Is it the Fat or is it the Carb that is making you Unhealthy – Depends on your metabolism!

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Personalized Nutrition – Role of  Fat, Carbohydrate and Protein

Fat and Protein are essential macro-nutrients. However, tasty, sustainable Indian meal needs a balance of Carbs, Fat and Protein and spices !

In our last blog post, we discussed the importance of weight management and keeping your waistline trim to avoid or reverse serious chronic diseases that plague South Asians more than other ethnic groups.

The #1 question regarding weight management I often get asked is: What should I eat? What diet is good for me? Low Fat or Low Carb ..or Mediterranean?  Paleo, Atkins, Zone, or perhaps I should follow the National nutritional guidelines for heart risk, diabetes? There are numerous diet books ranging from Dr. Atkins to Dr. Ornish, who recommend conflicting, opposite, diet plans and swear that their plan is effective for EVERYONE.

Indian meal – Low Fat or Low Carb?

Supposedly healthy “typical” Indian weight management diet (1,400-1,600 calories) tends to be “Low FAT” and high in CARBS.

Over the last 25 years, we have been told that eating less fat, more fruits and  less meat is good for Everyone! Really !!?? Well let’s find out>>

We have switched to low-fat milk, oats, orange juice, brown rice, Whole wheat roti, quinoa, dal, chicken curry and spinach sabzi cooked in less oil, no ghee, salad and fruits. All this typically adds up to +200 gms of carbohydrates daily providing ~ 50% of the total calories. The rest 15% comes from protein and 25% from fat. I am assuming you have already cut back on sugary drinks,  starchy carbs, refined sugar, deep fried carbohydrate-rich pakoras and toxic trans fat rich packaged snacks. This diet has probably worked for some of you,  but clearly has not worked for many of you. Why?

The advice has not worked for many of us as obesity rates have gone up 600% over the last 30 years!

 The Era of Low- Fat may be coming to an end.. Long Live Low-Carb?

While  ‘Low-FAT’ diet was the dominant public health recommendation for weight loss, good health and weight control for the past several decades, the obesity epidemic, cardiac disease and diabetes has continued to grow during this time period for Indians and South Asians living around the world.

Recently, there is a lot of discussion around ‘low-carbohydrate’ (Low-Carb) diet approach – its value, its risk. Although originally dismissed and even vilified, Low Carb meals have been rigorously and comparatively tested in a series of research studies over the past 15 years. Low-Carb diets have have been found to be as effective, if not more, as the Low-Fat approach for weight loss and for several related metabolic health markers that impact Indian’s heart risks and diabetes risk.

A systematic review of data from over 1,100 obese people across 17 clinical investigations showed that “LOW CARB” diets are an effective weight loss strategy.

It resulted in, on an average, significant  reduction of:

  1. Body Weight (−7.04 kg/~15 lbs)

  2. Waist Circumference (−5.74 cm/2.2 inches)

  3. BMI (−2.09 kg/m2) (click on the link to Check your BMI)

  4. Blood Pressure

  5. Triglycerides – Fat stored in your body for energy

  6. It resulted in significant Increase of the  “good cholesterol”-  HDL

  7. And “bad Cholesterol” – LDL cholesterol did not go up significantly.

Another analysis of over 1,200 people compared Low CARBohydrate diets vs. Low FAT/low calorie diets found that those on a Low CARBohydrate diet lost more weight and saw improvement in key health markers “…there were significant differences between the groups ( Low fat vs Low carb) for weight, cholesterol, triglycerides and blood pressure, favoring the low-carbohydrate diet.” There was a higher attrition rate in the low-fat compared with the low-carbohydrate groups suggesting a patient preference for a low-carbohydrate/high-protein approach as opposed to the Public Health preference of a low-fat/high-carbohydrate diet.

A-Z Study 

Perhaps the most interesting research was a year-long clinical trial conducted at Stanford University few years ago. 300 overweight, premenopausal women from the Bay Area were split into 4 groups and each group was asked to follow one of the 4 popular diet programs – Atkins, ZONE, LEARN and Ornish for a period of one year and their weight and key health markers were tracked after 8 weeks, 6 months and one year.

    1. Atkins diet (Low CARBohydrate, high protein, high fat),
    2. Zone (40% carbohydrate, 30% protein, 30% fat),
    3. National Guidelines (55-60% carbohydrate, less than 10% of energy from saturated fat, and overall calorie restriction),
    4. Ornish (Low FAT 10% or less of energy from fat) diets.

Here are  the key findings:

A) Not Surprising… It is Hard for People to Stay on Extreme Diets – Either Low Carb or Low Fat

People on Low-Carb/Atkins Diet started eating more Carbs and Less Fat than recommended in the book.

Source:http://jama.jamanetwork.com/article.aspx?articleid=205916

And People on Low Fat/Ornish diet ended  up eating more FAT!

Source:http://jama.jamanetwork.com/article.aspx?articleid=205916

B) Low Carb Diet Works Better than Low Fat…( on an Average )

Still after six months, the group on a Low CARBohydrate diet (Atkins), on an average, lost the most weight and the loss was statistically significant than the baseline weight and lower than the other three diets. For the other three groups, the weight loss was not statistically lower from the baseline weight the people started their diet.

OK!  So should we ALL switch to a LOW Carb diet? NO. Because you are not an Average and one size diet does NOT fit all ..

C) Food Needs to be Personalized; Because You’re Not an Average…

Here is the more interesting part of the research that provides compelling and ever increasing evidence for  a) the need, and b) the differential effectiveness of personalized nutrition based on your metabolic markers on weight management and good health management.

As you dig deeper into the Stanford research, look beyond the group averages,  and chart out weight loss for each of the 300 individuals, a very different story emerges. The heterogeneity of individual responsiveness to weight-loss diets is substantial.

Source: http://www.nature.com/ijosup/journal/v2/n1s/full/ijosup20124a.html

a) While on an average the group on Low Carb, High Fat/Protein diet lost more than 6 Kgs; there were individuals within the group who gained  over 8 Kgs on the same diet!

b) Simultaneously while the group on Low Fat/High Carb diet, on an average did not significantly lose weight,   there were people in the group who lost more than 10Kg eating Low Fat diet and people who gained weight 8 Kg eating Low Fat diet!

So individuals are unique and this uniqueness extends to how they respond to foods they eat. This is one of the key tenets of Ayurveda . There is strong emerging modern scientific evidence that how YOU  respond to food is based on metabolic uniqueness which is based on your underlying genes and the food interaction.

So how do I determine which diet .. Low Carb or Low Fat, No ghee, or more coconut oil is good for me? Research has isolated key metabolic markers that seem determine if you should be a Low- Fat or a Low-Carb meal person.  I will deep dive into it  with detailed evidence in my next blog.

DNA Take Home

  1. Belly fat is particularly dangerous for Indians. Just a small amount of excess circumference can put you at risk.
  2. A waist size of more than 90 cms ( 35″) in men and more than 80 cms (31″) in women are considered unhealthy.
  3. The right personalized nutrition can  significantly improve and protect  your health.
  4. Doing extreme diets – very low fat or very low carb –  is not a sustainable health or weight management approach.
  5. Map your diet to your body and you have the best chance of success and better health!
  6.  Do not assume a Low Fat diet (less oil, less ghee, token brown rice, fat free milk) is best way to manage weight and waist. Your metabolic markers will help you decide what the right balance  of Fat, Carbs and Protein  should be for you.

Avoid the Nutritional Whitewash. Understand your unique metabolism through a simple blood draw. Here are your choices:

If you live in the United States, you can set up a screening and lifestyle phone consult at

For International scheduling, you can contact Stanford South Asian Translational Heart Initiative at +1 650-723-8561 or email ssathiclinic@stanford.edu

  • Or a local physician in your town or city.

These results will help you determine the best nutritional regimen ( Low Fat or Low Carb or High Protein) YOU need to follow to manage your weight and lower your health risk. There is increasing evidence that mapping/personalizing your nutrition to your metabolic markers is key to counteracting these chronic conditions in Indians and South Asians. Despite your genetic susceptibility, your health can still benefit dramatically from lifestyle changes.

Stay Informed. Stay Healthy!

Notes:

Source: Sample Meal; http://aapiusa.org/Resources/Resources/ArticleID/97/Indian-Foods-AAPIs-Guide-to-Nutrition-Health-and-Diabetes-2nd-Edition

3 COMMENTS

  1. Hi

    Thanks for this great article. I was about to start my low carb diet, when this article just warned me not go too far down the line.

    Keep up the great work

    • Sashi,
      There is a link in this article where you can get your BMI
      Your BMI ( Body Mass Index) is normally a good indicator if you will benefit from a Low carb diet. If your BMI is > 24 you may benefit from Low carb diet.
      I will follow up with a more detailed blog.. but if you have Triglyceride/HDL Ratio >3.5 or have diagnosed pre diabetic condition you have a higher chance of benefiting from Low carb diet vs Low Fat diet . I suggest you consult with a doctor for a simple blood draw.

  2. Hi,
    I also want to know about your thoughts on hypothyroidism/hashimotos. I have a TSH above 4.5 and suffer from issues like tiredness, sleepiness, lethargy and body aches when I get up from sleep. I do have metabolic syndrome with high TG (above 230), belly fat though I am lean (57 kg, 40 yrs of age, South Indian). I also have low Vitamin D (around 16). Are all these linked? Please enlighten.

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