Sustainability of Low Carbohydrate Diets

Introduction

Between the years of 1960 and 2000, the presence of obesity in adults aged 20 to 74 years old in the United States increased from 13.4% to 30.9% (Bravata, 2003). There were an estimated 325000 deaths due to obesity and a staggering number of $39-$52 billion dollars in direct health care costs to treat obese individuals (Bravata, 2003). According to the World Health Organization, in 2014 more than 1.9 billion people across the world were obese (Hashimoto,2016). Due to this serious health crisis, low-carbohydrate diets have surged as a way of quick weight loss, yet their long-term sustainability remains poorly understood (Bravata, 2003). While it is challenging to estimate the number of individuals who have followed low-carbohydrate diets, the popularity of books advocating their use is a testament to the high demand and interest in these diets (Bravata,2003). Low-carbohydrate diets are a quick way to lose weight and can be kept sustainable over a period of time as long as the patient understands the proper nutrition needed to keep their body healthy. In order to understand the demand for low-carbohydrate diets, the short and long term effects these diets can have on the human body needs to be understood first.

History of Low Carbohydrate Diets

The prevalence of low-carbohydrate diets began in 1890 and 1900. An agricultural chemist by the name of Wilbur Atwater discovered how to precisely calculate the amount of energy in food by burning food to ash inside a calorimeter (Bowden,2004). He called this unit of measurement a calorie and believed the human body would function the same way as the chamber used in his experiment and will “burn” calories the same way (Bowden,2004). This experiment lead to the “calories in versus calories out” hypothesis which demonstrated the general understanding of weight management. This theory was named the energy balance theory and stated that if the body takes in more calories than it burns off, weight gain is apparent (Bowmen,2004). After this hypothesis was in place, Wilbur observed that the type of calories he was consuming made more of a difference to his weight than the amount of calories he consumed. While some low-carb scientists today may argue that calories are not an accurate measurement of food intake, it is now widely believed that the type of calories the body is consuming is more important (Bowman,2004). Different foods create different reactions to the body’s hormonal responses, which in turn determines the body’s ability to store or release fat.

Carbohydrates trigger the body’s hormonal response to store fat as opposed to releasing it; making high carbohydrate diets very fattening and not sustainable. This experiment brought upon a series of experiments demonstrating how low-carbohydrate diets can trigger the body’s hormonal response to burning fat storages in the body, helping the patient lose weight as opposed to gaining it.

Sustainability

Although it is very evident that low-carbohydrate diets are effective to treat obesity, the long term sustainability and results of these diets remain complex. There have been many failed studies trying to figure out the long-term benefits of these diets, most of which resulted in participants dropping out and the study failing due to not having a large enough pool of results to support the hypothesis (Goldberg, 2006). However, the successful studies show enough insight to support the theory of low-carbohydrate diets. Low-carbohydrate diets become effective when the body reaches a state of ketosis. Once ketosis is reached, it is sustainable as long as the patient can follow their diet. Reduced insulin levels as well as reduced fat accumulation are direct results of the absence of dietary carbohydrates (Paoli et al. 2013) After a couple of days of reduced carbohydrate consumption, glucose reserves become insufficient and unsustainable.Glucose is the main energy source for the central nervous system due to the inability to use fat as energy. If glucose is not present, the central nervous system needs to find an alternate energy source. The alternative energy source is a derivative of acetyl coenzyme A. This enzyme assists in the production of ketone bodies to help metabolize fat storages in the body (Paoli et al. 2013). If dietary carbohydrate levels in the body remain low, these diets are sustainable for weight loss long-term. If the levels increase and the patient begins to eat more carbohydrates, the body will start to metabolize carbohydrates the same way as before and the process of ketosis will stop. In order for the body to stay in the state of ketosis, fifty grams or less of dietary carbohydrates must be consumed in a day as well as high portions of fat and protein. As a long-term diet, low-carbohydrate diets will help assist the body in more ways than just weight loss. If a patient undergoes a massive dietary change and reverts back to eating large amounts of carbohydrates, rapid weight gain will take place. A low-carbohydrate diet needs to be sustained even after a patient's goal weight is reached. If a patient does not want to continue a low-carbohydrate diet, it is imperative to keep carbohydrate consumption levels low by eating more proteins and fats to prevent unwanted weight gain.

Long-Term Health Benefits

Although fighting obesity is the main function of low-carbohydrate diets, many other long-term health problems can also be treated. These diets have been used since the 1920’s to treat epilepsy and can remove the need for medication, in some cases, all together (Paoli et al. 2013). Diabetes, polycystic ovary syndrome, acne, neurological diseases, and cancer, are few of the many health risks that low-carbohydrate diets help to prevent (Paoli et al. 2013) They also helps to fight against life threatening diseases due to obesity such as hypertension and chronic kidney disease which are more common amongst older adults (Hashimoto et al. 2016) There are several studies that point to the benefits of low-carbohydrate diets on cardiovascular risk factors (Paoli et al. 2013). In the 1920’s low-carbohydrate diets were first known to help prevent neurological diseases, specifically epilepsy. The state of ketosis influences neurotransmitter activity in the neurons, helping to prevent or seizures. This activity is brought on by the metabolic mechanisms of ketosis (Paoli et al. 2013). Besides epilepsy, cardiovascular disease has also been prevented due to these diets increasing the size and volume of lipoprotein-cholesterol particles (Paoli et al. 2013). Type 2 diabetes results from the resistance to insulin. Due to being directly diverted into the liver, a greater portion of dietary carbohydrates will be converted into fat (Paoli et al. 2013). If dietary carbohydrate levels drop to levels much lower than normal, it cannot sufficiently be converted into fat. This prevents patients with diabetes from experiencing spikes in blood sugar levels as well as prevents drastic weight gain. ​Low-carbohydrate diets, while most cases just result in extreme weight loss, can remain to be sustainable for patients suffering from diseases or patients trying to prevent certain diseases.

Conclusion

Low-carbohydrate diets have many important long term health effects. As the world's population continues to increase and food becomes more processed, the incidence and prevalence of obesity is rapidly rising (Joshi & Mohan, 2018). Globalization, urbanization, and rapid lifestyle changes are few of the many reasons behind this shift (Joshi & Mohan, 2018). It is not just the developed countires being affected by obesity, this pandemic has also reached developing countries as well, leaving behind even more devastation due to inadequate health care (Joshi & Mohan, 2018). Obesity leaves humans at risk of developing diseases like diabetes and cardiovascular disease, all of which are preventable as long as good eating habits and a proper diet are integrated into everyday life. All of these diseases make it apparent that weight loss and healthy eating habits in society is no longer a want, but also a need.

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