A brief history of low carb and keto movement

Trends and fads come and go.  Ideas rise in popularity when someone discovers something that works.  A few people apply this initial idea and get great results. 

In time, entrepreneurial people realise there is money to be made and scramble to sell things to make it ‘easier’ and ‘more enjoyable’.  Often these marketers play fast and loose with the facts (or don’t understand them to start with).

Later, once the benefits of the original insights become diluted, or more people move beyond the initial stage, where the idea works magically, the trend begins to die.  Before long, something fresh rises to take its place as people search for a new, quick and easy fix.

Over the years, there have been several iterations of low carb and keto, each with their own unique emphasis (e.g. ketones, insulin, protein, fat etc).  Before we dive into dissecting the dogma and conflicting theories in nutrition, I thought it would be useful to give you a quick tour of the different versions that have come and gone. 

See if you can spot the common themes and differences.

Banting

One of the earliest versions of low-carb was the ‘Banting Diet‘ prescribed to William Banting by Dr Harvey in 1862.  Harvey recommended a lower carb, protein-focused, whole food diet that became super popular in the day. 

The term ‘Banting’ made a comeback in 2014 (as shown in the chart from Google Trends below), spearheaded by South African Professor Tim Noakes who advocated a low-carb, high-fat version and was careful not to overemphasise protein to keep insulin levels low. 

Dr Richard Bernstein

My family owes a massive debt of gratitude to the work of Dr Richard Bernstein and his followers.  Dr Bernstein, who is thriving with Type 1 Diabetes at the age of 86, is an excellent example of the power of reducing carbs for people who are injecting insulin.  Dr B (as he is known by his followers) also walks the talk in terms of maintaining strength to maximise insulin sensitivity and resilience. 

Bernstein, who has had Type 1 Diabetes since he was 12, was initially trained as an engineer.  Through his wife, who was a doctor, he was able to obtain one of the first glucose meters in 1969 (pictured below). 

Bernstein, an avid self-experimenter, measured his blood sugars 6 times a day.  Over time, he gained an understanding of how much a certain amount of carbohydrate raised his blood glucose levels, and conversely, how much a certain amount of insulin lowered them. 

By reducing the carbohydrates in his diet, he was able to stabilise his blood sugars and insulin doses.  Bernstein’s early learnings formed the basis of the basal/bolus insulin dosing calculations built into the insulin pumps used today by most people with Type 1 Diabetes.

Bernstein initially published The Glucograf Method for Normalizing Blood Sugar in 1981.  At 45 years of age, he went to medical school and became a doctor to have his methods recognised.  He published Dr Bernstein’s Diabetes Low Carbohydrate Solution in 2005 and Dr Bernstein’s Diabetes Solution:  The Complete Guide to Achieving Normal Blood Sugars in 2011.

Bernstein’s recommended diet is protein-focused to promote the growth of lean muscle mass as well as non-starchy veggies to ensure you can get adequate micronutrients.   Dr Bernstein emphasises the importance of injecting sufficient insulin to maintain stable blood sugars after eating protein (i.e. about half as much as required for carbohydrates).

Bernstein’s approach to managing insulin and blood sugars revolves around ‘The Law of Small Numbers’.  That is, that large inputs of refined carbohydrates require large doses of insulin.  Due to the numerous variables involved, it is incredibly hard to precisely calculate the dosing of insulin needed for large amounts of carbohydrates. 

To illustrate what this looks like in practice, the chart below the blood sugars of someone with Type 1 Diabetes on a typical high-carb diet.  Reducing the inputs of nutrient-poor processed carbohydrates enables the minimisation of errors and reduces the wild swings in blood sugar and insulin dosing. 

The next chart shows the type of blood sugar control that can be achieved once the inputs of processed carbohydrates are reduced.  Once we reduce the variability in blood sugars, we can bring down the average blood sugar overall without fear or low blood sugars (hypoglycaemia).

Monica and I were fortunate enough to be introduced to the Type One Grit Facebook Group in 2015 and became believers after seeing the fantastic results that could be achieved for people living with Type 1 Diabetes. The changes in Moni’s blood sugars, mood, energy and weight as we have applied these principles have been life changing.  We are immensely grateful!

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  • Sue Davies says:

    Once again you manage to make the complex relatively simple and explanations make sense. Good reading – the book is amazing.

  • Wenchypoo says:

    For me, keto seemed to only work once–I initially lost 60 lbs. (while in menopause), but then it just slowly came creeping back, even though I remained eating keto. I still eat keto to this day, but have not experienced another “miracle” like I did the first time.

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