Low Carb Diet – To Love or to Hate?

Nutrition is a field of major interest in the last decades, not only for the medical community, but also for the general population. We know today that what one eats can influence one’s health and well-being. This simple truth is unfortunately not so simple at all, because there is no consensus about what exactly one should eat in order to stay healthy and there is a lot of information in the medical (and not only) literature about nutrition and a debates are going on about the best diet composition. More than that, things are changing, information that was true and proven yesterday is not valid anymore today. This is why we need to be informed, to think and to choose in order to be able to pick the best data. A trend that is, on one hand, gaining more and more credit and, on the other hand, having a lot of opponents, is the low carbohydrate, known as low carb, diet. There are quite impressive theories stating the beneficial effects of a low carb diet, but also, in a traditional way, it is (or was?) a habit to take a high percentage of total energy intake from carbs. Where is this tradition coming from? First of all, from the landmark studies published in the ‘60s and ‘70s that showed the negative effects of fats on weight, cardiovascular disease, etc. One of these publications is The Seven Countries Study that showed an association between saturated fat intake and cardiovascular mortality [1]. Since then, the guidelines recommended a low fat diet that provided subsequently a higher percentage of carbohydrates (around 50-60% of total energy intake). Newer study showed that a diet high in carbohydrates elevates postprandial glycaemia and serum insulin level, leading to an accelerating in the progression of type 2 diabetes and atherosclerotic cardiovascular disease [2]. So maybe it is time for a paradigm change. Before debating about the effects of a low carb diet, we need to answer the question: what is a low carb diet? There are several definitions in the medical literature; the easiest way is to consider that restricted carbohydrate intake means an intake below the currently recommended amount of 45-65% of total daily energy intake [3]. But for a more detailed definition the classification in to three different types of low carb diet is useful [4]: moderate carbohydrate diet (26-45% of total daily energy intake), low carbohydrate diet (<26% of total energy intake or <130 g carbohydrates/day) and very low carbohydrate (ketogenic) diet (20-50 g carbohydrates/day or <10% of total daily energy intake in a 2000 kilocalories/day diet). There are many studies published in the last decades that show evidence for the beneficial effect of a low carb diet on various parameters of the cardio-metabolic syndrome. © 2018 ILEX PUBLISHING HOUSE, Bucharest, Romania http://rjdnmd.org Rom J Diabetes Nutr Metab Dis. 25(3):233-236 doi: 10.2478/rjdnmd-2018-0026