Diet and nutritionKeto or just fewer carbs—why make things difficult?
Sources: 16 · Article: 19 148 characters
The data described do not show that a ketogenic diet is necessary: benefits have also been reported with 80–90 g of carbohydrates per day.
- Here, keto means a stricter restriction: below 50 g per day, often below 20 g.
- Prof. David Ludwig notes that some people prefer gentler plans with slower-acting carbohydrates because they are easier to stick to.
- Benefits of restricting carbohydrates have been reported for type 2 diabetes, but ketosis has not been shown to be necessary.
What the authors write
Bracia Rodzeń
In a study, a diet providing 20% of energy from carbohydrates, or 80–90 g per day, was associated with improved diabetes control and weight.
„In the low-carbohydrate group, a follow-up assessment after 44 months showed continued improvements in HbA1c and body weight, and a reduction in diabetes medication.
Nutrition & Metabolism 2008: A low-carbohydrate diet in type 2 diabetes. Stable improvement in body weight and glycemic control over 44 months of follow-up.”W grupie niskowęglowodanowej, ocena kontrolna po 44 miesiącach wykazała ciągłą poprawę HbA1c, masy ciała i redukcję leków przeciwcukrzycowych.
Odżywianie i metabolizm 2008: Dieta niskowęglowodanowa w cukrzycy typu 2. Stabilna poprawa kontroli masy ciała i glikemii w ciągu 44 miesięcy obserwacji.
Bracia Rodzeń
A review of studies points to benefits of restricting carbohydrates in type 2 diabetes, and includes a diet providing 90 g per day.
„LINK – takes you to the source
A 2017 meta-analysis found that a low-carbohydrate diet reduced the need for medication and improved metabolic health indicators (HbA1c, HDL, TG, and blood pressure). The authors concluded: “Reducing the amount of carbohydrates in the diet may lead to clinical improvements in the treatment of type 2 diabetes”:
European Journal of Clinical Nutrition 2017: Interpretation and impact of a low-carbohydrate diet in the treatment of type 2 diabetes.”LINK – przenosi do źródła
Metaanaliza z 2017 roku wykazała, że dieta niskowęglowodanowa spowodowała zmniejszenie zapotrzebowania na leki i poprawę wskaźników zdrowia metabolicznego (HbA1c, HDL, TG i ciśnienia krwi). Autorzy doszli do wniosku, że: „Zmniejszenie ilości węglowodanów w diecie może przynieść kliniczną poprawę w leczeniu cukrzycy typu 2”:
European Journal of Clinical Nutrition 2017: Interpretacja i wpływ diety niskowęglowoda-nowej w leczeniu cukrzycy typu 2.
Bracia Rodzeń
In one study, a low-carbohydrate diet meant fewer than 40 g per day and resulted in greater weight loss than a low-fat diet.
„In addition to losing 3.5 kg more than the low-fat group, the low-carbohydrate group also had greater improvements in high-density lipoprotein (HDL) cholesterol, triglycerides (TG), and other cardiovascular risk factors.
LINK – takes you to the source
Comparison of the Atkins, Zone, Ornish, and LEARN diets for weight change and related risk factors in overweight premenopausal women.”Oprócz utraty 3,5 kg więcej niż grupa o niskiej zawartości tłuszczu, grupa niskowęglowodanowa miała również większą poprawę w zakresie cholesterolu o wysokiej gęstości (HDL), trójglicerydów (TG) i innych czynników ryzyka chorób układu krążenia.
LINK – przenosi do źródła
Porównanie diet Atkins, Zone, Ornish i LEARN pod kątem zmiany wagi i powiązanych czynników ryzyka u kobiet przed menopauzą z nadwagą.
Bracia Rodzeń
Restricting carbohydrates to below 50 g per day, often below 20 g, is described as the main principle of this way of eating.
„The main principle of this lifestyle is to limit carbohydrates to below 50 g/day, often below 20 g/day.
By gradually lowering your carbohydrate intake, you increase the amount of high-quality protein and fat you eat (until you feel full). This puts your body into a metabolic state called ketosis, in which fat from food and the body is burned for energy.”Główną zasadą tego stylu życia jest ograniczenie węglowodanów do poniżej 50 g/dobę, często poniżej 20 g/dobę.
Obniżając stopniowo ilość spożywanych węglowodanów, zwiększasz ilość wysokiej jakości białka i tłuszczu (do sytości). W wyniku takiego postępowania, wprowadzasz organizm w stan metaboliczny zwany ketozą, w którym tłuszcz pochodzący z diety i ciała jest spalany w celu uzyskania energii.
Bracia Rodzeń
The same description says that gradually restricting carbohydrates leads to ketosis, in which fat is used for energy.
„By gradually lowering your carbohydrate intake, you increase the amount of high-quality protein and fat you eat (until you feel full). This puts your body into a metabolic state called ketosis, in which fat from food and the body is burned for energy.”Obniżając stopniowo ilość spożywanych węglowodanów, zwiększasz ilość wysokiej jakości białka i tłuszczu (do sytości). W wyniku takiego postępowania, wprowadzasz organizm w stan metaboliczny zwany ketozą, w którym tłuszcz pochodzący z diety i ciała jest spalany w celu uzyskania energii.
Bracia Rodzeń
According to this description, eating below 20 g of carbohydrates per day is said to practically guarantee ketosis.
„Reducing carbs to below 20 g a day practically guarantees ketosis;
add #healthyNOTeating16to8 — 16 hours without eating may help you get into ketosis faster. This can be done easily by simply skipping breakfast or dinner, which may feel very natural on a ketogenic diet because you will feel less hungry;
don’t be afraid of good-quality fat.”Obniżając węgle poniżej 20 g dziennie, praktycznie gwarantuje osiągnięcie ketozy;
dołącz #zdroweNIEjedzenie16na8 - 16 godzin bez jedzenia może pomóc w szybszym wejściu w ketozę. Można to łatwo zrobić, po prostu pomijając śniadanie lub kolację, co może wydawać się bardzo naturalne na diecie ketonowej, ponieważ będziesz odczuwać mniejszy apetyt;
nie bój się dobrej jakości tłuszczu.
Bracia Rodzeń
After restricting carbohydrates for one or two days, glucose stores are said to run out and the liver to increase ketone production.
„However, when you lower your carbohydrate intake for one to two days, these glucose stores run out.
Your liver regularly produces ketones, even when you eat a higher-carbohydrate diet. This happens mainly at night while you sleep, but only in small amounts.”Jednak, kiedy obniżysz spożycie węglowodanów przez jeden do dwóch dni, te zapasy glukozy wyczerpują się.
Twoja wątroba regularnie produkuje ketony, nawet podczas spożywania diety o wyższej zawartości węglowodanów. Dzieje się to głównie w ciągu nocy podczas snu, ale tylko w niewielkich ilościach.
Bracia Rodzeń
Bracia Rodzeń writes that the brain can function even without eating carbohydrates.
„We still hear dietitians say: “You need to eat about 130 g of carbohydrates a day for your brain to function properly.”
But that is not true. In fact, your brain will remain healthy and functional even if you do not eat any carbohydrates at all. Yes, that’s right—your brain does not need carbohydrates. We’re very sorry if your worldview has just collapsed.”Nadal spotykamy się z opiniami dietetyków: “Żeby mózg prawidłowo funkcjonował, potrzeba spożywać około 130 g węglowodanów dziennie”.
Jednak tak nie jest. W rzeczywistości Twój mózg pozostanie zdrowy i funkcjonalny, nawet jeśli w ogóle nie jesz węglowodanów. Tak, tak - węglowodany nie są potrzebne Twojemu mózgowi. Przykro nam bardzo, jeżeli Twój światopogląd właśnie runął.
prof. David Ludwig
Some people do well on strict low-carbohydrate or ketogenic diets, while others find plans with slower-acting carbohydrates easier to maintain.
„While some people find great success by following strict “low carb” or ketogenic diet plans, others find sticking with Phase 1 or 2 slow carbs more sustainable. See our post on Keto vs AH for more on ultra low carb diets.
Guiding you to listen to your body is key here.”While some people find great success by following strict “low carb” or ketogenic diet plans, others find sticking with Phase 1 or 2 slow carbs more sustainable. See our post on Keto vs AH for more on ultra low carb diets.
Guiding you to listen to your body is key here.
prof. David Ludwig
Too few carbohydrates may cause mental fog and fatigue, and it can take several weeks to get into ketosis.
„It can also increase cravings and lead to the yo-yoing that we work so hard to leave behind. The adjustment period to get into ketosis can be a few weeks, and staying in it requires discipline. Just proceed with caution.
And if you stay in Phase 1 or 2 remember to add your slow carb to each meal.”It can also increase cravings and lead to the yo-yoing that we work so hard to leave behind. The adjustment period to get into ketosis can be a few weeks, and staying in it requires discipline. Just proceed with caution.
And if you stay in Phase 1 or 2 remember to add your slow carb to each meal.
prof. David Ludwig
Available research suggests possible benefits of low-carbohydrate diets, but more research is needed.
„Indeed, among the relatively few studies with adequate numbers of participants lasting more than 3 weeks, there is some evidence for an advantage of low-carbohydrate diets for metabolism, and possibly body composition (the relative amounts of fat to lean tissue), but we need more research to know for sure.”Indeed, among the relatively few studies with adequate numbers of participants lasting more than 3 weeks, there is some evidence for an advantage of low-carbohydrate diets for metabolism, and possibly body composition (the relative amounts of fat to lean tissue), but we need more research to know for sure.
prof. David Ludwig
Prof. David Ludwig says that low-carbohydrate diets are currently not recommended for type 1 diabetes because of the risk of complications.
„However, low-carbohydrate diets are currently not recommended for T1DM, in which the body can’t make any insulin, for fear of complications like ketoacidosis, severe hypoglycemia and poor growth in children. This, despite the fact that an ultra-low-carbohydrate/high-fat diet was the most effective treatment for severe diabetes before insulin was discovered.”However, low-carbohydrate diets are currently not recommended for T1DM, in which the body can’t make any insulin, for fear of complications like ketoacidosis, severe hypoglycemia and poor growth in children. This, despite the fact that an ultra-low-carbohydrate/high-fat diet was the most effective treatment for severe diabetes before insulin was discovered.
Hubert Czerniak
For treating allergies, Hubert Czerniak recommends a ketogenic diet and gives very low proportions of energy from carbohydrates for the 4:1 version.
„For treating allergies, it is worth using a ketogenic diet, which puts the body into a natural metabolic state called nutritional ketosis. The ketogenic diet should begin with two days of fasting, preferably on water with a pinch of Kłodawa salt. The ratio of nutrients in the diet is 4:1 or 3:1.”W leczeniu alergii warto stosować dietę ketogenną, która sprawia, że organizm wchodzi w naturalny stan metaboliczny, zwany ketozą odżywczą. Dietę ketogenną należy rozpocząć od dwóch dni głodówki, najlepiej na wodzie ze szczyptą soli kłodawskiej. Stosunek składników pokarmowych w diecie wynosi 4:1 lub 3:1.
Hubert Czerniak
For treating allergies, Hubert Czerniak recommends a ketogenic diet and gives very low proportions of energy from carbohydrates for the 4:1 version.
„For treating allergies, it is worth using a ketogenic diet, which puts the body into a natural metabolic state called nutritional ketosis. The ketogenic diet should begin with two days of fasting, preferably on water with a pinch of Kłodawa salt. The ratio of nutrients in the diet is 4:1 or 3:1.”W leczeniu alergii warto stosować dietę ketogenną, która sprawia, że organizm wchodzi w naturalny stan metaboliczny, zwany ketozą odżywczą. Dietę ketogenną należy rozpocząć od dwóch dni głodówki, najlepiej na wodzie ze szczyptą soli kłodawskiej. Stosunek składników pokarmowych w diecie wynosi 4:1 lub 3:1.
Bracia Rodzeń
Bracia Rodzeń describes a study of a ketogenic diet involving about 330 people, in which most participants reduced or stopped using insulin.
„LINK – takes you to the source
A study of a low-carbohydrate ketogenic diet involving about 330 people found that within one year, 97 percent of participants reduced or stopped using insulin. In addition, 58% no longer had a diabetes diagnosis; in other words, they had reversed their disease.”LINK – przenosi do źródła
Badanie diety ketogenicznej o niskiej zawartości węglowodanów, z udziałem około 330 osób wykazało, że w ciągu jednego roku 97 procent uczestników zmniejszyło lub zaprzestało stosowania insuliny. Ponadto 58% nie miało już diagnozy cukrzycy; innymi słowy, odwrócili swoją chorobę.
Bracia Rodzeń
Bracia Rodzeń links higher carbohydrate intake to a greater risk of weight gain and metabolic diseases.
„The more carbohydrates in your food, the faster and more you will gain weight and develop insulin resistance and other metabolic diseases.
obesity/insulin resistance,
metabolic diseases (type 2 diabetes, fatty liver, high blood pressure, PCOS, and many cancers).”Im więcej węglowodanów w Twoich pokarmach, tym szybciej i bardziej przytyjesz, zachorujesz na insulinooporność i inne choroby metaboliczne.
otyłość/insulinooporność,
choroby metaboliczne (cukrzyca typu 2, stłuszczenie wątroby, nadciśnienie tętnicze, PCOS, liczne nowotwory).
M. Williamson i N. Moustaid-Moussa i L. Gollahon
M. Williamson, N. Moustaid-Moussa, and L. Gollahon describe possible benefits of reducing glucose and carbohydrates, and of a ketogenic diet, for several health problems.
„Reduction of glucose, energy/calorie restriction, and ketogenic diet can be beneficial in reducing visceral fat accumulation, ROS generation, lipid peroxidation, symptoms of diabetes, hypertension, and even COVID-19 complications. It has been suggested that reducing glucose and carbohydrates by ketogenic diet can reduce the amount of energy produced from aerobic glycolysis and therefore switch metabolism to be more advantageous to non-inflammatory phenotype or M2 macrophages ().”Reduction of glucose, energy/calorie restriction, and ketogenic diet can be beneficial in reducing visceral fat accumulation, ROS generation, lipid peroxidation, symptoms of diabetes, hypertension, and even COVID-19 complications. It has been suggested that reducing glucose and carbohydrates by ketogenic diet can reduce the amount of energy produced from aerobic glycolysis and therefore switch metabolism to be more advantageous to non-inflammatory phenotype or M2 macrophages ().
Research from PubMed · Europe PMC
We selected 5 studies with the best, positive results. This is a selection, not a full review of all research.
Total number of studies on this topic in PubMed: 909.
In a 12-week study, restricting simple sugars reduced fat mass without requiring a ketogenic diet.
Aim of the study: Restricted sugar and ketogenic diets can alter energy balance/metabolism, but decreased energy intake may be compensated by reduced expenditure. In healthy adults, randomization to restricting free sugars or overall carbohydrates (ketogenic diet) for 12 weeks reduces fat mass without changing energy expenditure versus control.
Results: In contrast, a ketogenic diet decreases glucose tolerance, increases skeletal muscle PDK4, and reduces AMPK and GLUT4 levels. By week 4, the ketogenic diet reduces fasting glucose and increases apolipoprotein B, C-reactive protein, and postprandial glycerol concentrations. However, despite sustained ketosis, these effects are no longer apparent by week 12, when gut microbial beta diversity is altered, possibly reflective of longer-term adjustments to the ketogenic diet and/or energy balance. These data demonstrate that restricting free sugars or overall carbohydrates reduces energy intake without altering physical activity, but with divergent effects on glucose tolerance, lipoprotein profiles, and gut microbiome.
Money for the studycompany together with others · Medical Research Council, British Heart Foundation
Do the authors have ties to companies?yes — the authors reported it
Did a manufacturer help with the study?YES
Type of studystudy with random allocation to groups (RCT)
“Not stated” does not mean nobody paid — the database does not always record it.
A review suggests that restricting carbohydrates alone may improve glycemic control, although the evidence is limited and varied.
Aim of the study: Despite advances in technology, the overall management of type 1 diabetes mellitus (T1DM) remains suboptimal. The idea of restricting carbohydrate intake to decrease glycemic spikes and insulin requirements has been revisited in recent years.
Results: In general, carbohydrate restriction enhances glycemic control by reducing postprandial glucose excursions, improving time-in-range, and lowering HbA1c, with conflicting effects on other parameters such as lipid profile and body weight. Adverse effects such as hypoglycemia and diabetic ketoacidosis are rarely reported, although some concerns have been raised regarding growth in children. The correct implementation of these diets requires a multidisciplinary approach by highly specialized healthcare professionals, who will address the medical, social, and psychological concerns that a restrictive diet entails. Large-scale and long-term studies are needed to provide more robust data before carbohydrate restriction can be widely applied to patients with T1DM.
Money for the studynot stated
Do the authors have ties to companies?no — the authors say so
Did a manufacturer help with the study?NO
Type of studydiscussion of other studies
“Not stated” does not mean nobody paid — the database does not always record it.
A review describes the benefits of carbohydrate-restricted diets for diabetes, but does not directly compare their effectiveness with that of a ketogenic diet.
Aim of the study: The inability of current recommendations to control the epidemic of diabetes, the specific failure of the prevailing low-fat diets to improve obesity, cardiovascular risk, or general health and the persistent reports of some serious side effects of commonly prescribed diabetic medications, in combination with the continued success of low-carbohydrate diets in the treatment of diabetes and metabolic syndrome without significant side effects, point to the need for a reappraisal of dietary guidelines.
Results: They represent the best-documented, least controversial results. The insistence on long-term randomized controlled trials as the only kind of data that will be accepted is without precedent in science. The seriousness of diabetes requires that we evaluate all of the evidence that is available. The 12 points are sufficiently compelling that we feel that the burden of proof rests with those who are opposed.
Money for the studynot stated
Do the authors have ties to companies?not stated
Did a manufacturer help with the study?unknown
Type of studydiscussion of other studies
“Not stated” does not mean nobody paid — the database does not always record it.
With similar prescribed energy intake, a ketogenic diet was associated with slightly greater weight loss than a diet higher in carbohydrates.
Aim of the study: Background/Objectives: Whether ketogenic diets provide greater weight-loss benefits than higher-carbohydrate diets when prescribed energy intake or targeted energy deficit are comparable remains uncertain. This systematic review and meta-analysis evaluated their effects on body weight change in adults with overweight or obesity.
Results: In three trials meeting the prescribed protein-matching criterion, the effect remained directionally consistent but was imprecise and compatible with no difference. Certainty of evidence was low because of risk of bias and imprecision. Conclusions: Under comparable prescribed energy conditions, ketogenic diets may produce a small additional reduction in body weight. However, predominantly short-term evidence, uncertainty regarding achieved energy and protein intakes, the absence of a synthesis of body composition, and low certainty of evidence limit confidence in the magnitude, durability, and clinical significance of this advantage.
Money for the studynot stated
Do the authors have ties to companies?no — the authors say so
Did a manufacturer help with the study?NO
Type of studycombined analysis of many studies (meta-analysis)
“Not stated” does not mean nobody paid — the database does not always record it.
In the cases described, reintroducing a moderate amount of carbohydrates was associated with a substantial drop in LDL and ApoB without lipid-lowering medication.
Aim of the study: The lean mass hyper-responder (LMHR) phenotype describes marked increases in low-density lipoprotein cholesterol (LDL-C) and apolipoprotein B (ApoB) during carbohydrate-restricted ketogenic diets, usually in lean, metabolically healthy individuals with high high-density lipoprotein cholesterol and low triglycerides.
Results: These cases suggest that ketogenic diet-associated severe hypercholesterolemia may extend beyond classical LMHR criteria and can closely mimic FH. Dietary patterns, weight trajectory, and secondary causes should be assessed before assigning an FH diagnosis. Because ApoB-containing lipoproteins are causal in atherosclerosis, severe diet-induced ApoB elevation should not be assumed to be benign.
Money for the studynot stated
Do the authors have ties to companies?not stated
Did a manufacturer help with the study?unknown
Type of studyother
Participants3
“Not stated” does not mean nobody paid — the database does not always record it.
Perspectives and opinion materials
The content below presents the authors’ opinions, interpretations and hypotheses. It is not treated as equal to scientific studies and systematic reviews.
Orthomolecular Medicine News Service Opinion material
„Mitoprotective dietary approaches for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Caloric restriction, fasting, and ketogenic diets. Med Hypotheses 85, 690-693 (2015). 38. Brockhoff, J. D., Bereswill, S. & Heimesaat, M. M. The impact of ketogenic diet on the onset and progression of multiple sclerosis. Eur J Microbiol Immunol (Bp) 13, 29-36 (2023). 39. Pathak, S. J. & Baar, K. Ketogenic Diets and Mitochondrial Function: Benefits for Aging But Not for Athletes. Exerc Sport Sci Rev 51, 27-33 (2023). 40. Ahn, Y. et al.”Mitoprotective dietary approaches for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Caloric restriction, fasting, and ketogenic diets. Med Hypotheses 85, 690-693 (2015). 38. Brockhoff, J. D., Bereswill, S. & Heimesaat, M. M. The impact of ketogenic diet on the onset and progression of multiple sclerosis. Eur J Microbiol Immunol (Bp) 13, 29-36 (2023). 39. Pathak, S. J. & Baar, K. Ketogenic Diets and Mitochondrial Function: Benefits for Aging But Not for Athletes. Exerc Sport Sci Rev 51, 27-33 (2023). 40. Ahn, Y. et al.
Orthomolecular Medicine News Service Opinion material
„Dietary Composition: Studies suggest that diets low in carbohydrates, such as ketogenic or low-carbohydrate high-fat (LCHF) diets, may enhance vitamin D status. These diets often include higher amounts of vitamin D-rich foods, which may contribute to better overall vitamin D levels compared to high carbohydrate diets (32,33).”Dietary Composition: Studies suggest that diets low in carbohydrates, such as ketogenic or low-carbohydrate high-fat (LCHF) diets, may enhance vitamin D status. These diets often include higher amounts of vitamin D-rich foods, which may contribute to better overall vitamin D levels compared to high carbohydrate diets (32,33).
Orthomolecular Medicine News Service Opinion material
„Noakes TD, Windt J (2017) Evidence that supports the prescription of low-carbohydrate high-fat diets: a narrative review. Br J Sports Med. 51:133-139. Boal AH, Kanonidou C (2024) The Ketogenic Diet: The Ke(y) - to Success? A Review of Weight Loss, Lipids, and Cardiovascular Risk. J Cardiol Cardiovasc Med. 9:052-057. Dyńka D, Kowalcze K, Charuta A, Paziewska A (2023) The Ketogenic Diet and Cardiovascular Diseases. Nutrients, 15:3368. Sharman MJ, Kraemer WJ, Love DM, et al. (2002) A ketogenic diet favorably affects serum biomarkers for cardiovascular disease in normal-weight men. J Nutr. 132:1879-1885.”Noakes TD, Windt J (2017) Evidence that supports the prescription of low-carbohydrate high-fat diets: a narrative review. Br J Sports Med. 51:133-139. Boal AH, Kanonidou C (2024) The Ketogenic Diet: The Ke(y) - to Success? A Review of Weight Loss, Lipids, and Cardiovascular Risk. J Cardiol Cardiovasc Med. 9:052-057. Dyńka D, Kowalcze K, Charuta A, Paziewska A (2023) The Ketogenic Diet and Cardiovascular Diseases. Nutrients, 15:3368. Sharman MJ, Kraemer WJ, Love DM, et al. (2002) A ketogenic diet favorably affects serum biomarkers for cardiovascular disease in normal-weight men. J Nutr. 132:1879-1885.
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