Low carbohydrate diets for weight loss: historical & environmental perspective

Obesity in the past was only seen in great numbers in Western countries but is now gaining prevalence in India with a growing Indian economy. Historically a favourable phenotype, obesity has been associated with multiple diseases affecting almost all organ systems. In addition, the cost of obesity to a health care system is enormous. Weight loss improves many of the outcomes and yet is a difficult process for most patients with even the medical community baffled about methods for weight loss. Our group and others have looked at weight loss in obese individuals using a low carbohydrate diet and have shown some success at six months and one year. Many studies have also shown a decrease in insulin resistance and improvement in lipid profiles when obese individuals are placed on a low carbohydrate diet. The reason for weight loss on this diet was initially thought to be diuresis from increased ketone production but it may be due to decreased insulin concentrations causing a decrease in appetite. In addition, lowering carbohydrates limits food choice and in the process decreases overall calorie consumption. In the United States, an increase in calories, predominantly from carbohydrates, appears to parallel the obesity epidemic. However, it is not known if guidelines or policies lowering carbohydrates in normal or slightly overweight individuals may help prevent obesity and its complications. Equally less known, is the applicability of a low carbohydrate diet to populations like India where many main dishes are carbohydrate-based.