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.
