Low-carb diets do not require meat

Dear Dr Roach: I recently had my yearly physical with my primary care doctor of

10 years. I am a male, 75, who is 5 feet, 10 inches tall and weighs 152 pounds.

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 low-carb 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.

My previous A1c tests with my primary care doctor have shown my A1c between 6.2 and 6.0 over the past five years. I would appreciate your opinion on all of this.

K.C. Answer: The advice you received from both sides about low-carbohydrate diets was both right and wrong, in my opinion.

I mostly agree with your doctor, but his answer needs 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). You do not need to lose weight, so that isn’t an issue for you. Personally, I don’t “order” people to reduce starches and sugars to zero, as that seems to me to unnecessarily restrictive.

The information about low-carb diets is, at best, misleading: It’s possible to change a high-starch 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. Saturated fat comes mostly from animal sources, and a healthy plant-based diet uses mono- and polyunsaturated fat, which has been shown to reduce cholesterol numbers and 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.

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