One of the most discussed topics in nutrition of all time is “Low Carb vs. High Carb – whats better?”
In the 80s and 90s fat was demonized as causing heart disease and carbs were said to be essential for physical and cognitive performance. What a decade later had been proved wrong, even in the public eye. And the low carb craze started. Carbs were demonized in the cause of all obesity and nutritional problems. One step further No Carb and Ketogenic Diets promised health, performance and longevity. Basically all of them have some compelling arguments that speak for their approach.
If I d have to give one single option to everyone, assuming that this won't work for everyone. Still, it would work for the most, I'd clearly choose a low carb approach.
Am I a fan of a low carb approach?
Yes, I am.
First, looking a the research, were I reference Jonny Bowden as he has done the best job so far in his book "Living the Low Carb Life" (1) at collecting, dissecting and presenting the scientific benefits of a low carb approach. The points are clear, there are many benefits to a low carb approach. The human genome and metabolism has evolved on a low carb approach. Primarily because there was no access to regular high carb feedings before the invention of agriculture. Without agriculture, we cannot consume regular high carb meals and therefore have a steady intake of carbs. As agriculture is only about 6000 to 12000 years old depending on the region. And we humans have been around for about a million years. So the total time that we had access to a potential high carb diet is very small compared to the total time of our existence. We have evolved on a low carb diet. A historical fact.
Second, look at empirical evidence, the majority of people in the western world have experienced that cutting carbohydrates and eating more protein and fats, leads not only to a decrease in body fat, it also leads to an increase in cognitive performance and wellbeing. Many think better and feel better on a low carb approach.
Low carb doesn't equal no carb
The definition of Low Carb is needs to be clearly set to differentiate between Low Carb and No Carb. The major definition of low carb is around 20% of the calories from carbs. That means a 3000kcal or 2000kcal daily consumption lies between 150g or 100g of carbs per day. Which is actually a decent amount of carbs and therefore a quite sustainable approach to nutrition.
Compared to a No Carb approach which is primarily defined as less than 30g of carbs per day with all carbs coming from vegetables with zero starches and sugars. Even though many do well on a no carb approach due to the reliable decrease in body fat and an increase in cognitive performance and wellbeing, few will maintain a no carb approach for long. As these initial improvements often wind off with weeks or months and downsides emerge. Which makes a No Carb approach not sustainable for most.
Especially for the majority of wellness-oriented clients that are not willing to sacrifice as much as more performance-oriented athletes.
That means low carb is for everyone?
Definitely not. Even though the majority does well on a Low Carb approach, some actually experience a decrease in performance, recovery, sleep quality and stagnant fat loss.
Low carb does not work for everyone.
When considering carbohydrate intake and a nutritional approach there are basically three major options. High carb, low carb and no carb.
All of these actually do get results. For some people. And for some goals.
Let's look at each of the three main options, their history and their definitions
The Rise of High Carb
During the second half of the last century the High Carb Low Fat Approach was heavily popularized for improving cardiovascular health. In the 1950's an American physiologist named Ancel Keys spread the idea that saturated fat caused high cholesterol and that high cholesterol caused heart disease. He did a study called "The Seven Countries Study"(2) that looked at a number of different countries, and correlated their consumption of saturated fat with the risk of heart disease.
He published a paper that claimed that it was a high fat intake that causes cardiovascular disease. While ignoring multiple countries where this correlation actually wasn't true. Chile had high rates of heart disease and diets low in saturated fat. The Netherlands and Norway had low rates of heart disease and diets high in saturated fat. Those countries were just left out. This form of science led physicians to embrace the low fat diet for heart disease prevention and weight loss. By the 1960s, the low-fat diet began to be touted not just for high-risk heart patients, but as good for everyone.
Were many jumped to the conclusion that if low fat is also better physical performance. Primarily based on the lines of thought. First, fat is bad for heart and cardiovascular health which is essential for sports performance, so low fat increase performance. Second, carbs are necessary for sports performance, so more carbs equal more performance. Pre-competition carloading or so called "pasta parties" were very common in the 80s and 90s. Not just for endurance sports, also for team and individual sports. And if its good for sports it must also be good to lose weight and body fat. And since fat makes fat, it all made sense.
So High Carb Low Fat was heavily promoted as being the healthiest diet. As it improved cardiovascular health and performance.
The High Carb Low Fat approach became a dominant ideology, promoted by physicians, the government, the food industry, and the popular health media. Many subscribed to the ideology of low fat, even though there was no clear evidence that it prevented heart disease or promoted weight loss. Ironically, in the same decades that the low-fat approach assumed ideological status, people were getting fatter, leading to what many called an obesity epidemic. Only in the last two decades scientific and empirical evidence has let to a paradigm shift putting sugar and transfer consumption at the forefront of nutritional risk factors for cardiovascular conditions (2) and as an efficient approach to loose body weight and body fat. And that way initiating the rise of the low carb wave.
The Resurrection of Low Carb
The initial evidence of a low carb approach being used as a "diet" dates back to the 1700s.
In 1797, John Rollo reported on the results of treating two diabetic Army officers with a low-carbohydrate diet and medications. A very low-carbohydrate, ketogenic diet was the standard treatment for diabetes throughout the nineteenth century (4.5).
In 1863, William Banting, a formerly obese English undertaker and coffin maker, published "Letter on Corpulence Addressed to the Public", in which he described a diet for weight control giving up bread, butter, milk, sugar, beer, and potatoes ( 6). His booklet was widely read, so much so that some people used the term "Banting" for the activity now called "dieting"(7).
The next big step was in In 1972, Robert Atkins published Dr. Atkins Diet Revolution, which advocated the low-carbohydrate diet he had successfully used in treating people in the 1960s (8). Despite reserving plenty of public criticism, Dr Atkins paved the way for a low carb approach in medicine and eventually in sports performance.
With research showing that eating fat doesn't necessarily makes fat and nutritional fat doesn't equal blood lipids and a high risk for cardiovascular disease, the low carb approach caught up again.
And it took over in the late 1990s and early 2000s as the go to approach to loosing body fat and regaining health.
Without looking at any research here and just connecting dots. If one gains body fat and loses health due to an excess of carbs, lower carb intake is a logical solution to lower body fat and regain health. Research proved this over and over again. So did success stories.
Important to note here is despite the research and overwhelming amount of success stories there were still cases of people loosing body fat with a high carb approach and sworn by high carbs to improve sports performance. More on this later.
With the new wide spread surge of the Low Carb approach it wasn't long until some took it further with a No Carb Approach or even Ketogenic Diet. Often fueled by: If low carb is better, no carb is best. And definitely some compelling research about No Carb or Ketogenic Diet.
Going No Carb
A no carb approach is often a synonym for the ketogenic diet. Yes, a Ketogenic Diet involves eating no carbohydrates, for most truly going into ketosis a no carb, low to moderate protein and high fat approach is necessary. Getting more than 30% of their calories from protein pushes many out of ketosis, while its still technically a no carb diet. This can be 60% of calories from protein, 35% from fat, and less than 5% from carbs. At 2500kcal per day that macro distribution is about 375g protein, 110g fat and 30g carbs. Thats an approach often used in physique competitions such as bodybuilding with great success especially in the intermediate and final stages of a competition prep.
It basically means a no carb approach is not always a ketogenic diet.
A ketogenic diet is always a no carb approach though.
The Comeback of the Ketogenic Diet
The Ketogenic Diet has risen to new heights in the last few years. And has produced excellent results for many when it comes to fat loss, every day performance and health. An important fact to consider though is that a ketogenic diet is rarely sustained over a longer period of time such as 6 months and more. The main reason for this is because a long-term ketogenic diet leads to a negative feedback loop and neurochemistry and the stress hormones. Often resulting in mood swings, a decrease in sleep quality and volume, fatigue, impaired recovery from training and more.
That doesn't make a ketogenic diet a bad approach. It adjusts points out that the sustainability of the Ketogenic Diet is low for most. The Ketogenic Diet is actually an excellent approach from a health standpoint especially for people with certain conditions. Of the years science has observed exceptional results with the Ketogenic Diet on brain-related conditions such as epilepsy.
In the 1920s a group of Doctors at the Mayo Clinic with the Ketogenic Diet to mimic the success of fasting on epilepsy with great results. Which was one of the first scientific medical breakthroughs in using nutrition to deal with a medical condition, in this case epilepsy. Proven by several notable medical authorities, the Ketogenic Diet as a treatment for childhood epilepsy found its way into medical textbooks in the 1940s and has remained there until today.
Beyond this example from 100 years ago, many benefits of the Ketogenic Diet have been proven over the last decades.
A true ketogenic diet is a rather extreme approach and will work in many for many goals. Its low sustainability is definitely one of its major drawbacks.
Using a Ketogenic Diet for a specific goal over a short- or mid-term time frame is how I approach it in my work at the YPSI. Which has shown to provide the advantages will dealing with the disadvantages quite well.
Speaking of High Carb, Low Carb and No Carb another group of nutritional prophets will claim: That doesn't matter, just go to into a calorie deficit and you will lose fat.
Macros don't matter. Only calories matter.
The CICO or calories in vs. calories out card has been played for years. The are many studies like this one (9) that basically "prove" that it makes no differences what you eat as far as macro nutrient distribution, only the calories matter. Sounds simple. Technically it's highly oversimplified though. Looking at a study like the one above the participants are obese. One of the main reasons for obesity is overeating or a constant calorie surplus. That's correct. Therefore basically just restricting calories will make the obese lose weight and fat. The study proved that. And there are many other examples that are often cited that prove the same, results in for a very narrow target group and a very narrow setting.
Three considerations that are crucial when considering the success rate of a CICO approach are:
1. What is success?
This one might seem obvious. Especially in the context of nutritional success the clear definition of "success" is a missing piece. Are we just talking about weight and fat loss? Or do we consider wellbeing, sleep quality, recovery from training and every day performance especially brain performance factors that need to be considered? All the sudden a CICO approach will do not produce such great results anymore. Food is energy. Calories are energy. Energy needs to be taken in, to be spent. One needs to eat to work train, train hard and recover. These three aspects that go beyond just weight and fat loss need to be considered when defining the success of a nutritional approach.
2. Still no results despite a calorie deficit?
Whats with the ones that still don't lose fat despite being in a calorie deficit? As a rule of thumb, the younger, leaner and more active a person is, the greater the results with a CICO approach. Statistically the majority of people that like to loose weight and body fat while functioning well and feeling great in their daily life are not on the younger, leaner and more active side. I regularly see clients that consult with me that are convinced that they are fat or can't get abs because they eat too much. After some analysis it is clear that they are far from eating too much or a calorie excess on a daily and weekly basis. And clients show me their nutrition history including periods of a severe calorie deficit. And they consult me because they still didn't loose the body fat they wanted to loose. Whats with these cases? Is there something else that matters beyond calories?
3. Calories matter. They are just not the only thing that matters.
Hormones have an impact, too. So does neurochemistry. If one gets lean and progresses in training while feeling great and having a functioning brain by just going into a calorie deficit, great, keep going. If thats not the case, more factors, such as food choice, hormones and neurochemistry need to be assessed and optimized.
But, calories directly influence hormones and neurochemistry. That is correct. Still calories is only one factor that influences hormones and neurochemistry.
Certain foods have a greater impact on each that others, like 1000kcal from steak and spinach vs. a 1000kcal from ice cream. Certain drinks have a greater impact on each that others, like water vs. coffee. Certain activities have a greater impact on each that others, like working a 14h day vs. lying on a beach all day. And so on.
Calories in vs. calories out for fat loss and results in the gym matters. Its just not the only aspect that matters. Next to hormones and neurochemistry, a definite aspect for multi-faceted success through nutrition is macronutrient distribution.
Many diets play around with macronutrient distribution. And many diets show scientific and anecdotal success.
In the end if all diets work, is it just about adherence?
Lately I hear this one a lot. And its one of the most short-sighted statements that I have ever heard about nutrition.
The main argument on that one is: Research proves all diets work, so you can just choose one and stick to it and you'll get results. So it's just about adhering to one diet.
Its like stating: It doesn't matter if you go north, south, east or west, statistics prove that you ll always end up in Rome.
That's actually correct. Statistically many will end up in Rome at some point. That questions bearing are: How many end up in Rome, how long did it take, how much effort was invested and how did you feel along the way?
In the sense of a diet, basically everyone that has tried different approaches, has experienced with at least one, were they just didn't feel and perform good on.
Which is one of the main downsides of the majority of research regarding diets as the majority only measures weight and/or fat loss completed negating every day wellbeing and performance.
There is research on people have lost weight and body fat on an all-pizza, all-cake and all-McDonalds diet. It proves one point. Yet, imagine only eating pizza for weeks, or only eating cake for weeks, or only eating McDonalds for weeks. How would you feel? How would you function? Most feel miserable after just eating like that for a single day.
How well do you feel and perform on a nutritional approach is crucial and needs to be considered when stating "all diets work". How is "work" defined? Just from a pure weight and fat loss standpoint? Science mostly does that. The Real World doesn't.
Some will just toughen through feeling worse and having a slow brain for the sake of some weight and fat loss. Its just not a realistic approach for most.
The multitude of benefits of a high carb intake
Carbs are not bad. They are good if you deserve them. Thats a point I made in my " 2 Things I know for sure about nutrition " article a few year ago. I also wrote on a “ Peri-Workout Carb Loading Protocol ” and the great success I have had with the recommendation of consuming in between 400g and 600g of carbs just around the workout window with some clients and athletes.
Carbs have many benefits. Yes, they are not Paleo. Yet, being muscular 100kg body weight and squatting 200kg is not Paleo either. Carbs applied properly can facilitate progress and allows to get leaner fater, get bigger faster and get stronger faster. Sleep better, think better and live better.
History has proved over and over again that demonizing a certain aspect will turn out as false over time. Just consider the concept of witches.
There are two primary benefits of eating carbohydrates that I constantly address working with clients and athletes:
1. Carbs & Neurochemistry
Carbs have impact on blood sugar levels which impacts neurotransmitter production. Neurotransmitters regulate the signaling in our nervous system which governs the majority of functions in our body. From recruiting muscle fibers and increasing testosterone to calming down the system at night and sleeping better. Carb intake correctly adjusted and timed is a major tool in getting to nutrition and training goals faster.
2. Carbs & Glycogen Synthesis
Glycogen is carbs stored in our muscles. In circa-maximal and maximal efforts below 2 minutes carbs are the primary energy source. Thats because the anaerobic energy system is the primary energy system in this demands which provides us with ATP, the form of energy that all our cells use. And the anaerobic energy system primarily turns glycogen into ATP. The majority of training that one does for strength, hypertrophy, fat loss and conditioning are circa-maximal and maximal efforts below 2 minutes. So they primarily take place in the anaerobic energy system and therefore glycogen levels are crucial to provide energy. And more energy spent means a greater training effect from a metabolic perspective. Using carbs to increase glycogen content in the muscle via muscle glycogen synthesis is essential for many training goals. That way carb intake optimally adjusted and timed is a major tool in getting to nutrition and training goals faster.
So what's the best diet? Low carb, high carb, keto, or…
The best diet for an individual is the one that allows them to achieve their goals, which in many cases is the loss or maintenance of bodyweight and body fat, combined with a high level of wellbeing and every day performance. While being a diet that is sustainable for them.
Simple, but not easy
Sounds very simple. It is very simple. Its just not easy. And the two major hurdles here are:
1. To assess the success of a nutritional approach we need objective measures
One of the downfalls of a sustainable change in nutrition is the lack of objective proof that the change actually led to results. And vice versa, that means we need objective measures that proof if something is working. If its working, keep going. If it's not working, time to change. Next to the most popular tool the objective assessment of success through dietary change, which is the scale, we need a more precise tool to assess body fat specifically. That tool of choice for my work is the YPSI Skinfold Assessment. As it not only allows to assess body fat, it also allows specifically assess where one is losing, stalling or gaining body fat. That allows to make more precise choice in changing nutrition to get and keep getting results.
And I choose objective measures such as the skin fold measurement over subjective measures such as the mirror, any given day. As the emotional mind likes to play tricks with subjective measures. And the rational mind dominates objective measures. Which is key to getting results with a wide variety of people in a wide variety of scenarios.
2. The only constant is change.
Even for an individual the approach that works right now hasn't necessarily work 5 years ago, or will work in 5 years form now. Life is reactive, it changes. Many factors influence the currently best nutritional approach. Sleep, lifestyle, stress, activity level, micronutrient deficiencies and more all have an effect. This is why the nutritional approach needs to be adapted. Just cause Low Carb worked 5 years ago doesn't mean it works now. Just cause Low Carb didn't work 5 years ago doesn't mean it works now. And vice versa. The optimal nutritional approach needs to be adaptive to work. And the basis of adaptation is a thorough assessment.
The end of nutritional paralysis through analysis
The intent of this article isn't to give the ultimate answer to the question of what nutritional approach is best. As trying to answer this one leads to paralysis in many cases. The more one starts to read on nutrition or gets "expert" advice on nutrition, the more confusion starts to settle in. There is some positive research of basically every nutritional approach. And definitely some positive stories.
What works for me?
That's the biggest question. What works for me right now is even more precise. Thats what everyone has to define for themselves individually. With or without the assessment and advice of a Coach.
The goal for every and every given point is to adjust nutritional habits to the current goal and time. As thats technically the only approach to determine and do whats currently working.
The human genome has evolved on a low carb approach, still going no carb or high carb, does bring benefits.
Low carb is the best diet for humans, is like saying Mallorca is the best vacation spot ever. Sometimes its good to go to the top of a mountain in the Alpes or to some ice and rocks in Ushuaia in southern Argentina. Times change. Needs change. Assess and adapt.
(1) Living the Low Carb Life, by Jonny Bowden
(2) The Seven Countries Study
(4) Morgan W (1877). Diabetes mellitus: its history, chemistry, anatomy, pathology, physiology, and treatment .
(5) Unicorn M (1905). Lectures on dietetics .
(6) Banting W (1869). Letter On Corpulence, Addressed to the Public (4th ed.). London, UK: Harrison. Retrieved 2 January 2008.
(7) Groves B (2002). "William Banting Father of the Low-Carbohydrate Diet" .
(8) Gordon E, Goldberg M, Chosy G (October 1963). " A New Concept in the Treatment of Obesity ". JAMA . 186 (1): 50-60.