Hands On Webinar | Low Carbohydrate Diets and Exercise: What Do We Know? | Recording-Low Carbohydrate Diets and Exercise: What Do We Know?

Video Transcription

Video Summary

The webinar, moderated by Dr. Steve Mallon, focused on low-carbohydrate diets and exercise in managing type 2 diabetes, featuring expert panelists Dr. John Vittle and Dr. Brett Goodpaster. Dr. Vittle reviewed the efficacy of low-carb and ketogenic diets, highlighting that glycemic load predicts glucose spikes and that carbohydrate intolerance underpins type 2 diabetes. He explained that low-carb diets (generally <26% carbs) and ketogenic diets (<10% carbs) improve glycemic control and can induce significant short-term weight loss (5-10% in 3-6 months). Clinical trial data showed rapid glucose improvements on very low-carb diets alongside medication reductions. However, low-carb diets raise LDL cholesterol, though particle quality may improve, potentially mitigating cardiovascular risk. He debunked myths, noting that low-carb diets can be high in fiber, adherence rates are comparable to other diets, and costs are slightly higher but manageable. Exercise compatibility with low-carb diets was affirmed, citing benefits on glucose control.<br /><br />Dr. Goodpaster emphasized that exercise combined with weight loss (e.g., post-bariatric surgery or diet-induced) significantly enhances insulin sensitivity, cardiorespiratory fitness, mitochondrial function, and preserves muscle mass more than weight loss alone. Resistance and endurance exercises are recommended for sustainability and muscle quality, especially in older adults who experience sarcopenia and increased muscle fat infiltration—a marker of poor muscle quality linked to reduced strength and function. Physical activity prevents the increase of this harmful muscle fat. Emerging therapies targeting muscle preservation, such as myostatin inhibitors, were discussed but exercise remains central. Both experts agreed that individualization of diet and exercise is critical, carbohydrate fueling for typical exercise isn’t generally necessary, and careful monitoring (e.g., LDL cholesterol) is important. The panel addressed ketosis versus diabetic ketoacidosis, emphasizing differences in metabolic context and ketone levels. Overall, the session advocated for a personalized combination of low-carb diets and regular exercise to optimize diabetes management and cardiometabolic health.

Keywords

low-carbohydrate diets

ketogenic diets

type 2 diabetes management

glycemic control

weight loss

LDL cholesterol

exercise and insulin sensitivity

muscle preservation

sarcopenia

personalized diabetes treatment