Wednesday, June 19, 2019

Retrospective #124: Low Carb vs. Paleo

In July 2013, when this post was originally written, there were two popular movements on the ascendancy among the alternative diets. They were broadly speaking Low Carb and Paleo. Lamentably I think there is confusion among newbies as to which is “right” or “best” to follow and for what reasons. I will attempt to explore and clarify them.
The modern era of the low carb diet is largely attributed to Dr. Robert Atkins. In his 1972 book, “Dr. Atkin’s Diet Revolution,” carbohydrates were severely restricted. In the Induction Phase of his diet, which I followed, carbs were limited to just 20 grams a day). The purpose of the diet was weight loss. It worked very well but was widely criticized as dangerous. Other physicians, notably Dr. Richard K. Bernstein, himself a Type 1 diabetic, developed specialized practices in which very low-carb diets were specifically tailored to diabetics, both Type 1s and Type 2s.
In July 2002, award-winning science writer Gary Taubes revived the Atkins controversy and broadened the debate with his influential New York Times Sunday Magazine cover story, “What If It’s All Been a Big Fat Lie?” In 2007 his “Good Calories – Bad Calories” (“The Diet Delusion” in the UK) further explored his “Alternative Carbohydrate Hypothesis.” Among Taubes’s 10 “certain conclusions” (pg. 454) was, #2: “The problem is the carbohydrates in the diet, their effect on insulin secretion, and thus the hormonal regulation of homeostasis – the entire harmonic ensemble of the human body. The more easily digestible and refined the carbohydrates, the greater the effect on our health, weight and well-being.” To mix my metaphors, that pearl is “it” in a nutshell.
There are many practicing clinicians, researchers and bloggers out there today who espouse a low carb or even a very low carb diet for those diagnosed with Metabolic Syndrome, insulin resistance, and carbohydrate intolerance. Severe restriction of dietary carbohydrates will improve glucose regulation and regularize your metabolism very effectively. It will also result in easy, hunger-free weight loss and improved blood cholesterol (lowering triglycerides and raising HDL), and, as a consequence of weight loss, improved blood pressure and inflammation markers.
The low carb diet can still also be used as Atkins originally intended, which was principally for weight loss.  All of the attendant benefits will accrue. Frankly, I would recommend the low-carb Atkins diet to the entire U. S. population.
The modern Paleo movement in the U. S. came along much later than Atkins and about the time of Taubes’s 2002 seminal NYT piece. In a few short years it has made a very big splash, especially in the “real food” niche. An early proponent was Loren Cordain. Rob Wolf, an exercise physiologist who worked with Cordain, followed. Michael Pollan’s “Omnivore’s Dilemma” (2006) gave it a big boost. My favorite exponent in this area was Dr. Kurt Harris, who came along later and then disappeared. He had an epiphany after hearing Taubes and reading his book (GC-BC). His “Archevore program,” originally dubbed Pa-Nu, was to avoid the Neolithic Agents of Disease (NAD): wheat, excess fructose and excess linoleic acid (Omega 6s). Several influential researchers, among them Paul Jaminet (PHD diet), Stephan Guyenet, Peter D. (Hyperlipid), J. Stanton (, and Chris Kresser are regular bloggers.
The Paleo movement, like low carbing, has many variants. However, it is not a program designed for glucose regulation, for people whose glucose metabolism is “broken,” or for people who need to regulate their blood sugar by diet. It is not intended to produce the benefits needed if you are Insulin Resistant, carbohydrate intolerant, have Metabolic Syndrome, are pre-diabetic or have been diagnosed with Type 2 diabetes. Many of the Paleo diet variants, for example, permit root vegetables (very starchy carbohydrates!) and even white rice! Rice is a non-wheat grain and therefore gluten-free, but it is still a very starchy food. If you have insulin resistance and are carbohydrate intolerant, root vegetables and white rice will cause your blood glucose to go through the roof!
To summarize, Paleo is an appealing approach to eating a healthy diet, if you have a healthy glucose metabolism. I would definitely follow it if I did, but you have to know if your metabolism is “broken” before you decide. Get to know your own health markers, and don’t be in denial; if you are pre-diabetic, get a meter and eat to it. If your metabolism is “normal,” then go “whole hog” with Paleo. Eat “real” (unprocessed) food, the way we all used to!

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