I keep my net carbs (total carbs minus dietary fiber) below 50g/day, and it has put my type 2 diabetes into remission. The calories lost by restricting carbs to that extent are replaced by eating more fat— protein intake stays the same. The high-fat diet staves off hunger quite well—fat in general is more slowly digested than carb and in particular more slowly than refined carbs (sugar, flour products such as bread, pasta, pastries, boxed breakfast cereals, and the like). And the slow digestion prevents insulin spikes.
One still must watch caloric intake, of course, but the absence of hunger pains makes it easier to keep calorie intake reasonable. I’ve lost 20 lbs since the beginning of the year, which amounts to 5 lbs/month, a reasonable rate of loss.
Some doctors and dietitians still say a low-carb, high-fat (LCHF) diet is dangerours. That’s despite compelling evidence to show both safety and efficacy of LCHF for weight loss, diabetes, heart disease, cancer and even dementia. Some specialists call dementia type 3 diabetes because of its links with diet.
LCHF is a global phenomenon. In South Africa there are three million “Banters”, as fans of LCHF regimens are known in that country. Banting pioneer is UCT emeritus professor Dr Tim Noakes, a world-renowned scientist rated A1 by the National Research Foundation for expertise in both sports science and nutrition. He documented his theories in the best selling The Real Meal Revolution, co-authored with chef Jonno Proudfoot and nutrition therapist Sally Ann Creed that is known as the “Tim Noakes Diet”. Here, in a Q&A, Noakes gives the basics and an Idiot’s Guide to getting started on the LCHF path. First question:
Is LCHF a diet?
No, it’s a lifestyle.
Do you say your diet’s right for everyone – a one-size-fits-all?
There’s no such thing. No diet is right for everyone. LCHF is best for people who have insulin resistance (the inability to tolerate carbohydrate).
Is it correct to call it “Banting”?
It’s probably more correct to call it Ebstein – after German physician Dr Wilhelm Ebstein who first made it high-fat. That was the diet Sir William Osler promoted in his monumental textbook: The Principles and Practices of Medicine published in the US in 1892.
Is LCHF a fad?
Anyone who claims Banting or Ebstein diets are fads knows nothing about medical nutrition history. Nutrition did not begin in 1977 as our students seem to be taught.
Is LCHF the same as Paleo?
The Paleo diet is slightly different; it promotes consumption of only those foods that would have been available to Paleolithic man from about 2.5 million years ago to the Agricultural Revolution starting about 12 000 years ago. Foods allowed on Banting but excluded on Paleo are dairy; fruits are allowed on Paleo but excluded on Banting.
What about Atkins?
The Atkins diet is similar to Banting. Perhaps Banting promotes the use of low-carb vegetables rather more than Atkins did, but the differences are trivial. This shows that (i) first priority, and the commonality of all these diets, is to cut carbs and sugar (and vegetable oils) and (ii) whether you go Paleo or Banting or Atkins is determined by how you respond to the different options in the different diets. To find the ideal low-carb diet you need to experiment to see how you respond.
Is LCHF extreme?
It depends what you mean by extreme. Moderation is a smug, puritanical word. No mammal eats in moderation. In nature all diets are extreme: lions eat only meat, polar bears mainly fat, panda bears only bamboo shoots, giraffes only acacia leaves.
Is it balanced?
Balance is what has worked for each of these species for millions of years. LCHF can be extremely low in carbohydrate – the one nutrient for which humans have absolutely no essential requirement, but that depends on how sick you are. In 1977, when we were told to eat diets extremely high in carbohydrates, human health started to fail on a global scale.
Your recommended carb range is <200g to <25g, correct? What are the indications?
It depends how insulin resistant you are and how much exercise you do. If you are completely insulin sensitive (that is, you tolerate carbohydrates well, have low fasting blood glucose, insulin and triglyceride concentrations, low small LDL particle numbers; low HbA1c; high HDL-cholesterol concentrations; and absence of fatty liver) and exercise regularly a few hours a week, then it is can be safe to ingest up to 200g carb per day, or at least until your HbA1c rises above 5.5% . That’ll be time to start reducing the carbs.
On the other hand, if you are profoundly insulin resistant with type 2 diabetes, morbidly obese, or with heart disease, cancer or dementia, you’ll probably do best on a very low-carb diet of about 25 grams carbs per day. This won’t change even if you do more exercise. Exercise is helpful but doesn’t obviate the need to eat very few carbs, even if you exercise for many hours a week.
What carb-fat-protein ratio is best?
It depends how sick you are. If you’re diabetic, we say 20% to 30% protein, 60% to 70% fat, 5% carbs. The sicker you are, the more fat you need because fat is insulin-neutral. The more insulin resistant you are, the more fat you can eat, because even when the pancreas fails, fat is the only fuel you can metabolise safely without requiring insulin. It’s perfect for blood sugar control.
Any weighing of food on your diet? . . .