Low-Carbohydrate Nutrition Approaches in Patients with Obesity, Prediabetes and Type 2 Diabetes

Low Carb Nutritional Approaches - Guidelines Advisory

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15 Physician-Patient Communication Topics — Dispelling Myths • Myth: Low-carb nutritional approaches are a fad Response: Over the past several decades, many randomized controlled trials, both short term and long term (up to 2 years or more), have demonstrated that a low-carbohydrate eating pattern is effective for weight loss, metabolic improvement, and weight maintenance. • Myth: Low-carb is bad for your heart Response: Carefully controlled randomized trials have demonstrated reduction in cardiometabolic risk factors and carotid intimal thickness. • Myth: Low-carb is not sustainable long-term Response: Reducing daily carbohydrate intake has the effect of decreasing appetite and increasing satiation or sense of fullness and corresponding biomarkers. This effect assists in long term maintenance. Randomized trials typically show that patients persist with low-carbohydrate eating plans similarly to comparison diets. • Myth: Plant foods are reduced Response: Non-starchy vegetables (green leafy, cruciferous, zucchini, cucumber, celery, etc.) are the foundational foods of a low-carbohydrate eating pattern and are nutrient dense with abundant amounts of folate, potassium, vitamins and phytonutrients. Proteins or fats can also be obtained from vegetable sources such as nuts, tofu, tempeh, olive oil, avocado and others. • Myth: Ketosis is dangerous because the brain needs glucose Response: Restricting dietary carbohydrates has been an established treatment option for children with hard to control epilepsy since the 1920s and has no proven deleterious effect on cognitive function. • Myth: Ketone products and fats are necessary to get into nutritional ketosis Response: The most important factor to attain nutritional ketosis is to consume a small amount of carbohydrate. Adding ketones or fats or oils is not necessary. • Myth: Low-carb eating patterns negatively influence kidney function Response: This myth stems from the confusion between low-carb eating patterns and high-protein eating patterns. Low-carb does not necessarily mean high protein. Further, for people without existing kidney disease, and for those eating to satiety, higher protein intake does not appear to be related to lower kidney function.

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