Milly Gaines
Low-carb diets have been a popular strategy for weight loss since 1860, and especially since 1972. However, there is no clear consensus on what defines a low-carb diet. Generally, low-carb diets involve limiting your intake of carbohydrates to less than 26% of your daily calories. While low-carb diets have been shown to be effective for weight loss, there are also several side effects and risks associated with them. These include fatigue, headaches, muscle cramps, bad breath, and reduced exercise performance. There may also be more serious long-term health risks, such as increased risk of premature death, coronary heart disease, stroke, and cancer. Despite these concerns, some studies have found that low-carb diets can have benefits such as improved heart health and type 2 diabetes management.
| Characteristics | Values |
|---|---|
| Purpose | Weight loss and weight management |
| Health Benefits | Improved heart health, lower triglycerides, boost in HDL cholesterol, type 2 diabetes management |
| Risks | Nutrient deficiencies, fatigue, headaches, muscle cramps, bad breath, reduced exercise performance, negative effect on gut microbiome, increased risk of premature death, coronary heart disease, stroke, cancer, heart arrhythmias, cardiac contractile function impairment, osteoporosis, kidney damage, increased cancer risk, impairment of physical activity, lipid abnormalities |
| Macronutrient Intake | Carbohydrates: less than 26% of daily calories; Fat: 9 kcal/g; Protein: 4 kcal/g |
| Food Options | Non-starchy vegetables, fruits low in sugar, lean meats, healthy fats |
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What You'll Learn
Weight loss and weight management
Low-carb diets have been a strategy for weight loss since 1860, and especially since 1972. While there is no clear consensus on what constitutes a low-carb diet, studies have defined it as a percentage of daily macronutrient intake or total daily carbohydrate load. For example, a very low-carb diet could be defined as less than 10% carbohydrates, or 20 to 50 grams per day.
Several studies have demonstrated that low-carb diets are as effective, if not more effective, for weight loss compared to other diets. One study found that a group of participants who consumed a low-carb diet burned an average of 209 more calories per day than a group consuming a high-carb diet. Another study found that healthy low-carb diets were associated with lower mortality, while unhealthy low-carb diets were associated with higher mortality. This suggests that the quality of food matters, not just the level of macronutrient intake.
However, there are also risks and side effects associated with low-carb diets. One concern is the effect on lipids, specifically an increase in LDL cholesterol. There may also be an increased risk of long-term cardiovascular safety issues, renal effects, and nutritional ketosis. Low-carb diets can also be difficult to maintain, and there is limited evidence about how they affect the gut microbiome. Some studies suggest that low-carb diets may change the levels of beneficial microorganisms in the gut, which could have unknown health effects in the long term.
Additionally, low-carb diets can lead to fatigue, as carbohydrates are the body's preferred fuel source. They can also cause a decrease in physical performance and exercise capacity, as well as mineral deficiencies such as potassium and magnesium, which can result in muscle cramps. It is important to note that there is limited research on the long-term effects of low-carb diets, and some studies have suggested potential risks, including an increased risk of premature death, heart disease, stroke, and cancer.
Overall, while low-carb diets may be effective for weight loss and weight management, it is important to consider the potential risks and side effects and consult a healthcare professional before making any significant dietary changes.
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Cardiovascular health
Low-carb diets are popular for weight loss and weight management. However, they are not recommended in leading guidelines due to the perception that an increase in dietary fat intake may lead to adverse cardiovascular risks. Obesity is a well-known risk factor for cardiovascular disease, and a low-carb diet is often used as an intervention.
Several studies have been conducted to determine the effect of a low-carbohydrate diet on cardiovascular health. A 2021 study published in the American Journal of Clinical Nutrition found that a carefully constructed low-carbohydrate eating plan may reduce some risk factors for cardiovascular disease, despite a high saturated fat content. However, the study period was short, and the diet used in the trial was healthier than many low-carb approaches.
Another study, which lasted 20 weeks, found that a low-carb diet improved cardiovascular risk factors compared to moderate and high-carb diets. The low-carb diet included many healthy foods but was still restrictive, making it challenging to follow long-term.
A meta-analysis of randomized controlled trials also confirmed that low-carbohydrate diets have a beneficial effect on cardiovascular risk factors. However, the long-term effects on cardiovascular risk factors require further research.
In addition, a pilot study on patients with diabetic cardiomyopathy found that a low-carbohydrate diet led to significant weight loss and improved quality of life scores.
Overall, while a low-carb diet may improve some cardiovascular risk factors, more research is needed to understand the long-term effects. Experts recommend finding a sustainable diet that includes a healthy mix of nutritious foods rather than solely focusing on carbohydrate content. A well-planned low-carb diet should include a variety of nutritious, whole, unprocessed foods, such as vegetables, fruits, beans, and small portions of whole grains.
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Gut health
The human gut is home to trillions of bacteria, viruses, and fungi, collectively referred to as the gut microbiome. These microbes play a crucial role in breaking down nutrients as they travel through the intestines and supporting digestive health. The diet we adopt has complex effects on our intestines, gut bacterial composition, and overall health.
Low-carb diets, such as the ketogenic diet, have gained popularity in recent years due to their proposed benefits, including weight loss, improved heart health, and type 2 diabetes management. These diets typically involve limiting carbohydrate intake to less than 26% of daily calories, which forces the body to use fat instead of glucose as its primary energy source. While low-carb diets may offer certain benefits, their impact on gut health is more nuanced and has been the subject of much debate.
Several studies have found that low-carb diets can have a significant impact on the gut microbiome. A UC San Francisco study showed that a low-carb, high-fat ketogenic diet reduced the number of Th17 immune cells, a type of T cell critical for fighting off infectious diseases. Additionally, switching from a balanced diet to a high-fat, no-carb diet increased strains of bacteria that metabolize fatty acids while decreasing bacteria such as Bacteroides, Clostridium, and Roseburia, which are responsible for degrading proteins and carbohydrates. This reduction in specific bacteria can lead to a decrease in the production of short-chain fatty acids and antioxidants, which are essential for reducing inflammation and protecting against DNA damage and colon cancer.
However, not all effects of low-carb diets on the gut microbiome are detrimental. Some studies suggest that the microbial shifts caused by ketone bodies, a byproduct of the ketogenic diet, may have potential benefits for gut health. These shifts in microbes may ultimately suppress inflammation and have therapeutic effects for autoimmune disorders affecting the gut. Additionally, low-carb diets have been found to improve insulin sensitivity and may be useful for managing certain metabolic health conditions.
It is important to note that the impact of low-carb diets on gut health may depend on the specific types of carbohydrates restricted. Carbohydrates that are refined, processed, or simple sugars can negatively impact the gut microbiome. On the other hand, complex carbohydrates, such as dietary fibers, whole fruits, and whole grains, can feed the beneficial microbes in the gut and promote the production of short-chain fatty acids, supporting digestive health and overall gut health. Therefore, while some low-carb diets may reduce the variety of plant foods consumed, it is possible to maintain a diverse and gut-healthy diet while restricting certain types of carbohydrates.
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Nutrient deficiencies
A low-carbohydrate diet involves limiting your intake of carbohydrates, with less than 26% of daily calories coming from carbs. While it can be a nutritious way of eating, some nutrient goals may be harder to achieve. It is important to vary your protein sources and vegetable options, as well as include some nuts, seeds, and dairy to meet your recommended dietary intake (RDI) and avoid deficiencies.
Carbohydrate-rich foods such as whole grains, fruits, and vegetables contain many important vitamins and minerals. Eliminating these foods can lead to nutritional deficiencies and serious health problems. Good carbs like fiber and starch are essential for overall health and wellness, and the high vitamins in carbs regulate blood sugar, cholesterol, digestion, and weight.
The main nutrients that are more likely to be deficient in a low-carb diet are thiamine, folate, vitamin C, magnesium, iron, vitamin D, vitamin E, calcium, and fibre. For example, fortified cereals and breads, which are absent in low-carb diets, contain lots of vitamin B12, which is necessary for turning food into energy, DNA creation, and healthy blood vessels. Similarly, vitamin D can be difficult to obtain through food sources alone, and regular sun exposure is the best source.
It is important to be aware of any deficiencies before starting a low-carb diet to ensure you are not already deficient in any of the necessary nutrients. A low-carb diet may not be sustainable in the long term, and research shows that once people go back to their regular diets, there is no lasting effect on their weight.
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Fatigue
There are several reasons why a low-carb diet can lead to fatigue. Firstly, when you lower your carbohydrate intake, you also reduce your sugar intake. This can lead to withdrawal symptoms, including headaches and fatigue, as your body adjusts to using alternative fuel sources. A sudden decrease in carbohydrates can result in a loss of body water, which may contribute to feelings of tiredness. Additionally, a low-carb diet may not provide enough calories to support your lifestyle, leading to a calorie deficit that reduces your total daily energy expenditure and slows your metabolism.
The fatigue associated with a low-carb diet tends to occur at the beginning of the diet and may pass quickly. According to a March 2018 study in PeerJ Life & Environment, mild side effects like fatigue are usually due to water loss, electrolyte imbalances, and fluctuations in blood glucose, which typically start to improve around the fourth day. However, the more severe "keto flu" can appear two to seven days after starting the diet and may include additional symptoms like lightheadedness, dizziness, constipation, and muscle weakness.
To mitigate fatigue on a low-carb diet, it is important to ensure you are consuming enough calories and staying properly hydrated. Maintaining blood sugar stability by combining complex carbohydrates with protein and healthy fats can help. Additionally, supplementing with MCT oil may reduce low-carb diet fatigue and related symptoms, as found in a small 2018 study in the Journal of Nutrition and Metabolism. Finally, increasing your intake of high-fibre complex carbs can slow digestion and help prevent blood sugar spikes and crashes, which can lead to feelings of tiredness.
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Frequently asked questions
A low-carb diet involves limiting your intake of carbohydrates. Typically, this means that less than 26% of your daily calories come from carbs.
Low-carb diets are associated with weight loss and weight management, improved heart health, and type 2 diabetes management. A 20-year study found that women who ate low-carb diets high in vegetable sources of fat or protein had a 30% lower risk of heart disease and a 20% lower risk of type 2 diabetes.
There are concerns about the long-term effects of low-carb diets on cardiovascular and gut health. Some studies suggest that low-carb diets may negatively impact the gut microbiome and increase the risk of premature death, coronary heart disease, stroke, and cancer. Additionally, low-carb diets can cause fatigue, headaches, muscle cramps, bad breath, and reduced athletic performance.
Pregnant and breastfeeding mothers should likely avoid low-carb diets. Anyone with diabetes, high blood pressure, or other health conditions should consult a healthcare professional before starting a low-carb diet.
