Carbohydrates and false myths: Hypoglycemia
Anyone who follows my posts, you know that my relationship with the ketogenic diet is a relationship of love and hate. Faithfully believe that in situations like epilepsy or other diseases, carbohydrate restriction should be an imperative to combat tool, however, when it comes to fat loss, the ketogenic diet does not provide any benefit that can not be achieved with a diet low in carbohydrates.
The problem we encountered is the imposition by the food industry eating carbohydrates, the more the merrier …
Daily bombard us with messages like: “Our brain needs glucose to function”, “If you do not eat carbs will give hypoglycemia and dizziness” or “Eat fewer carbohydrates damage your kidney.”
How would you choose if I told you that none of these claims has a single study to support it? Probably you would have asked them to remove my title and I invested pharmacists in a similar place to appearing in “Shutter Island”.
Throughout this series of articles, you’ll see firsthand how our body is much more efficient than most people believe, being able to lead a normal life with a minimum intake of carbohydrates.
Myth 1: Carbohydrates to avoid hypoglycemia
When our diet is low in carbohydrate (and thus in glucose), our body initiates a number of mechanisms that alter the energy substrate of the cell, reducing the use of glucose for use fatty acids.
Thus, your body saves glycogen emergency or highest priority, such as maintaining plasma glucose or energy supply to those cells that are unable to use another substrate, such as erythrocytes, retinal cells or renal medulla.
Even with zero carbohydrate intake in our diet, our body is able to produce between 100-200g glucose through amino acids and fat (gluconeogenesis).
This impact on the metabolism of amino acids, has led many experts to consider necessary to increase protein intake in athletes during a ketogenic diet. Personally, I think it is not necessary to increase protein intake in the diet, since most athletes (and part of the general population) than covers their protein requirements.
In addition, we have two important factors into account:
- On one hand, there is some evidence that ketone bodies reduce protein degradation, which has a protective effect on muscle mass.
- On the other hand, we found that certain amino acids tend to be used to produce glucose, such as alanine or glutamine, hence the belief that certain types of foods rich in protein can get ketosis.
In my opinion, the glucose production can be divided into four stages or even in 3 if glycogenolysis and gluconeogenesis see the as a simultaneous process. In the next picture, you will notice how the body is able to maintain a supply of glucose even after being 40 days without consuming food (3):
To understand this better, we will explain each of the four phases:
After several hours without consuming carbohydrates, our body reduces the use of glucose by cells, facilitating the use of fatty acids as an energy source.
The body uses the liver glycogen to maintain a constant supply of glucose. Muscle lacks the enzyme necessary for glycogen break and release glucose molecules into the bloodstream, making reservations hardly vary.
Glycogen stored in the liver begins to run and the body must use amino acids and fatty acids to produce glucose. This is the transition phase.
Liver glycogen is depleted and the body must rely on gluconeogenesis as the primary source to supply the requirements of glucose during the following weeks.
Diet comparison “standard” VS Low Carb Diet
As I mentioned lines above, the amount of glucose produced is sufficient to supply the requirements of certain tissues, in fact, if we look at the aggregate, the amount of glucose used only represents 10% of the total requirement (the other 90% provide fatty acids and ketone bodies).
The above situation does not vary much from a diet without carbohydrates, in fact, many of the effects produced by the ketogenic diet reproduced during prolonged fasting.
As I know many of my detractors will tell me that the ketogenic diet is not equal to fasting, we’ll see what happens with the plasma glucose during a low-carb diet. To do this, we note the following study (2) in which for 2 days were given a “standard” 60% carbohydrate diet with 30% fat and 10% protein.
After these 48 hours, they were given for one week, the same amount of calories but with a different distribution, being 5% carbohydrates, 60% fat and 35% protein.
Despite a slight decrease in glucose during the first days, he returned to pre-intervention level on the fourth day, remaining stable subsequent days. An important detail is that only 24h of the ketogenic diet is reduced by 43% the use of glucose as an energy source.
As a personal opinion, I believe that for very restricted carbohydrate diets, the body prevents oxidation of glucose systemically to facilitate storage of this.
In short, we can see how there is no need to consume carbohydrates every 3 hours or ingesting huge amounts to avoid hypoglycemia. Our body has various means to maintain a steady supply of glucose although we speak of weeks without ingesting glucose.
For this reason, avoid them fool you with advertising that promises energy in the morning or you instill fears for not giving “cookies dinosaurs” your children, your health and theirs will thank you.