When people want to lose weight - they often cut down on carbs. It can work like a charm - with the pounds melting off (at least initially). But is this a good approach for everyone for the long term? Are there some downsides? This article helps you to know if low carb might be right for you, and also when your low carb diet might be backfiring...
Want to know what one of the most controversial and misunderstood areas of nutrition is?
On the one hand, you have the Low Carb enthusiasts, who tout the myriad of benefits of less carbs and more fat - who tout the low carb diet as the secret to resetting the metabolism and getting out of insulin resistance. And there is a lot of evidence that they are right - the majority of the population is getting way too many carbs in their diets - especially simple carbs.
A recent study supports the low carb approach - it found that doubling the intake of saturated fats did not affect the levels of fats in the blood. And conversely, the study found that an increased intake of carbohydrates increased the levels of fats in the blood. According to Dr. Dariush Mozaffarian, dean of the Friedman School of Nutrition Science & Policy at Tufts University, dietary refined carbohydrate is the primary driver of circulating saturated fatty acids in the bloodstream. "White bread, rice, cereals, potatoes, and sugars — not saturated fat — are the real culprits in our food supply," said Mozaffarian.
So if you are one of the millions of Americans that is struggling with stubborn weight gain - you might find that cutting down on carbs like bread, crackers, and cereals, and dialing up on the fats - can improve insulin sensitivity, reduce hunger, and improve many metabolic markers like triglycerides, cholesterol...and allow you to finally drop those stubborn pounds.
There are some people that take it a step further than low carb - to a Ketogenic approach - which is basically an extremely low carb, very high fat diet. Ketogenic diets train the metabolism to run on ketones for fuel instead of glucose/carbs. A recent study confirmed that a ketogenic diet led to a reduction in body mass, decreased triglycerides, LDL cholesterol and blood glucose; and an increase in HDL cholesterol.
If you haven't already, you might be ready to jump on the low carb bandwagon now! But wait - is low carb or ketogenic a panacea? Is it right for everyone? Should we all just go low carb and call it a day?
One the other side of the argument are the Carb enthusiasts, who say our bodies and brains run on glucose and so carbs are what give our body and brain energy. And without them, we will bonk and this can eventually send our body go into hormonal havoc.
Well then. Who is right?
They both are - because the answer depends on the person, their current situation, and most importantly the TYPE of carbs we are talking about. Not all carbs are created equal - and so we can not "lump" all carbs into one basket - you can't really put sodas in the same bucket as broccoli! To truly comprehend this conundrum, we need to first ask...
What are carbohydrates?
Carbohydrates are macronutrients that are basically made up of chains of sugars. These chains can be simple or complex. Simple carbs (monosaccarides) contain one or two sugars in their chain. Simple carb chains are broken apart easily, and therefore are a quick source of energy.
Generally speaking, simple carbs do provide quick energy (calories), but not much else - so most are "empty calories." After or during a hard long workout, you might need a simple carb to replenish energy, but generally speaking eating a lot of simple carbs overtime can lead to insulin resistance, weight gain and many other health problems. And if they do not come paired with any fiber, the energy boost that you get from simple carbs is short-lived and can be followed by a "crash."
There are many issues with eating a lot of sugar or simple carbs:
the energy is short lived, followed by a crash.
they stimulate your hunger and cravings for sweets
overtime, eating a lot of sugar and simple carbs can lead to insulin resistance - which means your metabolism can not effectively process carbs for energy, and blood sugar stays elevated
excess sugar is linked to most major non-communicable diseases.
Complex carbs (polysaccarides) contain 3 or more chains of sugars, they are not broken down as quickly as simple carbs - and therefore serve as a longer lasting energy source. Complex carbs contain fiber and/or starches.
Carbs often get a bad rap, but nutritious carbs that come paired with fiber, vitamins and minerals (like vegetables and fresh, whole fruits) give you longer lasting energy, satisfy your hunger better, and have even been shown to lower the risk of many diseases including cancer, heart disease and diabetes.
Is Low Carb a Good Option for You?
Let's take a look at the pros and cons of a low carb diet, some common pitfalls - and who might benefit from lowering carbs, and who may not.
Going low with carbohydrates in our diets (especially simple carbs) can be useful strategy for those with:
Excess body fat/weight (especially around the midsection)
Chronic and systemic inflammation
Some Autoimmune Conditions (grain free is recommended for this population)
Extremely low carbohydrate/ high fat diets (KETOGENIC diets) has been studied for years to benefit persons with:
According to this article in the NY Times, low carb, higher fat diets can help people improve their heart health markers and also lose unwanted body fat. The people who diet was comprised of at least 40% dietary fat (13% saturated) were found to lose more weight (about 8 pounds on average more in a year's time) and have better inflammation and triglyceride markers than the people who took in less than 30% fat in their diets. The people who had lower fat intake also lost muscle along with any fat loss, which is not good for the metabolism.
While low carb diets can reset our insulin sensitivity and it can be THE factor that gets some people's metabolism going again....sometimes, low carb diets for a long term can lead to a myriad of issues - including thyroid issues and hormonal havoc. Some studies even show that low carb diets can actually cause insulin resistance - the very condition that it can initially improve! (read this article to learn more).
Low carb diets are not a panacea, and may not work for everyone, in fact they could be disastrous to some people's health. Below are some signs that a low carb diet may not be for you, or that you need to adjust your diet to include some more nutritious carbs.
Signs Your Low Carb Diet May be Backfiring:
You have lost your period (hypothalmic amenorrhea) - this usually means that your body is basically in "starvation mode" - (if this happens, you need to eat more calories, reduce your stress, stop the cardio and do easy calming exercise like yoga. Read: How to Eat for Hypothalamic Amenorrhea)
You have developed adrenal fatigue, thyroid issues, fertility problems or other hormone issues since going low carb - or it has worsened. (Read: Stop Eating Low Carb if you Care about Your Thyroid)
Your weight loss has stalled, or you are gaining weight
You have melasma or "liver spots" (this can be a sign of adrenal fatigue/hormone issues)
Your sleep is sub-par. Carbohydrates help to lower cortisol levels, so very low carb diets can mess with our cortisol rhythms and sleep patterns. Sometimes all it takes is adding 1 serving of starcy carbs at dinnertime (or a resistant starch drink before bedtime - see below)
You are tired a lot, or have a hard time getting out of bed
You are losing your hair, or it is thinning
You have developed digestive issues (low carb diets are naturally low in fiber. Fiber supports healthy digestion and is the "food" for our good bacteria. So overtime a low carb diet could lead to digestive distress)
You have dark circles under your eyes, or the areas under your eyes have a "sunken" appearance (this can be a sign of adrenal fatigue)
You are seriously underweight
You are a woman. Women in general do not fare as well as men on very low carb diets long term. There are exceptions to every rule, but this is true in general. (read: Females, Carbohydrates and Hormones)
You are not effectively building muscle (despite working out).
Common mistakes Made on Low Carb or Keto Diets:
Not getting enough healthy fats! This is extremely common and very important to understand that you just can't lower your carbs, you need to balance it out by increasing healthy fats, and to a lesser extent protein. One of the most common mistakes that happens when people go low carb - is they do not dial up their healthy fats enough. I call it "The Carb & Fat See -Saw" - the lower your carbohydrate intake, the more you have to dial up the healthy fats. The higher you go with the carbs, the lower you should go with the fats. Many people find that a balanced approach works the best - like a 40-30-30 approach (40% fat, 30% carbs, 30% protein). If you are going to a ketogenic diet - you are getting upwards of 60% fat and very low carbs (very low glycemic, no sugar at all). Although eating that much fat sounds fun - it is actually not easy to sustain - that is a lot of fat!
Not getting enough total calories/food (putting the metabolism into 'famine' mode - which slows the metabolism down and messes with hormones).
Going too high with the protein (or sometimes too low). Protein is important for building and maintaining muscle, keeping blood sugar level, and so you want to get plenty of protein. But getting too much protein can lead to weight gain, and if you are following a ketogenic diet - excesses of protein can put you out of ketosis.
Being Dogmatic. Sticking to a low carb diet when it is clearly no longer serving your health is not a good idea. I think the bottom line is - not all dietary approaches work the same for everyone, all the time. And even if one approach works for you at one point, it may need to be adjusted later. So stay in tune with your body and mind to know when you need to make adjustments.
Not keeping tabs on your lipids with regular bloodwork. Some people (especially those with 2 copies of the APOE4 alleles) can be what is referred to as "Hyper-responders" to saturated fats - which means eating more than a very small amount of saturated fats can raise cholesterol levels. Hyper-responders may not be good candidates for a keto approach, or at least not a Keto diet that is high in saturated fats (they may be better off on a low carb diet that is richer in mono-unsaturated fats, with less saturated fats). It is not cut & dry, but it is important to get a full lipid panel run, and to stay on top of it before & while embarking on a keto or low carb diet. It actually is a good idea to get a thorough blood panel run before you begin any major dietary changes, and after a few weeks to a few months to see if you are responding well to the changes. Learn more about what a "Hyper-responder" is here.
Read: Is a Low Carb Diet Ruining Your Health?
How Many Carbs Do I Need?
I get this question A LOT in my Break up with Sugar program. And as much as I want to give them an answer - there really is no one real clear answer for everyone. The amount of carbs a person needs depends on a number of factors. You need to find the right balance for you for that timeframe in your life.
Here are a few things to consider when determining your carb need:
Are you sedentary? You need less carbs, because you are not regularly burning sugars/carbs and glycogen (stored sugars). Sitting is the new smoking - so if you are sedentary - one of the best things you can do is to gradually get more movement in your life. Start with easy activities like walking or gentle yoga.
Do you exercise regularly & intensely – you might need more carbs if you exercise intensely. There are cases of very low carb/high fat endurance athletes, but generally speaking – those in endurance sports will need higher amounts of carbs than the average – because they are burning through their glycogen stores in their muscle and livers.
Do you have a fast metabolism? Persons with a fast metabolism tend to do better on diets with slightly more carbs. If you tend to have a more sluggish metabolism, then you might do better on a paleo/low carb approach.
Do you have insulin resistance, pre-diabetes, or metabolic syndrome? - If you have insulin resistance (your body is not responding to insulin signals and therefore not effectively processing carbs & sugars for energy), you generally need less carbs until you can recover your insulin sensitivity.
Do you have adrenal fatigue? – People with adrenal fatigue and high levels of stress generally do better when they don’t skip breakfast and have some high quality healthy carbs first thing in the morning and at regular intervals throughout the day. Once you get your stress levels in check, and your adrenals healed - then a low carb diet might be more suitable for you.
Do you have thyroid or hormonal issues? – being on a low carb diet can throw your thyroid and hormones for a loop (especially if you are female). Thyroid and hormone issues and blood sugar imbalances are often tied together.
Are you Under Stress? When you are under high levels of stress - this causes your blood sugar to get disregulated. High levels of cortisol, a stress hormone, causes spikes in bloodsugar. So being under stress is kind of like eating a Snickers bar - it spikes your blood sugar. So when you are under stress, you are more prone to blood sugar lows and highs. You need to find ways to keep your blood sugar more stable - which means finding the right balance of blood sugar stabilizing nutrient dense carbs, protein and fats.
Are you pregnant, breast feeding or trying to get pregnant? Low carb diets are not appropriate during pregnancy (except in some rare cases & under the care of a qualified health expert that is closely monitoring you). Your need for carbs typically goes up during pregnancy and lactation. If you are low carb and have been trying to get pregnant and are having issues - consider working with a qualified health practitioner to get your hormones back into balance.
Do you have other health issues or are you taking medication? Talk to your practitioner to get specific recommendations. For example, if you are on insulin, or cholesterol medication - making dietary changes can impact your need for those medications. You might need to adjust your dosage with changes to diet. Please consult with the prescribing doctor.
According to Paul Jaminet in this post, a mildly low carb diet (20-30% carbs) appears to promote longevity, a carb "overfed" diet (40-50% carbs) promotes fertility and athleticism, and a moderate carb diet (30-40% carbs) is essentially "neutral" and places minimal stress on the body. So if you are struggling with hormones or fertility, or you are an endurance athlete - you might think twice before cutting out carbs. If you are dealing with elevated disease markers - like high triglycerides, you might want to consider going lower carb.
Including Quality Carbs in Your Diet
People that have been on a low carb diet often have a fear of carbs. They think that carbs cause weight gain and therefore are evil (even if they know their low carb diet is no longer working for them). So getting more carbs in your diet may not be an easy mental shift for low carb devotees. But if you are experiencing some of the above symptoms - it is probably time to dial up the carbs, or you could potentially find yourself with a serious case of adrenal fatigue, hormonal havoc, and/or a thyroid disorder.
Choose Your Carbs Wisely:
So in order to choose wisely, when deciding whether or not to eat a carb – ask yourself
Is it nutritious? You want to select carbs that have naturally-occurring vitamins and minerals, considered "nutrient-dense" carbs (foods like vegetables, fruits, some whole grains, legumes). Carbs that are heavily processed or lacking nutrients? Skip it, you might get a burst of energy, but the energy won't last, and eating a lot of empty calories overtime can cause insulin resistance and metabolic mayhem. So be wary of foods high in sugar, and foods with “enriched flour” – which are usually processed to the point of no nutrients being left - and that is why they need to add vitamins back in.
Does it have fiber? Fiber helps to keep your bloodsugar stable and supports healthy digestion - so carbs with fiber tend to keep you fuller longer, serve as food for your good bacteria, and help keep things "moving" and prevent constipation. But be wary of processed foods with added fibers though (ie: fiber snack bars), because these foods are often junk food disguised as healthy - they are made with enriched flours and sugar - with fiber added back in. And when incorporating fiber, just realize that if you are not used to much fiber - you will want to gradually increase your intake to allow your digestive system to adjust. Cooking vegetables helps make them more easily digestible.
Is it low glycemic? Carbs that are lower on the glycemic index won’t spike your blood sugar higher/faster, so these are less likely to lead to blood sugar instability - so you will have less cravings and longer lasting energy. Generally speaking, you want to go for carbs that are lower on the glycemic index, so you will not get the rush and crash!
One option to consider - Carb Cycling.
One possible approach to the dilemma of whether or not to go Low Carb or not - is to cycle back and forth between low carb/higher fat, and moderate carbs. This is great for commitment fobes, and more importantly, keeps the metabolism on it's toes. This approach has long been used by weight lifters to lean out and bulk up - but is becoming more mainstream as of late.
There are several ways to do this, these are just some examples:
2 days low carb, higher fat, followed by a day of higher carb, lower fat - called a "refeed day."
Low carb, higher fat in the morning, followed by a starchy carb-rich dinner (like a serving of rice, sweet potato, etc). You might find that solves your sleep problem if you have been on a low carb diet and are having trouble sleeping.
5-6 days of low carb, higher fat followed by a day (usually on the weekends) where you get to "splurge" a bit - and enjoy dessert.
Or you could do a mix of the above - or your own cycle.
Read: The Science of Carb Cycling: How It Works and How to Do It Right
Consider Adding Resistant Starch
Whether you stick with a low carb diet or not, you might want to consider adding in a serving or two of resistant starch to your diet. Resistant starch is unique, in that it resists digestion, so it does not get broken down in the small intestine like other starches, instead it travels to the large intestine where it serves as food for the good bacteria.
Resistant starch does not spike blood sugar or insulin like regular starches/carbs, and it supports healthy bacteria in the gut. It is sometimes called the "skinny starch" because it can help people lose excess weight and help balance gut health to give you a flatter belly.
Learn more - What is Skinny Starch?
This article is an excerpt from Sara's Break up with Sugar program.
Article edited on January 12, 2019