What Are Carbs?
Carbohydrates, also referred as carbs, are one of the three main macronutrients (along with fats and proteins) and gives you energy to keep you fuelled for the day.
Carbs also contribute towards your fibre intake. Fibre is important to help you go to the toilet (it prevents constipation), it can help with blood glucose control, and it reduces the risk of cardiovascular diseases and bowel cancer. It also increases gut-friendly bacteria that assists against inflammatory disorders and allergies.
The key sources of carbohydrates in our diet are:
Starch (found in grain-based foods such as rice, breads, pasta), some fruits and some vegetables, beans and peas)
Fibre (fruits, vegetables, and whole grains)
Sugar (fructose in fruit, lactose in milk-based products)
Added sugars (also known as free sugars) are also a form of carbohydrate that is added to food (for example, cake, biscuits, ice cream) or naturally occurring sugars (honey, fruit juices and syrups)
What Counts As A Low-Carb Diet?
Reducing the amount of carbohydrates that you eat is known as a ‘’low carb diet.’’
The research on the definition of a low carb diet is very mixed and not concrete, not everyone agrees on the exact amounts.
Fortunately, the classification by Feinman et al (2015) [1] has suggested the following cut offs that are being referred to more frequently:
Ketogenic diet = <50g per day
Low carb = 50-130g per day
What About Following The Low-Carb Diet When You Have Type 2 Diabetes?
According to the Science Advisory Committee on Nutrition (SACN) and Diabetes UK [2], a low-carb diet is an effective short-term (less than 12 months) strategy for weight loss for those with type 2 diabetes. Going low carb is defined by limiting carb intake between 50g to 130g a day.
Not everyone living with type 2 diabetes are overweight but regardless of an individual’s weight, eating less carbs improves glycaemic control [3].
What’s the Difference Between Keto Versus Low-Carb?
A ketogenic diet, also known as a keto diet, is an extremely low carb and high fat dietary approach. By drastically reducing your carb intake and increasing your fat intake, the reduction in carb intake means that your body will utilise fat for energy instead – this is called ketosis. It is defined by having less than 50g of carbs a day.
Anecdotal reports from patients and the public are that it can be challenging to adhere to a keto diet on a long-term basis and therefore, an unrealistic, sustainable approach to weight loss.
A keto diet can be used under medical supervision for those with epilepsy and metabolic disorders.
How About Low-Carb Versus The Mediterranean Diet?
A low carb diet may improve cardiovascular health, blood glucose control and aid weight management but it's not the only diet that has been shown to do so. The Mediterrenean Diet has been claimed as one of the best-researched backed diets and include carbs.
Based on traditional eating habit from the Mediterranean, the diet includes lots of vegetables, fruits, nuts, beans, wholegrains, seeds and olive oil. Dairy, fish, chicken and eggs are eaten in moderation and red meats consumed sparingly.
Whilst the diet does include a reasonable amount of carbs it must be underlined that these come in the form of wholegrains and from whole foods (not refined processed sources); however it is not superior to other dietary approaches, it is not culturally inclusive, and it is not personalised.
What Are The Pros And Cons of Low-Carb Diets?
Pros
Replacing refined carbs and/or ultra-processed foods with whole foods.
As with all dietary approaches, it increases food awareness, so it makes people think about what there are eating
It is likely you will have added more fibre in your diet so your gut health may improve
It is likely that you will have adequate protein intake daily so it may help you to feel fuller for longer and reduce the food cravings
Short-term weight loss
Improved blood glucose control
Cons
Risk of not eating enough fibre which may lead to constipation
Risk of not eating enough carbs to suit your daily energy requirements which may result in headaches, increased food cravings and low energy
Risk of meals being a bit boring and lacking in variety
Risk of micronutrient deficiencies if not eating a range of foods
Risk of an unhealthy relationship with food (e.g., over restriction and/or obsessiveness about food)
Risk of bad breath and/or unpleasant taste in mouth
Important Considerations For Some Individuals
A low carb diet improves cardiovascular health, blood glucose control and aids weight management however it is still controversial and certain population groups should modify their carb intake with caution.
Are you taking insulin? If you are using insulin, there is a risk of hypoglycaemia or in exceptional cases, diabetic ketoacidosis (DKA). Please speak to your doctor if you are taking insulin prior to trying a low carb approach.
Do you take hypertension medication? Please consult your doctor to inform them before starting a low-carb approach as there is a risk of low blood pressure and dizziness.
Are you breastfeeding? Please speak to your doctor before experimenting with low carb as the metabolic demands are slightly higher than your usual daily calorie intake.
Some Final Thoughts
More research is needed to analyse the long-term effects of following a low carb diet and currently, there is not enough evidence to suggest that such a diet is a better intervention than other approaches for weight loss.
But as the saying goes, ‘’different strokes for different folks,’’ everyone is different and different diets work differently for everyone. A personalised approach is essential – including considerations for physical activity levels, personal weight loss goals, dietary preferences, lifestyle and (cultural) beliefs [4].
This article was written by Mei Wan FdSc, BSc (Hons), RD, MBDA, an HCPC Registered Dietitian and Nutritionist in collaboration with Sasha Watkins, RD, Chief Science Officer and Co-Founder of Field Doctor.
Are you worried about your carb intake and confused about portion sizes? Are you struggling with your weight and want to kick start your health journey? Book your free 15 minute discovery call with Mei to find out how she can help!
References
[1] Feinman RD, Pogozelski WK, Astrup A, Bernstein RK, Fine EJ, Westman EC, Accurso A, Frassetto L, Gower BA, McFarlane SI, Nielsen JV, Krarup T, Saslow L, Roth KS, Vernon MC, Volek JS, Wilshire GB, Dahlqvist A, Sundberg R, Childers A, Morrison K, Manninen AH, Dashti HM, Wood RJ, Wortman J, Worm N. Dietary carbohydrate restriction as the first approach in diabetes management: critical review and evidence base. Nutrition. 2015 Jan;31(1):1-13. doi: 10.1016/j.nut.2014.06.011. Epub 2014 Jul 16. Erratum in: Nutrition. 2019 Jun;62:213. PMID: 25287761.
[2} Low carb diets position statement for professionals (May 2021) [accessed August 2022 via https://www.diabetes.org.uk/professionals/position-statements-reports/food-nutrition-lifestyle/low-carb-diets-for-people-with-diabetes]
[3] Wheatley SD, Deakin TA, Arjomandkhah NC, Hollinrake PB, Reeves TE. Low Carbohydrate Dietary Approaches for People With Type 2 Diabetes-A Narrative Review. Front Nutr. 2021 Jul 15;8:687658. doi: 10.3389/fnut.2021.687658. PMID: 34336909; PMCID: PMC8319397.
[4] Low carbohydrate diets for the management for type 2 diabetes in adults [accessed August 2022 via https://www.bda.uk.com/resource/low-carbohydrate-diets-for-the-management-of-type-2-diabetes-in-adults.html]
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