Conclusions that all diets are the same and all food calories are the same do not make any sense in the 21st century. We now understand that the body processes food macronutrients differently. Carbohydrates, more than fats and proteins, promote weight gain, hunger and inflammation.

There have been numerous diets, books and studies in the last 10 years that demonstrate the problem with carbohydrate consumption. Carbohydrate-restricted diets definitely have an edge - more sustained weight loss and improved markers of inflammation.

Insulin, a hormone produced in the pancreas, functions to regulate energy and energy storage in our body. Carbohydrates, a simple form of food energy, triggers insulin significantly more the fats and proteins. When insulin levels are high, the body wants to store food energy. A diet restricting carbohydrates tends to leave insulin levels lower, regulating appetite and signaling the body to burn body fat and promote weight loss.

We have spent the last 60 years attacking fat and cholesterol in the diet and today we have an epidemic of obesity and diabetes. We now understand that it is carbohydrates, especially the refined carbs, that trigger insulin and the inflammatory response leading to atherosclerosis, heart attack and stroke. The combination of saturated fats and cholesterol consumed in the presence of carbohydrates is a killer. This is the present American diet.

It is inaccurate to say that we need to be avoiding fat and cholesterol in our diet. If we reduce carbs, we will eat more high protein foods and the fat and cholesterol content increases. If we loose weight we see improvements in the cholesterol profile. It is the combination of the macronutrients, specifically carbs, saturated and trans fats that kill us.

Restricting carbohydrates regulates insulin levels. It is the fluctuations of blood glucose and insulin that drives our appetite. As we gain weight we become more and more insulin resistant and this further promotes hunger and appetite. Restricting carbs by losing weight treats both insulin resistance and appetite. There is medication to control appetite - older and new, exciting medication, but it starts with the food and the right food choices.

I personally support any diet and exercise program that is working, but try to teach patients how to focus on the carbohydrate content of food, such as teaching patients how to use the glycemic index of foods and count grams of carbohydrates.

The goal is to better regulate levels of insulin and by reducing the carbohydrate content in the diet rather then focusing on quantity and calories. I refer to this as the physiologic edge.

Jeffry N. Gerber, M.D.
South Suburban Family Medicine 7780 S. Broadway #250 Littleton, CO 80122 303-346-9490 http://jgerbermd.com