People often hold fast to their favorite dietary dogma and get annoyed if it is challenged. But lately there has been a great deal of controversy about the best diet for good health, especially for people with diabetes or heart disease.

One sign of a possible paradigm shift is the publication of three different articles in The New England Journal of Medicine this week. Although all were focused on the health implications of sodium intake, they came to rather different conclusions.

The usual recommendation for people with diabetes is to follow a low-fat diet and avoid saturated fat in particular like the plague. The natural consequence of following these rules is a diet for diabetes that is high in carbs, sometimes highly processed carbs, though it may be low in fat. Is this truly the healthiest way a person with diabetes can eat? Or should the food pyramid be turned upside-down so that grains are the smallest proportion of the diet and fats provide the most calories?

We talk with Dr. Eric Westman about the benefits of a ketogenic diet for a variety of health problems. He’ll tell us why he often recommends such a diet for his patients, and he will answer your questions.

Eric Westman, MD, MHS, is an associate professor of medicine and director of the Duke Lifestyle Medicine Clinic. He is medical director of the Duke Center for Smoking Cessation and co-author of the books, The New Atkins for a New You and KetoClarity: Your Definitive Guide to the Benefits of a Low-Carb, High-Fat Diet. The website is http://www.KetoClarity.com. His scientific article on “Dietary carbohydrate restriction as thefirst approach in diabetes management” has just been published online in Nutrition.

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