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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2674146/

I found some papers suggesting AMDR is not the optimum and it is too high on carbohydrates in particular.

Is it generally safe to undergo a

27.1% Protein 40% Fat and 32.9% Carbohydrate diet?

How about neoglucogenesis from amino-acids?

Which would be the side effects from Reduced Carbs and Increased Fats even if it doesn't reach ketosis?

Would there be any systematic(systemic) damage(damage to the systems) Digestive(mainly thinking of the specific organs liver and pancreas), Endocrine(thinking of growth hormone and kids), Urinary. Circulatory?

Fats mainly from Fish(Cod and Pollock), Strawberries, Spinach, Almond Milk, Walnuts.

Which people should be exluded from such a modified diet for safety reasons?

  • @Jan Are you an Endocrinologist or a Dietitian so you can help with the diet in a straighforward way? Or maybe a Gastroenterologist, Nephrologist or Cardiologist to help with the potential side-effects if you know of any of them if they should occur(have the potential) to occur? – George Ntoulos Jun 14 '19 at 16:23
  • I am nothing of that but I was researching about nutrients a bit. Theoretically, carbohydrates are not essential nutrients, so there should be no side effects due to low carbohydrate intake if one does not go into ketosis (except constipation due to lack of fiber). Possible side effects of ketosis are described here. I'll try to look at this a bit more, but I doubt I will find some reliable evidence. – Jan Jun 14 '19 at 16:32
  • @Jan Lack of fiber and spinach? How is that possible? – George Ntoulos Jun 14 '19 at 16:34
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In short: low-carbohydrate diets may be associated with less health benefits than the high-carbohydrate ones. A carefully designed low-carbohydrate diet high in whole fruits, grains and vegetables and low in added sugars and saturated and trans fats should not cause side effects within 1-2 years. Long-term effects of low-carb diets are not known due to lack of studies (APJCN, 2003).

A low-carbohydrate non-ketogenic diet is the one in which carbohydrates represent 20-40% of energy intake (Current Diabetes Reports ; APJCN). The current Acceptable Macronutrient Distribution Ranges (AMDR) are: carbohydrate: 45-65%, fat: 20-35%, protein: 10-35% (National Academics).

Low vs high carbohydrate diets

The diet quality as measured by Healthy Eating Index (HEI) was highest for the high carbohydrate groups and lowest for the low carbohydrate groups. The BMIs were significantly lower for men and women on the high carbohydrate diet; the highest BMIs were noted for those on a low carbohydrate diet (Jandonline, 2001).

For macronutrients, more favorable Chinese Healthy Eating Index (CHEI) scores were associated with higher intakes of protein, carbohydrate, dietary fiber and lower fat intake...(Nutrients, 2018 ; Table 6)

Low-carbohydrate diets were associated with a significantly higher risk of all-cause mortality and they were not significantly associated with a risk of CVD mortality and incidence (Plos One, 2013).

The available scientific literature shows that controlled diet studies (several weeks to <‚ÄČ2 year) with low-carb high-fat in persons with obesity and diabetes do induce favorable effects on weight loss, blood glucose and insulin as well as some less desirable effects (increase LDL cholesterol, decrease vascular reactivity) (European Journal of Nutrition, 2018).

Carbohydrate quality

However, carbohydrate quality seems to have a more important role in population health than carbohydrate amount. A strong case can be made for consumption of high glycemic load grains, potato products, and added sugars (especially in drinks) being causally related to obesity, diabetes, cardiovascular disease, and some cancers; whereas non-starchy vegetables, whole fruits, legumes, and whole kernel grains appear protective (BMJ, 2018).

In the Nurses' Health Study (NHS) and the Health Professionals Follow-Up Study (HPFS), including 203,457 adults, the intake of vegetables, whole fruit and whole grains was associated with lower and intake of red and processed meat with higher risk of cardiovascular disease; the intake of green leafy vegetables (but not potatoes) and whole grains was associated with a lower and intake of sugar-sweetened beverages (soda, fruit juices) with higher risk of diabetes (Journal of Nutrition, 2012 ; Table 1).

In summary, there seems to be no evidence that a carefully designed low-carbohydrate non-ketogenic diet (33% energy from carbohydrates and enough polyunsaturated fats as suggested in the question) would cause any short-term (1-2 years) side effects on the gastrointestinal, urinary, circulatory, neurological or other system, but long-term effects are not known. When lowering carbohydrates, it may be a good idea to increase protein rather than fat intake.

  • Please define significant. Which is the significance lever you are using, in this I am asking for qualitative information; which and how, not necessarily quantitative; how much? In a nutshell I am asking in some way what is significant. I asked for systematic side effects; related with some specified system, digestive, urinary, respiratory, endocrine. I did not ask for significant side effects as perhaps with cardiovascular diseases, death hazard, hospitalisation. – George Ntoulos Jun 19 '19 at 22:00
  • How safe is it for a person's only carbohydrate intake to be 3 servings of Strawberries (180 kcal * 85% from carbs) or some other fruit high in polyunsaturated fats, protein and fiber like apricots, kiwifruit, oranges, peaches, nectarines, 4 servings of cooked spinach( 100 kcal * 52%) or tomatoes in the summer, 8% of the calories one gets from walnuts. And for the main almost to an exclusion being (cod, pollock, chicken breasts meat only, and rarery pork leg rump half) at 27.1% total protein intake? – George Ntoulos Jun 19 '19 at 23:04
  • I think the diet you've described can be safe and should not cause any side effects on any body system. – Jan Jun 20 '19 at 13:04
  • 40 calories from unsweetened Almond Milk, 100 calories from Cooked Spinach, 180 calories from Strawberries, 350 calories from Cooked Cod, 1030 calories from Walnuts? This barely gives 20% Carbs as an Intake imagine if you cannot get Strawberries or Cod? Imagine if you are left with Pork and Apricots or Nectarines. A good part of your carbohydrates come from walnuts. If you do not get you get less protein You will eat more pork and less walnuts to get even. – George Ntoulos Jun 20 '19 at 18:33

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