Category Archives: Low-Carb Mediterranean Diet

Low-Carb Diets Killing People?

Animal-based low-carb diets are linked to higher death rates, according to a study in the Annals of Internal Medicine. On the other hand, a vegetable-based low-carb diet was associated with a lower mortality rate, especially from cardiovascular disease.

As always, “association is not causation.”

Since I created the Low-Carb Mediterranean Diet, it’s just a matter of time before someone asks me, “Haven’t you heard that low-carb diets cause premature death?” So I figured I’d better take a close look at the new research by Fung and associates.

It’s pretty weak and unconvincing. I have little to add to the cautious editorial by William Yancy, Matthew Maciejewski, and Kevin Schulman published in the same issue of Annals.

The study at hand was observational over many years, using data from the massive Nurses’ Health Study and Health Professionals’ Follow-up Study. To find the putative differences in mortality, the researchers had to compare the participants eating the most extreme diets. The 80% of study participants eating in between the extremes were neutral in terms of death rates.

They report that “…the overall low-carbohydrate diet score was only weakly associated with all-cause mortality.” Furthermore,

These results suggest that the health effects of a low-carbohydrate diet may depend on the type of protein and fat, and a diet that includes mostly vegetable sources of protein and fat is preferable to a diet with mostly animal sources of protein and fat.

In case you’re wondering, all these low-carb diets derived between 35 and 42% of energy (total calories) from carbohydrate, with an average of 37%. Anecdotally, many committed low-carbers chronically derive 20% of calories from carbohydrate (100 g of carb out of 2,000 calories/day). The average American eats 250 g of carb daily, 50-60% of total calories.

Yancy et al point out that “Fung and coworkers did not show a clear dose-response relationship in that there was not a clear progression of risk moving up or down the diet deciles.” If animal proteins and fats are lethal, you’d expect to see some dose-response relationship, with more deaths as animal consumption gradually increases over the deciles.

The Fung study is suggestive but certainly not definitive. Anyone predisposed to dietary caution who wants to eat lower-carb might benefit from eating fewer animal sources of protein and fat, and more vegetable sources. Fung leaves it entirely up to you to figure out how to do that. Compared to an animal-based low-carb diet, the healthier low-carb diet must subsitute more low-carb vegetables and higher-fat plants like nuts, seeds, seed oils and olive oil, and avocadoes, for example. What are higher-protein plants? Legumes?

You can see how much protein and fat are in your favorite vegetables at the USDA Nutrient Database.

The gist of Fung’s study dovetails with the health benefits linked to low-meat diets such as traditional Mediterranean and DASH. On the other hand, if an animal-based low-carb diet helps keep a bad excess weight problem under control, it too may by healthier than the standard American diet.

See the Yancy editorial for a much more detailed and cogent analysis. As is so often the case, “additional studies are needed.”

Steve Parker, M.D.

Reference: Fung, Teresa, et al. Low-carbohydrate diets and all-cause and cause specific mortality: Two cohort studies. Annals of Internal Medicine, 153 (2010): 289-298.

KMD Now Available in Book Form

A number of my patients and blog readers have asked for a more comprehensive presentation of the Ketogenic Mediterranean Diet, a free abbreviated version of which is at my Diabetic Mediterranean Diet blog. The KMD, as you may be aware, is the cornerstone of the Low-Carb Mediterranean Diet. Both of them are in The Advanced Mediterranean Diet (2nd Edition) and Conquer Diabetes and Prediabetes: The Low-Carb Mediterranean Diet.

Odd cover, huh?

The new book is geared for folks who don’t have diabetes, but want to lose weight with a very-low-carb diet. It’s called KMD: Ketogenic Mediterranean Diet. Readers of Conquer Diabetes and Prediabetes  and Advanced Mediterranean Diet (2nd Edition) will get nothing out of the new book: they’ve seen it all before. Here’s the book description from

Dr. Steve Parker presents the world’s first low-carbohydrate Mediterraneandiet.  Nutrition experts for years have recommended the healthy Mediterranean diet.  It’s linked to longer life span and reduced rates of heart attack, stroke, cancer, diabetes, and dementia.  Dr. Parker (M.D.) has modified the Mediterranean diet to help you lose excess weight while retaining most of the healthy foods in the traditional Mediterranean diet.  What’s the secret?  Cut back on the fattening carbohydrates such as concentrated sugars and refined starches.

You’ll discover how to manage your weight without exercise, without hunger, without restricting calories, while eating fish, meat, chicken, vegetables, fruits, wine, olive oil, nuts, and cheese.

The book includes advice on how to avoid weight regain, instruction on exercise, a week of meal plans, special recipes, a general index, a recipe index, and scientific references.  All measurements are given in both U.S. customary and metric units.  Are you finally ready to lose weight while eating abundantly and without counting calories?

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KMD: Ketogenic Mediterranean Diet is available for purchase at (Kindle edition here, also) or Barnes and Noble (Nook version here). The ebook version is available in multiple formats at Smashwords.

Steve Parker, M.D.