Sometimes, when I hear objections to low carb, I think, “this person must just be repeating something they have heard.” Why? Because as shown above, the objections are, most often, ludicrous. Let us take a look at common objections and my thoughts to these.
Objection: “Low carb is NOT evidence-based.”
Answer: Firstly, the typical carbohydrate recommendations lead to the consumption of upwards of 200-240g of carbohydrates per day. So, please show me EVIDENCE wherein a person with diabetes was well controlled on this amount of carbohydrate. I have read HUNDREDS AND HUNDREDS of nutrition studies and I have yet to come across even ONE wherein those with diabetes were well controlled when their diet included 240g of carbohydrates (nearly 60 teaspoons of glucose) per day. These recommendations are also not evidence based. If you show me a study that shows that people with diabetes are BETTER controlled eating a diet with 200-240g of carbs versus, say, under 100g, I would be happy to reconsider my opinion. In fact, as mentioned in the MNT guidelines, studies HAVE shown improved glycemic control with lower carbohydrate intakes. Every single recommendation by both the ADA and the AADE states that monitoring carb intake is the most relevant factor in glycemic control.
Objection: “Cutting out foods will lead to malnourishment.”
Answer: If one was to eat 200-240g of carbohydrates per day, they would HAVE to be eating a great deal of processed, refined carbohydrates. It would be EXTREMELY difficult to consume this amount of carbohydrates by eating REAL FOOD unless you are the “banana girl.” Refined and processed carbohydrates are nutrient poor. The very premise of a low carbohydrate way of eating is to choose the healthiest, most nutrient dense, real, whole foods available. A person on a typical high carb diet may be consuming lots processed carbohydrates like bread, pasta, crackers, popcorn, as well as high sugar fruit, etc. A person on a typical low carb diet will replace these high glycemic foods with REAL food sources of carbohydrates, such as, non-starchy vegetables, low glycemic fruit, nuts and seeds. In reality, if you cut out junk, food-like products (things that sit in a bag or box on a shelf), you are almost low carb by default. We did not have these ultra processed foods until the last 50-60 years of our existence. We don’t need them, whether we have diabetes or not. Low carb most often leads to significant IMPROVEMENT in nutrient status. These are the foods on a typical low carb diet. Nutrient poor? Hardly.
Objection: “Low carb is not sustainable.”
Answer: No DIET is sustainable. Why is the diet industry a multi-billion dollar industry? Because ALL diets fail, causing the “dieter” to “diet” over and over and over. If the low fat diet (the diet that has been recommended for the last 50 years) worked, why do we have an explosion of obesity and Type 2. Is low fat sustainable? No. Once again, NO diet is sustainable. Therefore, we have to think in terms of making permanent lifestyle change. This means cutting out (for the most part), foods that are nutrient poor and detrimental to our health, and replacing them with foods that nourish and heal. Once again, doing this, will just about make you “low carb” by default. Many have sustained on a low carb lifestyle for decades, in fact, permanently, for life. Why? People on a low carb diet typically are not hungry, they are meeting their body’s nutritional needs, they are not starving themselves, they do not weigh and measure their food, they do not need to strictly count calories, they do not have to exercise excessively. They typically lose more weight, improve all markers of health and feel great doing it.
This Type 1 physician has been following a low carb diet for over 50 years and prescribing such to all of his diabetic clients. He is in his 80’s and has an A1c of a non-diabetic. Low carb ways of eating are not new. In fact, they were the standard treatment in diabetes care before insulin was discovered.
Objection: “People on low carb diets eat NO carbohydrates.”
Answer: People on low carb diets eat all the carbohydrates their bodies need. However, the focus is on choosing the carbohydrates that have minimal blood glucose and insulin response. The focus, once again, is also on choosing REAL food sources of carbohydrates, not ultra-processed, refined carbohydrates. Once again, see the image above. There are plenty of sources of healthy carbohydrates in a low carb way of eating.
Objection: “People on low carb just eat tons of meat.”
Answer: Most of the people that are low carb eat more vegetables than they ever did on any other “diet.” I often tell folks that I eat more vegetables than most vegetarians. Refined sugar often alters people’s palates, causing real food to taste dull. Most people, when eliminating sugar with a low carb way of eating, taste food for the first time, and real food tastes amazing! Low carb diets are NOT high meat diets. Typically, meat consumption is no greater with a low carb way of eating than any other “diet.” Once again, see the image above. There is as much, if not more, plant food in this image than meat.
Objection: “People on low carb eat much more fat.”
Answer: That is true. When carbohydrate consumption is decreased, healthy fat consumption is increased. And this is COMPLETELY healthy. There is PLENTY of evidence showing that in countries where fat consumption is very high, heart disease and diabetes is very low. There is no negative connection with heart health and consumption of healthy fats. In fact, there is growing evidence to the contrary, that higher consumption of healthy fats IMPROVES heart health. For more informaiton, please see my “Cholesterol and Fat” page HERE.
In closing, this low carbohydrate approach is being used effectively by Registered Dietitians, Nutritionists, Diabetes Educators and physicians worldwide with the goals of lowering medication needs (or eliminating medications), halting the progression of diabetes and improving cardiovascular health. Diets with a low carbohydrate focus WORK, they are healthy and sustainable for long term management.