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Expert explains how to use Paleo and low carb diet for diabetes and weight loss

Get this expert's views.
William Lagakos

Whether you call it the hunter-gatherer diet, Primal plan or Ancestral health approach, the Paleolithic way of eating has become increasingly popular. But what does the term really mean? Dr. William Lagakos answered that question in an exclusive interview.

"There isn’t one singular “Paleolithic” diet. At any given time in history, the diet would’ve differed markedly across different geographical locations. People residing near bodies of water would have had a greater reliance on seafood than those who lived more inland. The species of seafood and land animals would’ve also differed geographically. Seasonality also had a big impact on diet; for example, honey was highly available in some regions during the rainy season, a time when hunting game was less productive," he noted.

What is known from existing research, says Lagakos: "Our ancestors ate a diet rich in seafood and meats, and a variety of plants, nuts and berries, and fruits. And possibly more importantly, is what these diets lack: processed foods, refined sugars, industrial trans fats – all in all, a diet significantly healthier than modern Western diets."

When it comes to diabetes, Lagakos is adamant that low carb diets trump low-fat for type 2 diabetes. A new study recently was published which adds even more meat to the low-carb approach: Click here for details.

"According to the literature, low-carbohydrate diets consistently perform better than low-fat diets for the treatment of type 2 diabetes. More importantly, low-carbohydrate diets also reduce the need for antidiabetic medications significantly more so than low-fat diets," he told me.

But don't neglect exercise: "Another important, yet frequently overlooked aspect is physical inactivity, which should be minimized. Intentional exercise and/or weight lifting is beneficial, but a few scheduled walks throughout the day will also be helpful," he stated.

If you follow a low-carb diet, do you need to count calories as well, or do people intuitively eat less because of the satiety factor?

"For obese patients beginning a low-carbohydrate diet, strict calorie counting isn’t necessary; appetite spontaneously declines to a level that naturally facilitates weight loss. This appears unique to obese patients; that is, for people who have already lost a significant amount of weight, or for people that only need to shed a few pounds, it gets trickier – they may need to more closely monitor food intake regardless of which diet they’re following," explained Lagakos.

One of the biggest debates is over how much protein is needed.

"The amount of protein required to maintain nitrogen balance (and thus maintain lean body mass) increases as calorie intake declines – so people who are losing weight may need to increase their absolute level of protein intake. As a crude rule of thumb, the total amount of protein should be maintained or slightly higher than pre-diet levels. This will differ markedly between different people, but another crude rule of thumb might be 20-30% of calories, or in the ballpark of 2 grams per kilogram of body weight. Getting an adequate amount of dietary protein is critical to preserve lean mass during weight loss. Furthermore, high protein diets are very effective at maintaining long-term weight loss and preventing weight regain," he added.

If you're obese, Lagakos recommends minimizing carbohydrates, using the above formula for protein and choosing your remaining foods from healthy fats, such as "avocado, dark chocolate, seafood, meat. Saturated fats and those found in seafood are likely the most beneficial."

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