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Published on March 13, 2019

variety of carbohydrate rich foods

Low Carb, No Carb: What’s The Real Deal?

From Keto to Paleo to Atkins (remember that one?) many mainstream diets seem to be focusing on carbohydrates. But what are they?

Carbohydrates can be divided into three groups: starches, sugars and fibers. Starch is found primarily in starchy vegetables like peas, corn and potatoes, as well as beans and lentils. Starch is also found in several grains, including wheat, oat, barley and rice.

Sugars are found naturally in milk and fruit, and added sugars can be found in most processed or packaged foods. The final carb form is fiber, and it comes in digestible or indigestible forms. We find it primarily in fruits, vegetables, whole grains, nuts and legumes.

Let’s now consider a few things about diets that aim to limit – or eliminate – this part of many foods:

Understand The Diet’s “What and Why”

  • The Paleolithic or “Paleo” diet’s name alludes to that era in time, and it’s based on the idea that we haven’t evolved enough to handle the rapidly changing food industry and our modern diet. Specifics vary, but the general idea is to eat like the hunter/gatherers of the era – fruits, vegetables, nuts and seeds, fish and lean meats, like wild game or grass-fed livestock. Portions and nutrient ratios are not emphasized.
  • The Atkins Diet, which may be responsible for launching this low-carb trend, drastically reduces carbohydrate intake to no more than 20 grams per day (in phase 1.) It does not require fat or protein monitoring, and while it was not the original design of the diet, many of its recipes and resources emphasis protein and limit fat. This diet has extremely specific recommendations.
  • The ketogenic diet was originally created to help pediatric patients with epilepsy. It’s extremely low in carbohydrate, low to moderate in protein and extremely high in fat. This combination forces the body to use fat for energy and creates ketones as a byproduct. Although recommendations vary, ketosis requires about 75-90% of calories from fat, 5-10% from protein and only 5% from carbohydrate.

Not All Carbs Were Created Equal

Processed grains like white bread, snack cakes, crackers and such, as well as added sugar have been linked to weight gain and inflammation. On the other hand, whole grains such as brown rice, quinoa and steel-cut oats, along with fruits are linked to a reduced risk from weight gain. The “good” group also serves as great sources of vitamins, which often offer antioxidants to reduce inflammation.

So it’s important to remember that carbohydrate is an extremely broad term that includes foods from both ends of the health spectrum. Good examples are beans and whole grains – they are carbs, but they’re among the best foods sources of B vitamins and soluble fiber. Soluble fiber not only helps lower cholesterol, but it also helps keep our gut healthy.

Not All Fats Are the Same

Some studies have shown that following a ketogenic diet can increase LDL or “bad” cholesterol. Emphasizing plant-based fats from avocados, nuts, seeds and olive oil will allow the body to stay in ketosis, but reduces the possible impact on heart health.

Extremely Strict Diets Pose Some Risks

When starting a lower-carbohydrate diet, many people will complain of lightheadedness, fatigue, headaches, nausea and constipation. These typically are due to the rapid loss of sodium and fluids. Muscle and hair loss also can be side effects when diets are not properly managed. Although rare, ketogenic diets can cause nondiabetic ketoacidosis, a condition where the blood becomes too acidic. In addition to these physical risks, extreme diets increase risk of developing disordered eating behaviors and obsessions.

Between the Hype and the Research is a Big Gap

Nutrition research is hard, but it becomes nearly impossible when you ask participants to follow extremely strict diets for long periods of time. Therefore, the amount of high quality research that focuses on these low-carb diets is limited.

My recommendation is a “lifestyle” which includes moderate amounts of healthy carbohydrates, instead of a low-carbohydrate “diet”… at least for now!

Cucumber Tomato Avocado Salad

Servings: 4


  • 1 pound Roma tomatoes, chopped
  • 1 English cucumber, sliced
  • ½ medium red onion, sliced
  • 2 avocados diced
  • 2 tablespoons extra-virgin olive oil or sunflower oil
  • Juice of 1 large lemon
  • ¼ cup cilantro, chopped
  • Salt and pepper to taste


  1. Place chopped tomatoes, sliced cucumber, sliced red onion, diced avocado and chopped cilantro in a large salad bowl.
  2. Drizzle with olive oil and lemon juice.
  3. Just Toss gently to combine. Just before serving add salt and pepper to taste.

Nutrition information, per serving: 261 calories, 22 grams of fat, 17 grams total carbohydrate, 3 grams protein, 8 grams of dietary fiber.

Lauren Cornay, RD, LN, is a registered dietitian at Avera Heart Hospital. Get more insight on nutrition and health.

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