Low-Carb vs. Low-Fat: Which is Better for Your Health?

Some years ago, writer Gary Taubes challenged the fat-free and low-fat lunacy that had taken hold of the U.S. since the 1970s. His article in The New York Times ran with this headline: “What If It’s All Been a Big Fat Lie?” (1).

When Dr. Robert Atkins came out with his Diet Revolution in 1972 (2), Americans were just getting used to the flawed idea that fat ─ especially from meat and dairy ─ was the main nutritional “evil” in the world.


The Fat-Free Follies

Professional organizations and public health leaders were up in arms (1). The main medical association attacked Atkins’ low-carb/high-fat approach, dismissing the book as filled with “bizarre concepts of nutrition and dieting” (3) that pushed for an “unlimited intake of saturated fats and cholesterol-rich foods” (1). Believe it or not, Dr. Atkins even had to defend his diet in Congressional hearings (1).

While Atkins got a good bit right, what he ─ and science ─ didn’t fully grasp at that time were two important things: that the type of fats we eat matters a lot; and that we don’t need to eat a lot of protein.

Since then, the pendulum has certainly swung the other way (10). Many of us remember when Dr. Barry Sears’ Enter The Zone diet book came out. But the anti-fat crusaders weren’t ready to give up yet.


Low-Carb vs. Low-Fat: The Battle Lines Are Drawn

Dr. Dean Ornish’s ultra-low-fat, vegetarian-friendly Program for Reversing Heart Disease was published in 1990 (4) and less than 10 years later, the government’s similarly fat-phobic DASH Diet (Dietary Approaches to Stop Hypertension) became all the rage (5).

And in between these skirmishes, the massive consumption of trans-fat packed tub margarine was contributing to an extra 50,000 early deaths per year, according to Dr. Walter Willett (6).

And circling back to the early 1970s, just around the time Dr. Atkins came out with his revolutionary book, Woody Allen’s madcap comedy, Sleeper, was released.

The movie is set in some dystopian future that has progressed so far in the field of nutritional science that foods which were thought to be the biggest fatty no-nos of the 1970s ─ steak and cream pies ─ were now considered the most healthy foods of all.

Ironically the movie wasn’t that far off the mark. Grass-fed, pasture-raised beef is very healthy, and at least the cream in cream pie is healthy!


Ketogenic is the Key

Fortunately for us, science has been building for some years now, showing the powerful cardiovascular health benefits of low-carb/high-fat and ketogenic eating.

In fact, a 2017 scientific review by Swiss researchers found that ketogenic diets significantly reduce total cholesterol, increase HDL (or “good”) cholesterol, lower LDL (or “bad”) cholesterol and lower triglyceride levels ─ just the opposite of what keto critics have been preaching for decades (7).

And in 2004, a group of researchers studied the effects of a ketogenic diet in a group of obese patients over a six-month period (8).

What did they find? That the ketogenic diet significantly reduced triglyceride levels, total cholesterol and LDL cholesterol, but significantly increased levels of good HDL cholesterol.

The researchers were building on results that they’d published one year earlier, which also looked at a ketogenic diet in obese participants (9). It showed that the diet lowered excess body weight, improved body composition, dropped total and LDL cholesterol, and dipped triglyceride levels.

Another study, in this case from New Zealand, set out to see how a low-carbohydrate/high-fat diet fared in healthy adults over a three-month period (10).

The results? The low-carb/high-fat diet resulted in weight loss, reduced waist size, better “good” cholesterol and lower triglycerides.

And not only is the ketogenic diet, as a whole, turning the anti-fat rebellion on its head, but individual components of the diet are also showing their heart-healthy stripes.

In fact, a Brazilian study looked at BHB (beta-hydroxybutyrate) in overweight rats (11). Lo and behold, BHB boosted good cholesterol by 39%, dropped bad cholesterol by 35% and improved the HDL:LDL ratio ─ which some scientists say is even more important than HDL or LDL by themselves ─ by a whopping 49%!

Somebody, please pass the steak!


  1. Centers for Disease Control and Prevention. (November 1, 2016). It’s Your Life. Treat Your Diabetes Well. Retrieved October 28, 2017 from http://www.cdc.gov/features/livingwithdiabetes/index.html
  2. Ishii, Y., Ohta, T., Sasase, T., Morinaga, H., Hata, T., Miyajima, K., . . . Matsushita, M. (2010). A high-fat diet inhibits the progression of diabetes mellitus in type 2 diabetic rats. Nutr Res, 30(7), 483-491. doi: 10.1016/j.nutres.2010.06.013
  3. Mobbs, C. V., Mastaitis, J., Isoda, F., & Poplawski, M. (2013). Treatment of diabetes and diabetic complications with a ketogenic diet. Journal of Child Neurology, 28(8), 1009-1014. doi: 10.1177/0883073813487596
  4. Paoli, A., Rubini, A., Volek, J. S., & Grimaldi, K. A. (2013). Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. European Journal of Clinical Nutrition, 67(8), 789-796. doi: 10.1038/ejcn.2013.116
  5. Shifflett, T. (September 26, 2017). Diabetes & Ketogenic Diet: Can You Manage Your Diabetes On A Ketogenic Diet? Retrieved October 29, 2017 from http://www.thediabetescouncil.com/can-you-manage-your-diabetes-on-a-ketogenic-diet/
  6. Zhang, X., Qin, J., Zhao, Y., Shi, J., Lan, R., Gan, Y., . . . Du, B. (2016). Long-term ketogenic diet contributes to glycemic control but promotes lipid accumulation and hepatic steatosis in type 2 diabetic mice. Nutr Res, 36(4), 349-358. doi: 10.1016/j.nutres.2015.12.002

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