A New Clinical Trial Found a Low-Carb Diet Better Than the Dash.
4 reasons why a low-carb diet might produce better results than a high-carb diet for metabolically disadvantaged people.
I have been a proponent of low-carb diets for decades as they helped me and others in my circles to overcome metabolic disorders. High-carb, low-fat diets gave me nightmares in my younger years. However, I am not against the Dash diet or other high-carb diets, as they work for healthy people. My concern is metabolically disadvantaged people.
As millions of people are metabolically disadvantaged and two billion people live with fatty liver disease, we need a paradigm shift. Old-school thinking no longer works, and it does not serve our purpose.
Therefore, in this story, I provide a neutral perspective based on my experience and research and highlight a recent clinical trial conducted and published, giving us a valuable perspective.
However, for awareness purposes, I emphasize the value of low-carb, high-fat diets based on my experience discussing four compelling reasons.
Diet is an individual matter. Thus one diet working for a person might not work for another. Yet, understanding the mechanisms and principles behind diets can help us make informed decisions in customizing our diets based on our goals, body type, age, sex, medical history, and other factors.
The context of my article is vital. I specifically highlight the value of low-carb diets for metabolically challenged people, not for the general population. I know some healthy and fit people do well in high-carb diets due to their active lifestyles. But this does not mean they will work for unhealthy people, especially those with a sedentary and stressful lifestyle.
From my experience in my mid-20s, when on high-carb diets, I was working out more than most of my friends, but I became prediabetic mainly due to my intolerance to carbs. My condition only reversed after cutting carbs and adding healthy fats with moderate protein, giving me a healthier body in my older years.
High carbs for active people like athletes do not seem to be a problem. However, some former athletes, like best-selling author Professor Timothy Noakes and Dr. Jeff Volek, changed to low carbs seeing better benefits as they age.
They empirically have shown us that what we believed about carbs and healthy fats was wrong. It is possible to make the body fat-adapted and perform better with dual-energy from glucose and fats.
Like hundreds of others, these two practitioners and thought leaders shed light on the value of low carbs on athletes and others with scientific rigor. Their findings align with what I documented in a previous story reflecting my two decades of experience transforming to a better metabolism.
In this article, first, I will introduce the findings of this new clinical trial, providing a high-level perspective from the literature. Then, I share my experience and perspectives on how low-carb, high-fat diets might be a valuable alternative for metabolically disadvantaged people for awareness.
An Overview of the New Clinical Trial
The randomized clinical trial, "Comparing Very Low-Carbohydrate vs DASH Diets for Overweight or Obese Adults With Hypertension and Prediabetes or Type 2 Diabetes,” was published in the Annals of Family Medicine on 21 May 2023.
Since adults with hypertension, prediabetes, type 2 diabetes, overweight, or obesity are at increased risk of severe health complications and experts disagree on which dietary patterns and support strategies should be recommended, the researchers wanted to explore two significant diets well-documented in the literature.
They randomized 94 adults from southeast Michigan with triple multimorbidity criteria using a 2 × 2 diet-by-support factorial design.
They compared VLC (a very low-carb diet) with DASH (Dietary Approaches to Stop Hypertension), a relatively higher-carb diet.
They also created a third control mechanism comparing results with and without extra multicomponent support like mindful eating, positive emotion regulation, social support, and cooking.
The trial lasted for four months. At the end of the trial period, using intention-to-treat analyses, researchers found that the very low-carb diet produced better results than the Dash diet.
For example, “the estimated mean systolic blood pressure was −9.77 mm Hg vs −5.18 mm. Greater improvement in glycated hemoglobin −0.35% vs. −0.14% was observed. A better improvement in weight −19.14 lb vs. −10.34 was evident.”
They noticed that the extra support did not produce a statistically significant result.
Researchers of the study concluded that:
“For adults with hypertension, prediabetes or type 2 diabetes, and overweight or obesity, the VLC diet resulted in greater improvements in systolic blood pressure, glycemic control, and weight over a 4-month period compared with the DASH diet. These findings suggest that larger trials with longer follow-ups are warranted to determine whether the VLC diet might be more beneficial for disease management than the DASH diet for these high-risk adults.”
Like any study, the research had its limitations, like only for four months. However, their findings depicted valuable perspectives. The paper is informative, providing background information on previous trials and metanalysis linking to 35 scientific papers. It is publicly available at this link.
You may also check the perspectives of medical doctor Kevin Berry on this research in a short video on Twitter. Famous journalist and the author of the best-selling book The Big Fat Surprise, Nina Teicholz, also posted an inspiring tweet on this research.
I won’t delve into the Dash diet in this story, but if you want to learn more about it and discover Dash-friendly recipes, you may check this resource published by the National Heart, Lung, and Blood Institute.
4 Compelling Reasons Why Low-Carb Diets Might Produce Better Results than High-Carbs Diets.
In this section, I discuss four compelling reasons why low-carb and high-fat diets might produce better results than high-carb and low-fat diets for metabolically disadvantaged people. I only focus on the most critical points due to the scope of the article.
1 — Controlling Glucose and Addressing Insulin Resistance
Metabolically disadvantaged people, such as those with obesity, metabolic syndrome, and type 2 diabetes, have insulin resistance. Thus, they need glycemic control.
Glycemic control is regulating and maintaining blood glucose levels within a healthy range. It involves managing and stabilizing blood sugar levels to prevent low blood sugar (hypoglycemia) and high blood sugar (hyperglycemia).
Low-carbohydrate diets result in lower blood glucose levels and more stable blood sugar control than high-carbohydrate diets.
Glycemic control is significant for people with diabetes or prediabetes, as it helps them prevent large spikes and crashes in blood sugar levels, reducing the risk of complications.
High-carb diets with low fat can lead to elevated blood sugar levels and subsequent insulin spikes, further exacerbating insulin resistance.
On the other hand, people on low-carb diets mainly get energy from healthy fats restricting carbs. This approach can reduce blood glucose and the need for insulin secretion, improving insulin sensitivity.
So the significant difference between carbs and healthy fats is glucose and insulin. Healthy fats do not raise blood sugar and do not spike insulin. But there is more to it, which I cover in the subsequent sessions.
2 — Balancing Hormones and Creating an Alternative Energy Source
Even though the first point is critical to damage control, this point constitutes the more significant part of the iceberg.
Our hormones determine our metabolism. Therefore, the old model calories in and out model does not work for weight loss or reversing metabolic disorders even though calories still matter. The critical point is the balance and function of hormones.
Some critical hormones like testosterone and estrogen, especially leptin, require fat and maintain satiety based on the existence of fat molecules. So, since people on low-carb diets consume sufficient healthy fats, they solve the satiety problem, which is a critical factor in the weight loss journey.
In addition, low-carb diets can increase glucagon levels, a hormone that opposes insulin and helps us mobilize stored energy and burn it more efficiently. Scientists propose paying as much attention to glucagon as it is to insulin when treating type II diabetes for valid reasons.
My favorite part of the low-carb diets is the availability of ketone bodies as an alternative energy source for the body, especially for the brain. Ketones not only provide alternative energy but also act as valuable signaling molecules communicating with our genes.
Moreover, as a clean energy source, ketone bodies, especially β-hydroxybutyrate (BHB), provide cleaner energy and boost the BDNF for better brain and mental health. BHB is not just another molecule. It’s a potent byproduct of our evolution.
Having a fat-adapted body through low-carb, high-fat diets has been the best lifestyle modification that improved my health, enhanced my happiness, gave me a desirable physique, and unlimited energy, making me feel younger as I get older.
3 — Lowering Chronic Inflammation and Oxidative Stress
One of the significant problems with cardiometabolic disorders is chronic inflammation, usually triggered by oxidative stress. The old hypothesis blamed cholesterol and saturated fat for cardiovascular diseases.
However, new studies point it through chronic inflammation even though lipids (hyperlipidemia) still play a role in the process, but not as causative as they were thought compared to inflammation.
Some dietary regimens, like cutting certain nutrients/antinutrients or junk foods, can lower inflammation. They are great as supplementary regimens, but none of those can have better effects than ketosis on inflammation.
β-hydroxybutyrate (BHB) can act as a signaling molecule, interacting with genes, enzymes, and various signaling pathways to regulate the expression of pro-inflammatory molecules and promote anti-inflammatory responses.
BHB can increase the expression of the anti-inflammatory gene PPAR-gamma in adipose tissue, muscles, and the liver. PPAR-gamma is a transcription factor. It regulates the expression of genes involved in inflammation and glucose metabolism.
BHB can modulate the expression of genes involved in oxidative stress and inflammation. Studies identified that BHB might reduce the expression of pro-inflammatory genes, like TNF-alpha IL-1b and IL-6, in adipose tissue, muscles, and the liver and contribute to insulin sensitivity.
In addition, BHB interacts with genes related to the antioxidant defense system. It can activate the transcription factor Nrf2, a master regulator of the antioxidant response element. This process might reduce the ROS levels, neutralize them, and lower oxidative stress.
BHB increases the expression of the gene encoding for enzymes like superoxide dismutase and catalase. These enzymes might neutralize reactive oxygen species and prevent oxidative stress.
Studies indicate two pathways, the Nuclear Factor Kappa B (NF-KB) and mitogen-activated protein kinase (MAPK), associated with producing pro-inflammatory molecules that BHB inhibits.
Some studies indicate that BHB can lower the risks and even contribute to treating inflammatory bowel disease (IBD). This is a condition characterized by chronic inflammation of the gut.
I documented details in an article titled. Ketosis Can Lower Chronic Inflammation and Improve Metabolic and Mental Health in 6 Ways.
4 — Cleaning the Garbage from Cells and Mitochondria
For obvious reasons, mitochondrial and cellular health is critical for metabolic and mental health. Low-carb and high-carb diets can initiate autophagy and mitophagy processes, clearing the garbage from cells and mitochondria.
When glucose levels drop, and ketones increase, the body initiates autophagy, a cellular process in which damaged or unnecessary cellular components are degraded and recycled. This process maintains cellular homeostasis.
BHB plays a vital role in regulating autophagy and mitophagy. These processes are critical in lowering stress and inflammation by removing garbage from the body and contributing to longevity. I introduced them in previous articles, so I will not repeat the details here.
In terms of BHB’s contribution to autophagy and mitophagy, it can stimulate these processes in various cell types and mitochondria. BHB can activate the critical regulator of autophagy, the AMP-activated protein kinase (AMPK) pathway.
BHB can also impact autophagy by modulating the activity of autophagy-related genes and proteins (P62, Beclin-1, and LC3). This modulation can empower the autophagy process.
I felt much younger and more energetic in my 50s than in my 20s, thanks to the autophagy and mitophagy-producing lifestyle giving me a fat-adapted body moving from glucose to fat-burning metabolism.
Conclusions and Takeaways
When I delved into literature decades ago, there was too much noise with nitty-gritty details of carbs versus fats. They were confusing and irrelevant, preventing us from seeing the big picture. I had to unlearn and relearn many points, which were even in textbooks in the 1970s and 80s.
These arguments still happen and are confusing to the public as they happen in social media, mainly promoted by celebrities who aim to earn money and fame by endorsing well-converting products and making their fans advocates of high-carb products.
However, the noise is relatively lower in scientific communities as the metabolic effects of carbs and healthy fats are crystal clear, especially for metabolically disadvantaged people. Clinical trials like I exemplified in this story add clarity and give us hope.
I don’t consume carbs but am not against them, as they might be helpful for healthy people in moderation as an energy source, but overconsumption of refined carbs with empty calories quickly turning to glucose and raising blood sugar levels is undoubtedly risky for metabolic health and obesity.
Recommending high-carb diets to type II diabetes does not make sense at all. It is counterproductive. Fortunately, new generation scientists and practitioners firmly challenge the old school thinking and establish practices still touting such unfitting practices.
I mainly touched on metabolic health, but low-carb, high-fat diets can also improve mental health. For example, BHB can improve cognitive function by providing an alternative energy source for the brain during low glucose availability. It can be valuable for people with glucose-impaired metabolism in the brain.
The brain is highly dependent on glucose as an energy source. Creating an alternative energy source puts the brain in a favorable position as a treatment or preventative method, such as increasing cognitive reserves as we age.
By reducing oxidative stress, BHB can protect neurons, increase energy efficiency, and put the brain in growth mode by increasing BDNF (Brain-Derived Neurotrophic Factor), as I explained in a previous article.
BDNF is active in brain regions such as the hippocampus, the cortex, the basal forebrain, and the cerebrum. These regions help us learn and build new memories. For example, practitioners observed low BDNF levels in Alzheimer’s patients.
Therefore, research into ketosis on obesity, type II diabetes, neurodegenerative diseases, cardiovascular diseases, mitochondrial disorders, weight loss (reducing visceral fat), and cancer treatment proliferates.
After years of research and experimentation, I chose a ketogenic diet (high healthy fats, consuming around 200 grams a day) with a time-restricted eating regimen to reap the benefits of deep or mild ketosis for metabolic and mental health.
But not everyone needs to choose a keto diet to reap the benefits of ketosis. Some people still enter ketosis by eating some carbs. I documented a case in a story titled Here’s How Amy Entered Ketosis without Following a Ketogenic Diet.
It is also possible to gain a fat-adapted body by eating some carbs in moderation, as I explained in another story titled Here’s How to Get Fat Adapted Even If You Consume Some Carbs.
In addition, Solely Eliminating Sugar Won’t Suffice to Shrink Waistlines or Prevent Obesity. There are many more factors to be considered.
These stories show that I am not against carbs, but my point is they must be consumed carefully, not as advised on social media by biased people. And metabolically disadvantaged people must be more diligent about carb consumption for the reasons I explained.
The key takeaway of this story is to customize our diets based on our needs, remain open-minded to new findings by scientists and clinicians, and adjust our needs with experimentation and professional support.
Thank you for reading my perspectives. I wish you a healthy and happy life.
To inform my new readers, I wrote numerous articles that might inform and inspire you. My topics include brain and cognitive function, significant health conditions, longevity, nutrition/food, valuable nutrients, ketogenic lifestyle, self-healing, weight management, writing/reading, and humor. 100+ Insightful Life Lessons from My Circles for the Last 50+ Years
I publish my health and wellness stories on EUPHORIA. My posts do not include professional or health advice. I only document my reviews, observations, experiences, and perspectives to provide information and create awareness. Be Your Own Therapist in 10 Steps.
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