
Carbohydrates are a basic nutrient that the body turns into glucose, providing energy for the body to work. Low-carb diets have been a popular strategy for weight loss since 1860, with a recent resurgence in 1972. While a low-carb diet may aid in short-term weight loss, it may also be unsafe and harmful to health in the long run. Studies have shown that low-carb diets are linked to an increased risk of premature mortality and death from several chronic illnesses, including cardiovascular disease, cerebrovascular disease, and cancer. Additionally, very low-carb diets can lead to adverse side effects such as weakness, fatigue, dizziness, and an increased risk of kidney stones or gout flares. Therefore, it is essential to consult with a doctor or dietitian before drastically reducing carbohydrate intake.
| Characteristics | Values |
|---|---|
| Risk of premature mortality | 15% higher risk of death from any cause |
| Risk of cardiovascular death | 13% higher risk |
| Risk of cancer | 8% higher risk |
| Weight loss | Effective in short term, but may harm health in the long term |
| Blood sugar | Can lower blood sugar, but hypoglycemia is a risk |
| Cholesterol | May increase LDL ("bad") cholesterol, which can lead to heart disease |
| Kidney health | May increase uric acid levels, leading to kidney stones or gout |
| Diet restrictions | May be overly restrictive and unsustainable in the long term |
| Medication adjustments | May require rapid medication adjustments |
| Energy levels | May cause weakness, fatigue, and dizziness |
| Mental health | May impact serotonin levels, affecting anxiety and depression |
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What You'll Learn

Increased risk of premature mortality
A low-carb diet can be defined as a diet with less than 26% carbohydrates or 130 grams of carbohydrates per day. Very low-carb diets are those that contain less than 10% carbohydrates or 20 to 50 grams of carbohydrates per day.
Low-carb diets have been a popular strategy for weight loss since 1860 and continue to be of interest to many people. However, a large study has found that a low intake of carbs raises the risk of premature mortality and mortality from several chronic illnesses. The study, which examined the links between low-carb diets and the risk of death from any cause, found that the overall risk of death from any cause was 15% higher in those who consumed the least amount of carbs.
The study also found that the risk of cardiovascular death was 13% higher and the risk of dying of cancer was 8% higher in those with a low-carb intake. This may be due to the increased intake of animal protein, cholesterol, and saturated fat that often accompanies low-carb diets, as well as a reduced intake of fiber, fruits, minerals, vitamins, and phytochemicals.
In addition, very low-carb diets can lead to nutritional deficiencies and side effects such as weakness, fatigue, dizziness, and headaches. They can also cause a drop in blood sugar levels, which may be beneficial for those with diabetes but can also lead to hypoglycemia, a dangerous condition where blood sugar levels become too low.
While low-carb diets may be useful in the short-term for weight loss and improving blood glucose control, the evidence suggests that they are linked to an increased risk of premature mortality in the long term. Therefore, it is important to consult a doctor or dietitian before drastically lowering carb intake.
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Higher risk of chronic illnesses
Low-carb diets have been linked to an increased risk of mortality from several chronic illnesses. Studies have shown that people who consume fewer carbohydrates have a 15% higher overall risk of death from any cause, a 13% higher risk of cardiovascular death, and an 8% higher risk of dying of cancer.
The increased risk of mortality is thought to be caused by a reduced intake of fiber, fruits, and vegetables, as well as an increased intake of animal protein, cholesterol, and saturated fat. Low-carb diets are also often high in red meat and low in whole grains, dairy, and fruit, which can lead to a higher risk of developing kidney disease.
Additionally, very low-carb diets can cause nutritional ketosis, which occurs when the body breaks down fat for fuel instead of using glucose. While this can be beneficial for weight loss and blood sugar control, it can also lead to an increased risk of hypoglycemia, or low blood sugar, which is dangerous for people with diabetes.
Furthermore, low-carb diets have been shown to negatively impact mental health. One study found that people who followed low-carb diets had lower serotonin levels in their brains, which can increase the risk of anxiety and depression.
Overall, while low-carb diets may offer some health benefits in the short term, they have been linked to an increased risk of several chronic illnesses and higher mortality rates in the long term. It is important for individuals to carefully consider the potential risks and benefits before starting any restrictive diet and to consult with a healthcare professional to ensure safe and effective dietary choices.
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Nutritional ketosis and hypoglycaemia
Carbohydrates have long been vilified as a dietary evil, with low-carb diets being a popular strategy for weight loss since 1860 and gaining renewed interest in 1972. While there is no clear consensus on what constitutes a low-carb diet, it generally involves reducing the overall intake of carbohydrates. Some popular low-carb diets include the ketogenic, South Beach, and Atkins diets.
The ketogenic diet, in particular, has gained popularity for its weight loss benefits and is characterized by a severe restriction of carbohydrate intake, typically to less than 10% of total calories, with most variations recommending less than 50 grams of carbohydrates per day. This restriction of carbohydrates shifts the body's metabolism towards fatty acid oxidation and the production of ketones as an alternative fuel source, a state known as nutritional ketosis.
While the ketogenic diet has been shown to be safe in the short term, there have been several case reports of individuals developing hypoglycemia, also known as low blood sugar. Ketotic hypoglycemia refers to a state where low blood glucose is accompanied by ketosis, resulting in symptoms such as lethargy, malaise, sugar cravings, mental fogginess, and abdominal discomfort. This condition has been observed in both adults and children, with children being more susceptible due to their reduced fasting tolerance and minimal fat storage.
In adults, ketotic hypoglycemia can be triggered by extended fasting or the consumption of alcohol in combination with the ketogenic diet. In the case of the 69-year-old female patient, she presented with symptoms of malaise, sugar cravings, and mental fogginess after adhering to a strict ketogenic diet for nearly a year. After consuming alcoholic beverages, she was admitted to the hospital with hypoglycemia and elevated levels of ketone bodies, indicating starvation ketosis.
It is important to note that while the ketogenic diet can lead to rapid weight loss, it may also contribute to adverse effects if followed long-term. Additionally, very low-carb diets can be overly restrictive, limiting the intake of several nutritious food groups. Therefore, it is always recommended to consult with a doctor or dietitian before drastically reducing carbohydrate intake to ensure a safe and effective approach to weight loss or blood sugar management.
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Lack of fibre
A diet that is high in carbohydrates and low in other food groups can lead to a lack of fibre intake. Fibre is a type of carbohydrate that cannot be digested or absorbed by the human body. It is found in fruits, vegetables, whole grains, beans, legumes, nuts and seeds. There are two types of fibre: soluble and insoluble, both of which have distinct health benefits.
The recommended daily fibre intake in the UK is 30g for adults, whereas the average intake is only 18g. Similarly, in the US, the recommended daily intake is 25g for women and 38g for men, whereas most adults average just 16g per day.
A lack of fibre in the diet can lead to a range of health issues. Firstly, fibre helps to slow the absorption of sugar into the bloodstream. Without fibre, blood sugar levels can rise and fall rapidly, leading to tiredness and mood changes. Low fibre diets have been linked to increased anxiety and depression. Fibre also plays a role in maintaining healthy skin by supporting the production of anti-inflammatory compounds through the gut-skin axis. A lack of fibre can lead to skin issues such as acne and dull skin.
Additionally, a diet low in fibre can cause digestive issues. Fibre helps to regulate bowel movements, and a lack of fibre can lead to constipation and related issues such as halitosis. Fibre also helps to lower cholesterol by removing excess cholesterol from the body through waste matter. Without sufficient fibre, cholesterol levels can rise, leading to potential health issues.
Furthermore, a lack of fibre can contribute to chronic inflammation, a risk factor for several diseases, including cardiovascular disease, type 2 diabetes and cancer. Fibre helps to fuel beneficial bacteria in the gut, supporting the gastrointestinal immune system and reducing inflammation. A diet low in fibre can lead to an imbalance of gut bacteria, known as dysbiosis, which can cause inflammation, digestive issues, fatigue and mood changes.
Overall, a lack of fibre in the diet can have significant negative impacts on health, including digestive issues, increased risk of chronic diseases, and potential mood and skin-related issues. It is important to ensure adequate fibre intake to support overall health and well-being.
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Increased risk of heart disease
Carbohydrates are one of the essential macronutrients, along with protein and fat. They are a vital source of energy and are found in a wide variety of foods, including grains, fruits, starchy vegetables, and dairy products. However, the role of carbohydrates in a healthy diet has been the subject of much debate and controversy.
While a carb-based diet can be healthy, an excessive intake of carbohydrates, especially refined carbohydrates and added sugars, can lead to an increased risk of heart disease. This is because a high-carb diet can contribute to weight gain, elevated blood sugar levels, and insulin resistance, which are all risk factors for heart disease.
Several studies have examined the link between carbohydrate intake and heart disease risk. One study, published in the New England Journal of Medicine, followed 82,802 women over 20 years and found a positive association between a low-carbohydrate diet and a reduced risk of coronary heart disease. However, it is important to note that this study only assessed risk factors and did not look at actual cardiovascular events.
Another study, with a shorter duration of 20 weeks, compared low-carb, moderate-carb, and high-carb diets and found that the low-carb diet improved cardiovascular risk factors, despite a high saturated fat content. However, this study also did not examine actual cardiovascular events, and the diet was healthier than many typical low-carb diets.
It is worth noting that not all carbohydrates are created equal. "Good carbs", found in whole, unprocessed foods like vegetables, fruits, beans, lentils, and whole grains, provide nutritional value and are an essential part of a healthy diet. On the other hand, "bad carbs", found in sugary, salty, and fatty processed foods like cookies, pretzels, and soda, should be limited as they contribute to negative health outcomes.
In conclusion, while a well-balanced carb-based diet can be healthy, excessive carbohydrate intake, especially refined and processed carbohydrates, can increase the risk of heart disease. It is important to focus on a sustainable diet that includes a variety of nutritious foods and maintains a healthy weight, blood sugar levels, and insulin sensitivity to reduce the risk of heart disease and other chronic conditions.
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Frequently asked questions
Carb-based diets are those where an individual gets most of their calories and nutrients from carbohydrates, or macronutrients that the body turns into glucose or blood sugar, which is then used to generate energy.
Carb-based foods include bread, pasta, rice, milk, and starchy vegetables like potatoes.
The health benefits of a carb-based diet depend on the types of carbs consumed. Complex carbs, such as those found in whole grains, are considered healthier than simple carbs like those in sugary breakfast cereals. Very low-carb diets can be unsafe and have been linked to an increased risk of premature mortality and death from chronic illnesses such as heart disease and cancer. However, unhealthy low-carb diets have also been associated with higher mortality rates.
Low-carb diets can lead to nutritional ketosis, which may cause weakness, fatigue, dizziness, headaches, stomach pain, nausea, and vomiting. They can also negatively impact your mental state, causing grogginess and potentially impacting your serotonin levels.
Alternatives to a carb-based diet include low-carb diets, such as keto and Atkins, which emphasize animal protein and high-fat foods. However, these diets can be overly restrictive and unsustainable in the long term, and it is best to consult a doctor or dietitian before drastically changing your carb intake.











































