I think it’s about time I wrote a post about one of my favourite topics: diet. Or more specifically, the Low Carb/High Fat (LCHF) or the ketogenic diet.
My impetus for writing about this is a recent decision in the UK to give the Low Carb Program accreditation to be used as a management option by the NHS.
My own interest in low carb began sometime around last year, when I was sort of in a lull. I came across a short article describing the ketogenic diet for weight loss, and decided to give it a go, to see if it was possible to “achieve ketosis,” and whether it was really something I could recommend to my patients.
Rather than go into all the scientific specifics on LCHF/keto here, take a look at the Diet Doctor’s website which is really informative, really user friendly, and most importantly, is backed by real doctors and scientists.
Here is the scientific premises behind the keto diet in a nutshell:
Our bodies rely predominantly on carbohydrates as a source of energy and fuel. In particular, our brains function almost solely on glucose. That’s why you always feel more alert after a sugar hit at 3pm. However, your body has a back-up fuel: fat. This was used in times of famine and starvation when carbohydrates weren’t available as a fuel source. Burning fat produces ketones, which can be used by the brain for energy. The idea in the LCHF/keto diet is that you restrict your carbohydrate intake and increase your fat intake to train your body to use this secondary fuel source, allowing you to burn fat and lose weight.
Now it does come with some caveats. I personally do not think the keto diet is the best diet for weight loss for everyone. I am of the personal belief that there are many roads to get to your destination, but that the journey should be individually tailored. I personally found the keto diet too arduous, and ultimately decided it wasn’t the best diet for me. However, I do think that it makes sense for patients with Type 2 diabetes or insulin resistance, as in these diseases these patients have a metabolic disturbance that prevents them from processing carbohydrates properly. You might say these patients are carbohydrate intolerant. It makes sense that you would want to restrict carbohydrates in these patients.
And there is plenty of science to back it up. You can find a list here and also here. For myself, I also found reading The Art and Science of Low Carbohydrate Living by Jeff Volek and Dr. Stephen Phinney to also be very interesting and inspiring. I also found a study by Dr. David Unwin, a UK GP, to be incredible inspiring. You can read that here. Essentially, he trialed a low carbohydrate diet with a group of his own diabetic and prediabetic patients over 8 months with amazing results: lower blood sugars, weight loss, lower blood pressure, and reduced cholesterol. In the UK, he helped to develop an online program called the Low Carb Program which is free and designed to assist patients to undertake a low carbohydrate way of living by themselves, with informative videos, diet plans, and testimonials. There is also a group discussion board where you can get support from other members of the program.
And now we go back to how I started this post, with the accreditation of the Low Carb Program for use by the NHS. What this does is legitimize this way of treating prediabetes and diabetes, and it means we no longer have to subsist in the shadows, worrying that we’re doing something outside the guidelines.
While this online program is a great initiative, if you have quite complicated diabetes and are on several medications and/or insulin, you should still see your doctor first before trying this program on your own. Never cease your diabetes medications without first consulting a doctor. However, through this diet, there is potential to eventually reduce or stop your medications entirely in the future.
If you aren’t sure your doctor would be comfortable with guiding you on a diet like this, please feel free to see me in my practice for a bulk billed consultation about whether this low carb program would work for you.