Dr Robert Szabo on why a low carbohydrate approach to nutrition is here to stay.
Today we live in an epidemic of chronic disease. Since 1975, global obesity rates have tripled, diabetes rates have nearly quadrupled and almost everybody in Australia today would know somebody who is affected by heart disease, high blood pressure, or stroke. In my work as a GP over the past 19 years, these troubling statistics have certainly been reflected in the chronic health conditions suffered by my patients.
Six years ago, at the age of 37, I was diagnosed with type 2 diabetes. I was shocked – I was not overweight and had been following what I thought was a very healthy lifestyle: exercising six times a week and following the same diet that I prescribed my patients – low in fat and high in wholegrains, with lean meats and vegetables. After my diagnosis, I was told by my endocrinologist and a dietitian to stick to my ‘healthy’ diet, and to take medication to manage my diabetes. I thought this was odd, how could I have a lifestyle disease if at the same time, the experts had told me I was already following a healthy lifestyle? Something didn’t add up.
Soon after a friend pointed me to research showing that in fact diabetes is not due to dietary fat or a lack of exercise, but rather due to an excess of sugar and carbohydrates in the diet. The research showed that these foods had an impact on a hormone called insulin, and it was a disease called insulin resistance which was wreaking havoc on my glucose control.
Insulin’s primary job is energy storage. Insulin moves glucose out of our blood stream and into our cells. Once the cells are full, insulin stores the excess glucose as fat. Yes – fat! This fat ends up hidden in places like our liver and our pancreas – or, more visibly, in our stomach, legs and arms.
As well as promoting fat formation – insulin prevents fat burning. Every time insulin adds fat to our organs, our belly or our thighs, we are at increased risk of obesity and chronic disease. Where does most of the glucose in our bodies come from? From carbohydrates. Dietary carbohydrates (whether whole-grain or not) keep insulin high, and hence keep levels of fat burning low.
This is why conventional advice for weight loss – to follow a calorie-restricted, low-fat, high-carbohydrate diet is not an effective long term strategy. Not only does that approach reduce the amount of energy coming in, all of the glucose in our bloodstream (from the dietary carbohydrates) keeps insulin levels elevated, therefore preventing us from accessing our stored body fat for fuel. This puts our body in an energy crisis, which we respond to by dropping our basal metabolic rate – that is, the amount of energy we burn, moment to moment. That’s why we end up cold, tired and hungry – and then guilty, after an evening of binge-eating on the couch. Anyone who has ever tried a conventional calorie-restricted diet will know that weight loss in the short term will ultimately to be reversed: starve the body of energy, and the body fights back!
But if we lower insulin, we can access all of the energy we need: from fat. Eating fat does not make you fat: in fact, eating fat barely promotes any insulin response at all. In fact, eating fat trains the cells of the body to burn fat for fuel – including our stored body fat.
By eating a low-carbohydrate or ketogenic diet, you optimise your hormones and your cells for fat-burning. Rather than burning glucose, you teach your body to burn ketones – created via fat metabolism, they are a clean and efficient fuel source that can be used by every organ in the body.
After putting my type 2 diabetes into remission through adopting a low-carbohydrate diet, I was able to come (and remain) off medication, for the last 6 years I have discovered the many benefits of low carb: I don’t struggle with low energy or moodiness, and I don’t put on weight.
Getting started with low-carb and keto is easy. Here are five tips to get you going:
- Quit sugar, which promotes a rapid insulin response: remove sweets and treats, bottled drinks, chips and biscuits, sauces and condiments, and most processed foods
- Swap ‘low-fat’ for full-fat: keep yourself feeling fuller for longer by choosing full-fat dairy and meats
- Replace ‘staple’ carbohydrates (like bread, pasta, rice, cereals and grains) with low-carbohydrate vegetables, salads and whole food-proteins (like fish, meat, dairy and eggs)
- Don’t fear healthy fats: add olive oil, butter, coconut oil and animal fats to your cooking – they help train your body to burn fat, are delicious and satiating
- Listen to your body and eat only when you are hungry – if you don’t feel like eating, don’t eat!
Experiencing the power of these simple changes myself led me to establish The Low Carb Clinic and subsequently Diversa Health. Since 2016 we have helped over a thousand people make positive lifestyle change while medically monitoring them through the process, and I feel incredibly proud to be a part of the solution to the greatest health challenge of our time.
Although there is no universally agreed upon definition for the reversal of type 2 diabetes, Diversa uses HbA1c to assist in defining diabetes and pre-diabetes reversal.
Type 2 diabetes reversal is when a patient who previously had an HbA1c in the diabetic range (>6.5%) returning an HbA1c in the non-diabetic range (<6.4%) (along with the absence of medications used to manage diabetes). Pre-diabetes reversal is when a patient who previously had an HbA1c in the pre-diabetic range (5.7-6.4%) returning an HbA1c to the non pre-diabetic range (less than 5.7%).
It is important to recognise that although not everybody may be able to completely reverse type 2 diabetes, partial reversal, the reduction of medication dosages, along with the simultaneous lowering of HbA1c, will unquestionably achieve a better quality of life and improve health outcomes for those living with type 2 diabetes.
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