Exercise, long walks, choral singing and meditating; there are numerous ways to increase ones well-being. Anyone who goes from feeling bad to finding something that works, is prone to believe that the solution found is a general one – but as we know, all methods are not suitable for everyone.
In analogy with the above, it is a reasonable question whether an in itself beneficial and working diet can also be considered general; are there groups for whom the model needs refining?
Lately, a discussion has been emerging about how various Low-Carb advocates view the generality of that particular diet. The aim of this post is to clarify which opinions are really represented in the Swedish Low-Carb community, and whether or not a minimized carbohydrate consumption is viewed as a general method for better health for everyone.
Three questions below have been sent to Dr. Annika Dahlqvist, Mr. Sten Sture Skaldeman, Mr. Lars-Erik Litsfeldt and Dr. Andreas Eenfeldt. I asked them for concise answers, and I also added my own opinions.
To put our replies in perspective, it is worth noting that the Swedish official dietary recommendations advice a diet with 25-35 energy percent fat, 10-20 E% proteins, and 50-60 E% carbohydrates. The actual average consumption is 36 E%, 13 E% and 51 E%, respectively. (The figures cited are from 2002).
1. In terms of fat, protein and carbohydrates, how much of each of these macronutrients should people who are healthy and free from illness (Defined as free from insulin resistance and feeling well) eat?
I recommend healthy people eat liberal amounts of natural fat. Then they automatically consume less carbohydrates because they have normal appetite regulation. If you count on it I guess the intake of carbs will be half of what is recommended (by the health authorities). Protein should be consumed “normally”–that is 1g per kilo of normal body weight.
Healthy persons have a greater freedom of how they put together their diet. For example, people keeping a diet low in the glycemic index make it fine with that. The more insulin resistant you are, the less freedom you have to eat if you want to regain your health. I can’t see any reason for a healthy person to keep up a specific level of carbohydrates in his diet. Carbohydrates are the only macronutrients we don’t need to eat. I think most people realize what level is most suitable to them.
I think across the board recommendations like 55:25:20 (carbohydrate:protein:fat) become arbitrary and in the end are not very meaningful. I believe it is arbitrary because there are no comparing studies looking at the different amounts of carbs within the definition of “low-carb.” Therefore, that recommendation is just a personal opinion based on anecdotal stories. It’s not meaningful at all because it is a very small minority of people who actually keep up with the breakdown of macronutrients of their daily dietary intake.
It is my opinion that healthy persons who don’t feel they need to lose weight should exclude sugar from their diet. The rest of the carbohydrates ought to be natural and not refined–that is carbs with a low glycemic index. Plus, the less physical activity you engage in, the more careful you must be with the total amount of carbohydrates consumed.
Sten Sture Skaldeman:
For healthy persons, the most important thing is to eat food that is natural and not processed. How it is divided in macronutrients you don’t have to feel distressed about. Fat must be the primary source of energy intake and protein and carbohydrates can divide the rest. Your diet should look like this: 20% protein, 10-20% carbohydrates and 60-70% fat. This will give you a lot of freedom in making up your diet.
Many proportions can work well, but most people would get the best health if they had an intake of 40–60% fat, 20–30% protein and 10–20% carbohydrates. Muscular persons need to eat more protein than others and inactive people ought to eat less carbohydrates than others. The distribution of macronutrients also varies based on how much you eat. A person who eats smaller portions may need to have a larger percent of protein than a person who eats larger portions because protein gets stored in the body as energy.
2. In your opinion, will some people feel bad following a low-carb, high-fat (LCHF) diet because it is too low in carbohydrate intake or is this a diet that can work well for everybody?
I know some people say that they are not feeling well while on a low-carb, high-fat (LCHF) diet and I usually give them this advice: Increase the carbs and decrease the fat and then go back slowly to see what level of carbohydrates suits them best.
I don’t know, but I believe feeling bad on a low intake of carbohydrates is only temporary. But it is all about individuals and you can’t exclude the possibility that some people need a certain intake of carbs in order to feel fine. I have heard that people who workout a lot need carbohydrates to recover faster after their workout.
I think it is possible that some people feel more tired and weak even after been on a low-carb, high-fat (LCHF) diet for a longer time, although it’s not very common. I think practical issues arise because people on these diets are eating different from others or different from their previous diet and that’s what presents an even bigger problem.
Sten Sture Skaldeman:
No, nobody can feel bad from eating a low-carbohydrate diet, except for the first two first weeks. When we are adapted to operating on fat for fuel, the need for carbohydrates is zero. (No, a low-carb, high-fat (LCHF) diet is not for everyone. It demands people have both willpower and intelligence.)
I see a strict low-carb, high-fat (LCHF) diet as a method for insulin resistant people. Insulin resistance means that insulin regulation doesn’t work properly, probably because of too much stress on the system because of too much high-glycemic food. As a result of too high insulin levels in the body, the organs have decreased their sensibility to insulin. That leads to problems with high levels of blood glucose that can be remedied with a low-carb diet because it is mostly the carbohydrates that raises the glucose level in the blood. (Insulin resistance depends on the diet and lifestyle mostly, but heredity is also a factor. The more insulin resistant you are the more important is minimizing carbohydrates.)
If you start a strict low-carb diet and have no problems with insulin resistance, then your blood glucose level will fall. Different hormone systems will be activated to keep the blood glucose at a normal level. There are different hormones that can be activated to normalize the blood glucose levels and some are more desirable than others. Cortisol and glucagon are both working to increase the blood glucose level. Cortisol is a stress hormone but glucagon will be activated when you workout.
If you change to a new diet suddenly, there may be major changes in the hormone systems and that can make you feel bad. Insulin resistant people usually have no problem when changing to a strict low-carb diet. You may have a good production of blood glucose even before you start a low-carb diet and there will probably no problems when changing and you will feel better after you reduce the carbs.
3. Which differences–if any–can you distinguish between the kinds of carbohydrates (for example, sugar and starch) and do you differentiate these differences in your dietary advice?
They are all the same to me. Future research will perhaps point out the differences that may be there.
I don’t see any differences. Fiber may be harmless for most people, but the point is it is still about the amount of carbohydrates.
Yes, there are a lot of things indicating that an excessive intake of sugar (sucrose) is worse than a high intake of starch because of the fructose in the sugar. If the carbohydrate intake isn’t very low, then the glycemic index comes into play.
Sten Sture Skaldeman:
Sugar and starch are equally bad. The addiction is as equally strong in both sugar and starch. I accept the carbohydrates that come from animal products without limitations. For example liver, seafood, eggs and cheese. Vegetables (grown on top of the soil) can be eaten without limitations by most people. I myself restrict tomatoes and peppers, but I’m very liberal with onions. I think the healthy benefits of the onion are more important than the few carbohydrates that are in them.
I think there is a big difference between the different kinds of carbohydrates. I wrote earlier about insulin resistance and a lot of the science that tells us that different sources of carbohydrates influences our body differently. Most important is that sugar releases more insulin than starch. That means that insulin resistant persons should reduce starch and non-insulin resistant persons should reduce sugar intake first.
Fructose should not be consumed in any larger amounts at all by anyone. In short: When the glucose stores are filled, there will be problems with the surplus of fructose. Diabetics should not eat very many carbs at all, but for those who are not insulin resistant and want to eat carbs I recommend them to eat most of it as starch. Sugar is also a problem for those who are addicted to carbohydrates. Sugar seem to cause addiction easier than starch does. Sugar also stimulates your appetite mostly because of its content of fructose.
Fructose activates ghrelin and ghrelin stimulates your appetite. Of course, you should pay attention to the glycemic index of those starchy foods and how easily the carbs are digested. Parboiled rice increases the blood glucose level slower than sticky rice. You must understand that foods containing sugar (like fructose and lactose) have a relatively low glycemic index, but it is not healthy to eat a lot of fructose and lactose.
Finally: I don’t question at all that low-carb diets are working for many people. They can actually work great, providing good appetite regulation, a good nutrient intake, steady blood sugar, lower blood pressure, good hormonal levels, better vigour and last but not least, tasty food.
On the other hand, low-carb can be a very poor method for some, mostly because of the hormonal fluctuations induced. Some people may find that they gain weight on low-carb diets, or they might encounter problems such as low blood pressure, poor appetite, gloominess, low blood sugar levels and irregular menstruation. Side-effects from low-carb diets often pass if one stays on the diet, but sometimes they do not.
My concern is that low-carb, high-fat diets should not be viewed as more beneficial the more strict they are; by “strict” I mean a fat diet extremely low in carbohydrates, where even vegetables mostly fill decorative purposes.
Banning the fear of fats is a common interest, while banning carbohydrates can never be. It remains a special interest.
I would like to thank Mr. Arne Anderson for translating the actual interview part.
This interview was also discussed in some detail in Jimmy Moore’s Livin’ La Vida Low-Carb™ Blog.