It’s no secret that our health can be directly impacted, both positively and negatively, by the food we consume. An unhealthy diet can bring forth many problems, some of which we have covered in previous articles, but generally speaking it can cause spikes in a person’s cholesterol, put them at risk of developing type 2 diabetes., and put them on a path toward obesity. On the other hand, a healthy, balanced diet allows a person to lead their ideal lifestyle and achieve personal fitness goals if they’re also following an exercise routine.
However, some health afflictions can present themselves even though a person is following a healthy diet and it may be because their body isn’t processing the micro or macronutrients appropriately. Underlying medical conditions can also alter how a person’s metabolism responds to food, which is why it’s important to talk to a doctor or nutritionist if you’re not noticing any positive changes. There are several restriction diets, we’ve covered the keto diet in another article, that have several goals according to the patient’s needs; for this article, we’ll talk about therapeutic carbohydrate restriction, what it means, and how to limit a person’s carbohydrate intake.
At LIMARP®, our medical team, led by Dr. Liza María Pompa González, counts with licensed nutritionists that can help you achieve your goals and make sure that you’re healthy despite any underlying medical conditions. They go over your medical history and talk with you about your expectations to create a nutrition plan that covers all your needs. They will also ensure that, if you do qualify for therapeutic carbohydrate restriction, that it’s carried out safely and that your overall health is not compromised by this.
As always, we’d like to remind you that the information in the following article concerning therapeutic carbohydrate restriction is general and that you shouldn’t apply any drastic changes to your diet without proper supervision by a nutritionist. If any of the information presented below resonates with you, make sure to contact your doctor first so that they can carry out a proper diagnosis and confirm if you’re eligible for therapeutic carbohydrate restriction.
Now, let’s delve into therapeutic carbohydrate restriction to get a better understanding of it.
Therapeutic Carbohydrate Restriction: What is it?
First of all, it’s very important to make the following clear: therapeutic carbohydrate restriction is not a diet, but rather a medical nutritional therapy[1], whose intent is to manage metabolic health conditions.
This restriction method can be useful for people who have diabetes, since several articles[2] have noted that the goal of therapeutic carbohydrate restriction is to reduce insulin levels to facilitate fat lipolysis, allowing a physiologic response in the body that mimics fasting. When the carbohydrate intake is restricted, insulin and glucose levels drop and trigger a cascade of reactions that lead to the use of an alternative fuel source. This can result in lower insulin levels, a diuretic effect, decreased hunger and subsequent reduction in intake even in the absence of a caloric restriction, and increased resting energy expenditure.
Now, what role do carbohydrates play in a person’s life?
Well, unlike amino acids, fatty acids, and many micronutrients, dietary carbohydrate is not required for human survival[3]. In fact, although some cells, such as red blood cells, white blood cells, and some parts of the kidney, require glucose, the body can produce enough glucose on its own to meet those needs. According to one study, despite the widespread belief that the brain can only run on glucose, the brain can run on both glucose and ketones[4].
You may be wondering if following therapeutic carbohydrate restriction means completely cutting back on carbs; well, that is not the case. “Carbohydrate restricted diets usually include some carbohydrates, but even if we eat no carbohydrates, the body provides us with all the glucose and energy we require as long as we eat enough fat and protein. As a result, a well-planned, carbohydrate-restricted diet will provide all the nutrients needed”.
All of these changes caused by therapeutic carbohydrate restriction, such as lowering fasting, postprandial blood glucose, insulin levels and resistance, can improve metabolic syndrome markers [5]. When it comes to reducing blood glucose levels, it’s necessary to restrict whole-grain starches and high-sugar fruits; in fact, it is highly recommended that patients starting therapeutic carbohydrate restriction monitor their glucose levels constantly.
So, which foods should you avoid while on therapeutic carbohydrate restriction?
Similar to the keto diet, you should cut back on bread, sweets, starchy vegetables, and some fruits. Other foods that should be limited on therapeutic carbohydrate restriction include:
- Apples, bananas, dates, and mangoes
- Corn, potatoes, yams, and cooked beets
- Pasta
- Cereals
- Beer
- Sweetened yogurt
- Beans and legumes
- Milk
One study[6] found that therapeutic carbohydrate restriction can help reduce the effects of metabolic syndrome, which may increase the risk of heart disease, stroke, and type 2 diabetes. in people with obesity.
To finish this article, we’d like to discuss the different levels of therapeutic carbohydrate restriction. However, we invite you to contact your doctor so that they can provide the proper care when starting therapeutic carbohydrate restriction; this change in your diet is pretty drastic, so it’s important that it’s carried out safely to avoid any type of health complications in the future.
A 2019 study[7] found that different degrees of carbohydrate restriction may result in different metabolic effects[8] and it provides the following example: “[…]while low-carbohydrate diets that provide more than 50 g of carbohydrates per day prevent dietary ketosis in most people, a very-low carbohydrate ketogenic diet that provides less than 50 grams carbohydrates per day typically leads to the production of measurable amounts of ketone bodies in the urine. The metabolic switch to ketosis may result in immediate side-effects like loss of appetite or in long-term side effects, such as kidney stones.”
This is just an example of many and, as we mentioned, you’re free to contact us through the information below if you have any lingering questions.
Contact Us to Learn More
If you want to learn more about therapeutic carbohydrate restriction, schedule an appointment with one of our doctors. We can help determine the right treatment for you. Contact us online anytime or give us a call at (619) 373-0229.
References
- [1] “Therapeutic Carbohydrate Restriction (or Reduction) & Diabetes”. https://www.waterloowellingtondiabetes.ca/userContent/documents/Professional-Resources/Therapeutic%20CHO%20Restriction%20HCPhandout%20Updates%202021Final.pdf (Accessed July 22, 2023).
- [2] Cucuzzella M, Hite A, Patterson,K, et al. A clinician’s guide to inpatient low-carbohydrate diets for remission of type 2 diabetes.: toward a standard of care protocol. Diabetes Management. 2019; 9(1), 7–19.
- [3] Chadwick, Joshua, et al. ‘Treating type 2 diabetes. with Therapeutic Carbohydrate Restriction’. Cardiovascular Diseases [Working Title], IntechOpen, 3 Nov. 2022. Crossref, doi:10.5772/intechopen.107184.
- [4] Trumbo P, Schlicker S, Yates AA, Poos M. Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein and amino acids. Journal of the American Dietetic Association. 2002;102(11):1621-1630
- [5] Volek JS, Feinman RD. Carbohydrate restriction improves the features of metabolic syndrome. Metabolic syndrome may be defined by the response to carbohydrate restriction. Nutrition and Metabolism. 2005;2:31
- [6] Hyde PN, Sapper TN, Crabtree CD, LaFountain RA, Bowling ML, Buga A, Fell B, McSwiney FT, Dickerson RM, Miller VJ, Scandling D, Simonetti OP, Phinney SD, Kraemer WJ, King SA, Krauss RM, Volek JS. Dietary carbohydrate restriction improves metabolic syndrome independent of weight loss. JCI Insight. 2019 Jun 20;4(12):e128308. doi: 10.1172/jci.insight.128308. PMID: 31217353; PMCID: PMC6629108.
- [7] Fechner E, Smeets ETHC, Schrauwen P, Mensink RP. The Effects of Different Degrees of Carbohydrate Restriction and Carbohydrate Replacement on Cardiometabolic Risk Markers in Humans-A Systematic Review and Meta-Analysis. Nutrients. 2020 Apr 2;12(4):991. doi: 10.3390/nu12040991. PMID: 32252374; PMCID: PMC7230871.
- [8] Brouns F. Overweight and diabetes prevention: is a low-carbohydrate-high-fat diet recommendable? Eur J Nutr. 2018 Jun;57(4):1301-1312. doi: 10.1007/s00394-018-1636-y. Epub 2018 Mar 14. Erratum in: Eur J Nutr. 2019 Apr 16;: PMID: 29541907; PMCID: PMC5959976.
