Low-carb diet info may be misleading

Dear Dr Roach: I recently had my yearly physical with my primary care doctor of 10 years. He sent me my lab results and commented: “Your A1c (5.8) was in the prediabetic range of 5.8-6.4. Please remove all grains/breads/ carbs/sugars and processed food from your diet and recheck this level in 6 months.” I read up on lowcarb diets and found that low-carb diets are rich in saturated fat and cholesterol, which might raise bad cholesterol and increase risk of heart disease. — K.C.

The advice you received from both sides about lowcarbohydrate diets was both right and wrong, in my opinion. I mostly agree with your doctor, but with some context. Cutting down greatly on simple sugars and starches, including grains, breads and pasta, is likely to improve your A1c (a measure of blood sugar over time). Personally, I don’t “order” people to reduce starches and sugars to zero, as that seems to me to unnecessarily restrictive. Further, by having limited amount of starches in combination with protein and healthy fat, you can limit the rise in blood sugar associated with their consumption. The information about low-carb diets is, at best, misleading: It’s possible to change a highstarch diet to a much healthier diet without eating much (or any) meat or eggs. There are many plant-based sources of protein to fulfill the body’s needs. People also may eat modest amounts of fish, skinless poultry or lean meat without increasing heart disease risk. The largely plant-based diet I recommend is largely carbohydrate, but not starchy. Unlike processed starches like white rice and white flour, vegetables and legumes are high in fiber, which helps people feel fuller and attenuates the blood sugar response. Similarly, fruits are high in sugar, but whole fruits do not increase A1c the way added sugars do.