I Will Dispel 10 Low Carb Dietary Myths

Applying Science To Dispel Key Dietary Myths by Dr Trudi Deakin PhD | #PHCvcon2021

I Will Dispel 10 Low Carb Dietary Myths

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Video Transcript

I’m going to take around 30 minutes to dispel 10 low carb dietary miss and please do email me if you have any questions myth number one low carb starts the brain from essential glucose it’s stated that the brain requires 130 grams of glucose per day is this correct if this is the case then why do people report that they have more mental clarity and energy once they restrict carbohydrates to below 130 grams per day this is a pet scan that shows that glucose is being used by the brain but is the glucose the only fuel that the brain can use first of all let’s explore where the 130 gram comes from the dietary reference document published by the institute of medicine in 2005 states that the estimated average requirement for adults is 100 grams of carbohydrate per day the recommended daily amount is then set by using a 30 coefficient of variation to cover the majority of the adult population but it also states the brain can adapt to a carbohydrate or energy restricted diet by utilizing keto acids as part of its fuel requirements what are keto acids a natural byproduct created when we burn fat for fuel ketones can supply 80 of the fuel for the brain and the brain likes this fuel because it’s clean energy it doesn’t cause reactive oxygen species that damage the brain so the actual requirement for the brain of glucose is only 22 to 28 grams a day is it essential to obtain this from the diet this would make carbohydrate or glucose an essential nutrient what is an essential it’s nutrient neat nutrient that we can’t make so therefore we have to eat it this is a list of all the essential nutrients take a look carbs or glucose are not on the list no that’s because we don’t have to eat it because we can make glucose out of protein or fat for every 100 grams of protein we eat we could make 56 grams of glucose for every 100 grams of fat we eat we could make 10 grams of glucose so basically a cooked fried cooked breakfast could provide all the additional glucose we need for the break and it states in the document on page 275 the lower limit of dietary carbohydrate compatible with life apparently zero provided that adequate amounts of protein and fat are consumed so this is a process called glucose gluconeogenesis which simply means the making of new glucose and we can make up to 600 grams of glucose in a 24-hour period from fat and protein if we needed to this is 24 times more than the brain needs myth number two low carb results in eating more saturated fats that clogs the arteries so first of all does adopting a low carb dietary approach result in eating more saturated fat well yes it does in a way because natural healthy real foods such as extra virgin olive oil oily fish and nuts do contain saturated fat the low-carb lifestyle also supports cooking foods in natural stable fats that are not prone to oxidation such as dripping lard and extra virgin olive oil so the next question does saturated fat clog the arteries and lead to cardiovascular disease it’s easy to see why people may think that saturated fat has been demonized for years and it does look a bit like fatty plaques however dietary fat doesn’t even go through the arteries it’s taken from the gut to the via the lymphatic system to the fat tissue the adipose tissue where it’s either stored or used for energy saturated fat circulating in the blood is more likely to come from the excessive consumption of dietary carbohydrate that’s been converted to saturated fat by the process known as novo lipogenesis which means the production of new fat we really aren’t what we eat just think about how we fatter fatten or cattle we feed them grass or grain we don’t feed them fat to make them fat what about the evidence base does eating saturated fat has it been shown to cause cardiovascular disease now we don’t look at observational studies because they can’t prove causation so let’s go to the best level of evidence which is a cochrane systematic review the hooper review on reduction of saturated fat for cardiovascular disease was updated just last year it includes 15 randomized control trials 159 000 participants it demonstrates that reducing dietary saturated fat does not reduce mortality but suggests that it would cut the relative risk of a cardiovascular disease event by 21 however this finding did become non-significant when only studies with a low risk of bias were included also the review didn’t demonstrate reducing dietary intake of saturated fat would reduce heart disease strokes or even diabetes most important take-home message from this review is on page 159 where the authors ran a sensitivity analysis for rcts that did actually reduce saturated excluding studies that aim to reduce saturated fat but didn’t and then the only finding for cardiovascular disease events ceased to be significant so basically we should promote the message that the case should now be closed if you’re still not sure we’ve researched saturated fat quite extensively so you can read our position statement or watch the youtube presentation from a previous phd conference for more information it is fantastic news that now there is a proposal that the current nutrient-based recommendations are replaced with food-based recommendations instead and i really hope that this happens but just a word of caution when we talk about fueling from fat would mean fueling from stored fat as well as dietary fat it is best to obtain fat from real foods during meals rather than having large quantities of butter and or cream and coffee between meals most of us have plenty of energy stored as fat in our bodies that we should be able to dip into between eating episodes for example a 48 kilogram athlete with only 10 to 12 body fat still is 44 000 calories of stored body fat a 70 kilogram wonder with 25 body fat has 157 000 calories of stored body fat an obese woman with more than 50 body fat has 427 000 calories of stored body fat therefore if you’re fat adapted meaning that your body can easily dip into your fat stores you will not hit the wall and go into dietary starvation mode instead you’ll have enough stored energy to keep you going myth number three low carb isn’t evidence-based compared to the well guide the eat well guide was launched in march 2016 and is full of evidence-free ideas it encourages consumption of nutrient nutritionally poor foods rather than nutritionally rich foods this is our nutrition for health model which guide do you think looks the healthiest public health england published five sample daily meal plans alongside the eat well guide which are analyzed it wasn’t but wasn’t surprised to find them very high in carbs more than 300 grams of carbs each day and more than 100 grams of sugars each day too the look ahead rct tested the low fat high carb diet in 545 patients and stopped early after 9.6 years because there was no reduction in cardiovascular disease the woman’s health initiative rct included almost 49 000 individuals post-menopausal women and found they did not reduce the risk of diabetes after 8.1 years in comparison carb restriction has been shown to improve diabetes and cardiovascular disease risk factors so this myth is really easy to bust myth number four is low carb a high protein diet and if so does this protein damage the kidneys so what is protein it’s building blocks of amino acids some are essential and some aren’t as all cells tissues and many hormones contain protein eating protein that contains essential amino acids is important for growth repair and a wide range of metabolic processes that keep us healthy non-essential amino acids can be converted to glucose so they don’t go to waste when we fill containing protein it’s digested into amino acids any leftover amino acids are transported to the liver when they’re broken down to ammonia and then converted to urea the urea is transported in the blood back to the kidneys and the blood is filtered and the urea is passed out of the body in the urine so basically our kidneys act like a sieve to get rid of waste products it’s been demonstrated that there’s no difference in kidney function between those who eat a high protein diet compared to those who eat a normal or low protein diet the conclusion states that there’s no evidence that high protein intake leads to a decline in real function and regal function in healthy individuals or even those populations with a greater risk of renal decline such as those people with type 2 diabetes so given the advantage of consuming protein to build muscle lose weight and maintain muscle with aging this finding is really really important in fact not eating enough protein is more detrimental to health the protein leverage hypothesis suggests that we’ll continue eating until our protein requirements have been met no matter how many calories are consumed and therefore ultra processed food that is lacking in protein is actually driving no obesity pandemic it is known that protein increases satiety and low carb real food meals reduce appetite however low carb tends to be moderate protein not high protein total daily calories often reduce because people feel less hungry so the percentage of calories coming from the protein may increase but not necessarily the grams of protein eaten nephropathy is a known complication in both type 1 and type 2 diabetes where the kidneys become damaged and can no longer filter the blood as well lead to protein escaping in the urine just because protein is found in the urine does that mean that protein caused the damage now we have excellent evidence from uk pds studies that both hypoglycemia high blood glucose and hypertension high blood pressure causes the kidney damage and a cochrane systematic review has shown that restricting protein intake in diabetic renal disease is is not effective whereas not only do low carb diets treat the hypoglycemia but also the hypertension so much more likely to treat the true cause of the kidney disease myth number five it is true that low carb results in fewer eating episodes but is skipping meals bad for your metabolism people only go into dietary starvation mode which results in the body slowing down when they’re insufficient calories for the body to use we’ve already seen that even lean people have plenty of stored fat in their body people are able to access their fat stores for energy which is only possible when insulin levels are low their body will obtain all the energy it needs and doesn’t need to conserve calories by reducing the metabolic rate the hormone cortisol peaks first thing in the morning whether you eat or not so why is this important the cortisol tells the body to release energy and this boosts metabolism so we don’t have to eat to actually boost our metabolism in the morning and researchers also show that extending the overnight fast does not cause compensation really eating later on in the day it’s important to note that you cannot burn fat and store fat at the same time so eating carb containing meals and snacks repeatedly throughout the day raises insulin and puts you into fat storage mode so the only person the only time this person can burn fat is when they’re sleeping and that’s shown here with this green section eating two meals a day has been shown to be beneficial for people with type 2 diabetes because there’s so much more time when they’re in fact burning mold and this can be shown here myth number six low carb is expensive and unaffordable if you eat less often don’t snack not eat junk food and have more nutrients per calorie is that really expensive karen a dietitian in new zealand compared three meals and three snacks for low carb with low fat and found that low carb to be very only very slightly more expensive around 1 pound 14 a day which for many is worth it due to an increase in quality of life and perhaps work productivity but an important note is when you take into consideration the reduced frequency of eating this additional cost is probably wiped out this is certainly my own personal experience and the experience of many people i’ve talked to myth number seven will low carb lead to nutritional deficiencies really do you really think that these types of meal will lead to nutritional deficiencies compared to ultra-processed food i analyze a typical low carb plan of three males and a typical low fat plan over five to six eating episodes neither diets contained a lot of ultra processed food as you’d expect there was a big differences between the carbs and the fats opposites but there wasn’t real differences between the diets for protein or fiber interestingly the low fat diet was deficient in vitamin d iron calcium and zinc and no we don’t meet our nutrients every day but there was no deficiencies with the low carb diet and there is published evidence that indeed consuming a well-balanced low diet can provide you with all the nutrients you need myth number eight a low-carb dietary approach isn’t suitable for many conditions clearly one size doesn’t fit all but some level of carbohydrate restriction has been shown to be effective for a whole host of conditions and probably more besides i think the safety essentials are to provide education and medication review and ongoing support risk number nine it’s not sustainable a while back i reached out to members of the low carb forum on diabetes.com.uk to ask this very question i got 21 responses everyone thought it was sustainable and intended to stay on it basically it’s when the benefits outweigh the costs these people achieved improved glycemic control and weight loss no one increased medication and they all felt so much healthier isn’t that a great motivator to stick to it myth number 10 we’ll finish with the poop is a low-carb dietary approach lacking in fiber and will it eliminate the good books the good bugs in the gut there are many strategies that can help you keep regular with passing stools such as fiber hydration movement magnesium and even dietary fat it’s wrong to say that a low carb diet is lacking a fibre as there’s plenty of options the green traffic light coding here shows that many high fiber foods are also low carb and the foods that promote a healthy gut microbiota are the very foods that we are courage on a low-carb diet whereas the processed food that damages the gut microbiota are eliminated so 10 missed busted hopefully leading to more confidence in the promotion of low carb dietary so thank you very much for listening and i hope you found it interesting once again email me with any queries thank you [Music] you

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