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Why I Follow a Moderate Carb Diet

April 2, 2021

Why I Follow a Moderate Carb Diet

Why I Follow a Moderate Carb Diet

An important note: I am not your doctor or YOU. Your primary care physician and any medical professional you work closely with know you best, and YOU know your body best. Always talk to your doctor first before making any dietary changes.

What are carbs?

The food we eat contains macronutrients: carbohydrates, protein, and fat. When we digest them, all carbohydrates break down into a molecule called glucose, which is the energy source our body utilizes first when available (1). When we eat, we consume different types of carbohydrates, including the following forms:

Why I Follow a Moderate Carb Diet

Understanding how different types of carbohydrates affect our blood sugar is crucial for making healthier dietary choices. This brings us to an important concept: the glycemic index (GI). The GI is a tool that helps us evaluate how various carbohydrate-containing foods influence our blood sugar levels.

What is the Glycemic Index?

The GI ranks foods based on how quickly and how much they raise blood sugar levels after eating. Foods are scored on a scale of 0 to 100. High-GI foods, which score above 70, like some breads and sugary treats, cause rapid spikes in blood sugar. On the other hand, low-GI foods, with a score of 55 or less, such as most fruits and non-starchy vegetables, result in a slower, more gradual increase in blood sugar (2). This slower increase is beneficial for keeping our energy levels stable and managing our appetite (3). 

For example, one study provided the two participant groups with milkshakes that were exactly the same, except one had a high GI and the other had a low GI. The high GI milkshake group experienced increased hunger and cravings compared to the low GI shake group (4). Another study demonstrated that when fed a high GI meal, compared to a low GI meal, teenage boys eat 81% more calories (5).

The difference in GI values among foods depends on many factors, including the type of carbohydrate they contain. Simple carbohydrates, often found in processed foods, tend to have higher GI scores, whereas complex carbohydrates, like those in whole grains and legumes, usually have lower GI scores. By understanding the glycemic index, we can make informed choices about the carbs we consume, favoring those that have a gentler effect on our blood sugar and overall health (6).

Why Care About How Many Carbs You Eat?

Carbs, while an energy source for our bodies, can impact our health depending on the amount and type we consume (7, 8). Simple carbs and starches, such as sugars in refined foods, lead to quick spikes in blood sugar (9). These spikes deliver rapid energy but can cause short-term consequences like physical and mental cravings and overeating, potentially leading to weight gain (10). Additionally, eating a lower-carb diet can help reduce your appetite, leading you to eat fewer calories overall and leading to weight loss (11). 

In contrast, fibrous carbs, such as non-starchy vegetables, provide a steadier energy release, helping maintain a balanced appetite and prevent overeating. Consistently high blood sugar requires more insulin to manage, which can result in insulin resistance over time. This condition is an underlying factor in several health issues, including prediabetes, type 2 diabetes, polycystic ovary syndrome (PCOS), and gestational diabetes. It can also contribute to long-term risks like hardened and narrowed blood vessels, leading to heart disease and stroke. There are even recent theories that link poor glucose management to mental health conditions (12, 13).

Understanding Insulin Resistance

Before we delve deeper, let’s pause to understand what insulin resistance means. Insulin is a hormone that helps our bodies turn the sugar (glucose) from the foods we eat into energy. Insulin resistance occurs when the body’s cells don’t respond well to insulin. As a result, the body needs more insulin to help glucose enter cells. Over time, this can lead to higher insulin and blood sugar levels, making the body less efficient at processing glucose. This inefficiency is a precursor to a range of health issues, including type 2 diabetes and cardiovascular diseases, and is why managing carbohydrate intake is so important.

Maintaining a balanced diet is crucial for managing these health risks. Opting for complex carbs rich in fiber and limiting simple carbs and starches helps maintain healthy blood sugar and insulin levels. One of the functions of insulin is to store fat in our body when we eat more energy than our needs are, so many experts believe one of the reasons that lower carb diets work is because the amount of insulin in your bloodstream is also reduced (14, 15). Moderating our glucose and insulin is particularly vital today as we navigate a food environment rich in ultra-processed and genetically modified options, which most likely impact our health in ways we are still understanding.

Why Care About Carb Sources?

As you see in the table above, simple carbs are made up of either glucose, fructose, lactose, or sucrose. Glucose is found in things like honey, and all other sugars are broken down into glucose in the bloodstream. Fructose is another monosaccharide (like glucose) and is the sugar found in fruits. Lactose, found in milk, is a disaccharide because it comprises two monosaccharides: glucose and galactose. Finally, there is sucrose, another disaccharide composed of glucose and fructose. Due to their lack of complex structures, they are easily absorbed and digested into the bloodstream. 

Complex carbs, in contrast, are either starches or fiber. Starchy vegetables comprise amylose and amylopectin, polysaccharides of glucose monomers linked together. Due to their more extensive nature, complex carbohydrates take a bit longer for the body to digest and absorb than simple carbohydrates. Fiber, however, takes longer than starches to digest and also helps form a barrier between the small intestine and the bloodstream, slowing down the amount of time it takes for glucose to be absorbed into the blood.

Quality carb sources go beyond calorie counts and impact our health on multiple levels. For instance, gut health is significantly influenced by the types of carbs we consume. Fiber-rich carbs support the growth of beneficial gut bacteria, which is crucial for digestion, immune function, and even mental health due to the gut-brain axis. Diets high in refined sugars can lead to an imbalance in gut flora, inflammation, and a weakened gut barrier, potentially triggering or exacerbating conditions like irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) (16, 17).

Inflammation is another critical aspect of health impacted by carb sources. Processed and high-glycemic carbs can trigger an inflammatory response, whereas low-glycemic, fibrous carbs are linked to lower levels of systemic inflammation (7, 8, 17). This inflammation can affect everything from joint pain to mood disorders; research suggests that a diet high in refined sugars may contribute to symptoms of depression and anxiety, while a diet rich in complex carbs with steady glucose release can support better mood regulation and cognitive function (18, 19, 20).

Inflammation is the body’s natural response to protect itself against harm. There are two main types: acute and chronic. Acute inflammation is what you see when you get a cut or a bruise – it’s short-term and the body’s way of healing itself. Chronic inflammation, however, is long-term and occurs under less noticeable conditions. This type of inflammation is often influenced by our diet and is linked to various health issues.

When we talk about the GI, we’re referring to a scale that ranks carbohydrate-containing foods by how much they raise blood glucose levels compared to a standard food, typically glucose or white bread. Like many processed foods, sugary drinks, and sweets, high-glycemic carbs rapidly break down into glucose, causing a quick spike in blood sugar and insulin levels. This can lead to increased inflammation as the body responds to the rapid changes in blood sugar as a threat. Additionally, choosing whole, unprocessed carb sources with a good amount of fiber is essential for decreasing the blood sugar spike upon them entering your system (21, 22).

Low-glycemic carbs, such as most fruits, non-starchy vegetables, legumes, and whole grains, break down more slowly due to their fiber content, releasing glucose gradually into the bloodstream. This slower absorption helps maintain steady blood sugar levels and minimizes insulin spikes, which can help reduce the risk of inflammation. Over time, eating a diet rich in low-glycemic, fibrous carbs has been associated with lower levels of chronic inflammation, which may protect against various undesirable health statuses, such as obesity and diabetes (23, 24).

Chronic inflammation is insidious and can contribute to a host of health problems, from heart disease to type 2 diabetes, joint pain, and even mental health conditions (25, 26, 27). Research has indicated that diets high in refined sugars and high-glycemic carbs may exacerbate symptoms of depression and anxiety (28, 29, 18). On the other hand, a diet that emphasizes complex carbs with a low glycemic index can aid in mood stabilization and support cognitive functions like memory and attention (30).

Whole foods, by their nature, are nutrient-dense and provide a host of benefits that processed foods cannot match. They are generally higher in fiber and contain a spectrum of vitamins and minerals often lost during food processing. These naturally occurring nutrients are vital for energy production, immune function, and disease prevention. Fiber, for instance, not only aids in digestion but also helps regulate blood sugar levels, which can reduce the risk of developing health conditions such as type 2 diabetes.

Processing methods and food additives often found in high-carb products can have detrimental health effects. Additives like high-fructose corn syrup, found in many processed foods, can lead to more significant health issues than natural sugars due to how they are metabolized in the liver (31). Additionally, the high temperatures and chemical processes used to produce refined carbs can create harmful compounds like acrylamide, which is linked to an increased risk of cancer (32). Processing can also strip away beneficial nutrients, leaving consumers with a calorie-dense but nutritionally poor product that can contribute to nutrient deficiencies and poor health outcomes.

What is “Too Many Carbs”?

Understanding what constitutes “too many” carbs is essential, yet the answer varies greatly among individuals. The standard American diet is often used as a benchmark, typically featuring carbohydrate intake that far exceeds needs, with averages upwards of 300 grams per day. Much of this comes from processed and refined sources with low nutritional value (33)

The recommendation that 45-65% of total daily calories come from carbohydrates is endorsed by the Dietary Guidelines for Americans, a joint effort by the U.S. Departments of Health and Human Services (HHS) and of Agriculture (USDA) (34). 

However, more recent research challenges the current Dietary Guidelines recommendation as it can be more than required for most of us, leading to poor glucose management, even in individuals living without insulin resistance. A “moderate” level of carb intake might look different than what we’re used to seeing in the US but often falls below these percentages. I will explore this further in our discussion on moderate carbohydrate consumption. I advocate for an intake that aligns with individual metabolic health and lifestyle needs rather than a generalized percentage.

Signs that you may be consuming “too many carbs” include:

Energy Fluctuations: Regularly experiencing energy highs followed by crashes can indicate overconsumption of simple carbohydrates (35).

Cravings: Frequent cravings for sugary snacks or starchy foods may suggest your diet is too rich in refined carbohydrates (36).

Weight Challenges: Difficulty obtaining and sustaining a supportive weight despite being active could indicate that your carbohydrate intake isn’t aligned with your body’s energy requirements.

Blood Sugar Levels: Monitoring glucose levels can help fine-tune carb intake, even before you have the potential to develop a health condition resulting from insulin resistance. 

Digestive Issues: A high intake of processed carbohydrates can disrupt gut health, leading to discomfort such as bloating or gas (37).

Remember, not just the quantity but the quality of carbohydrates matters. Whole, fiber-rich carbohydrates have a different, more favorable effect on the body than an equivalent amount of processed carbohydrates. Whole sources provide energy steadily without the disruptive spikes in blood sugar.

Determining if you’re eating “too many carbs” is a personal journey. It involves understanding your body’s responses and the types of carbs consumed.

What is “Low Carb”?

A “low carb” diet is generally characterized by a significant reduction in carbohydrate intake compared to traditional Western diets. While there is no strict definition of what constitutes “low carb,” it often involves limiting total carbohydrate intake to between 20 and 120 grams per day (38). This range can vary based on the diet’s strictness and the individual’s goals, such as weight loss, managing diabetes, or improving metabolic health.

Popular ways of eating that are considered low to moderate carb:

  • Ketogenic (“Keto”): This diet is one of the lowest in terms of carbohydrate intake. It typically involves consuming 70-80% of calories from fats, 10-20% from proteins, and 5-10% from carbohydrates. This usually amounts to about 20-50 grams of carbs per day. The primary goal is to reach a state of ketosis, where the body burns fat for fuel instead of carbs (39).
  • Paleo: The Paleo diet focuses on foods presumed to be available to Paleolithic humans. It emphasizes meats, fish, nuts, leafy greens, regional veggies, and seeds while excluding processed foods, grains, dairy, and refined sugar. Carbohydrate intake varies but is generally lower than a typical diet, as it focuses on whole foods and naturally occurring carbs (40).
  • Atkins: This is a phased diet, starting with a very low carbohydrate intake and gradually increasing carbs over time. The initial phase, often the strictest, limits carbs to about 20-25 grams daily, focusing on high-protein and high-fat foods. Later phases allow for gradually introducing more carbs while monitoring weight loss progress (41).
  • Zone: The Zone diet aims for a nutritional balance of 40% carbohydrates, 30% fats, and 30% protein at each meal. It focuses on controlling blood sugar and reducing inflammation. The carbohydrate sources are usually fruits and vegetables, and it restricts high GI carbs (42).
  • South Beach: This diet starts with a lower-carb phase to stabilize blood sugar and reduce cravings, followed by a gradual reintroduction of healthy carbs. Initially, it restricts carbs like fruits and whole grains but then gradually reintroduces them. It emphasizes high-fiber, low-glycemic carbohydrate sources (43).

In a low-carb diet, the reduced carbohydrate intake is typically compensated for with higher intakes of proteins and fats. Depending on how much carbohydrate and protein is in the diet, the shift to significantly lower carbs can encourage the body to use fat as its primary energy source, a process known as ketosis, especially in very low-carb or ketogenic diets.

Here are some key aspects of a low-carb diet:

Macronutrient Ratio: A significant portion of calories, usually from carbohydrates, is derived from proteins and fats. The exact ratio can depend on the specific diet plan followed.

Food Choices: Diets rich in carbohydrates, particularly processed and sugary foods, are replaced with leafy greens, non-starchy vegetables, proteins, and fats. Whole food sources become the foundation of meals, which leads to higher nutrient intake and the potential for lower calorie intake.

Health Benefits: Research has shown that low-carb diets can lead to weight loss, improved blood sugar control, reduced blood pressure, and improved cholesterol levels (44, 45, 46, 47). A low-carb diet can be particularly beneficial for individuals with type 2 diabetes or metabolic syndrome (48, 49).

Personalization: The level of carb reduction can be personalized. For some, a slightly higher carb intake may be sustainable and effective, while others may require a different approach to achieve their health goals.

Sustainability: While a low-carb diet can provide numerous health benefits, its sustainability varies. Long-term adherence can be challenging for some, making it essential to develop a diet plan that is both beneficial and realistic in the long run.

It’s important to note that a low-carb diet is not suitable for everyone. Certain populations, such as athletes who engage in high-intensity training, may require higher carb intakes for optimal performance. Additionally, individuals with specific health conditions should consult healthcare providers before making significant dietary changes.

In the next section, we’ll explore what I consider a “moderate carb” intake, which can offer a more flexible and varied dietary approach while still conferring many of the health benefits associated with lower carb consumption.

What is “Moderate Carb”?

A “moderate carb” diet can be seen as the middle ground between the traditional high-carb diet common in many Western countries and the very low-carb approaches, such as ketogenic diets. It’s a flexible approach that prioritizes balance and can be more sustainable for many people in the long term.

While there is no standard definition, a moderate carb intake typically means that approximately 25-35% of your total daily calories come from carbohydrates. For the average adult, this translates to roughly 100-150 grams of carbohydrates per day, although this can be adjusted based on individual factors such as age, activity level, and metabolic health.

Key characteristics of a moderate-carb diet include:

Quality Over Quantity: The focus is on consuming high-quality carbohydrates. This means choosing whole grains, legumes, fruits, and vegetables over processed foods and refined sugars (50).

Balanced Meals: Meals are composed of a balanced mix of carbohydrates, proteins, and fats. This balance helps maintain stable blood sugar levels and provides a steady energy supply throughout the day.

Portion Control: A moderate-carb diet emphasizes portion control instead of eliminating carbs. This approach allows for enjoying a variety of foods without overconsumption.

Flexibility: A moderate carb approach offers more dietary flexibility, making it easier to stick with long-term. It can also accommodate desserts and exceptions, helping prevent feelings of deprivation that sabotage diet efforts.

Health Benefits: A moderate-carb diet can support weight management, control blood sugar, and reduce cardiovascular disease risk factors. It’s a viable approach for those looking to improve their overall health without the strictness of low-carb diets.

A moderate carb approach is about finding a sustainable, healthful eating pattern that includes a wide range of nutrients. It’s about making informed choices and understanding that carbohydrates are not inherently “bad” but rather an important part of a balanced diet when chosen wisely and consumed in supportive amounts.

In the subsequent sections, we’ll delve into the benefits of moderate carb consumption and how it can be effectively integrated into your lifestyle, potentially leading to better health outcomes without the restrictiveness of low-carb diets.

What Are The Benefits of This Way of Eating?

Adopting a moderate-carb diet has many benefits that can contribute to both short-term and long-term health and well-being. Here’s a look at why this balanced approach to eating might be advantageous:

Sustained Energy Levels: Moderate amounts of complex carbs provide a consistent energy supply, preventing the rapid spikes and crashes in blood sugar associated with higher-carb diets. This translates into steadier energy throughout the day and can enhance overall productivity and mood (20).

Improved Metabolic Health: Moderate carb intake can help regulate blood sugar and insulin levels, reducing the risk of insulin resistance — a key factor in developing type 2 diabetes and other health conditions (51, 52, 53). It’s a diet that supports the body’s natural metabolism without overwhelming it with excess glucose.

Weight Management: This approach can aid in weight loss and maintenance by preventing overeating. Balanced meals with adequate fiber keep you full longer, reducing the likelihood of snacking on high-calorie, nutrient-poor foods (54).

Heart Health: Diets that include moderate carbs are often fiber-rich, which can help lower LDL cholesterol levels and decrease the risk of heart disease (55). Avoiding excessive amounts of refined sugars and grains also reduces the risk of developing related cardiovascular issues.

Nutritional Adequacy: A moderate-carb diet can supply the body’s essential nutrients. It allows for various foods, ensuring you get a broad spectrum of vitamins, minerals, and other nutrients necessary for good health.

Psychological Well-being: Given that it is not restrictive, a moderate-carb diet is often more psychologically satisfying, making it easier to adhere to over time. It can also help in establishing a healthier relationship with food, reducing the anxiety and stress that can come with more extreme dietary restrictions.

Gastrointestinal Health: The fiber content in a moderate-carb diet promotes a healthy digestive system by contributing to regular bowel movements and fostering a favorable environment for beneficial gut bacteria. A lower intake of sugars, especially refined sugars, is also beneficial for gut health. High-sugar diets can feed potentially harmful bacteria and yeasts in the gut, leading to dysbiosis—a microbial imbalance that can cause bloating, gas, and inflammation (56). Maintaining a moderate carb intake and reducing sugar consumption helps protect the integrity of your gut lining, reduce inflammation, and support the growth of health-promoting gut flora. This balanced approach can be instrumental in preventing and managing conditions like irritable bowel syndrome (IBS) and can contribute to the overall health of your digestive system.

Flexibility and Variety: A moderate approach to carb intake allows for more dietary diversity. You can enjoy a broader range of foods, making meals more enjoyable and socially convenient.

Sustainability: One of the most significant benefits of a moderate-carb diet is its sustainability. It’s a way of eating that can be maintained for a lifetime, unlike more extreme diets that may only be suitable for short-term use.

In summary, a moderate-carb diet balances the need for energy and nutritional intake with the body’s ability to utilize carbohydrates efficiently. It avoids the extremes of overconsumption and strict restriction, aiming instead for a nutritious middle path that can be tailored to individual preferences and health goals.

Why Is It So Challenging to Eat This Way?

Despite its numerous benefits, adopting a moderate-carb diet can be challenging due to various factors. Understanding these challenges is the first step in overcoming them:

Prevalence of High-Carb Foods: Our food environment is saturated with high-carb and processed foods. From fast-food restaurants to supermarket aisles, options rich in refined carbs and sugars are abundant and heavily marketed, making them seemingly convenient choices.

Habit and Convenience: Many of us are accustomed to diets high in carbohydrates, especially simple carbs like white bread, pasta, and sweets. Changing these deeply ingrained eating habits requires effort and can be further complicated by the convenience of ready-to-eat, carb-heavy foods.

Social and Cultural Norms: Food is a significant part of our social fabric and cultural identity. Meals and gatherings often center around carb-rich foods, making it socially challenging to opt for lower-carb options without feeling out of place.

Emotional Eating: Carbohydrates, particularly those high in sugar, can trigger the release of dopamine, a neurotransmitter associated with feelings of pleasure and reward (57). This biochemical response can create a comforting effect, leading many to turn to high-carb foods in response to emotional triggers rather than hunger. This is not just a matter of willpower; it’s a physiological response that can create cravings and an emotional eating cycle. Breaking this cycle requires dietary changes and developing healthier coping mechanisms. Recognizing the role of dopamine and the body’s natural reward system in food cravings is key to developing effective strategies to manage emotional eating.

Lack of Awareness or Misinformation: There’s a lot of conflicting information about carbohydrates and different ways of eating. This can lead to confusion about what constitutes a healthy carb intake and which carb sources are beneficial.

Perceived Lack of Variety: Some believe reducing carb intake severely limits their food choices. However, a moderate-carb diet still offers a wide range of foods; it’s about making informed choices rather than restricting.

Initial Adjustment Period: Transitioning to a moderate-carb diet can come with an adjustment period. Changes in diet can initially affect energy levels, mood, and cravings, which can be discouraging.

Despite these challenges, a moderate-carb diet can become a sustainable and enjoyable way of eating with the right knowledge, planning, and mindset. It’s about making incremental changes, being patient, and understanding that it’s a journey towards better health.

Low-to-moderate Carb + Weight Loss 

For several reasons, a low-to-moderate carbohydrate approach can be highly effective for weight loss (58). By understanding these mechanisms, we can better appreciate how this dietary strategy supports a healthier body weight:

  1. Enhanced Satiety: Carbs, particularly refined ones, can lead to quick spikes and crashes in blood sugar levels, often resulting in frequent hunger and overeating. A diet lower in carbs and higher in protein and fats promotes greater satiety, reducing the overall caloric intake, whether you’re tracking calories or not (59, 20).
  2. Reduced Insulin Spikes: Carbs significantly impact insulin, a hormone that regulates blood sugar levels and fat storage. Lowering carbohydrate intake reduces insulin spikes, encouraging the body to use stored fat for energy instead of storing more. This shift is crucial for weight loss.
  3. Improved Metabolic Efficiency: Reducing carb intake, particularly simple and processed carbs, can improve metabolic health. A well-functioning metabolism is more efficient at burning fat, which is essential for weight loss. Since a lower carb intake will be compensated for with a higher protein intake, this will most likely lead to a higher metabolic rate (60, 61, 62)
  4. Elimination of Water Weight: Initially, a reduction in carb intake can lead to a significant loss of water weight. Carbohydrates bind with water in the body, so when carb intake is reduced, water retention decreases, leading to immediate, though often temporary, weight loss.
  5. Long-Term Sustainability: While very low-carb diets can be challenging to sustain, a low-to-moderate carb approach is often more manageable long-term. This sustainability is key to maintaining weight loss over time, as it encourages lasting dietary changes rather than short-term fixes.
  6. Overall Health Improvement: Beyond weight loss, reducing carb intake (especially refined carbs) can improve overall health markers like blood sugar levels, cholesterol, and blood pressure, reducing the risk of chronic diseases (63, 64, 65, 66, 67, 68, 69, 70). For example, in a randomized controlled trial of 132 individuals with severe obesity, the researchers found that the participants who followed a low-carb diet (in comparison with a low-fat diet) lost about three times more weight, had lower triglycerides, fasting blood glucose, and insulin, as well as improved insulin sensitivity (71). 
  • Inherent Calorie Restriction: One of the ways that low-carb diets lead to fewer calories per day is by reducing appetite (20, 72).
  1. Behavioral Changes: Adopting a low-to-moderate carb diet often involves learning new eating habits, such as choosing whole foods over processed ones and understanding the effects of different carbs. These behavioral changes can have a lasting impact on weight management.

When compared to low-fat diets, many studies have found that low-carb diets are more impactful (often 2-3 times more effective than the comparison group, which was often a low-fat diet) in accomplishing weight loss (71, 73, 74, 63, 64, 72, 75, 20, 67, 76, 77, 68, 69, 78, 70).  

It’s important to note that while a low-to-moderate carb approach can benefit weight loss, it’s most effective when combined with other healthy lifestyle choices, such as regular physical activity, adequate sleep, and stress management.

Low-to-moderate Carb + Insulin Resistance (and Related Diseases – PCOS, Type 2 Diabetes, and Gestational Diabetes) 

Adopting a low-to-moderate carbohydrate diet can significantly impact managing insulin resistance and related conditions, such as PCOS, type 2 diabetes, and gestational diabetes. Here’s a closer look at the benefits:

  1. Improved Insulin Sensitivity: Insulin resistance, where the body’s cells don’t respond effectively to insulin, can be mitigated by reducing carbohydrate intake. This reduction helps lower blood sugar levels, lessens the demand for insulin, and promotes increased insulin sensitivity (79).
  2. Stabilized Blood Sugar Levels: By limiting carbs, particularly high-glycemic varieties, blood sugar levels are more stable throughout the day. This is crucial for individuals with type 2 and gestational diabetes, where blood sugar control is essential to manage the disease and reduce the risk of complications (80, 68).
  3. Weight Management: Being overweight, especially carrying excess weight around the abdomen, increases the risk of developing insulin resistance (81). A low-to-moderate carb diet aids in weight control, which is vital for improving insulin sensitivity and can be particularly beneficial for women with PCOS or those at risk of gestational diabetes.
  4. Reduced Diabetes Risk: Reducing carb intake can help prevent the onset of type 2 diabetes for those predisposed to it. It’s also an effective strategy for managing existing diabetes and can be a crucial component of gestational diabetes management, helping to maintain maternal and fetal health (82, 83).
  5. Alleviation of PCOS Symptoms: PCOS is often associated with insulin resistance. Managing carb intake can balance insulin levels, potentially reducing PCOS symptoms like weight gain and irregular menstrual cycles (84).
  6. Healthier Fat Distribution: Lowering carbohydrate intake, particularly refined carbs, can affect body fat distribution, reducing visceral fat linked to various metabolic diseases (85).
  7. Long-Term Health Improvements: Beyond immediate benefits like blood sugar and insulin level regulation, a low-to-moderate carb diet can lead to lasting health improvements, including a reduced risk of heart disease and stroke, common complications of insulin resistance, and diabetes (86, 87).

For expectant mothers, managing carb intake is crucial. Gestational diabetes, if uncontrolled, can lead to complications for both the mother and baby. A balanced approach to carb intake can help regulate blood sugar levels during pregnancy, contributing to a healthier pregnancy outcome.

It’s important to note that individual responses to dietary changes vary. Those with health conditions like diabetes, PCOS, or gestational diabetes need to work closely with healthcare professionals when modifying their diet. Personalized guidance ensures that nutritional needs are met while effectively managing these conditions.

Low-to-moderate Carb + Tummy Fat Reduction

One of the notable benefits of a low-to-moderate carb diet is its effectiveness in reducing visceral fat, often referred to as “tummy fat.” This type of fat is not just about aesthetics; it has significant health implications.

  1. Understanding Visceral Fat: Visceral fat is the fat stored around your abdominal organs. It’s different from subcutaneous fat, which you can pinch. Visceral fat is more metabolically active and is linked to a higher risk of serious health issues like type 2 diabetes, heart disease, and certain cancers (88, 89, 90, 91, 92, 93). 
  2. Impact of Carbs on Visceral Fat: A high intake of refined carbohydrates and sugars can contribute to visceral fat accumulation (94, 95). These types of carbohydrates can cause spikes in blood sugar and insulin, leading to fat storage, particularly in the abdominal area.
  3. Why Low-to-Moderate Carb Works: Reducing carbohydrate intake, especially refined carbs, can help reduce the body’s insulin response (96). This shift encourages the body to use stored fat, including visceral fat, for energy, reducing belly fat. Additionally, a lower-carb diet will also increase protein intake, which has been observed to lead to less abdominal fat than those who eat a lower-protein diet (97, 98, 99).
  4. Sustainable Fat Loss: A low-to-moderate carb approach is often more sustainable than much lower-carb diets, including the ketogenic diet. It allows for a greater variety of foods while effectively targeting visceral fat, making it easier to stick to in the long term.
  5. Whole Foods and Fiber: This diet isn’t just about reducing carbs; it’s also about choosing the most supportive carbs. Whole grains, legumes, fruits, and vegetables contain fiber that helps regulate appetite and can aid in reducing visceral fat (100, 72). Fiber-rich diets have been associated with less abdominal fat accumulation (101). 
  6. Improved Metabolic Health: As visceral fat reduces, metabolic health often improves. This includes better blood sugar control, improved lipid profiles, and reduced risk of metabolic syndrome, further reinforcing the health benefits of managing tummy fat (102, 85, 96).

Visceral fat reduction is essential to an overall healthy lifestyle. This includes dietary changes, regular physical activity, stress management, and adequate sleep. Combining these factors, a low-to-moderate carb diet can be a powerful tool in reducing tummy fat and improving overall health.

Low-to-moderate Carb Diet + Alzheimer’s Prevention

Alzheimer’s disease, sometimes referred to as “Type 3 diabetes,” has been increasingly linked to metabolic issues like insulin resistance. This connection highlights the potential role of diet in prevention and management. A low-to-moderate carbohydrate diet may offer benefits in this context:

  1. Insulin Resistance and Brain Health: Alzheimer’s disease has been linked to insulin resistance in the brain, where brain cells become less responsive to insulin (103, 104). Insulin is not just a blood sugar regulator — it also plays roles in neuron growth and brain signaling.
  2. Reduced Inflammation: Chronic inflammation, which can be exacerbated by high intakes of processed carbs and sugar (105), is a recognized factor in the development of Alzheimer’s. A diet lower in carbs can help reduce systemic inflammation, potentially lowering the risk of neurodegenerative diseases.
  3. Stable Blood Sugar Levels: High blood sugar levels can affect brain health over time. A diet with moderate carbs, focusing on low-glycemic foods, helps maintain stable blood sugar and may protect brain cells from the damage associated with glucose metabolism irregularities (106, 107).
  4. Ketone Production: While a low-to-moderate carb diet is not as restrictive as a ketogenic diet, it can still promote a mild level of ketone production. Ketones are an alternative fuel source for the brain and may offer neuroprotective benefits (108).
  5. Cognitive Function: Diets high in refined sugars and starches can impact cognitive function and may exacerbate Alzheimer’s symptoms. In contrast, a balanced, low-to-moderate carb diet can support cognitive health (109, 110).
  6. Nutrient-Dense Diet: This approach emphasizes whole foods rich in nutrients such as antioxidants and omega-3 fatty acids, which are beneficial for brain health (111, 112). Foods like leafy greens, berries, nuts, and fatty fish are staples in this dietary pattern.
  7. Research Continues: While the connection between diet and Alzheimer’s disease is an area of ongoing research, current evidence supports the idea that a diet lower in refined carbs and sugars may be beneficial in reducing the risk and managing symptoms.

A low-to-moderate carb diet could help prevent and manage Alzheimer’s disease. It aligns with general dietary recommendations for overall brain health and may be particularly beneficial for individuals with a family history of Alzheimer’s or early signs of cognitive decline.

Low-to-moderate Carb + Cancer Prevention

The relationship between diet and cancer is complex, but emerging research suggests that dietary patterns, including carbohydrate intake, may influence cancer risk:

  1. Sugar and Cancer Cell Growth: Some studies indicate that high levels of simple sugars can fuel certain cancer cells, which prefer glucose for energy (just like all cells) (113). A diet lower in simple carbohydrates may help reduce this readily available energy source for cancer cells.
  2. Inflammation Reduction: Chronic inflammation is a known risk factor for several types of cancer (114, 115). Diets high in processed carbs can contribute to inflammation (116). In contrast, a low-to-moderate carb diet, especially rich in anti-inflammatory foods like vegetables and omega-3 fatty acids, may help reduce inflammation (117, 118).
  3. Weight Management: Obesity is a significant risk factor for several types of cancer (119, 120). A low-to-moderate carb diet can play a role in cancer prevention by facilitating weight control.
  4. Hormonal Balance: High-carb diets, particularly those rich in sugars, can disrupt hormonal balance, including insulin and related growth factors (121). These hormonal imbalances are linked to an increased risk of certain cancers, like breast cancer (122).
  5. Gut Health: A moderate-carb diet rich in fiber supports a healthy gut microbiome, which is important for immune function and may reduce cancer risk (123).

It’s important to note that while diet is a crucial factor in cancer prevention, it’s one of many. Genetic, environmental, and lifestyle factors also play significant roles (124).

Low-to-Moderate Carb Diet and Heart Disease Prevention

Heart disease remains one of the leading causes of death worldwide (125), and diet plays a crucial role in heart health:

  1. Improved Lipid Profile: A low-to-moderate carb diet, especially when it replaces high-carb foods with fats, can improve blood lipid profiles. It can lower triglycerides and raise HDL cholesterol levels, which benefit heart health (126).
  2. Blood Pressure Regulation: Reducing carb intake, particularly refined carbohydrates, may help lower blood pressure, a significant risk factor for heart disease (127, 128, 129).
  3. Reduced Inflammation: Chronic inflammation is a key player in the development of atherosclerosis, the buildup of plaque in artery walls. A diet lower in processed carbs can help reduce systemic inflammation (130).
  4. Weight Management: Excess weight, particularly around the midsection, increases the risk of heart disease (131). A low-to-moderate carb diet can aid in weight loss and maintenance, reducing this risk.
  5. Stable Blood Sugar Levels: High blood sugar levels, often a consequence of a high-carb diet, can damage arteries over time and contribute to heart disease (132, 133, 134). A diet with moderate carbs helps maintain stable blood sugar.
  6. Whole Foods Focus: This diet emphasizes whole foods like vegetables, nuts, seeds, and proteins. These foods provide essential nutrients for heart health, including fiber, micronutrients, and fats.

How to Avoid Restriction & Binge Eating

Adopting a balanced approach to eating, particularly in the context of a low-to-moderate carbohydrate diet, is crucial for avoiding the pitfalls of restriction and the subsequent risk of binge eating. The moderate carb approach, specifically, provides a sustainable path to healthy eating by allowing flexibility and variety, which are crucial for long-term adherence and psychological well-being.

  1. Avoiding Extreme Restrictions: Unlike very low-carb diets, a moderate-carb approach doesn’t involve drastic elimination of carbohydrates. This avoids the likelihood of feelings of deprivation and frustration often associated with more narrowed diets, which can lead to binge eating.
  2. Steady Energy and Mood: As previously mentioned, by providing a balanced mix of macronutrients and focusing on low-glycemic, complex carbs, the moderate carb approach helps in maintaining steady blood sugar levels. This stability is key to avoiding the mood swings and energy crashes that can trigger emotional eating.
  3. Satisfying and Nutritious Choices: Emphasizing the quality of carbohydrates, such as whole grains, fruits, and vegetables, ensures that meals are both satisfying and nutritious. This helps in managing hunger and reduces cravings for high-sugar, high-carb foods that are often linked to emotional eating. This way of eating also promotes satiety (72).
  4. Flexibility in Food Choices: The moderate carb approach allows for the inclusion of various foods, making it easier to enjoy social meals and special treats without guilt. This flexibility can prevent the perfectionistic “all or nothing” mindset, which often leads to dietary lapses and binge eating episodes.
  5. Holistic Approach to Health: By focusing on overall nutritional balance rather than strict carb restriction, this approach encourages a more holistic view of health. It recognizes the importance of addressing emotional wellbeing and developing a healthy relationship with food.
  6. Practical Strategies to Manage Cravings: Understanding the role of carbohydrates in energy and mood regulation provides valuable insights into managing cravings (20). This knowledge can be empowering and assist in making mindful food choices that align with both physical and emotional health needs, especially when paired with new mindset strategies.

Conclusion: Embracing a Balanced Approach with a Moderate Carb Diet

As you’ve seen, a moderate-carb diet is a helpful way of eating to promote positive health outcomes while also continuing to be able to live life and socialize. This way of eating navigates between the extremes of overconsumption and restrictive crash dieting, offering a sustainable path to long-term health and well-being. By understanding the types of carbs and their impact on our body, embracing a variety in our diet, and focusing on whole, nutrient-dense foods, we can effectively support our body’s needs without falling into the traps of quick-fix diets.

A moderate-carb diet is more than just a dietary choice; it’s a holistic approach to eating that considers our physical health and our relationship with food. It allows for flexibility, making it adaptable to different lifestyles and preferences, and is grounded in the idea that food should be both nourishing and enjoyable.

As we have seen, this approach has manifold benefits, spanning improved metabolic health and weight loss and maintenance to the potential prevention of chronic diseases. It’s about making informed choices, understanding the nuances of our bodies, and finding a harmonious balance that works uniquely for us.

As you consider your dietary choices, I encourage you to think beyond the numbers and focus on the quality of the foods you consume. Remember, the health journey is personal and continuous, and it’s important to consult with healthcare professionals to tailor dietary choices to your specific health needs and goals.

The moderate carb approach isn’t just a diet; it’s a lifestyle choice that prioritizes balance, health, and enjoyment. It’s a path to not just living but thriving with every bite we take.

Download Free Guides to Get Started

Here are some of my free guides and downloads to help you start your health journey. You can also see how I incorporate carbohydrates as part of an overall healthy diet in practice.


  1. Astrup, A., Brand-Miller, J., & Willett, W. C. (2018). Dietary carbohydrates: role of quality and quantity in chronic disease. BMJ, 361, k2340.
  2. Atkinson, F. S., Foster-Powell, K., & Brand-Miller, J. C. (2021). International tables of glycemic index and glycemic load values: 2021. The American Journal of Clinical Nutrition, 114(5), 1625–1632.
  3. Barclay, A. W., Petocz, P., McMillan-Price, J., Flood, V. M., Prvan, T., Mitchell, P., & Brand-Miller, J. C. (2008). Glycemic index, glycemic load, and chronic disease risk—a meta-analysis of observational studies. The American Journal of Clinical Nutrition, 87(3), 627-637.
  4. Lennerz, B. S., Alsop, D. C., Holsen, L. M., Stern, E., Rojas, R., Ebbeling, C. B., Goldstein, J. M., & Ludwig, D. S. (2013). Effects of dietary glycemic index on brain regions related to reward and craving in men. The American journal of clinical nutrition, 98(3), 641–647.
  5. Ludwig, D. S., Majzoub, J. A., Al-Zahrani, A., Dallal, G. E., Blanco, I., & Roberts, S. B. (1999). High glycemic index foods, overeating, and obesity. Pediatrics, 103(3), E26.
  6. Hardy, D. S., Garvin, J. T., & Xu, H. (2020). Carbohydrate quality, glycemic index, glycemic load and cardiometabolic risks in the US, Europe and Asia: A dose-response meta-analysis. Nutrition, Metabolism & Cardiovascular Diseases, 30(8), 853-871.
  7. Ludwig, D. S., Hu, F. B., Tappy, L., & Brand-Miller, J. (2018). Dietary carbohydrates: Role of quality and quantity in chronic disease. BMJ, 361, k2340.
  8. Kelly, R. K., Tong, T. Y. N., Watling, C. Z., Reynolds, A., Piernas, C., Schmidt, J. A., Papier, K., Carter, J. L., Key, T. J., & Perez-Cornago, A. (2023). Associations between types and sources of dietary carbohydrates and cardiovascular disease risk: A prospective cohort study of UK Biobank participants. BMC Medicine, 21, 34.
  9. Augustin, L. S. A., Kendall, C. W. C., Jenkins, D. J. A., Willett, W. C., Astrup, A., Barclay, A. W., … & Poli, A. (2015). Glycemic index, glycemic load and glycemic response: An International Scientific Consensus Summit from the International Carbohydrate Quality Consortium (ICQC). Nutrition, Metabolism and Cardiovascular Diseases, 25(9), 795-815.
  10. Ludwig, D. S. (2002). The glycemic index: Physiological mechanisms relating to obesity, diabetes, and cardiovascular disease. JAMA, 287(18), 2414-2423.
  11. Hu, T., Yao, L., Reynolds, K., Niu, T., Li, S., Whelton, P., He, J., & Bazzano, L. (2016). The effects of a low-carbohydrate diet on appetite: A randomized controlled trial. Nutrition, metabolism, and cardiovascular diseases: NMCD, 26(6), 476–488.
  12. Palmer, C. M. (2022). Brain Energy: A Revolutionary Breakthrough in Understanding Mental Health–and Improving Treatment for Anxiety, Depression, OCD, PTSD, and More. BenBella Books.
  13. Ede, G. (2024). Change Your Diet, Change Your Mind: A Powerful Plan to Improve Mood, Overcome Anxiety, and Protect Memory for a Lifetime of Optimal Mental Health. Balance. 
  14. Noakes, M., Foster, P. R., Keogh, J. B., James, A. P., Mamo, J. C., & Clifton, P. M. (2006). Comparison of isocaloric very low carbohydrate/high saturated fat and high carbohydrate/low saturated fat diets on body composition and cardiovascular risk. Nutrition & metabolism, 3, 7.
  15. Hernandez, T. L., Sutherland, J. P., Wolfe, P., Allian-Sauer, M., Capell, W. H., Talley, N. D., Wyatt, H. R., Foster, G. D., Hill, J. O., & Eckel, R. H. (2010). Lack of suppression of circulating free fatty acids and hypercholesterolemia during weight loss on a high-fat, low-carbohydrate diet. The American journal of clinical nutrition, 91(3), 578–585.
  16. Clemente-Suárez, V. J., Mielgo-Ayuso, J., Martín-Rodríguez, A., Ramos-Campo, D. J., Redondo-Flórez, L., & Tornero-Aguilera, J. F. (2022). The burden of carbohydrates in health and disease. Nutrients, 14(3809).
  17. Firth, J., Gangwisch, J. E., Borisini, A., Wootton, R. E., & Mayer, E. A. (2020). Food and mood: How do diet and nutrition affect mental wellbeing? BMJ, 369, m2440.
  18. Basiri, R., Seidu, B., & Rudich, M. (2023). Exploring the interrelationships between diabetes, nutrition, anxiety, and depression: Implications for treatment and prevention strategies. Nutrients, 15(4226).
  19. Kris-Etherton, P. M., Petersen, K. S., Hibbeln, J. R., Hurley, D., Kolick, V., Peoples, S., Rodriguez, N., & Woodward-Lopez, G. (2020). Nutrition and behavioral health disorders: Depression and anxiety. Nutrition Reviews, 79(3), 247–260.
  20. McClernon, F. J., Yancy, W. S., Jr, Eberstein, J. A., Atkins, R. C., & Westman, E. C. (2007). The effects of a low-carbohydrate ketogenic diet and a low-fat diet on mood, hunger, and other self-reported symptoms. Obesity (Silver Spring, Md.), 15(1), 182–187.
  21. Weickert, M. O., & Pfeiffer, A. F. (2008). Metabolic effects of dietary fiber consumption and prevention of diabetes. The Journal of nutrition, 138(3), 439–442.
  22. Jenkins, A. L., Jenkins, D. J., Wolever, T. M., Rogovik, A. L., Jovanovski, E., Bozikov, V., Rahelić, D., & Vuksan, V. (2008). Comparable postprandial glucose reductions with viscous fiber blend enriched biscuits in healthy subjects and patients with diabetes mellitus: acute randomized controlled clinical trial. Croatian medical journal, 49(6), 772–782.
  23. Jenkins, D. J., Kendall, C. W., Augustin, L. S., Franceschi, S., Hamidi, M., Marchie, A., Jenkins, A. L., & Axelsen, M. (2002). Glycemic index: overview of implications in health and disease. The American journal of clinical nutrition, 76(1), 266S–73S.
  24. Wolever, T. M., Jenkins, D. J., Jenkins, A. L., & Josse, R. G. (1991). The glycemic index: methodology and clinical implications. The American journal of clinical nutrition, 54(5), 846–854.
  25. Tsalamandris, S., Antonopoulos, A. S., Oikonomou, E., Papamikroulis, G. A., Vogiatzi, G., Papaioannou, S., Deftereos, S., & Tousoulis, D. (2019). The Role of Inflammation in Diabetes: Current Concepts and Future Perspectives. European cardiology, 14(1), 50–59.
  26. Mathias, K., Amarnani, A., Pal, N. et al. Chronic Pain in Patients with Rheumatoid Arthritis. Curr Pain Headache Rep 25, 59 (2021).
  27. de Roos, E. W., van den Berg, R., van der Helm-van Mil, A. H. M., Huizinga, T. W. J., & Toes, R. E. M. (2019). Rheumatoid arthritis does not require the presence of autoantibodies at diagnosis. Annals of the Rheumatic Diseases, 78(5), 688-692.
  28. Li, T., Huang, T., He, J., Yang, B., Wang, Z., & Yang, H. (2021). The impact of food additives on gut microbiota: A review. Journal of the Science of Food and Agriculture, 101(11), 4098-4105.
  29. Makhani, S. S., Davies, C., George, K. A., Castro, G., Rodriguez de la Vega, P., & Barengo, N. C. (2021). Carbohydrate-to-fiber ratio, a marker of dietary intake, as an indicator of depressive symptoms. Cureus, 13(9), e17996.
  30. Murtaza, B., Hichami, A., & Khan, N. A. (2021). Food lipids and dietomics in the prevention of neurodegenerative diseases. Biochimie, 193, 29-44.
  31. Siedlecka, D., Micał, W., Krzewicka-Romaniuk, E., & Romaniuk, A. (2020). The bitter side of high fructose corn syrup (HFCS) – the global obesity pandemic. Journal of Education, Health and Sport, 10(9), 747-751.
  32. Başaran, B., Çuvalcı, B., & Kaban, G. (2023). Dietary acrylamide exposure and cancer risk: A systematic approach to human epidemiological studies. Foods, 12(346).
  33. Shan Z, Rehm CD, Rogers G, et al. Trends in Dietary Carbohydrate, Protein, and Fat Intake and Diet Quality Among US Adults, 1999-2016. JAMA. 2019;322(12):1178–1187. doi:10.1001/jama.2019.13771
  34. U.S. Department of Agriculture and U.S. Department of Health and Human Services. (2020). Dietary Guidelines for Americans, 2020-2025 (9th ed.).
  35. Al-Dwaikat, T. N., Aldalaykeh, M., Tuffaha, M., & Zahran, Z. (2022). The relationship between social media use and depressive symptoms among adolescents in Jordan. Journal of Nursing Scholarship, 54(1), 69-76.
  36. Ma, Y., Ratnasabapathy, R., & Gardiner, J. (2017). Carbohydrate craving: not everything is sweet. Current opinion in clinical nutrition and metabolic care, 20(4), 261–265.
  37. Seo, Y. S., Lee, H. B., Kim, Y., & Park, H. Y. (2020). Dietary Carbohydrate Constituents Related to Gut Dysbiosis and Health. Microorganisms, 8(3), 427.
  38. Sukkar, S. G., & Muscaritoli, M. (2021). A clinical perspective of low carbohydrate ketogenic diets: A narrative review. Frontiers in Nutrition, 8, 642628.
  39. Harvard T.H. Chan School of Public Health. (n.d.). Ketogenic diet. The Nutrition Source. Retrieved May 16, 2024, from
  40. Singh, A., & Singh, D. (2023). The Paleolithic diet. Cureus, 15(1), e34214.
  41. Anton, S. D., Hida, A., Heekin, K., Sowalsky, K., Karabetian, C., Mutchie, H., Leeuwenburgh, C., Manini, T. M., & Barnett, T. E. (2017). Effects of Popular Diets without Specific Calorie Targets on Weight Loss Outcomes: Systematic Review of Findings from Clinical Trials. Nutrients, 9(8), 822.
  42. Zone Labs, Inc. (n.d.). Zone diet. Zone Living. Retrieved May 16, 2024, from
  43. U.S. News & World Report. (n.d.). South Beach diet. U.S. News & World Report. Retrieved May 16, 2024, from
  44. Lupoli, R., Di Minno, M. N. D., Guidone, C., Cefalo, C., Capaldo, B., & Riccardi, G. (2016). Effects of low-carbohydrate versus low-fat diets on metabolic risk factors: A meta-analysis of randomized controlled trials. Journal of Nutritional Biochemistry, 27, 17-28.
  45. Ohio State University. (2019, June 20). Low-carb diet may reduce diabetes risk independent of weight loss. ScienceDaily. Retrieved May 17, 2024 from
  46. Dong, T., Guo, M., Zhang, P., Sun, G., & Chen, B. (2020). The effects of low-carbohydrate diets on cardiovascular risk factors: A meta-analysis. PLOS ONE, 15(1), e0225348.
  47. Gjuladin-Hellon, T., Davies, I. G., Penson, P., & Amiri Baghbadorani, R. (2018). Effects of carbohydrate-restricted diets on low-density lipoprotein cholesterol levels in overweight and obese adults: A systematic review and meta-analysis. Nutrition Reviews, 77(3), 161-180.
  48. Goldenberg, J. Z., Day, A., Brinkworth, G. D., Sato, J., Yamada, S., Jönsson, T., Beardsley, J., Johnson, J. A., Thabane, L., & Johnston, B. C. (2021). Efficacy and safety of low and very low carbohydrate diets for type 2 diabetes remission: Systematic review and meta-analysis of published and unpublished randomized trial data. BMJ, 372, m4743.
  49. Castro-Barquero, S., Ruiz-León, A. M., Sierra-Pérez, M., Estruch, R., & Casas, R. (2020). Dietary strategies for metabolic syndrome: A comprehensive review. Nutrients, 12(10), 2983.
  50. Sievenpiper, J. L. (2020). Low-carbohydrate diets and cardiometabolic health: The importance of carbohydrate quality over quantity. Nutrition Reviews, 78(S1), 69-77.
  51. Rippe, J. M., & Angelopoulos, T. J. (2015). Fructose-containing sugars and cardiovascular disease. Advances in nutrition (Bethesda, Md.), 6(4), 430–439.
  52. DiNicolantonio, J. J., O’Keefe, J. H., & Lucan, S. C. (2015). Added fructose: a principal driver of type 2 diabetes mellitus and its consequences. Mayo Clinic proceedings, 90(3), 372–381.
  53. Softic, S., Cohen, D. E., & Kahn, C. R. (2016). Role of Dietary Fructose and Hepatic De Novo Lipogenesis in Fatty Liver Disease. Digestive diseases and sciences, 61(5), 1282–1293.
  54. Hervik, A. K., & Svihus, B. (2019). The role of fiber in energy balance. Journal of Nutrition and Metabolism, 2019, Article ID 4983657.
  55. Soliman, G. A. (2019). Dietary fiber, atherosclerosis, and cardiovascular disease. Nutrients, 11(5), 1155.
  56. Jamar, G., Ribeiro, D. A., & Pisani, L. P. (2021). High-fat or high-sugar diets as trigger inflammation in the microbiota-gut-brain axis. Critical Reviews in Food Science and Nutrition, 61(5), 836–854.
  57. Hartmann, H., Pauli, L. K., Janssen, L. K., Huhn, S., Ceglarek, U., & Horstmann, A. (2020). Preliminary evidence for an association between intake of high-fat high-sugar diet, variations in peripheral dopamine precursor availability and dopamine-dependent cognition in humans. Journal of Neuroendocrinology, 32(12), e12917.
  58. Spreadbury I. (2012). Comparison with ancestral diets suggests dense acellular carbohydrates promote an inflammatory microbiota, and may be the primary dietary cause of leptin resistance and obesity. Diabetes, metabolic syndrome and obesity : targets and therapy, 5, 175–189.
  59. Grodstein, F., van Oijen, M., Irizarry, M. C., Rosner, B., Kang, J. H., & Breteler, M. M. B. (2005). Hormone therapy and markers of inflammation in postmenopausal women. The American Journal of Medicine, 118(12), 1420-1427.
  60. Batterham, R. L., Heffron, H., Kapoor, S., Chivers, J. E., Chandarana, K., Herzog, H., Le Roux, C. W., Thomas, E. L., Bell, J. D., & Withers, D. J. (2006). Critical role for peptide YY in protein-mediated satiation and body-weight regulation. Cell metabolism, 4(3), 223–233.
  61. Halton, T. L., & Hu, F. B. (2004). The effects of high protein diets on thermogenesis, satiety and weight loss: a critical review. Journal of the American College of Nutrition, 23(5), 373–385.
  62. Soenen, S., Martens, E. A., Hochstenbach-Waelen, A., Lemmens, S. G., & Westerterp-Plantenga, M. S. (2013). Normal protein intake is required for body weight loss and weight maintenance, and elevated protein intake for additional preservation of resting energy expenditure and fat free mass. The Journal of nutrition, 143(5), 591–596.
  63. Aude YW, Agatston AS, Lopez-Jimenez F, et al. The National Cholesterol Education Program Diet vs a Diet Lower in Carbohydrates and Higher in Protein and Monounsaturated Fat: A Randomized Trial. Arch Intern Med. 2004;164(19):2141–2146. doi:10.1001/archinte.164.19.2141
  64. Yancy, W. S., Jr, Olsen, M. K., Guyton, J. R., Bakst, R. P., & Westman, E. C. (2004). A low-carbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia: a randomized, controlled trial. Annals of internal medicine, 140(10), 769–777.
  65. Meckling, K. A., O’Sullivan, C., & Saari, D. (2004). Comparison of a low-fat diet to a low-carbohydrate diet on weight loss, body composition, and risk factors for diabetes and cardiovascular disease in free-living, overweight men and women. The Journal of Clinical Endocrinology & Metabolism, 89(6), 2717–2723.
  66. Kastorini, C. M., Panagiotakos, D. B., & Pitsavos, C. (2005). Low carbohydrate diets and cardiovascular risk factors: A review of the evidence. Diabetic Medicine, 22(7), 730-738.
  67. Gardner CD, Kiazand A, Alhassan S, et al. Comparison of the Atkins, Zone, Ornish, and LEARN Diets for Change in Weight and Related Risk Factors Among Overweight Premenopausal Women: The A TO Z Weight Loss Study: A Randomized Trial. JAMA. 2007;297(9):969–977. doi:10.1001/jama.297.9.969
  68. Westman, E. C., Yancy, W. S., Jr, Mavropoulos, J. C., Marquart, M., & McDuffie, J. R. (2008). The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus. Nutrition & metabolism, 5, 36.
  69. Shai, I., Schwarzfuchs, D., Henkin, Y., Shahar, D. R., Witkow, S., Greenberg, I., … & Stampfer, M. J. (2008). Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. The New England Journal of Medicine, 359(3), 229-241.
  70. Volek, J. S., Phinney, S. D., Forsythe, C. E., Quann, E. E., Wood, R. J., Puglisi, M. J., Kraemer, W. J., Bibus, D. M., Fernandez, M. L., & Feinman, R. D. (2009). Carbohydrate restriction has a more favorable impact on the metabolic syndrome than a low fat diet. Lipids, 44(4), 297–309.
  71. Samaha, F. F., Iqbal, N., Seshadri, P., Chicano, K. L., Daily, D. A., McGrory, J., Williams, T., Williams, M., Gracely, E. J., & Stern, L. (2003). A low-carbohydrate as compared with a low-fat diet in severe obesity. The New England Journal of Medicine, 348(21), 2074-2081.
  72. Nickols-Richardson, S. M., Coleman, M. D., Volpe, J. J., & Hosig, K. W. (2005). Perceived hunger is lower and weight loss is greater in overweight premenopausal women consuming a low-carbohydrate/high-protein vs high-carbohydrate/low-fat diet. Journal of the American Dietetic Association, 105(9), 1433-1437.
  73. Sondike, S. B., Copperman, N., & Jacobson, M. S. (2003). Effects of a low-carbohydrate diet on weight loss and cardiovascular risk factor in overweight adolescents. The Journal of pediatrics, 142(3), 253–258.
  74. Brehm, B. J., Seeley, R. J., Daniels, S. R., & D’Alessio, D. A. (2003). A randomized trial comparing a very low carbohydrate diet and a calorie-restricted low fat diet on body weight and cardiovascular risk factors in healthy women. The Journal of Clinical Endocrinology & Metabolism, 88(4), 1617-1623.
  75. Daly, M.E., Paisey, R., Paisey, R., Millward, B.A., Eccles, C., Williams, K., Hammersley, S., MacLeod, K.M. and Gale, T.J. (2006), Short-term effects of severe dietary carbohydrate-restriction advice in Type 2 diabetes—a randomized controlled trial. Diabetic Medicine, 23: 15-20.
  76. Halyburton, A. K., Brinkworth, G. D., Wilson, C. J., Noakes, M., Buckley, J. D., Keogh, J. B., & Clifton, P. M. (2007). Low- and high-carbohydrate weight-loss diets have similar effects on mood but not cognitive performance. The American journal of clinical nutrition, 86(3), 580–587.
  77. Dyson, P. A., Beatty, S., & Matthews, D. R. (2007). A low-carbohydrate diet is more effective in reducing body weight than healthy eating in both diabetic and non-diabetic subjects. Diabetic medicine : a journal of the British Diabetic Association, 24(12), 1430–1435.
  78. Keogh, J. B., Brinkworth, G. D., Noakes, M., Belobrajdic, D. P., Buckley, J. D., & Clifton, P. M. (2008). Effects of weight loss from a very-low-carbohydrate diet on endothelial function and markers of cardiovascular disease risk in subjects with abdominal obesity. The American journal of clinical nutrition, 87(3), 567–576.
  79. Entezari, M. H., Salehi, M., Rafieian-Kopaei, M., & Kafeshani, M. (2017). Fat and carbohydrate proportions influence on the insulin resistance; a systematic review and meta-analysis on controlled clinical trials. Journal of Preventive Epidemiology, 2(1), e02.
  80. Zafar, M. I., Mills, K. E., Zheng, J., Regmi, A., Hu, S. Q., Gou, L., & Chen, L. L. (2019). Low-glycemic index diets as an intervention for diabetes: A systematic review and meta-analysis. The American Journal of Clinical Nutrition, 110(4), 891-902.
  81. Janochova, K., Haluzik, M., & Buzga, M. (2019). Visceral fat and insulin resistance – what we know? Biomedical Papers of the Medical Faculty of the University Palacky Olomouc Czech Republic, 163(1), 19-27.
  82. Snorgaard, O., Poulsen, G. M., Andersen, H. K., & Astrup, A. (2017). Systematic review and meta-analysis of dietary carbohydrate restriction in patients with type 2 diabetes. BMJ Open Diabetes Research and Care, 5(1), e000354.
  83. Farabi, S. S., & Hernandez, T. L. (2019). Low-carbohydrate diets for gestational diabetes. Nutrients, 11(8), 1737.
  84. Goss, A. M., Chandler-Laney, P. C., Ovalle, F., Goree, L. L., Azziz, R., Desmond, R. A., Wright Bates, G., & Gower, B. A. (2014). Effects of a eucaloric reduced-carbohydrate diet on body composition and fat distribution in women with PCOS. Metabolism: clinical and experimental, 63(10), 1257–1264.
  85. Gower, B. A., & Goss, A. M. (2015). A lower-carbohydrate, higher-fat diet reduces abdominal and intermuscular fat and increases insulin sensitivity in adults at risk of type 2 diabetes. The Journal of nutrition, 145(1), 177S–83S.
  86. Darjoko, S. T., Wahyuningsih, T., & Sudikno, S. (2019). High carbohydrate intake increases risk of coronary heart disease in adults: a prospective cohort study. Universa Medicina, 38(2), 90–99.
  87. Oh, K., Hu, F. B., Cho, E., Rexrode, K. M., Stampfer, M. J., Manson, J. E., Liu, S., & Willett, W. C. (2005). Carbohydrate intake, glycemic index, glycemic load, and dietary fiber in relation to risk of stroke in women. American journal of epidemiology, 161(2), 161–169.
  88. Elffers, T. W., de Mutsert, R., Lamb, H. J., de Roos, A., Willems van Dijk, K., Rosendaal, F. R., Jukema, J. W., & Trompet, S. (2017). Body fat distribution, in particular visceral fat, is associated with cardiometabolic risk factors in obese women. PLOS ONE, 12(9), e0185403.
  89. Lee, J. J., Pedley, A., Hoffmann, U., Massaro, J. M., Levy, D., & Long, M. T. (2018). Visceral and intrahepatic fat are associated with cardiometabolic risk factors above other ectopic fat depots: The Framingham Heart Study. The American Journal of Medicine, 131(6), 684-692.e12.
  90. Crudele, L., Piccinin, E., & Moschetta, A. (2021). Visceral adiposity and cancer: Role in pathogenesis and prognosis. Nutrients, 13(6), 2101.
  91. Silveira, E. A., Kliemann, N., Noll, M., Sarrafzadegan, N., & de Oliveira, C. (2021). Visceral obesity and incident cancer and cardiovascular disease: An integrative review of the epidemiological evidence. Obesity Reviews, 22(1), e13088.
  92. Kuwahara, K., Honda, T., Nakagawa, T., Yamamoto, S., Hayashi, T., & Mizoue, T. (2017). Body mass index trajectory patterns and changes in visceral fat and glucose metabolism before the onset of type 2 diabetes. Scientific Reports, 7, 43521.
  93. Lotta, L. A., Wittemans, L. B. L., Zuber, V., Stewart, I. D., Sharp, S. J., Luan, J., Day, F. R., Li, C., Bowker, N., Cai, L., De Lucia Rolfe, E., Khaw, K. T., Perry, J. R. B., O’Rahilly, S., Scott, R. A., Savage, D. B., Burgess, S., Wareham, N. J., & Langenberg, C. (2018). Association of genetic variants related to gluteofemoral vs abdominal fat distribution with type 2 diabetes, coronary disease, and cardiovascular risk factors. JAMA, 320(24), 2553-2563.
  94. Stanhope, K. L., & Havel, P. J. (2009). Fructose consumption: considerations for future research on its effects on adipose distribution, lipid metabolism, and insulin sensitivity in humans. The Journal of nutrition, 139(6), 1236S–1241S.
  95. Pollock, N. K., Bundy, V., Kanto, W., Davis, C. L., Bernard, P. J., Zhu, H., Gutin, B., & Dong, Y. (2012). Greater fructose consumption is associated with cardiometabolic risk markers and visceral adiposity in adolescents. The Journal of nutrition, 142(2), 251–257.
  96. López-Alarcón, M., Perichart-Perera, O., Flores-Huerta, S., Inda-Icaza, P., Rodríguez-Cruz, M., Armenta-Álvarez, A., Bram-Falcón, M. T., & Mayorga-Ochoa, M. (2014). Excessive refined carbohydrates and scarce micronutrients intakes increase inflammatory mediators and insulin resistance in prepubertal and pubertal obese children independently of obesity. Mediators of inflammation, 2014, 849031.
  97. Loenneke, J. P., Wilson, J. M., Manninen, A. H., Wray, M. E., Barnes, J. T., & Pujol, T. J. (2012). Quality protein intake is inversely related with abdominal fat. Nutrition & metabolism, 9(1), 5.
  98. Merchant, A. T., Anand, S. S., Vuksan, V., Jacobs, R., Davis, B., Teo, K., Yusuf, S., & SHARE and SHARE-AP Investigators (2005). Protein intake is inversely associated with abdominal obesity in a multi-ethnic population. The Journal of nutrition, 135(5), 1196–1201.
  99. Halkjaer, J., Tjønneland, A., Thomsen, B. L., Overvad, K., & Sørensen, T. I. (2006). Intake of macronutrients as predictors of 5-y changes in waist circumference. The American journal of clinical nutrition, 84(4), 789–797.
  100. Hervik, A. K., & Svihus, B. (2019). The Role of Fiber in Energy Balance. Journal of nutrition and metabolism, 2019, 4983657.
  101. Hairston, K. G., Vitolins, M. Z., Norris, J. M., Anderson, A. M., Hanley, A. J., & Wagenknecht, L. E. (2012). Lifestyle factors and 5-year abdominal fat accumulation in a minority cohort: the IRAS Family Study. Obesity (Silver Spring, Md.), 20(2), 421–427.
  102. Volek, J., Sharman, M., Gómez, A., Judelson, D., Rubin, M., Watson, G., Sokmen, B., Silvestre, R., French, D., & Kraemer, W. (2004). Comparison of energy-restricted very low-carbohydrate and low-fat diets on weight loss and body composition in overweight men and women. Nutrition & metabolism, 1(1), 13.
  103. Sędzikowska, A., & Szablewski, L. (2021). Insulin and insulin resistance in Alzheimer’s disease. International Journal of Molecular Sciences, 22(18), 9987.
  104. Nguyen, T. T., Ta, Q. T. H., Nguyen, T. T. D., et al. (2020). Role of insulin resistance in the Alzheimer’s disease progression. Neurochemical Research, 45(6), 1481–1491.
  105. Spreadbury I. (2012). Comparison with ancestral diets suggests dense acellular carbohydrates promote an inflammatory microbiota, and may be the primary dietary cause of leptin resistance and obesity. Diabetes, metabolic syndrome and obesity : targets and therapy, 5, 175–189.
  106. Wheeler, M. J., Dempsey, P. C., Grace, M. S., Ellis, K. A., Gardiner, P. A., Green, D. J., & Dunstan, D. W. (2017). Sedentary behavior as a risk factor for cognitive decline? A focus on the influence of glycemic control in brain health. Alzheimer’s & Dementia: Translational Research & Clinical Interventions, 3(3), 291-300.
  107. Tang, X., Cardoso, M. A., Yang, J., Zhou, J. B., & Simó, R. (2021). Impact of intensive glucose control on brain health: Meta-analysis of cumulative data from 16,584 patients with type 2 diabetes mellitus. Diabetes Therapy, 12(2), 765–779.
  108. Yang, H., Shan, W., Zhu, F., Wu, J., & Wang, Q. (2019). Ketone bodies in neurological diseases: Focus on neuroprotection and underlying mechanisms. Frontiers in Neurology, 10, 585.
  109. Fortune, N. C., Harville, E. W., Guralnik, J. M., Gustat, J., Chen, W., Qi, L., & Bazzano, L. A. (2019). Dietary intake and cognitive function: Evidence from the Bogalusa Heart Study. The American Journal of Clinical Nutrition, 109(6), 1656-1663.
  110. Reichelt, A. C., Stoeckel, L. E., Reagan, L. P., Winstanley, C. A., & Page, K. A. (2018). Dietary influences on cognition. Physiology & Behavior, 192, 118-126.
  111. Barnes, S., Chowdhury, S., Gatto, N. M., Fraser, G. E., & Lee, G. J. (2021). Omega-3 fatty acids are associated with blood–brain barrier integrity in a healthy aging population. Brain and Behavior, 11(8), e2273.
  112. Dighriri, I. M., Alsubaie, A. M., Hakami, F. M., Hamithi, D. M., Alshekh, M. M., Khobrani, F. A., Dalak, F. E., Hakami, A. A., Alsueaadi, E. H., Alsaawi, L. S., Alshammari, S. F., Alqahtani, A. S., Alawi, I. A., Aljuaid, A. A., & Tawhari, M. Q. (2022). Effects of omega-3 polyunsaturated fatty acids on brain functions: A systematic review. Cureus, 14(10), e30091.
  113. Epner, M., Yang, P., Wagner, R. W., & Cohen, L. (2022). Understanding the Link between Sugar and Cancer: An Examination of the Preclinical and Clinical Evidence. Cancers, 14(24), 6042.
  114. Singh, N., Baby, D., Rajguru, J. P., Patil, P. B., Thakkannavar, S. S., & Pujari, V. B. (2019). Inflammation and cancer. Annals of African Medicine, 18(3), 121-126.
  115. Korniluk, A., Koper, O., Kemona, H., & Dymicka-Piekarska, V. (2017). From inflammation to cancer. Irish Journal of Medical Science, 186(1), 57-62.
  116. Grosso, G., Laudisio, D., Frias-Toral, E., Barrea, L., Muscogiuri, G., Savastano, S., & Colao, A. (2022). Anti-Inflammatory Nutrients and Obesity-Associated Metabolic-Inflammation: State of the Art and Future Direction. Nutrients, 14(6), 1137.
  117. Zhu, F., Du, B., & Xu, B. (2018). Anti-inflammatory effects of phytochemicals from fruits, vegetables, and food legumes: A review. Critical Reviews in Food Science and Nutrition, 58(8), 1260–1270.
  118. Bäck, M., & Hansson, G. K. (2019). Omega-3 fatty acids, cardiovascular risk, and the resolution of inflammation. The FASEB Journal, 33(2), 1536-1539.
  119. Avgerinos, K. I., Spyrou, N., Mantzoros, C. S., & Dalamaga, M. (2019). Obesity and cancer risk: Emerging biological mechanisms and perspectives. Metabolism, 92, 121-135.
  120. Krupa-Kotara, K., & Dakowska, D. (2021). Impact of obesity on risk of cancer. Central European Journal of Public Health, 29(1), 38-44.
  121. Makarem, N., Bandera, E. V., Lin, Y., Jacques, P. F., Hayes, R. B., & Parekh, N. (2018). Consumption of sugars, sugary foods, and sugary beverages in relation to adiposity-related cancer risk in the Framingham Offspring Cohort (1991–2013). Cancer Prevention Research, 11(6), 347-358.
  122. Satpathi, S., Gaurkar, S. S., Potdukhe, A., & Wanjari, M. B. (2023). Unveiling the Role of Hormonal Imbalance in Breast Cancer Development: A Comprehensive Review. Cureus, 15(7), e41737.
  123. He, Y., Wu, C., Ma, X., & Shi, X. (2022). Dietary fiber and its effects on human health. Food Science and Human Wellness, 11(1), 1-10.
  124. Wu, S., Zhu, W., Thompson, P., & Hannun, Y. A. (2018). Evaluating intrinsic and non-intrinsic cancer risk factors. Nature Communications, 9(1), 3490.
  125. World Health Organization. (2020, December 9). The top 10 causes of death. World Health Organization. Retrieved May 16, 2024, from
  126. Chawla, S., Tessarolo Silva, F., Amaral Medeiros, S., Mekary, R. A., & Radenkovic, D. (2020). The effect of low-fat and low-carbohydrate diets on weight loss and lipid levels: A systematic review and meta-analysis. Nutrients, 12(12), 3774.
  127. Byun, S. S., Mayat, Z. K., Aggarwal, B., et al. (2019). Quantity, quality, and timing of carbohydrate intake and blood pressure. Current Nutrition Reports, 8(4), 270–280.
  128. Preuss, H. G., Clouatre, D., Swaroop, A., Bagchi, M., Bagchi, D., & Kaats, G. R. (2017). Blood Pressure Regulation: Reviewing Evidence for Interplay Between Common Dietary Sugars and Table Salt. Journal of the American College of Nutrition, 36(8), 677–684.
  129. Savoia, C. (2021). Carbohydrates and hypertension: The quality counts. Hypertension, 78(2), 431-433.
  130. Ma, X., Nan, F., Liang, H., Shu, P., Fan, X., Song, X., Hou, Y., & Zhang, D. (2022). Excessive intake of sugar: An accomplice of inflammation. Frontiers in Immunology, 13, 988481.
  131. Koparkar, G., & Biswas, D. A. (2023). Adiposity and Cardiac Defects: Pathophysiology and Etiology. Cureus, 15(1), e34026.
  132. Jo, U., & Park, K. (2023). Carbohydrate Intake and Risk of Cardiovascular Disease: A Systematic Review and Meta-Analysis of Prospective Studies. Nutrients, 15(7), 1740.
  133. Bancks, M. P., Ning, H., Allen, N. B., Bertoni, A. G., Carnethon, M. R., Correa, A., Echouffo-Tcheugui, J. B., Lange, L. A., Lloyd-Jones, D. M., & Wilkins, J. T. (2019). Long-term absolute risk for cardiovascular disease stratified by fasting glucose level. Diabetes Care, 42(3), 457–465.
  134. Ormazabal, V., Nair, S., Elfeky, O., Aguayo, C., Salomon, C., & Zuñiga, F. A. (2018). Association between insulin resistance and the development of cardiovascular disease. Cardiovascular Diabetology, 17, 122.

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