Quackery in Medicine: Low-Carb Diets

Many people have heard of the Atkins diet in one way or another. Several of my family and friends went on this diet for a time, but found it hard to stick with the low-carbohydrate restrictions. After all, pasta and pizza are wonderful foods. The Atkins diet explains that people can lose weight by reducing their carbohydrate intake to 20 grams a day or less initially, then slowly raising them to levels to encourage ketosis. Carbohydrates include things like sugar, fruit, and grains.

Before we get into the possible ramifications of such a diet, let us examine the possible deficiencies that can result from such a diet. The B-complex vitamins are essential for life, especially for pregnant women. Folate, for instance, is necessary for neural tube development, and a deficiency can cause severe birth defects. In general, though, the B-complex vitamins are used for metabolism. They help break down foods and push them through the citric acid cycle, which produces a great amount of energy with each turn. Without these vitamins, you will feel more lethargic, which is why many 'energy' supplements contain large amounts of B-vitamins. B-vitamins are primarily found in whole grains, so cutting them from your diet means you need to take a supplement. Of course, this probably isn't covered when discussing the benefits of a low-carb diet.

Ketosis, some say, is "a normal physiological state caused by very normal and healthy body functions" by which the body breaks down fats and proteins and produces ketones as a result. In diabetics, ketosis is more commonly referred to as ketoacidosis. This occurs when the sugars of the blood cannot get into the cells (due to insulin resistance), and so the cells break down themselves for fuel. The resulting ketones lower the pH of the blood, causing it to become more acidic. This can lead to coma and death if not treated immediately.

Those who encourage ketosis in normal (non-diabetic) people claim that because the blood sugar levels remain consistent, ketoacidosis does not result. In fact, they claim, ketones are the "preferred fuel for the heart, outer part of the kidneys, and most areas of the brain."

First and foremost, that sentence is a lie. The brain requires glucose, which the simplest 6-carbon sugar, for fuel. Furthermore, glucose is the precursor to many neurotransmitters, such as acetylcholine and glutamate. When there is not glucose in the blood, the brain can use some ketones for energy, but not as efficiently, and it takes about two days of 'starvation' for adequate ketone levels to be produced. More often, when glucose is not available, loss of consciousness results, as is the case with hypoglycemia.

Of course, proponents of the Atkins diet will then say that your body can produce glucose, which it can. It breaks down fat and protein in an attempt to form glucose. Thus, by eating large amounts of fat and protein, you can keep your muscle mass up so you aren't breaking down your own body tissues. So, if you aren't eating enough protein to sustain your muscles, you could end up dying from a low-carb diet. After all, your heart is just as much of a muscle as your biceps. The heart also needs certain proteins to be at its optimum point. If you're using protein for energy, it takes away from being able to go towards what it was intended for: cellular regeneration.

Ketones are organic acids. Whether they lower your blood pH or not is mostly irrelevant (studies show they tend not to make non-diabetics have acidosis); they have to be excreted as waste one way or another. Most often, they are excreted through the urine (making your kidneys not so happy), as well as through your breath and sweat. Thus, people in ketosis tend to have a really bad body odor, which some describe as 'fruity' smelling. Since the absorption of glucose in a healthy person is near 100% and ketosis isn't nearly as efficient, someone on the Atkins, or similar, diet will excrete a whole lot of waste products, perhaps in some not-so-pleasant ways.

Bottom line: Your body needs energy to survive. The easiest source of energy is carbohydrates, because fats and proteins, while able to produce just as much or more energy, have other functions in the body. If you want to lose weight, keep a balanced diet and exercise program going for the long term. You won't lose a lot real fast, but you'll be healthy and will be more likely to keep the weight off long-term.