Low Carbohydrate Diets

Richard D. Feinman, PhD, is Professor of Biochemistry at State University of New York Downstate Medical Center, co-editor-in-chief of the journal Nutrition & Metabolism, and Director of the Nutrition and Metabolism Society (www.nmsociety.org). Diabetes may be described as a disease of glucose intolerance: high blood glucose is both the characteristic indicator and the cause of complications. The loss of control of glucose metabolism is what makes a low carbohydrate diet a good therapeutic approach, and it's why I'm astonished that experts encourage people with diabetes to eat carbohydrates and then "cover" them with insulin [1]. I am also surprised to hear negative reactions to carbohydrate restriction from people who have actually seen the deleterious effects of high dietary carbohydrate on people with diabetes. On that note, I offer my personal rebuttal to Hope Warshaw's recent article, "Why You Don't Want to Go Low Carb or Vegan," April/May 2007. Ms. Warshaw's argument is that "avoiding carbohydrate, as some low carb diets suggest, does not entirely return blood glucose levels to the normal range after meals." Well, depending on the patient, sometimes blood glucose does return to normal. In any case, ingesting carbohydrate raises blood glucose.