Doctors from India explained that this isn’t another food trend pushed by celebrities. It’s a serious scientific intervention in a world drowning in chronic diseases.
Published Apr 18, 2025 | 7:00 AM ⚊ Updated Apr 18, 2025 | 7:00 AM
Sources of healthy protein. (Creative Commons)
Synopsis: A new paper by 24 doctors and researchers from across the world suggests a deeply nutritious, evidence-backed way of eating that supports real health change. Researchers say this pyramid isn’t just theory but is based on decades of research and clinical practice.
Picture a food pyramid where ghee, paneer, and chicken are in the daily essentials zone — and rice and roti are pushed aside. Sounds surprising? Not if you are among the growing number of Indians battling type 2 diabetes, obesity, or high cholesterol.
A new paper by 24 doctors and researchers from across the world, published in the peer-reviewed journal Nutrients, says it’s time to flip the old food pyramid — and your thali along with it.
A low-carb diet is not about eating meat all day. It’s a deeply nutritious, evidence-backed way of eating that supports real health change, say the authors. And for the first time, this team has visualised what a healthy low-carb plate looks like — with a full-fledged low-carbohydrate food pyramid that’s now going viral in the nutrition world.
Low-Carb Pyramid
Let’s take a look at the composition of this new food pyramid.
The base of the Pyramid (Most frequent consumption)
Middle tier (Regular consumption)
Upper tier (Occasional consumption)
Avoid foods high in carbohydrates:
Nowhere to be seen
Rice, wheat rotis, sugar, sweet fruits, juices, and processed snacks.
“The low-carb pyramid is built on real, whole foods. It’s not restrictive — it’s just smart eating,” said Dr. Mark Cucuzzella, a co-author of the study and family medicine professor.
India is known as the diabetes capital of the world. With over 100 million people with type 2 diabetes and millions more with prediabetic conditions, experts say it’s time to rethink food at the policy level.
Researchers say this pyramid isn’t just theory but is based on decades of research and clinical practice.
The authors stated that a clinical trial involving 238 participants with type 2 diabetes, conducted over an average of eight years, found that more than 50 percent reversed the disease on a ketogenic diet, with most reducing or eliminating medications within just 10 weeks. These results were sustained for the two-year duration of the trial.
“There are no essential carbohydrates,” the study stated and added: “The brain’s glucose needs can be met by the body through gluconeogenesis — even without dietary carbs.”
Meanwhile, agreeing that low-carb diets are very useful in reducing weight as well as controlling diabetes, Dr V Mohan, well-known diabetologist and chairman of Dr Mohan’s Diabetes Foundation and Research Centre said, “This new low-carb pyramid is interesting because it shows the food items those are low in carbs but higher in protein or fat. The pyramid suggests the reduction in intake of the high-carb foods,”
He explained that the ICMR study showed that 60 to 70 percent of diets in India are high in carbohydrates and that high-carbs is partly responsible for the increase in number of people with diabetes and obesity in India.
“Hence, replacing 10 to 20 percent of carbohydrates with protein, green leafy vegetables and healthy fruits — where the fibre content of the diet is also improved — will help in controlling and preventing non-communicable diseases like type 2 diabetes and obesity. In this sense, the low-carb pyramid is a very useful concept,” Dr Mohan added.
The authors also noted that, for people with carbohydrate intolerance, even two rotis could spike blood sugar dangerously. “It’s like gluten for a celiac patient,” the paper said.
However, there is a question whether this diet would raise cholesterol levels. Many Indian doctors and patients fear that eating fat will clog arteries. However, the paper busts that myth — with data from 41 clinical trials.
“LDL cholesterol may rise in some lean individuals, but 17 of 20 heart disease risk factors improve significantly on a low-carb diet,” the authors wrote.
One study showed an 11.9 percent reduction in 10-year heart disease risk, while another recorded a 44 percent decrease — even without restricting saturated fats. In the latest review by the American College of Cardiology, no link was found between saturated fat intake and heart disease.
“Low-carb diets don’t cause heart disease. In fact, they reverse most of its risk markers,” said Dr Catherine Shanahan, co-author.
One of the strongest arguments against low-carb diets is the belief that they’re expensive or “only for the rich.” However, the paper slams this as a misconception.
A cost study in New Zealand found that a low-carb diet costs only ₹100 more per person per day than the government’s standard guidelines. A pilot trial in New York’s poorest borough, the South Bronx — including people in homeless shelters — successfully implemented it.
This diet isn’t fancy. It’s based on eggs, seasonal vegetables, and coconut oil — foods most Indian kitchens already have.
The paper also addresses the “keto flu”— a set of symptoms like headaches and fatigue that some people feel when starting a low-carb diet. People starting a low-carb diet often worry about feeling tired, getting headaches, or experiencing muscle cramps.
These symptoms — sometimes called the “keto flu”— usually happen because cutting carbs makes the body lose sodium and fluids through urine, which slightly lowers blood volume.
Thankfully, it’s easy to avoid or fix this by simply drinking two cups of salty broth a day (even instant soup works) or getting enough salt and minerals from other sources.
Another common concern is ketoacidosis, a serious condition. This mainly affects people with type 1 diabetes who don’t have enough insulin. A rarer version, called euglycemic ketoacidosis, can happen in people on specific diabetes medications (like SGLT2 inhibitors).
However, the normal process of “nutritional ketosis”— where your body burns fat and produces ketones for energy — is safe and natural and does not lead to ketoacidosis.
Other common fears — like kidney damage, thyroid issues, gallstones, and constipation — are also addressed in the study.
Speaking about the myths busted in the published paper, Shashikant Iyengar, a Certified Metabolic Health Coach, and co-founder of dLife.in — India’s first low-carb diet platform — and co-organiser of the Metabolic Health Conference India, said: “The paper debunks common myths around low-carbohydrate diets, and it couldn’t be more relevant for India. With over 100 million diabetics and 136 million prediabetics (ICMR-INDIAB 2023), our carb-heavy dietary habits are clearly a big issue.”
One key myth the paper addresses is the fear of cardiovascular risk. In truth, low-carb diets consistently improve markers like triglycerides, HDL, and small-dense LDL which are critical factors often ignored in conventional lipid panels.
Moreover, people usually ignore hyperinsulinemia and insulin resistance as factors in cardiovascular diseases despite tons of studies implicating their role.
The“keto flu” is temporary and largely preventable by managing electrolytes, especially sodium. Ketoacidosis and Ketosis are different and often confused with each other.
“Ketosis happens under low carb of 30gms per day and under adequate insulin levels and normal blood sugar and is a metabolically healthy state while ketoacidosis happens when the blood sugars are high and the person has very low or no insulin levels,” he added.
Shashi Iyengar explained, “India’s addiction to sugar, refined grains, and ultra-processed foods has led to metabolic disorders from fatty liver in children to type 2 diabetes in teenagers. Adopting low-carb isn’t about eliminating tradition, but about reducing the overconsumption of carbs and restoring metabolic flexibility by eating more proteins and healthy fats like ghee, butter and coconut oil.
“The only difference of view is that the paper recommends 130 gm of carbs per day, but we have been using dLife.in’s 100 carb limit per day, which is based on liver glycogen storage capacity (as per Anup Singh, who formulated this number for India). We have seen hundreds and thousands respond well to 100 gm carb limit,” he clarified.
It’s time we stop dismissing low-carb diets as a fad.
They are rooted in science, supported by decades of clinical evidence, and offer a powerful tool to correct diabetes, hypertension, obesity etc & especially in a country where the metabolic crisis is already spiralling out of control.
Doctors from India explained that this isn’t another food trend pushed by celebrities. It’s a serious scientific intervention in a world drowning in chronic diseases.
“Doctors need to stop fearing fat and start fearing sugar and starch,” said Dr Robert Oh, a military physician and co-author of the study.
The pyramid is flexible, sustainable, and deeply nourishing, according to the authors. It can even be adapted for vegetarians using paneer, ghee, tofu, and nuts.
This study, Iyengar said, isn’t telling you to quit rice forever. “It’s saying that your plate may need a redesign if you’re struggling with diabetes, obesity, fatty liver, PCOS, or constant sugar crashes. The new pyramid offers a guide. It doesn’t demonise food. It just helps you choose smarter.”
“Low-carb diets are not just safe. They’re often life-saving. Let’s stop calling it a fad — and start calling it an option,” the study concluded.
(Edited by Muhammed Fazil.)
