Light Bulbs and Low Carb Diets

Main Category: Nutrition / Diet
Article Date: 20 Nov 2005 - 20:00 PST

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Researchers from the University of Connecticut and SUNY Downstate recently had one of those rare moments of scientific discovery -- while reviewing the medical literature about low-carb diets, something suddenly became very clear, the list of things carbohydrate restriction improves happens to be the same list of features a patient presents with in the diagnosis of Metabolic Syndrome.

It was a classic light bulb moment -- one that is destined to radically alter the clinical management of Metabolic Syndrome, a cluster of metabolic markers that increase the risk of diabetes, stroke and heart disease: obesity, high triglycerides, low HDL ("good" cholesterol), high blood sugar, high blood pressure and insulin resistance.

For decades, the medical community has been searching for a non-drug therapy to treat those diagnosed with metabolic syndrome. In the article published today in the journal, Nutrition & Metabolism, researchers point to the data already in the literature that clearly shows that the features of Metabolic Syndrome are precisely those improved with dietary carbohydrate restriction.

"It's been staring us in the face for years," said Dr. Richard Feinman, PhD, of SUNY Downstate. "Now we've connected the dots."

Dr. Jeff Volek, the lead researcher of the article added, "Make a list of the features of metabolic syndrome, then, make a list of the things that carbohydrate restriction is good at fixing. They're the same list. Somehow, we never really noticed that. We know the cause of metabolic syndrome is often linked to disruption of insulin. Thus, the key to treating metabolic syndrome is to control insulin, and carbohydrates are the major stimulus for insulin."

The article also highlights major research studies where study subjects followed low-fat diets to drive home their findings. The review of research showed that in studies where the dietary intervention was to restrict fat intake, study subjects actually had the features of their metabolic syndrome worsen following a low-fat diet.

"The most obvious factor in the obesity epidemic is the drastic increase in carbohydrate consumption in recent years and the decrease in fat consumption," Feinman points out, "so the story is consistent. I think people have learned the value of reducing carbohydrates during the media popularization of low-carb diets, but they are still making it hard for themselves by also trying to reduce fat, when fat seems to be much less important a factor than carbohydrates."

This new study brings into focus a very clear target for future discussions about evidence-based dietary recommendations. Dr. Feinman believes there are postive signs that various major medical organizations are already backing away from many of the decades-old dietary recommendations, "I think official agencies are trying to back off from recommending high carbs and low fat across the board," Feinman added, "so I think there are real signs of progress. The bottom line is that if you reduce carbohydrates, you can be less concerned about your fat intake, and that often makes it much easier to stick to a beneficial new diet or lifestyle change."

With a very specific focus -- metabolic syndrome -- it is hard to disagree with Dr. Feinman's assessment of the future of the dietary approach. The findings are not controversial when viewed as a way to approach treatment of metabolic syndrome.

These new findings also have the potential to firmly establish a set of criteria for the diagnosis of metabolic syndrome - a diagnosis which has recently been the subject of question in a recent position statement from the American Diabetes Association, countered by a position statement from the American Heart Association.

With an estimated 25% of adult Americans already presenting to their doctors with features classic to metabolic syndrome, practitioners will find this additional piece of the puzzle a welcome addition of not only an intervention that the research clearly shows works for improving metabolic syndrome, but also can be the foundation upon which diagnosis criteria is firmly established in the future.

Dr. Feinman and Dr. Volek are both organizers of the upcoming scientific conference, Nutritional & Metabolic Aspects of Carbohydrate Restriction, which will take place January 20-22, 2006 in Brooklyn, New York. Additional information about the conference is online at the Nutrition & Metabolism Society website, http://www.NMSociety.org

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