Low carb & keto
for clinicians

Name: Low carb and keto for clinicians
Creator: Dr. Evelyne Bourdua-Roy, MD
Published: 2017-10-10T11:12:35+02:00

By , medical review by

Introduction
Misconceptions
The science
Clinical tools
CME activity
Video course
Patient resources
Clinician resources
Find a low-carb doctor
Clinicians’ stories
Patients’ stories

1. Introduction

Are you a clinician curious about how low-carb nutrition can help your patients? Look no further. Or maybe you’re a clinician who has heard about low-carb nutrition, but some outlandish claims have given you a reason to doubt its scientific foundations. We sympathize with that perspective too.

Our main goal at Diet Doctor is to make low-carb diets simple for people who could benefit from them and to do so in the most trustworthy and reliable manner possible.

About Diet Doctor

This includes making it easy for clinicians to learn about low-carb diets. Carbohydrate reduction expands the options clinicians can offer patients. As these hundreds of success stories show, many individuals find low carb to be a life-changing discovery.

But there’s another important change that can occur: Not only can low carb transform patients’ lives, it can transform your clinical practice. Rising rates of metabolic diseases have highlighted just how ineffective our tools are for dealing with these conditions.¹ Many clinicians are frustrated with constantly juggling risk factors, medications, and side effects for patients with chronic disease.

We think all clinicians would like to see their patients become healthier. They’d like to remove medications instead of always adding them. Many clinicians who have started using carbohydrate reduction as a therapeutic tool have been able to do just that. As a result, they’ve found more enjoyment, satisfaction, and patient engagement in their daily work.

We can help that happen for you too, by giving you the tools to assist patients in working to reverse – rather than just manage – chronic conditions like obesity, type 2 diabetes, and metabolic syndrome.²

2. Misconceptions about low-carb and keto diets

We also understand if you are not yet sold on the idea that low-carb diets can help your patients improve their health long-term.

If you are concerned about some of the things you’ve heard about these diets, we have a guide dedicated to helping you understand the long-term safety and effectiveness of therapeutic carbohydrate reduction.

The guide for doctors skeptical of low carb

This guide will help explain the science surrounding low-carb diets. If you are a healthcare practitioner, this guide will hopefully help you reexamine the risk/benefit balance of low-carb diets.

3. The science behind low-carb and keto diets

We know busy clinicians may find it hard to keep up with the emerging literature on a topic. To help you become familiar with evidence supporting carbohydrate reduction as an intervention for a number of conditions, we have a guide to the science of therapeutic carbohydrate reduction.

While carbohydrate reduction is not a “cure-all” and there are many conditions for which no proof of benefit exists, studies have shown carbohydrate reduction can help improve these common conditions:

Dozens of studies show that low carb is an effective weight loss tool.³
Many studies demonstrate its effectiveness in reversing the clinical signs of type 2 diabetes or pre-diabetes and helping patients reduce their use of diabetes medications.⁴
Beyond weight loss and glycemic control, it improves other features of metabolic syndrome including blood pressure and dyslipidemia.⁵
Several studies show it helps manage epilepsy.⁶
Preliminary evidence shows it helps treat the clinical and biochemical features of PCOS.⁷
More preliminary findings indicate that low carb may be a beneficial option for people with irritable bowel syndrome (IBS), Alzheimer’s, and other conditions.⁸

4. Tools for low-carb clinical care

At Diet Doctor, we know clinicians must be comfortable with the effectiveness, safety, and science supporting low-carb before using it with their patients. We also understand many clinicians may not have time to provide patients with detailed information about how to follow a low-carb lifestyle.

No worries. We have all the tools you need to incorporate carbohydrate reduction in your practice, from a fully accredited CME course to patient education handouts and clinician resources.

We encourage you to start with our free CME activity, Treating metabolic syndrome, type 2 diabetes, and obesity with therapeutic carbohydrate restriction, and then explore other resources, such as our low carb for doctors video series.

5. Continuing medical education activity

The free CME activity, Treating metabolic syndrome, type 2 diabetes, and obesity with therapeutic carbohydrate restriction, was designed by and for clinicians. This course provides clinicians with the information and tools they need to use therapeutic carbohydrate restriction with their patients and includes a comprehensive review of the science of carbohydrate restriction as an option for helping patients improve their health.

If you are a physician, physician assistant, nurse practitioner, registered nurse, or registered dietitian, you can apply for a certificate that indicates you’ve completed our CME course and meet the criteria specified by Diet Doctor regarding ethical and appropriate clinical practice.

You can also join our map by filling out this online form.

After you finish the course, we encourage you to look around the rest of our website.

6. Low carb for doctors video series

In our low carb for doctors video series, Dr. David Unwin walks you through what you need to know to help your patients be successful following a low-carb or keto diet. Dr. Unwin is a family physician in the UK who has been treating patients with low-carb diets since 2012.

In 2016, he won the prestigious NHS Innovator of the Year award for his work with diabetes patients. Although aimed at doctors, other healthcare professionals can also learn more about low-carb care from Dr. Unwin’s experiences.

Low carb for doctors video course

This course will cover very practical tips for doctors, like how to effectively discuss the low-carb lifestyle with patients, how to handle medications, safety, patient motivation and much more.

7. Patient education resources

When it comes to helping your patients with recipes, meal plans, and practical tips for getting started and long-term maintenance, we have all the tools you need for providing low-carb care. These printable pdfs will educate patients about how to effectively adopt a low-carb lifestyle.

In addition, you can send your patients to DietDoctor.com to learn more. The most important resources on the site are freely available to everyone.

8. Clinician resources

These one-pagers condense key points from our CME course in one-page clinic reference tools.

Many people can safely start a low-carb or keto diet on their own. But individuals on certain medications — such as diabetes or blood pressure medications — may require more preparation and support. These guides can help you learn more about how to safely work with your patients as they begin carbohydrate restriction.

Clinicians can find additional information about “Low-carbohydrate nutrition approaches in patients with obesity, prediabetes, and diabetes,” in this online flipbook created by a group of clinicians and researchers with many years of experience in low carb.

Do you want to know about carb restriction in special cases such as breastfeeding, mental health, and other contexts?

Learn more

Eating low carb or keto when breastfeeding
Low carb and mental health: The food-mood connection
Promoting low carb in health care
The science and art of hopeful medicine
For resources in French and more clinical expertise from a physician who prescribes carbohydrate restriction, see columns and guides by Dr. Evelyne Bourdua-Roy
Saturated fat
Cholesterol
Low-carb recipes
Keto recipes

9. Find a low-carb doctor

On our “Find a low-carb clinician” page, you’ll see the names, faces, and stories of clinicians who use low-carb and keto diets with their patients.

This page also has a map of more than 700 health professionals (and growing!) you can use to connect with colleagues. If you’d like to put yourself on that map, you’ll also find a form and instructions on that page for joining this directory.

10. Low-carb clinicians’ stories

Listening to the experiences and insights of fellow clinicians can be a great way to learn more about how to use carbohydrate restriction in your own practice.

You’ll find more clinician stories in video format below. For many more have a look at our low-carb doctors video page.

A low-carb story with Dr. Sanjeev Balakrishnan
01:59
How can you as a doctor treat patients with type 2 diabetes? Dr. Sanjeev Balakrishnan learned the answer to this question seven years ago. Check out this video for all the details!
Can low carb make it fun to be a doctor?
36:47
Dr. Unwin about getting his patients off medications and making a true difference in their lives using low carb.
How to help patients reverse type 2 diabetes
27:43
How exactly do you as a doctor help patients reverse their type 2 diabetes?
MEMBERS ONLY
MEMBERS ONLY
MEMBERS ONLY
MEMBERS ONLY
MEMBERS ONLY
What's it like being a low-carb doctor on TV?
17:40
What’s it like working with patients and giving controversial low-carb advice in front of a TV audience?
MEMBERS ONLY
Practicing and promoting low carb
18:16
Dr. Joanne McCormack realized that the dietary advice we're giving to diabetics just don't work.
MEMBERS ONLY
Reverse diabetes by ignoring the guidelines
12:10
Can you reverse diabetes by ignoring the guidelines? Dr. Sarah Hallberg answers this question.
MEMBERS ONLY
MEMBERS ONLY
Diet Doctor Podcast #16 – Dr. John Limansky
43:49
What does biohacking really mean? Does it have to be a complicated intervention, or can it be a simple lifestyle change? Which of the numerous biohacking tools are really worth the investment?
The perfect treatment for diabetes and weight loss
45:20
Do doctors treat type 2 diabetes completely wrong today – in a way that actually makes the disease worse?
Becoming a low-carb doctor
19:30
How do you find a low-carb doctor? And how do we make it more simple for doctors to understand low carb?
Motivating people to change their lives
51:45
How do you help and motivate people to start and stay on a low-carb diet?
"After a day or two the hunger goes away"
33:21
How should you handle patients who want to lose weight on low carb, as a medical doctor?
MEMBERS ONLY

11. Patients’ stories

You may also be inspired by the stories of individuals who have improved their health and lost weight using carbohydrate-restricted diets.

“I am completely blown away by the changes”

Christine has completely transformed her health in only one year with a keto diet and intermittent fasting. Here she shares all the benefits and what it has been like ditching carbs.

Low-carb case report: Patrick

Patrick is in his 40’s and has been my patient since November 2016. He came to me with a diagnosis of type 2 diabetes and was overweight.

“I’m going to continue keto forever”

Lance has been on an incredible keto journey, to say the least. He initially started the diet as a way to manage his epilepsy, and ended up losing 70 lbs (32 kg) and reversing pre-diabetes.

Denis, and how the ketogenic diet saved his life

Dennis was on 10 medications and struggled to control his weight and diabetes. But switching to a keto diet gave him a new lease on life.

“I had been trying to lose weight since the age of 9. And they told me all that I had left was bariatric surgery”

Christian – Or how one man claims to have found the fountain of youth on low carb!

Importantly, these individuals improved their health because they chose a low-carb or keto approach from other options that were available and put in the effort necessary to succeed.

As Dr. Èvelyne Bourdua-Roy noted, “Perhaps low carb isn’t for everyone, but everyone deserves to know it’s a therapeutic option, and that it is safe and evidence-based.” Don’t you think your patients deserve this option as well?

Low carb and keto for clinicians - the evidence

This guide is written by Dr. Evelyne Bourdua-Roy, MD and was last updated on November 11, 2022. It was medically reviewed by Dr. Bret Scher, MD on September 25, 2022.

The guide contains scientific references. You can find these in the notes throughout the text, and click the links to read the peer-reviewed scientific papers. When appropriate we include a grading of the strength of the evidence, with a link to our policy on this. Our evidence-based guides are updated at least once per year to reflect and reference the latest science on the topic.

All our evidence-based health guides are written or reviewed by medical doctors who are experts on the topic. To stay unbiased we show no ads, sell no physical products, and take no money from the industry. We're fully funded by the people, via an optional membership. Most information at Diet Doctor is free forever.

Read more about our policies and work with evidence-based guides, nutritional controversies, our editorial team, and our medical review board.

Should you find any inaccuracy in this guide, please email andreas@dietdoctor.com.

CDC.gov 2018: National diabetes statistics report, 2017 [CDC consensus report article; ungraded]

Current Hypertension Reports 2018: The global epidemic of the metabolic syndrome [overview article; ungraded] ↩
Some disagree with the use of the word “reverse” when it comes to type 2 diabetes or metabolic disease. The concern is that it may imply the disease is completely gone, never to return. At Diet Doctor, we use the term “reverse” to indicate that blood sugars are no longer in the diabetic range. However, we acknowledge that blood glucose will likely rise back to that range if a patient goes back to their prior high-carb eating habits. Therefore, “reverse” does not imply a forever cure. ↩
Here are two examples of the many trials showing equivalent or greater weight loss on low-carb diets compared to low-fat diets:PLoS One 2015: Dietary intervention for overweight and obese adults: Comparison of low-carbohydrate and low-fat diets. A meta-analysis [strong evidence] Learn more
The British Journal of Nutrition 2016: Effects of low-carbohydrate diets v. low-fat diets on body weight and cardiovascular risk factors: a meta-analysis of randomised controlled trials [strong evidence] Learn more

Low carb does not just result in more weight loss than comparison diets, it also results in more fat loss, especially when carbs are limited to 50 grams per day:

Obesity Reviews 2016: Impact of low-carbohydrate diet on body composition: meta-analysis of randomized controlled studies [strong evidence] ↩
The advantage of a low-carb diet in type 2 diabetes was recognized in this meta-analysis of RCTs:Nutrients 2020: Impact of a ketogenic diet on metabolic parameters in patients with obesity or overweight and with or without type 2 diabetes: A meta-analysis of randomized controlled trials [systematic review of randomized trials; strong evidence]
In addition, both randomized and nonrandomized studies have shown better glucose control and more dose reduction/discontinuation of diabetes medications with low-carb diets.

Nutrients 2018: The effect of low-carbohydrate diet on glycemic control in patients with type 2 diabetes [moderate evidence]

Frontiers in Endocrinology 2019: Long-term effects of a novel continuous remote care intervention including nutritional ketosis for the management of type 2 diabetes: A 2-year non-randomized clinical trial [weak evidence]

Nutrition & Metabolism 2008: Low-carbohydrate diet in type 2 diabetes: stable improvement of bodyweight and glycemic control during 44 months follow-up [weak evidence] ↩
Obesity Reviews 2012: Systematic review and meta-analysis of clinical trials of the effects of low carbohydrate diets on cardiovascular risk factors. [systematic review of randomized trials; strong evidence]British Journal of Nutrition 2016: Effects of low-carbohydrate diets v. low-fat diets on body weight and cardiovascular risk factors: a meta-analysis of randomised controlled trials [strong evidence]
Nutrition Reviews 2018: Effects of carbohydrate-restricted diets on low-density lipoprotein cholesterol levels in overweight and obese adults: a systematic review and meta-analysis [strong evidence]

Lipids 2009: Carbohydrate restriction has a more favorable impact on the metabolic syndrome than a low fat diet [randomized trial; moderate evidence]
↩
Epilepsia 2018: Effect of modified Atkins diet in adults with drug-resistant focal epilepsy: a randomized controlled trial [moderate evidence]Epilepsia Open 2018: Ketogenic diet for treatment of intractable epilepsy in adults: A meta-analysis of observational studies [weak evidence] ↩
Nutrition & Metabolism 2005: The effects of a low-carbohydrate, ketogenic diet on the polycystic ovary syndrome: a pilot study [weak evidence]Journal of Obesity & Weight Loss Therapy 2015: Low-starch/low-dairy diet results in successful treatment of obesity and co-morbidities linked to polycystic ovary syndrome (PCOS) [weak evidence]
Journal of Translational Medicine 2020: Effects of a ketogenic diet in overweight women with polycystic ovary syndrome [nonrandomized study, weak evidence] ↩
Clinical Gastroenterology and Hepatology 2009: A very low-carbohydrate diet improves symptoms and quality of life in diarrhea-predominant irritable bowel syndrome [weak evidence]Neurobiology of Aging 2012: Dietary ketosis enhances memory in mild cognitive impairment [moderate evidence] ↩

Low carb & keto for clinicians