Low Carb Paleo, Low Carb Diet Risks and Insulin Resistance

How To Transition Off A Low Carb Paleo Diet And Improve Insulin Sensitivity

To carb or not to carb? That is the question.

Carbohydrates have gotten a bad rap in recent years leading to many people drastically reducing them from their diet.

While there certainly are benefits to reducing refined and processed carbohydrates, especially for blood sugar and insulin balance, have we gone too far and mistakenly thrown the baby out with the bathwater? 

It doesn’t have to be either a high carbohydrate or an extremely low carbohydrate diet. What if we seek to find a middle ground, where we aren’t overeating the processed carbs that contribute to an epidemic of poor metabolic health, but we aren’t over-restricting nutritious, whole plant foods? 

While the sweet spot and ideal diet pattern will certainly vary for each individual, which means that for some people the keto diet can be helpful if used as a therapeutic tool for a specific time, the aim of this article is to give you some guidance in experimenting to find what works for you.

Essentially, it’s helpful to understand your unique carbohydrate tolerance.

If you’ve been eating a low carb diet, and not feeling your best, keep reading to learn more about: 

• The Paleo diet 
• The Paleo low carb and the insulin resistance connection
• Risks and symptoms of over-restricting carbohydrates
• How to expand the diet and increase carbohydrates

The Paleo Diet

The Paleo diet is more than a diet trend, it speaks to the way that our hunter-gatherer ancestors ate in the days before agriculture and certainly before industrial agriculture gave us so many processed options.

This meant eating whole, real food – both plants and animals – that were available in the natural environment. Our ancestors ate based on what was available locally and seasonally, which greatly varied from place to place. 

The modern Paleo diet, born at the beginning of the century with the research of Loren Cordain, is meant to mimic this style of eating that is incredibly nutrient-dense and health promoting.

Research shows that a Paleo style of eating supports a balanced weight, metabolic health and is anti-inflammatory.

With the gaining popularity of the Paleo diet over the last decade, there are many different versions and interpretations of the diet. While what not to eat (grains, beans, dairy) often takes center stage in the Paleo conversation and feeds a stereotype of an all meat and bacon, carnivore diet. The truth is that plant foods are incredibly important to include. 

While some people choose to limit plant foods and follow a low-carb Paleo diet, others might be under eating carbohydrates and missing out on the immense benefits of  the phytonutrients in these foods without realizing it. 

A Low Carb Paleo Diet 

One of the main reasons that people limit carbohydrates is to address the issue of insulin resistance. Insulin is the hormone that helps to bring sugar from the blood into your cells for use as energy.

Resistance to this signal occurs when blood sugar is consistently high, typically from a standard American eating pattern high in refined flour and sugar combined with a sedentary lifestyle.

But the truth is there is more to insulin resistance than sugar – one of the main contributors that is especially critically underestimated is exposure to toxins. But let’s look at what happens physiologically with insulin resistance.

Over time, the pancreas keeps pumping out insulin to move the sugar into the cells, but the cells become numb to the signal. Unfortunately, this is quite common in our society and results in metabolic syndrome, diabetes, pre-diabetes and associated inflammatory conditions. 

By reducing carbohydrates, you can also reduce your blood sugar (and the symptoms that go along with elevated blood sugar). In some cases this is warranted and very helpful, but in other cases, as time goes on, a low carbohydrate diet may have some downsides. It’s especially important to point out the downsides of too few carbohydrates for those who are under eating these important foods! 

A low carbohydrate diet will be different for each individual, but typically lower than 50 to 75 grams of carbohydrates is considered low. A very low carbohydrate diet, with approximately 25 to 50 grams per day, is analogous to a ketogenic diet.

Contrast this to a Standard American Diet (SAD diet) where someone may easily eat 300 grams or more of carbohydrates in a day, primarily from processed foods. 

A middle ground, moderate carbohydrate diet may be the best choice for many people. By including Paleo plant foods, such as fruits and starchy vegetables, you’ll get the immense benefits from the phytonutrients in these foods, support metabolic health and even improve insulin sensitivity in many cases.  

The problem with unnecessary long-term adherence to a low carbohydrate diet is that your body’s ability to process carbohydrates is like a muscle or a skill – if you don’t use it, you can lose it.

It’s one thing if you can tolerate carbohydrates and eat a moderate carb meal and see your glucose return to normal levels 1 hour post prandial (post eating). This signals you have good insulin sensitivity. But it’s another thing if you eat a moderate or high carb meal and your glucose spikes and stays elevated past the 1 or even 2 hour mark and then crashes afterwards. This signals poor insulin sensitivity. 

Humans are meant to have metabolic flexibility and utilize both glucose (carbs) and ketones for fuel.  A good way to test this is with a continuous glucose monitor or with a glucometer. 

If neither of those work for you, try paying attention to subjective clues like your energy level. 

Are you tired immediately after eating?  Do you crave sweets or carbs after meals?  Do you feel hungry 1-2 hours  after meals? Do you feel your energy is erratic throughout the day, as though you were on an energy roller coaster?  Do you feel shaky or dizzy if you miss a meal? 

If you answered yes to any of those, you probably have some work to do with balancing your glucose and working on insulin sensitivity.

If you rely on a low carbohydrate eating pattern to manage your glucose readings however, you may be missing an underlying issue of insulin resistance.  Insulin resistance isn’t something you want to mask; it’s better to know if you are having trouble with your insulin because this lets us know we need to look at the root cause and not just treat the symptoms. As mentioned before, insulin resistance is caused by more than just what you eat but also by environmental factors as well.

Bottom line: low carb diets can be a band-aid approach for the treatment of insulin resistance and might not be the best long-term solution for every case. Those without good insulin sensitivity and metabolic health may do worse on a low carb diet than a moderate carb one. 

The Risks Of A Long-term Low Carb Paleo Diet

Some people do well with low carb diets, for a period of time, but then may start experiencing unwanted symptoms. Others might crash sooner when they are consistently not eating enough carbs.  

Here are some ways that your body might experience the downsides of too much carbohydrate restriction: 

• Poor sleep – trouble falling asleep or staying asleep through the night
• Decreased metabolism – weight gain or trouble losing weight from undereating carbohydrates and overall calories 
• Reduced thyroid hormone – hypothyroid symptoms such as cold hands and feet, hair loss, decreased metabolism and fatigue 
• HPA-axis dysfunction – it’s a stress on body to maintain blood sugar in the absence of carbohydrates, which impacts cortisol and adrenal health 
• Fertility challenges – irregular cycles, absence of ovulation, hormonal imbalances
• Negative changes in the microbiome – less beneficial bacteria, increased gut infections or overgrowth of unwanted microorganisms, increase in digestive symptoms.

Let’s focus on the microbiome part just a little more, since the health of the microbiome is linked to the health of just about every system in the body. 

It is quite clear that the microbiome of hunter-gatherer populations differs from that of modern eaters.

A 2019 study showed that a modern interpretation of the Paleo diet (including an emphasis on plant foods) has the ability to “re-wild” the microbiome. Fiber and plant compounds such as polyphenols from vegetables, tubers and fruits feed certain beneficial bacteria and support probiotic abundance and diversity. 

So while we might want to think that carbohydrates are just calories that cause us to gain weight, whole carbohydrate foods are incredibly important for the health of the microbiome, hormonal function, reproduction and even metabolic health. 

Luckily, the microbiome itself has an incredible ability to shift quickly based on the diet, so it may take very little time to reap the bacterial balance benefits of expanding your diet.

Now, let’s talk about how to do that. 

How To Increase Carbohydrates 

If you’ve been eating a low carb or very low carb diet, experiencing downsides and you are interested in increasing carbohydrates, these action steps are for you. The goal is to maintain the health benefits you’ve achieved with a Paleo diet, while expanding carbohydrates to the point where you feel your best. 

It may take some experimentation to find your “sweet spot” with carbohydrates, where blood sugar is balanced and metabolism is rich, without overdoing it. So go slow, be gentle with yourself and collect data, as feedback from your body, along the way. 

Step 1: Choose your carbs wisely. It’s easy to grab a gluten-free pastry or convenience item to get some carbs, but that’s not exactly what we are talking about! Be sure to choose whole food carbohydrates including but certainly not limited to:

Starches – sweet potatoes, plantains, green banana flour, acorn squash, spaghetti squash, cassava, taro, pumpkin 

Fruit – blueberries, apples, pears, oranges, nectarines, plums, strawberries

Vegetables and root vegetables – dark leafy greens, broccoli, carrots, beets, rutabaga, turnips, cauliflower

Step 2: Track your carbs. It’s helpful to track your carbs in an online tracking tool, to obtain a baseline and determine if, in fact, you are undereating carbs. This will also help you pinpoint what carb level works the best for you.

With a moderate carbohydrate diet, you’ll likely fall somewhere between 100 and 200 grams of carbs per day, depending on your body size, activity level and metabolic health. 

You might be concerned that increasing food in general, and carbohydrates specifically, will lead to weight gain. However, eating more may lead to increased nutrition and actually give your metabolism the boost you need or desire. 

Step 3: Stair step your way there. While some people might feel good immediately adding in several carbohydrate servings to their daily routine, others, and especially those who were originally limiting carbs because of insulin resistance, may have better results by going slow. Start by adding one serving of fruit or starch each day, while eating enough non-starchy veggies, nuts and seeds. Then increase from there. 

Pro tip: If you have trouble sleeping, start with a serving of starch with your dinner meal to see if that helps. 

Pro tip: Be sure to consume your carbs as a part of a balanced meal. Consider 50 to 75 percent of your plate filled with non-starchy and root veggies, a fist size serving of starch or a piece of fruit, 3-5 ounces of quality protein and 1 to 2 servings of good fats. 

Step 4: Increase the diversity of your diet. Most of us tend to grab the same foods with each grocery trip, however to nourish your microbiome and teach your metabolism to be flexible, try mixing it up daily and weekly. This is important for all foods, and especially for the carbohydrate foods where it’s easy to achieve variety by focusing on eating all of the colors. 

Pro-tip: Include specific foods to build and restore the microbiome including pre-biotic foods (garlic, onions, asparagus, chicory, sunchokes, artichoke, berries) and fermented foods (kimchi, sauerkraut, coconut yogurt, apple cider vinegar).  

While nutrition experts may recommend a specific amount of carbohydrates or a range to shoot for, your body is the true expert. If it’s time to change up your diet to achieve your next level of health, consider experimenting with your carbohydrate intake.

While recent nutrition messages have been so focused on limiting or eliminating carbs, perhaps we’ve swung too far in the direction of demonizing plant foods and are really missing out on some of the incredible benefits of these nutrient-rich foods.  

Supplements to Consider

A few key pharmaceutical grade supplements can help improve your gut barrier function and to help maintain healthy, well-functioning cells.

References

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6313618/
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6687155/