‘WILL I BE DEFICIENT IN CERTAIN NUTRIENTS IF I DON’T EAT CARBS?
AND 3 OTHER READER QUESTIONS FOR DR SCHOONBEE
Dr Schoonbee answers your questions
Q: Will I be deficient in certain nutrients if I don’t eat carbs? I was told to eat everything in moderation. A: I completely understand why you ask this question – we’ve heard so much contradictory nutritional information over the years that we aren’t sure who or what to believe anymore. What we do know is that there are three macronutrients that provide energy: protein, carbohydrates and fats. We need all three to survive but our bodies are able to ‘make’ sugar (carbs) out of fat and to use ketones as an energy source in the absence of glucose. On the other hand, our bodies can’t make all the building blocks needed for proteins and fats. That’s why the building blocks for protein are called essential amino acids and the building blocks for fats are called essential fatty acids. We have to get these via our diet; without them, we’ll die.
There are examples and early studies of people who have survived on a zero-carb diet for over a year without compromising their health but there have been no long term studies. We recommend a low-carb lifestyle to keep insulin levels low, which also reduces inflammation and the risk of metabolic syndrome.
Q: I weigh 168kg. I’m considering bariatric surgery because I was told I could lose a lot of weight this way but I’d have to adopt a healthy long-term lifestyle to maintain the weight loss. Would you recommend low carb? A: Before deciding to have bariatric surgery it is important to take the possible health risks of such a major procedure into account. Possible complications include bleeding and sepsis and, in the long term, complications such as dumping syndrome (causing diarrhoea, nausea or vomiting), malnutrition, bowel obstruction, gallstones, ulcers and stomach perforation. You should definitely look at other options that can help you to achieve the same goals of weight loss and healthier living.
I have personally followed a low-carb lifestyle for more than five years and have witnessed many instances of miraculous levels of weight loss in my patients – some of them have halved their own weight. I’d advise you to follow the low-carb lifestyle too. It is healthy and, above all, sustainable, which is how it differs from other diets that I have tried before.
Watch the video ‘Brian’s incredible story of weight loss’ on YouTube or read Brian Berkman’s inspiring story in the first issue of LOSE IT! Brian was in your exact position and managed to lose the weight that he needed to solely through following a low-carb diet.
Q: I have eczema on my scalp and I started following a lowcarb diet as I heard it could help. However, I haven’t really noticed an improvement. Does this mean I need to adjust my carb levels or are there other factors to consider? What else can I do to relieve it? A: There are many different causes of eczema so one has to find and treat the cause, if possible. A very common type is atopic eczema, which develops due to an autoimmune response. It is common in ‘atopic’ families with a history of allergic conditions such as hay fever, asthma and migraines and these patients will all benefit from a low-carb diet.
In adults the most common eczema of the scalp is called seborrheic dermatitis, which can cause chronic itchiness and dry scaliness (dandruff). It is believed that this skin condition is caused by an allergic reaction of the skin to the presence of fungi and their metabolites. This is why it is also treated with an antifungal ketaconazole shampoo. Another possible cause of scalp eczema is contact dermatitis triggered by certain shampoos or soaps, in which case you should avoid using these shampoos.
Q: I’ve recently been diagnosed with diverticulitis. Can a low-carb lifestyle help with managing this or will it make it worse? A: To understand the effects of diet on diverticulitis it’s important to explain the difference between diverticulosis and diverticulitis.
Diverticulosis is common in the elderly (70% of octaganarians will have these little bulging pouches protruding from the wall of the distal colon, which is the last, bottom part of the colon). The known contributing factors to the development of these pouches are old age and genetics. Other theories suggest a lack of fibre in the diet or increased intraluminal pressure due to chronic constipation as possible causes. However, all of these theories are derived from limited data with no definitive proof. Uncomplicated diverticulosis usually has no symptoms.
Diverticulitis is what develops when these pouches become infected with bacteria, which causes symptoms of severe lower abdominal pain, fever, blood in the stools and diarrhoea or constipation. This condition needs to be treated with antibiotics to prevent complications such as abscess formation or bowel perforation. As the low-carb lifestyle promotes a healthy gut and lowers inflammation it should not make your diverticulitis worse.
There are three macronutrients that provide energy: protein, carbohydrates and fats. We need all three to survive.