that it will cause a stall, so we avoid it!

So what about "Excessive amounts of red meat"? Well, what's excessive? To a veggie, an ounce is excessive, to a Texan, half a cow! On Atkins, however, although meat is "free", we are not getting our energy from meat, but from fats. Several people find that they need to restrict their protein intake too, but usually when near their target weight. There are some sites that advocate around 70-100g protein daily - but this is not 70-100g meat, as this contains other things apart from protein! (100g sirloin steak has ~23.6g protein) On that basis, around 300g of "meat" during the day would be needed - and that's just an "adequate" amount, not an "excessive" one.

Looking at the other factors, we can't do a lot about heredity! However,we are trying to do something about obesity and blood pressure with this way of eating. In short, it would seem that low carb eating is probably going to be the BEST thing to avoid gout!

FYI: Dana Carpender wrote a fantasic article on Gout and LC, back in 2001, when her doctor thought that the dull ache in her thumb "has to be gout, as you are on that crazy all meat diet!": Check the section Dealing with Doctors in this edition of the lowcarbezine!

(By the way, I didn't see these anti-low carb campainers saying that Vegetarians are in danger of getting gout, did I? The nuts, seeds peas, beans and lentils that should be avoided would seem to eradicate almost all their sources of protein!!)

Also, with respect to the eggs that this "Reason" branded as bad,this site:Purine-Yielding Foods lists them as LOW in purines, not high! Therefore,I suspect that the authors of the "Reasons" are as well informed about their whole argument as they are about this one thing!
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Reason 7:Increased risk of developing Kidney Stones.Both uric acid and calcium oxalate stones are more likely to form on a high protein, ketogenic diet than on a higher carbohydrate diet with more fruit and vegetables.
Elaine:Once again, a quick trawl of the net reveals some interesting sites. This one, "Kidney Stones in Adults" says:
"....For unknown reasons, the number of people in the United States with kidney stones has been increasing over the past 20 years. White Americans are more prone to develop kidney stones than African Americans. Stones occur more frequently in men. Kidney stones strike most typically between the ages > of 20 and 40. Once a person gets more than one stone, others are likely to develop."

*Ponders* I wonder what change has been made to peoples eating habits in that period? Oh yes, "Healthy Eating". And who are the people most likely to follow this message? The 20-40's? Well, well, so the reason is unknown is it?!?

"A simple and most important lifestyle change to prevent stones is to drink more liquids--water is best. If you tend to form stones, you should try to drink enough liquids throughout the day to produce at least 2 quarts of urine in every 24-hour period."

And what message do we keep pushing on this way of eating? Drink more water.....

"People who form calcium stones used to be told to avoid dairy products and other foods with high calcium content. But recent studies have shown that foods high in calcium, including dairy foods, help prevent calcium stones.However, taking calcium in pill form, may increase the risk of developing stones.
"You may be told to avoid food with added vitamin D and certain types of antacids that have a calcium base. If you have very acidic urine, you may need to eat less meat, fish, and poultry. These foods increase the amount of acid in the urine."

So, IF you have kidney stones, and IF you form calcium stones and IF you have very acidic urine you MAY need to eat less meat. But drinking lots of water will reduce the acidity, and this diet is known to reduce the need for antacids, and we don't need calcium supplements as we are eating enough, so where does the problem lie?

Well, if you are eating loads of meat, and NOT drinking the water AND you are a "susceptible person", then you might be in trouble. But for the majority of us, who are following the plan properly, and who are not "susceptible", there should be no problems!

Interestingly, this site: About Kidney Stones when discussing oxalate stones, says that: "The foods with a high content of oxalate are spinach, rhubarb, beets, strawberries, wheat bran, nuts and nut butters."

Note that - wheat bran could exacerbate kidney stones! Barry Groves also has it in for bran. He says on his site:Second Opinions - CLIMB DOWN FROM THE BRAN WAGON
"Bran is sold as a panacea for all kinds of disease from coronary heart disease to varicose veins. Not so long ago bran, which is the outer husks of wheat and other cereals, was a worthless by-product of the milling industry. It was thrown away. Today it can be bought in health food shops, pharmacies and supermarkets at great cost. But bran is not a food; there is no enzyme in our bodies which can break it down. But that doesn't mean that it is harmless. Bran is quite unlike vegetable fibre in that it contains phytate.
"Phytate binds with a number of minerals and vitamins, so that the body cannot absorb them, and it also depletes the body of a number of minerals."
 However, I couldn't find a direct mention of Kidney stones there, but he is well worth a read!

My reading of several sites leads me to believe that:
  1. No matter what they eat, some people are susceptible to kidney stones
  2. Drinking lots of water helps prevent their formation.
  3. Eating a low carb diet MIGHT be bad, if you fall into the first category, but not the second.
  4. Eating a "Healthy diet" is as likely to be bad as a low carb one.
  5. The incidence of kidney stones has risen with the incidence of "healthy eating" diets.
My Conclusion: this is the first argument that MIGHT have some validity, if you are not following the way of eating correctly and if you are already susceptible. Drink the water, and carry on eating this way, UNLESS you already had problems!
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Reason 8:Increased Risk of developing Osteoporosis: Over time, excess protein intake, especially from animal sources, increases the loss of calcium in the urine which may contribute to osteoporosis.
Elaine:All I have on this one is just a bunch of Peer reviewed, Published articles from various Medical publications refuting this piece of nonsence. Hope these help to allay your fears!

Reference:
Spencer, H., Kramer, L., "Osteoporosis, Calcium Requirement, and Factors Causing Calcium Loss," Clinical Geriatric Medicine, 3(2), 1987, pages 389-402.

Summary:
The researchers in this study reported that a large percentage of subjects receiving a normal calcium intake of 800 mg per day were in negative calcium balance. Increasing the calcium intake to various levels up to 2,200 mg per day showed a plateau of the calcium balance at the 1,200 mg per day intake, indicating this was the threshold level of calcium absorption. Dietary factors, such as a phosphorus intake up to 2,000 mg per day and intake of complex proteins, such as red meat, do not cause calcium loss. Several commonly used drugs induce significant calcium loss, particularly aluminum-containing antacids, and, if used for prolonged periods of time, can contribute to the development of osteoporosis.

Reference:
Wolf, R.L., Cauley, J.A., Baker, C.E., et al., "Factors Associated With Calcium Absorption Efficiency in Pre- and Perimenopausal Women," American Journal of Clinical Nutrition, 72(2), 2000, pages 466-471.

Research conducted jointly by the University of Pittsburgh, the Children's Hospital of Pittsburgh and Creighton University, Omaha, shows that a high-fiber, low-fat diet may significantly lower the amount of calcium the body can absorb. The 142 women between the ages 42 and 54 who participated in the program were classified as either premenopausal or perimenopausal.

The former reported having had a menstrual period within three months of a physical exam; the latter reported no menses within the prior three months.

Calcium absorption among participants ranged from 17 to 58 percent, but women who consumed low-fat diets absorbed 20 percent less calcium than the others did.

Researchers found that women who are better able to absorb calcium had higher body mass index ratings and higher blood levels of vitamin D, a fat-soluble vitamin necessary for calcium absorption, among other important functions. These results show that supplementation alone may not be enough to boost calcium levels and protect bones from osteoporosis. Diet also plays a key role.

Conclusion:Women on low-fat diets excrete most of the calcium they consume. However, following a controlled carb regimen that includes protein, butter and cream as well as vegetables rich in calcium ensures that the calcium and other important minerals are absorbed.

Reference:
Heaney, R.P., "Dietary Protein and Phosphorous Do not Affect Calcium Absorption," The American Journal of Clinical Nutrition, 72(3), 2000,pages 758-761.

Summary:
The purpose of this study was to evaluate whether variation in phosphorus and protein intakes is associated with variation in calcium absorption.

Over a 20-year period, 191 Roman Catholic nuns (with an average age 49 years) were studied approximately three times. At each check-up, calcium and phosphorus levels were measured. Both metabolic balance and absorption studies were performed every 5 years. Researchers discovered that there was no relationship between calcium absorption efficiency and either protein or phosphorus intake. Regardless of whether subjects' protein or phosphorus intakes were high or low, there was no impact on calcium absorption.

Reference: Heaney, R.P., "Excess Dietary Protein May not Adversely Affect Bone," Journal of Nutrition, 128(6), 1998, pages 1054-1057.
Summary:
This article analyzed the relationship between dietary protein and calcium on bone health. Insufficient amounts of protein intake harm the skeleton; however, eating too much protein may increase the calcium excreted from the body. The ability to adapt depends on the individual's calcium intake.

The author stated that in a natural setting, calcium intake would automatically increase when higher amounts of protein are consumed. Although calcium loss may occur, when calcium intake is adequate, bone density is unaffected.

The author concluded that excess protein would not harm the skeleton if the calcium levels were adequate. He states that a calcium-to-protein ratio greater than or equal to 20 mg /1 g will provide adequate protection for bones. Therefore, for every gram of protein eaten, 20 milligrams of calcium is needed.

Reference:
Spencer, H., Kramer, L., Osis, D., et al., "Effect of a High Protein (Meat)Intake on Calcium Metabolism in Man," The American Journal of Clinical Nutrition, 31, 1978, pages 2167-2180.

> Summary:
The purpose of this study was to analyze the effect of high-protein intake on calcium excretion, retention and absorption in 14 men. Subjects on the high-protein diet ate two grams of protein per kilogram of bodyweight, while subjects on the low-protein control diet ate one gram of protein per kilogram of bodyweight. Meat constituted the majority of dietary protein. Both groups took part in studies that included a period of low calcium intake (200 mg per day) and normal calcium intake (800 mg per day). Two additional studies looked at calcium intakes of 1,100 and 2,000 mg per day.

Fluid intake remained constant during all study phases. In addition to calcium-absorption studies, researchers measured urinary excretion of creatinine, calcium and phosphorus; body weight and 24-hour urine volume.

Researchers found a lack of significant urinary calcium loss in the majority of the studies. The calcium absorption also did not differ significantly between the high and low protein intake groups. Urinary calcium excretion did increase moderately in two studies during the higher calcium intakes, > however, in both cases, it decreased with time to normal levels.Researchers further concluded that in the present study, a high-protein intake from a high meat diet does not lead to a significant loss of calcium and that the urinary calcium decreases with time when it does occur. If the phosphorus intake is concomitantly increased, which will happen when more meat is consumed, the induced calcium loss diminishes or stops. Furthermore, the high meat content of the protein intake used in this present study is more representative of the usual high-protein diet consumed in the United States than are the purified proteins used in other studies, which have been shown to induce a calcium loss.
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Reason 9:Increased risk of Fainting: "Orthostatic hypotension", or a rapid drop in blood pressure when you go from lying down to standing, is caused by a loss of fluid and electrolytes and reduced sympathetic nervous system activity. Both of these occur when your body is deprived of CHO. This may result in dizziness or even fainting when you stand up quickly.
Elaine:Orthostatic Hypotension By Adam Brochert, MD seems to be saying that this CAN be caused by dehydration, but as we KEEP saying, Drink more water!

The other "treatments" include giving salt tablet, and/or increasing the salt in the diet(...erm, wasn't the salt in this way of eating used AGAINST us in Reason 5?) and taking drugs to INCREASE blood pressure! Nothing is said about increasing CHO in the Diet.

However, isn't High BP one of the alleged problems with obesity? Frankly, I'm not convinced by this reason, although, once again, if you don't drink the water, and become dehydrated as a result, then this MAY occur!
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Reason 10: "Keto breath": Keto-breath can be described as a cross between nail polish and over-ripe pineapple. This is common for dieters who consume so few CHO that they put their bodies in ketosis.
Elaine: HEY! They got one right! *applause* In deep BDK, keto-breath does happen! However, is this any reason NOT to lose weight?
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Sumation:Your best bet for permanent weight loss and control, as well as good health, is twofold:
  1. Increase the amount of fruits, vegetables, whole grains, beans and non-fat dairy products that you eat
  2. Eliminate calorie-dense foods such as cookies, sugary desserts, bagels, (Elaine Note:man, I miss those bagels) crackers, chips, fries, pizza, candies, etc.
Research on people who have successfully lost a lot of weight and kept it off long term, shows that the vast majority succeeded by consuming a low-fat, high-fiber diet coupled with regular exercise.
Well, we are following the advice in 2), if not in 1). However, IS their advice the best way to lose permanently? Would any of us be following this way of eating if it was? No, the "relapse" rate of dieters is much higher on low fat/low cal than low carb.
For example:
"Poll Results: Atkins Beats Out Low-Fat Diets
According to a 1999 independent Roper Starch public opinion poll, the Atkins Nutritional Approach (TM)beats out the tried-and-not-so-true low-fat approach to dieting on all key counts. Not only is Atkins rated more effective for weight loss, it also has a higher success rate than low-fat diets, says the poll.

More than twice as many Atkins followers lost weight than did low-fat dieters. This ground-breaking survey polled 307 American dieters. Approximately half stated they were doing Atkins; the remainder, a low-fat plan. The Atkins group spent fewer weeks on their weight-loss program but achieved a higher success rate. Atkins followers also didn't have to cope with side effects, such as hunger pangs, that commonly cause failure.

The bottom line: The Atkins group was twice as successful in sticking with the diet and controlling food cravings, meaning they were less likely to "cheat."

The Results

Weight loss met or exceeded expectations: Atkins: 54% Low-Fat Plan: 22%
Still want to lose more weight: Atkins: 76% Low-Fat Plan: 82%
Now on formal weight-maintenance program: Atkins: 15% Low-Fat Plan: 4%
Report satisfaction with plan as "highly favourable": Atkins: 49% Low-Fat Plan: 31%
Report no hunger pangs: Atkins: 52% Low-Fat Plan: 21%
Able to maintain a constant energy level: Atkins: 50% Low-Fat Plan: 31%
Able to control food cravings: Atkins: 54% Low-Fat Plan: 21%
Atkins Diet study November 1999 conducted by Roper Starch Worldwide, Inc."
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Final Thoughts:Frankly, IMO, the whole list of reasons is quite "bogus". It seems that they have decided on their hypothesis (low carb is BAD!) and tried to throw as much sand in the air to confuse the issues as possible. Even their concluding paragraph is wrong. Low carb is easier to stick with, and therefore better for weight control, and health. I would like to see any INDEPENDENT research they have that supports their evidence - independent means not sponsored by vegetarian groups, food manufacturers, or "diet factories". I realise that much of the evidence I have cited over the past 10 "reasons" may not be independent, or even particularly scientific, but it is as valid as theirs, and I am following this way of eating for two years because I feel fitter, better, healthier, more energetic, than I have for decades. I'm lighter, my "teenage acne" has at last cleared (I'm 44!) , and my hair is less greasy.

When I eat low carb my back and joint pain (car crash 5 years ago!) is less intrusive and easier to control. I don't have the chronic "windiness" I used to experience. I don't suffer from the tiredness, energy crashes and shakes, if I don't eat . I eat more veggies than I used to, and a greater variety of veggies, as well as meats. I used to have the most boring low fat, low cal diet in the world, this way of eating is sheer luxury, and I can experiment and change my meals around any time I want without feeling guilty about food.
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