There has been a lot of talk lately about low carbohydrate or ketogenic diets for health benefits.  Opinions vary widely about this dietary pattern. I would like to offer some clarity to this issue and discuss when and why I recommend a low carbohydrate eating pattern.

Why do I call it an eating pattern instead of a diet?

Simply because diets do not work. Diet is a 4-letter word that usually defines a temporary change in how you eat and usually leads to failure. The word diet has developed a negative connotation due to fad diets. It is associated with the struggles people have when attempting to lose weight, followed by the ultimate failure of the whole process.

I encourage my patients to adopt a healthy eating pattern that can be sustained indefinitely. This is much more likely to achieve long term success when applied for health benefit or weight loss.

What are some healthy Eating patterns that may benefit you?

Low carbohydrate eating patterns are now recognized by the American Diabetes Association as a legitimate dietary option for diabetes or pre-diabetes.  The Mediterranean dietary pattern has been shown to be beneficial in reducing the risk for heart disease.  The DASH Diet (Dietary Approach to Stop Hypertension) is shown to help lower blood pressure.  These are some options for people with these health conditions.

What are carbohydrates?

Sugar and starch in our diet. Bread, rice, pasta, potatoes, fruit, candy and sweetened beverages compose a great majority of carbohydrate containing foods in our diets.

What defines a low carbohydrate dietary pattern?

The average American diet (ex. Cereal and toast for breakfast, Sandwich with chips for lunch, Meat and potatoes for dinner) has around 300 grams or more of carbohydrate consumed each day.  A low carbohydrate is typically defined as less that 150 grams of carbohydrate. A very low carbohydrate diet is less than 50 grams and a ketogenic diet is usually less than 30 grams.  A Ketogenic diet is one where your body is using mostly fat for fuel and the liver produces ketone bodies to be used as an energy source.

  • The key concept of this eating pattern is to limit the intake of sugar, starch and processed foods, focusing on eating mostly natural whole foods.

When do I recommend a Low Carbohydrate eating pattern?

I recommend this diet for weight loss in most patients because I like the simplicity and sustainability of eating this way.  People with pre-diabetes, diabetes and those with high triglycerides can benefit tremendously.  With this eating pattern and the ensuing weight loss, Diabetes can be “reversed” or if you prefer, put into remission.

Patients with health issues on medications should be monitored by a Doctor with experience using low carbohydrate or ketogenic eating patterns.  This is not for everybody and you should consult with your Doctor before changing your eating pattern.

An excellent website and resource for eating this way is

James Fretwell, MD, Diplomate of the American Board of Obesity Medicine

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