The Low Carb Diet – an 18 Year Perspective.

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The "Low Carb Diet" has become the most popular diet in the world, over the past few decades. Whether Atkins, South Beach or Zone, people have learned to get away from carbohydrates and sugars and are much better off by doing so. It seems that everyone today is trying or has tried the plan, and you hear about it in restaurants, gyms and almost every type of meeting place imaginable. The main reason that it has become so popular is that it works. The following comments and articles will help you understand why.

People have been confused about diets for ages and have tried to do a variety of things to try to lose weight. Yet nothing works as well and for as long as the low carb idea.

To keep it simple, the body will do much better if it burns fat as a fuel than if it is burning primarily carbohydrate. Excess carb and sugar in the diet make it difficult to get to the fat.

Research, and certainly 18 years of my experience with patients, has described some fascinating information. Here goes a simplified explanation of the circumstances surrounding carbohydrate intake. 

1. Excess carb/sugar intake can deposit on, and damage the lining of blood vessels.

2. Over time, with repeated exposure, it can create an over production of insulin. This can cause a decline in blood glucose levels and create "hypoglycemia". Low blood sugar symptoms include fatigue, anxiety, depression, panic sensations, nausea, fainting, palpitations, and strong cravings for carbohydrate.

3. As more and more is ingested, it becomes impossible to get to the fat stores to burn them as fuel.

4. This causes increase in Cholesterol, Triglycerides, LDL, Weight, and over time Blood Pressure. Here, blood vessels can be damaged all over the body, affecting all organs.

5. As we age, and we become less active, it becomes much more difficult to burn calories.Over time, as well, our hormone levels decline and we are less able to burn sugars and fat.

6. The repeated demand for insulin, from months and years worth of carb ingestion, will cause the pancreas to falter. It can't keep up with the demand and will decrease its ability to make insulin. Less insulin creates high blood sugar. Here comes Type 2 Diabetes.

7. People try to cut down food portions and don't lose weight because they are keeping the carbs in the diet, and decreasing the fat and protein.

SO,  

1. Restricting carb and sugar allows a decline in blood sugar levels (excellent for diabetics)    I will help manage the changing of the medications with the patient, and primary care doc.

2. This also will allow the body to burn Triglycerides, Cholesterol and fat as a primary fuel.    These will decrease significantly, even within the first week of the diet.

3. Weight will also decline gradually and progressively week to week.

4. Craving will diminish and disappear, because there's no repeated demand for insulin, and therefore no repeated drops in blood sugar. This diet is so effective because it is the only type to stop cravings. It greatly reduces insulin release.

5. Fatigue, anxiety, depression, panic and a whole bunch of other things  can change as well.6 Typically I recommend that people eat 5 – 6 small meals a day, low in carb, low in fat, consisting of the best of the low glycemic index vegetables, with moderate amounts of good proteins.

7. I also recommend 30 – 45 min of simple exercise daily. 

See the main website http://www.drcalapai.net/freestuff/lowcarb.html for the sample diet.  

Please tell your friends about this info 

Thanks, 

Dr. Chris Calapai 

Effects of Low-Carb Diet on Appetite, Glucose, and Insulin Resistance. 

An Atkins-like low-carbohydrate diet can help improve glucose control, insulin sensitivity, and glycated hemoglobin (A1C), according to a trial reported in the March 15, 2005, issue of Annals of Internal Medicine.

Researchers studied diet in a controlled clinical environment among 10 obese people with type 2 diabetes. While staying in an inpatient hospital unit, participants were instructed to continue their usual diet, consisting of meals from the hospital kitchen augmented by food from the outside, for the first 7 days of the trial. Participants were encouraged to eat as much as they wanted of name-brand foods—McDonald's sandwiches, Dunkin' Donuts bakery products, Oreo cookies—for which dietary information was readily available.

After 7 days, all participants switched to a low-carb diet that reduced carbohydrates to about 21 g/day but permitted as much protein and fat as they desired. People were allowed to choose from a menu of foods prepared in the hospital kitchen. They remained on the low-carb diet for the next 2 weeks. All participants were encouraged to maintain their usual level of physical activity.

While on the low-carb diet, the average energy intake decreased from 3,111 kcal/day to 2,164 kcal/day, which contributed to an average weight loss of 3.6 lb during the 14-day low-carb diet phase. The average 24-hour blood glucose levels became normalized, the average A1C level dropped from 7.3% to 6.8%, and insulin sensitivity improved by about 75%, according to researchers.

Although the study had a small number of participants and lasted only a few weeks, it was strictly controlled and provides evidence concerning the value of low-carb diets that may merit further exploration in larger controlled studies. 

http://docnews.diabetesjournals.org/cgi/content/full/2/6/15 

The Ketogenic Diet: Adolescents Can Do It, Too.

Purpose: To determine both the efficacy of and compliance with the ketogenic diet in the adolescent population.

Methods: A retrospective study of 45 patients, aged 12–19 years, consecutively enrolled in a ketogenic diet program from 1994 to 2002, was performed. Thirty-seven patients were from The Johns Hopkins Medical Institutions; eight were from The University of Texas at Houston. Charts were reviewed, and patients were contacted by telephone.

Results: Six months after diet initiation, 28 (62%) of 45 remained on the ketogenic diet, with six (21%) of 28 having 50–90% seizure reduction, and eight (29%) of 28 having >90%. At 12 months, 20 (44%) of 45 remained on the diet, with seven (35%) of 20 having 50–90% seizure reduction and six (30%) of 20 achieving >90% efficacy. Only 22% discontinued the diet for perceived restrictiveness. The mean diet duration was 1.2 years. Patients with multiple seizure types did best, whereas gender, prior seizure frequency, diet ratio, and age did not influence outcome. Patients dependent on parents for daily care were more likely to remain on the diet at 6 months, but had less efficacy. Weight loss (60%) and menstrual dysfunction (45% of female subjects) were the most commonly reported side effects.

Conclusions: The ketogenic diet is as well tolerated and efficacious for adolescents with epilepsy as for the general childhood population.

http://www.blackwell-synergy.com/links/doi/10.1046/j.1528-1157.2003.57002.x 

Use of a reference four-component model to define the effects of insulin treatment on body composition in type 2 diabetes: the Darwin study . 

Aims:  To define the effects of insulin treatment on body composition and fat distribution, and investigate the potential role of body weight (BWt) gain predictors in patients with poorly controlled type 2 diabetes.

Methods: Assessments of body composition, using a four-component model, and biochemical indices were obtained in 19 patients [mean (SD): age, 60 (8.3) years; BMI, 25.3 (3.3) kg/m2] with poorly controlled type 2 diabetes, despite maximal oral hypoglycaemic agents, receiving insulin [40 (12.2) units/day] at baseline and after 1, 3 and 6 months.

Results:  Insulin therapy significantly reduced plasma glucose [–6.0 (4.3) mmol/l], improved [HbA1c [–1.9 (1.8)%], and reversed the BWt lost [3.3 (1.8) kg] before treatment. The 6-month BWt gain [+5.2 (2.7) kg] consisted of body fat [+2.9 (2.7) kg] and fat-free mass [FFM; +2.3 (1.8) kg], with the FFM increase due solely to total body water [TBW; +2.4 (1.5) l], as there were no detectable changes in total body protein or bone mineral, thereby increasing FFM hydration by 1.3%. More body fat was deposited centrally in patients receiving insulin alone than those receiving insulin with an oral hypoglycaemic agent (metformin). Daily insulin dose, HbA1c and hip circumference were independent predictors of BWt gain.

Conclusions:  Insulin treatment increased fat and FFM similarly in poorly controlled type 2 diabetes patients, with the FFM gain due entirely to TBW. The possible role of metformin in reducing central fat accumulation following insulin treatment warrants further investigation into its mechanism and potential long-term benefits.

http://www.springerlink.com/(bjirw4asvpr4vojzqjpwdrmx)/app/home/contribution.asp?referrer=parent&backto=issue,4,29;journal,19,457;linkingpublicationresults,1:100410,1