Low carb seems to be healthy in every way


new review of all major studies on low carb diets once again show good news. Not only the weight improves: All important risk factors for heart disease get better. That includes blood pressure, blood sugar and the cholesterol profile.

Insulin levels also drop, obviously. That should only surprise a few bloggers. Those who still refuse to believe that low carb diets lower insulin or that low insulin is important for weight loss.

Here’s the review

PS: For fast news consider following my Twitter-channel. I tweeted on this paper a few days ago.


  1. panny
    i find the last line comical:
    "however the effects on long-term health are unknown."

    That's the stupidest comment ever, considering the paleo diet that we evolved on for 99.8% of the time on the planet was a low carb diet. How many millions of years do they need to know the 'long-term' effects?

    You could also argue that the long term effects ARE known on a low-fat, high-carb diet since the 70s - which is increased cardiovascular disease, obesity, diabetes, etc.

  2. '...Long term effects are unknown'. Anders, what do you think personally, aren't prospective cohorts rather alarming and in conflict with shorter term RC trials? Of course we can dismiss cohorts because they do not prove causality...

    Authors seem to have excluded 3 longer term studies from the analysis (Guldbrand, Foster, Cerdillo et al). The results are driven by shorter term trials. Anyway, good results.

  3. Dr. Andreas Eenfeldt, MD Team Diet Doctor
    No I personally don't find observational studies alarming at all. Not only do they not prove causality, not only are any negative findings tiny, but most importantly in the cases I've seen we are comparing people who try to lead healthy lives with people who don't care. A good example:

    If some weak observational data is in conflict with repeated strong RCT data I know what I trust. ;)

  4. Tiny. Really? Isn't this is exactly the attitude S Guyenet urged to drop in his recent post: "This is the kind of head-in-the-sand approach to science that we need to move beyond in the ancestral community"
  5. Maki
    RE:Tiny. Really? Isn't this is exactly the attitude S Guyenet urged to drop in his recent post: "This is the kind of head-in-the-sand approach to science that we need to move beyond in the ancestral community"

    Observational studies aren't scientific experiments. The smaller the difference the easier it could be a result of other factors.

  6. Yoly
    S Guyenet is the epitome of the standard scientific bias we see in the academia world now days. His dogma promoting of the standard scientific view on obesity is all because of a wounded pride and his sucking up for financial backing. So common on academia now with need to sustain their career that is obvious to anyone with some critical analytical capacity. The same with Kresser who is only looking to advance his $$$$ trying to pose like an internet doctor in whatever is popular. Does two are further from true science as you can get.
  7. NM
    Guynet and Kresser are parasitical opportunists. That LCHF people give them any benefit of any doubt is an example of ecumenicism gone too far. Look at their creeping promotion of outdated prevailing wisdom: attempting to rehabilitate glycating chaos via "safe starch", the calories-in-calories-out dogma with "palatability" and so on. You mark
    my words: these Kids of Keys will have a cuddly alliterative way of re-demonising cholesterol next!
  8. gallier2
    Yoly, NM, the thing with SG is not because of oecumenisl that he was respected. Before his graduation he was good, you only need to read his blog archive entries before 2011. It is since his livelyhood depends "on not getting it" that he is more than worthless (in fact harmfull imho).
    For me, he is the poster child of what is wrong with academia.
  9. 1 comment removed
  10. PatrickP
    I lost over 20 pounds last year eating primal/paleo. It's just how I eat now and it's so simple. I was on blood pressure medication and I cut that in half with my doctor's blessing. I went off the meds completely a few weeks ago without telling the doctor. Had to go to the doctor for something yesterday and my blood pressure was fine. The nurse practitioner was visibly irritated when I told her I wasn't taking the meds any longer. My dysistolic number was "slightly" elevated, but fine. She wants me to buy a blood pressure sleeve so I can take readings over two weeks so they can be sure. They're nice folks at that office so I'm going to indulge them. My point here is that I corrected the blood pressure problem (and snoring and therefore sleep problem) by loosing the weight and keeping it off easily. I have also been able to rid myself of the medicine thereby avoiding long term impacts on my organs. I am only 41 and can't imagine having to take pills for the next 50 years. How's that for long term health effects?
  11. Ucho
    Have you seen this?


    Do you have any opinion abut the study?

  12. Wade Henderson
    LCHF "Healthy In Every Way"

    How about regarding prostate cancer? Would the increased consumption of bacon, cheese, beef, and such increase or decrease the probability of prostate cancer? Or advanced prostate cancer.
    In males, of course!

  13. Dani
    I teach evidence-based medicine and believe in low carb diets. I'm happy to see that a new review has reinforced benefits on cardiovascular risk factors - but, they ARE only surrogates. What we really want to know about is clinical events. In my heart of hearts, I believe that low carb is good for you - but the ideal data doesn't exist just yet. Oddly, when there is no "pill" and therefore no financial incentive for a pharma company, longer studies are harder to accomplish...
  14. Brandon
    Ucho, read the first few comments in the comment section and you will have your answer.
  15. Jonathan Swaringen
    @Wade Henderson Cancer is generally related to inflammation and so anything that is neutral or lowers inflammation is good for staying away from cancer.

    There some some potential issues with bacon especially bacon with nitrites...or nitrates I forget which one is the bad one. Cheese and beef are not overly inflammatory as far as I know though conventionally raised beef has a much worse ratio of Omega 6 to Omega 3. Omega 3 and 6 should be as close to 1 to 1 ratio as possible and Grain-fed feedlot beef can be as high as 20:1.

    Getting plenty of seafood to offset should help. I'm not entirely clear on whether feedlot beef is inflammatory or not as there may be other factors that are anti-inflammatory. Anyone have a better idea?

    I'd love to see some studies comparing low carb followers eating both pastured grass-fed everything and those eating low carbohydrate but cheaper sources of meat like conventionally grain fed...as for me I'm currently still eating feedlot beef and other meat.

    I occasionally get WIld caught fish....the few kinds they have at Sam's Club....but can't afford Grass-fed.

  16. 1 comment removed
  17. FrankG
    @Kenny: interesting that you try to undermine the value of HLD-C... did you purposely miss out on all the recent controversy as to whether LDL-C or Total Cholesterol is a valuable marker of CVD?

    There is enough doubt in the evidence to suggest that cholesterol levels serve no purpose in risk assessment... but so long as there is a multi-billion dollar industry marketing drugs that lower the calculated LDL-C volume, guess what the industry-funded studies show ;-)

  18. Jonathan Swaringen
    @Kenny It may well be that not all HDL is good. I don't doubt this as until recently everyone was making LDL to be all bad even though large and fluffy LDL seem to be benign. Maybe those aren't in every case either?

    I don't know but it seems there is a balance and a right amount to everything. Omega 3/6 seems to be best at a 1 to 1 ratio. You can't just look at TC because its not a complete picture, or LDL, or HDL, or Triglycerides. The whole point basically is that its a package.

    You mentioned inflammation and I'm guessing if they were to run an HS-CRP to test for inflammation it would be lower after a good low carbohydrate diet it would be lower. Anecdotal evidence supports this. I think there are studies too though I don't know of any offhand.

    Was this the review you were talking about? It was already pointed out in the comments that this article's linked study wasn't a real low carbohydrate diet. It was the equivalent of one of those diets on saturated fat where they feed the rats a diet with 80% saturated fat but the saturated fat is the kind that the body makes when you eat a ton of carbohydrates. They didn't feed them coconut oil or others that we consider good.

  19. Wade Henderson
    Jonathan Swaringen

    Just wondering, regarding the potential for prostate cancer, given the money you have to spend on beef, is eating the non-grass fed beef increasing one's risk level?
    Wondering if eating a smaller, but more expensive, quantity of grass-fed beef would be a better use of funds?

    How about the funds to purchase a wide variety of excellent vegetables and fruits.
    Is that consumption a greater or lesser priority compared to the type of meats, and how might that impact the risk profile for prostate cancer?

    How would most folks prioritize the not-unlimited funds most of us use.
    For example, would it be better to spend the funds on excellent vegetables even if it meant buying non-grass fed beef? Or would one buy fewer or lower quality vegetables in order to afford only grass-fed beef?

    Obviously if one has unlimited funds you can purchase whatever you want.

  20. Jonathan Swaringen
    It doesn't help that I have no car. I rely on my brother and mom...mostly mother for getting places and she buys most of the groceries. I really don't think we have as a house enough money to support the grass-fed meat or I would try and push it.

    I do try to buy fish when I can because that's a much better source of good healthy fats. Especially wild caught varieties. At some point I hope to change this but at the moment I don't think I can.

  21. Zepp
    "Overall, the results of studies on urological aspects of the metabolic syndrome seem to indicate that BPH and prostate cancer could be regarded as two new aspects of the metabolic syndrome, and that an increased insulin level is a common underlying aberration that promotes both BPH and clinical prostate cancer."


  22. Hans
    A lot of comments dealing with the findings in the article, whereas there is a variety of anecdotic case studies showing the health benefits of a low carb diet. Especially among diabetics.Personally I got my diagnosis diabetes type 2 last summer and nearly immediately changed my diet to a somewhat moderated LCHF. The result: Normal blood sugar, considerable weight loss and now no medication. Also good ,lipids.

    But still a lot of professionals in diabetes care persist that a diet of low fat with a quite high proportion of carbs should be an appropriate diet for diabetics - there are always medicines at hand if your sugar levels should be too high and finally there is insulin.

    Well, I´m glad I searched on the net after my diagnosis and found this site ( the Swedish version - Kostdoktorn) and also gained information from other sources.

  23. Erik
    Glad that you found success in your diet control of your diabetes Hans.

    Eric Westman and Mary Vernon had a good article in Nutrition and Metabolism regarding diet versus medication control of diabetes.


    Prior to the discovery of medical treatment for diabetes, carbohydrate-restriction was the predominant treatment recommendation to treat diabetes mellitus. In this commentary we argue that carbohydrate-restriction should be reincorporated into contemporary treatment studies for diabetes mellitus.


  24. Alan
    Thank youfor sharing this paper, Andreas. I read it today and it is very strong evidence for many improvements in metabolism using a LC diet. It was interesting that HDL improved as well, while they note that bariatric surgery does not improve HDL (but does improve most of the other measures even more dramatically; but who wants this invasive and risky procedure?)

    I wanted to see a correlation with the various measures (BMI, HDL, triglycerides, etc) and the number of grams of carbs (because there was some variation there). I wonder why they did not do this?

  25. Dr. Andreas Eenfeldt, MD Team Diet Doctor
    Reijo #4,

    Tiny. Really?

    Yes. For example in the recent meat & mortality study we are talking about a 10 - 20% increase in risk for those people eating more meat. Let's compare that to the 1,000% increase in risk of lung cancer in smokers. One number is tiny (for observational data), one is not.

    The problem is that when there are an infinite number of confounders a tiny increase in risk really does not prove much, if anything. You need a very big increase (and no obvious massive confounders) to be reasonably sure of cause and effect in these observational studies.

    A 1000% increase in risk makes me believe in the smoking - lung cancer connection. But a 10% increase in risk hardly proves anything. That's tiny.

  26. Charlie
    I am paleo LCHF but we got to be realistic. Paleo will always be a fad diet like veganism but smaller.

    1) Paleo is more expensive to follow that veganism, meat from free range is much more expensive that not eating meat.

    2) Veganism has a very strong ethical following even do misguided is a strong incentive to follow.

    3) Paleo has the main stream advice against it that is un-healthy, while veganism is much more similar to the government, grain promoting advice.

    4) While veganism has many gurus it has a main well defined goal don't eat meat. Paleo has degenerated in a lot of gurus each which is on book on what or not to eat. All based on if you can tolerate it and it makes you feel good then it is ok to eat. That has become a slippery road for many. It always happens following a diet that is restrictive in some nature, which requires people to sacrifice something. Hey, if potato s ok, why not some beans or some grains or whatever. People will just follow only when they feel like it.

    Low carb will be fringe but will always will have followers because is the only way some people can survive with their metabolic problems. Since the number of people with metabolic and weight problem is increasing it will always have a strong incentive to have followers. But since it has restriction that require some sacrifice and has to fight also with main stream government advice, it will never be main stream either.

  27. Kenny

    smoking status is easy to verify, it's a yes or no question. We have tons of people in these cohorts who have never smoked. Meat-eating is more problematic. Even the people who report lower meat intake in high risk, homogenously eating Western cohorts have still very high meat intake in a global context. The difference in disease outcome would most likely exacerbate had we more interindividual variation in these Western cohorts. I find your comparison to smoking somewhat flawed.


    No one in the biomedical research community takes the LDL particle-size argument seriously, apart from the one or two token lipidologist paid by Dairy Counsil and HealthDiagnosticLaboratoryInc. You probably know who I am referring to.

    A recent expert panel concluded in their report that LDL particle size measurement is not recommended for any of the patient groups. It only adds a tiny difference in accuracy with people who have metabolic syndrome, but even in this category, the particle size merely serves as an indicator for the aggressiveness of the LDL lowering theraphy.

    Clinical utility of inflammatory markers and advanced lipoprotein testing: Advice from an expert panel of lipid specialists (2011)

    “All lipoprotein particles in the LDL fraction are atherogenic, independent of size”


    The mainstream view of the biomedical research community is that any LDL over 100mg/dl is atherogenic per se. There's a substantiate body of research to atherosclerosis (pathophysiology) which validates this view.

    ATP-3 Guidelines

    "Any LDL cholesterol above 100 mg/dL appears to be atherogenic. The prevalance of elevated levels in large part accounts for the near universal development of coronary atherosclerosis in the United States and the high attendant risk for developing CHD over a lifetime—49 percent for men and 32 percent for women"

    "Only populations that maintain very low levels of serum cholesterol, eg. total cholesterol below 150mg/dl throughout the life do we see a near-absence of clinical CHD"


  28. 1 comment removed
  29. Dr. Andreas Eenfeldt, MD Team Diet Doctor
    Please stay on topic and don't copy-paste the exact same pages and pages of vegan ideas as you have copy-pasted here many times before (under different names). Use a blog of your own for that.
  30. Anders, where did tobacco come from? Insulin is much more effective than low carb diet in improving plasma glucose. But who cares, the talk is about diet. Let's not blurr...

    There are at least 7 prospective (!) cohorts that show somewhat troubling data. It may well be, as you said earlier above, these people are reckless, don't care about their health. But I don't yet buy it fully.

    I think it's ignorant and reckless to close eyes for the following data on "low carb indexes". The effects are not tiny.

    Fung et al., Lagiou et al., Trichopoulou et al.: Increased total mortality by 11-22 % per 5 index points (Max index points 20)

    Lagiou et al, Trichopoulou et al.: Increased cardiovascular mortality by 9-37 % per each 5 index points

    Sjögren et al.: Any CVD event 50 % increase per SD

    de Koning et al.: T2D, 37 % increase low vs high

    Similä et al. T2D, 2 % increase per each 2 % (E) increase in fat intake AND 15 % increase in each 2 % (E) protein intake

  31. What's funny is that doctors in the subcontinent (India/Pakistan/Bangladesh) had clued into the LC-may-cure-diabetes several decades ago, and advise their patients accordingly. Now only if their patients followed their advice and gave up just the sweets and the flour.
  32. Daniel FE
    side question: On low carb, is it ok to eat flax seeds? aren't they considered a grain?
  33. Galina L.
    There is an ethical component in eating a grass-fed meat - a support for environmentally-friendly practices of agriculture, but sure, It makes it an opposition to modern food technologies. I also noticed that eating 2 times a day nutritional food generates less garbage from household, requires less water, time and electricity. It didn't wrecked my budget because I buy less. I noticed that vegetarians do a lot of snacking, 90% of our local health food store is staffed with organic vegetarian junk food.
    My own son who is in a university right now spends 30% less money on a paleo-style eating that he used to spent on a cafeteria food. When he is too busy to cook, he just eats 2 stakes a day, cooking stake is even faster than a fast food take-out or de-frozening a frozen meal. When he has more time for cooking his meals contain also some veggies, eggs, cheese and tubers, but he saves a lot of money by not buying snacks and soft drinks.
  34. A couple of people above have mentioned possible problems with bacon. I've certainly heard this before and it is my own main concern since my husband and I have started having more cooked breakfasts, so they often include bacon or ham. I'm mostly buying bacon from the butcher, which I am told by them is home cured (although I do get some traditionally cured grass-fed bacon from a farm, most does come from the butcher). It seems to be different from the supermarket stuff in that you don't get that milky water coming out. I've also started buying ham from the butcher to cook at home, then soaking it for 24 hours before boiling it. Can anybody shed any realistic light on the bacon/nitrates/prostate cancer problem, as I don't want to kill my husband off that way having finally got him to go fairly low carb.
  35. Mike
    What you're seeing coming out when you cook the bacon is mostly water. With some meats, industrial sources will inject water to up the weight and polyphosphates to hold it. (You can see those in the list of ingredients on the back of packs of processed chicken slices, for example.) With bacon it's more likely a case of whether the cure used is "wet" or "dry". I think both are traditional.

    If you don't like the white fluid coming out, you could look for "dry cure" bacon. (Having said that I don't know what cures are available in Sweden and what names are used for them; that's a British term.)

    I don't think there are any suggestions that nitrates or nitrites are implicated in prostate cancer -- stomach cancer perhaps. There have been suggestions that "red meat and processed meats" are associated with it, but that seems to be la-la land:


    Prostate cancer is possibly (although not definitely) an increasing problem in the U.S. because the U.S. Government adds folic acid to flour for mistaken "health" reasons. (See "The Paleo Answer".)

    I wouldn't worry about a little bacon. You're probably likely to get more nitrates from your vegetables anyway, which can have non-trivial amounts:


  36. Thanks Mike. I'll look at those links. I'm in the UK by the way. We've eaten a mostly vegetarian diet for years so it's still quite hard in some ways to increase the meat we're eating when we had made those choices to eat less for health reasons in the first place!

    I'm currently reading Gary Taubes's The Diet Delusion and getting quite depressed about all I'm reading, even though I mostly knew what to expect. To think we made a point of choosing to eat healthily as we saw it and as it had been described to us over the years. I suppose the main reason why we have been pretty healthy is that we have never eaten any junk food - both my husband and I are keen cooks and have always prepared food from scratch.

  37. bill

    The link you gave:


    Was excellent!

    I'm gonna eat my bacon with gusto and confidence now.

    I wish people would stop the fear mongering.



  38. Hans
    Eric #23,

    Read the article. For me it's obvious. Why sticking to a diet with a high intake of carbs and gradually increase medication ending up injecting insulin, which can cause dangerous hypoglycemic reactions. You only get sicker i.e. more insulin resistant.
    Of course a low carb diet is preferable - less or no medication, a low stable blood sugar and significantly reduced risk of diabetes related complications. Just back to basics.

  39. I read an article recently, can't remember where dangit, and they author was suggesting that carbs were not necessary at all to human health. An interesting notion indeed. I think the key is in eating natural carbs like those found in fruits and vegetables. Our bodies are designed to metabolize them well. Most of us eat processed carbs, though, I think that is where the main problem begins. Processed carbs do, in fact, wreak havoc on insulin levels.
  40. Galina L.
    Just for clarification I want to say that my diet is either ketogenic or close because it is better for me, but I am not an advocate for everybody eating a VLC diet. While it is possible to generate all glucose our body needs from protein and to use ketone bodies made from fat (like Inuits), it looks like that some people especially IR and middle-aged could have a problem with too pronounced physiological insulin resistance, get their fasting BS too high even to a point that their glycated proteins test may be abnormal on a VLC diet. There are other possible issues. I don't think a carb-based diet is a good idea as well, and it is better to eliminate breads and sugars for everyone, but it is better for diet choices to be individualized.
  41. Jonathan Swaringen
    I do believe we can thrive without vegetables. The main things that matter to health are vitamins, minerals, and beneficial bacteria, and antioxidants. You can get plenty of every single one without any extra carbohydrates from Vegetables or Fruit.

    The one area I lack much knowledge of is antioxidants that are not plant related. I haven't read many articles on that but I do think I read somewhere that there are antioxidant properties of something in some meat.

    If anyone has anymore information on the antioxidants that found in non-plant sources I would love to read about them.

    This being said I'm not against vegetables or fruits I just think they aren't necessary. If cooked the right way they can be very good though....at some point I believe I might be able to like them raw as well...though at this moment I like very few that way. Cucumbers are probably my best vegetable raw....but even that I don't care for the taste. I like Bubbies pickles though.

    I am somewhat confused about the pickles issue though as I was reading somewhere that pickles weren't good for a leaky gut....but I heard fermented foods were great for a leaky gut....somewhat confused. Maybe its the vinegar pickles from the store that are an issue? If anyone has a good article on this issue I'd love to read it.

  42. Wade Henderson
    Dr. Mark, there are lots of natural carbs that are not found in fruits or vegetables. And there are lots of people that live in a healthy manner while including those carbs.
    No need to catagorize all carbs as poor choices just because they aren't from fruits or vegetables.
    Some people do better eliminating them, while others live long healthy lives while including them.
    I'm not talking about the refined carbs that make up the bulk of what we see on grocery store shelves.
    This is not all black or white when it comes to carbs.
  43. Jim Berry
    Thought I would share my own experience with a low-carb approach. I am 52 and had gained about 20 lbs in the past year, mostly eating like most folks do. Wife and I enjoyed our weekly Mexican fix, ate potatoes, bread, popcorn - you name it. Also have not been that active and it was showing on me physically and in my blood readings from a year ago. In Aug, 2011 - total chloresterol was 217, Trigs 135, HDL 50, LDL 140, VLDL 27. I was also on 20mg Simvastatin. On Aug 1, 2012, we decided to go hard-core low carbs - keeping total around 20 g per day - meat, green veggies, cheeses, a few nuts, eggs, and the like. We had our annual physicals the first week of Sept, so this gave us only 5 weeks on low-carb to test it for improved blood readings. Amazingly, we both showed markedly improved readings. My wife's total chloresterol dropped from 206 to 173, other readings fell in unison. She also lost 10 lbs. I lost 15 lbs and my total chloresterol fell like a rock - from 217 to 136! Trigs from 135 to 76, HDL rose from 50 to 53, VLDL from 27 to 15 and LDL from 140 to 68! I am 100% convinced that low carb is the reason. Yes, we eat eggs at least twice a week, also bacon occasionally and red meat, but have had NO bread, rice, potatoes, flour or sugar of any kind now in over 6 weeks. The other benefits have been much better sleeping at night, no indigestion - even after 3 pieces of bacon and 2 eggs. I consider myself in decent physical shape - 5ft 7in and 167 lbs (down from 182 when we started), non smoker, like my beer, occasional glass of wine. I will always tout the virtues of low-carb and believe the nay-sayers are fixated on the "high fat" mention - which has little to do with a real low-carb diet, in my opinion. Sure you'll get some fat, but it's more about PORTION size - 4 oz steak instead of 8. We are believers!
  44. Jackson
    Low carb eating can be as healthy as you want it to. I have definitely experienced great weight loss results and eat well all the time. I like to check http://www.lowcarbkitchen.net for creative meals and drinks.

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