Open Letter from Doctors + other Health Professionals to U.S. News & World Report

To: Editors, US News & World Report
Your Publication is Misinforming its Readers on Low-Carb Diets

U.S. News & World Report recently published an article criticizing the Department of Veteran Affairs (VA) for testing a new program to treat its population with diabetes in partnership with Virta Health, a private company. U.S. News quoted a number of skeptics of Virta’s novel approach, which includes the use of a ketogenic diet combined with a mobile app, to treat type 2 diabetes. We, as doctors, welcome skepticism, yet we wonder why U.S. News has been so excessively critical of a new, evidence-based approach that in our view, offers the first truly promising solution to a tragic epidemic. We further question the decision by the magazine to publish the complaints of a group that is motivated by an animal-rights agenda rather than science and human health.

For decades, pre-diabetes and type 2 diabetes, which afflict more than half the populations of the U.S. and Canada, has been considered a progressive, unstoppable disease that leads to painful decline and early death.

Virta’s findings should therefore be welcomed as a breakthrough. In a large trial undertaken at the University of Indiana, Virta has managed to demonstrate that a type 2 diabetes diagnosis can, in fact, be reversed. This controlled clinical trial, now in its third year, has sustained the results it obtained at year one, with more than half of its population reversing its diabetes diagnosis and more than 90% reducing or eliminating the need for insulin and other medications. Moreover, these patients have also seen the vast majority of their heart-disease risk factors (23 of 26 measured) improve.

Virta’s results are in agreement with nearly 100 additional trials on carbohydrate restriction, including some six experiments lasting at least two years, a period of time generally thought to be long enough to reveal potentially negative side effects; So far, there are none. This type of science —a controlled clinical trial—is considered to be the gold standard of science: a rigorous test that can yield reliable cause-and-effect data.

U.S. News erroneously attempts to contradict this data by citing a study employing observational, or epidemiological data. Yet epidemiology is a weak type of science that can ultimately only show associations, not cause-and-effect evidence. It is therefore a type of science best–if not effectively only–used for hypothesis generation. Once a hypothesis has been tested, in clinical trials, there is no longer a need to go back to this far weaker evidence.

Low-carb diets have now been tested, in numerous clinical trials, on thousands of people. These tests show that the diet is safe and effective in combating diet-related diseases. The evidence is especially strong for type 2 diabetes.

For these reasons, the American Diabetes Association (ADA) included low carbohydrate and very low carbohydrate diets as “Medical Nutrition Therapy” in their 2020 Standards of Medical Care in Diabetes and 2019 Consensus Report.

In fact, the ADA, in its 2019 consensus report, stated that “Reducing overall carbohydrate intake for individuals with diabetes has demonstrated the most evidence for improving glycemia and may be applied in a variety of eating patterns that meet individual needs and preferences.” [emphasis added]

Other concerns raised by U.S. News have also been already proven false: the low-carb diet is not nutrient deficient, and its tendency to raise LDL-cholesterol is usually transient (Read here, here, here, and here). Moreover, the type of cholesterol that inevitably goes up with carbohydrate-restriction is the “good,” HDL cholesterol that is linked with lower heart-disease risk.

According to the evidence, therefore, VA’s partnership with Virta, was a highly rational decision. The VA’s decision also seems highly rationale to us.

As physicians, we are successfully employing low-carb and ketogenic diets in our practices. Nearly all of us once recommended the official, traditional high-carb diet to our patients, only to see them gain weight and get sicker. Some of us got fat and sick ourselves. Switching to carbohydrate restriction has brought back hope into our practices: We now see people lower their blood pressure, lose weight effortlessly, and reverse their type 2 diabetes within weeks. We have seen these benefits endure in our patients and ourselves for years. Patients have been able to get off their medications and save money. Further, we know from the medical literature that our decisions and recommendations are based in sound science.

We ask: why does U.S. News appear to be pursuing a campaign to denigrate low-carb and ketogenic diets? We note that the “Best Diets” annual cover story routinely puts these diets at the bottom of the list, without any explanation or citation of the evidence. We have observed that the panel of experts assigned to rank diets includes many vegetarian/vegan advocates but not a single authority experienced with the practice and perhaps even the literature of low-carb or ketogenic diets. This is not balanced reporting for your readers and yields results that do not reflect the current science.

We also note that the recent article on Virta cites criticism by the Physicians Committee for Responsible Medicine,” which is an animal-rights group with physicians representing fewer than 10% of its members. Animal-rights groups tend to be opposed to low-carb diets based on the faulty assumption that these diets are based entirely on animal foods.

We don’t understand why U.S. News would promote ideological agendas and weak science. We urge you to develop a more balanced and evidence- based approach to your reporting on the science.

If you could meet one of our patients, with obesity and diabetes, facing limb amputation—as we have—we feel you would be more responsive to the science that would help your many thousands of readers. They deserve to know the best and most current science on how to get healthier.

1Alabama Christine County, RDNTuskagee
2Dr. Dean ThorntonBirmingham
3Dr. Scott HarperBirmingham
4Arizona Dr. David CrutchfieldPhoenix
5Dr. Seneca CarrilloPhoenix
6CaliforniaDr. Amy WeinbergBeverly Hills
7Megan Gerrard (Pharmacist)San Marcos
8Dr. James JohnsonIrvine
9Sabra Daly (Physician Assistant)Oakland
10Dr. Denson FujikawaLos Angeles
11Dr. Debra LondonOjai
12Norton Kitagawa, PhDMilpitas
13Dr. Richard O’LearySan Jose
14Dr. Brian LenzkesSan Diego
15Dr. Gaja AndzelYucaipa
16Dr. Ed HendricksRoseville
17Dr. Shebani Sethi DalaiMenlo Park
18Chad Larson, D.C.Solana Beach
19Dr. Michael MyersSan Jose
20Sandra Parkington (Nurse)San Diego
21ColoradoDr. Jennifer McCabe LentzFort Collins
22Conner Middelmann (Nutritionist)Boulder
23Pat Berndt (Nurse Practitioner)Colorado Springs
24Dr. Ari MelmedDenver
25ConnecticutSusan Masino, PhDWest Simsbury
26Dr. Kenneth BrooklerNorwalk
27Dr. Vatsal ThakkarWestport
28Dr. Charles CavoWest Hartford
29District of ColumbiaKathleen Ridgeway
30FloridaDr. Carlos MoreyraMarianna
31Dr. Philip OvadiaSt. Petersburg
32Dr. Stephen FitzmeyerPonte Vedra Beach
33Dr. Jaclynn MoskowPompano Beach
34HawaiiDr. Linda AnegawaHonolulu
35Idaho Dr. Mary HaferBoise
36Alyssa Gallagher (Dietitian)Boise
37Dr. David BrownBoise
38IllinoisDr. Dimitri PlikasMount Prospect
39Dr. Michael CloseChicago
40Mark Holtschlag, D.C.Quincy
41Dr. Tony HamptonOrland Park
42Dr. Naomi ParrellaChicago
43Dr. Christy KessleringWinfield
44Dr. Kristin BaierElmhurst
45IndianaBrandon Leeson (Pharmacist)Indianapolis
46Susan Schlundt (Nurse)Greenfield
47Madison Hayes (RDN)Muncie
48Dr. Jim IngramAuburn
49Kansas Dr. Melissa HagueWichita
50Dr. Sabrina MarkeseLawrence
51Dr. Tanya WilliamsDodge City
52KentuckyDr. Ivan SaraivaLexington
53MassachusettsDr. Georgia EdeNorthampton
54Dr. Angela FitchBoston
55Dr. Jessica InwoodWestport
56Jared Pecotich (Nutritionist)Boston
57Dr. Christopher PalmerBelmont
58Dr. Navid MahootiDanvers
59Michigan Dr. Celia EganGrand Rapids
60Darren Schmidt, D.C.Ann Arbor
61Dr. Rohit BhaveAnn Arbor
62Dr. Gaye GormanMidland
63MinnesotaDr. Todd GreatensBaxter
64Dr. Dave LaposkyLongville
65MississippiDr. John Lucas IIIGreenwood
66MontanaMichael Matury D.C.Great Falls
67NebraskaLouis Stoeger (Pharmacist)Juniata
68Theresa Link (Dietitian)Omaha
69Dr. George HeadOmaha
70Dr. Tom McGinnOmaha
71Dr. Douglas KosmickiGrand Island
72Dr. Kenneth PetersOmaha
73NevadaDr. John WohlwendHenderson
74New JerseyDonna Camara, D.C.Mountainside
75Dr. Pavel YufitMontclair
76New MexicoDr. Dan VanDeRietGallup
77Dr. Kathryn RandallDeming
78New York Dr. Eugene FineBronx
79Dr. Alan VanderwaldeGoshen
80Dr. Jennifer WalshBuffalo
81Jaclyn Heuer (Dietitian)Suffern
82Dr. Pradeep AtluriNew York
83Denise Coughlin, PhDPlattsburgh
84North Carolina Dr. Tommy MegremisChapel Hill
85Adele Hite, PhDDurham
86Dr. David MartinPinehurst
87Dr. Diane WilliamsPinehurst
88Dr. April KemperChapel Hill
89Dr. Eric WestmanDurham
90Ohio Dr. Juliet French-VallabhColumbus
91Dr. Faisal KhatriCincinnati
92Dr. Gregory KelsoZanesville
93Jenny Bowman (Nurse)Waverly
94OklahomaSarah Prater (Dietitian)Moore
95Oregon Dr. Ann ChildersWest Linn
96Dr. Gerald BarkerEugene
97Maureen Jones (Nurse)Wilsonville
98Dr. Karen OyamaPortland
99Pennsylvania Dr. Victoria GershuniPhiladelphia
100Dr. Pamela BrandtPottstown
101Jerry Schaeffer, D.C.Chalfont
102Dr. Janine KyrillosBala Cynwyd
103Dr. Eric SodicoffPottstown
104Rhode IslandDonna Soares (Nurse)Warwick
105South CarolinaCorinne Ingle (Nurse Practitioner)Beaufort
106Tennessee Gayla Jensen (Nutritionist)Elizabethton
107Dr. Sterling R CraigJackson
108Jaime Yaich (Nurse)Jackson
109Texas Dawn Ray, RDN
110Kristina Eggener, RDN
111Awbrey Lovrien-Moore (Dietitian)Temple
112Dr. David ClarkPlano
113Maria Ayarzagoitia (Nurse)Corpus Christi
114Dr. Jake KushnerHouston
115Gary Guerra, PhDSan Antonio
116Dr. Janelle LindowEl Paso
117Dr. Kissi BlackwellWichita Falls
118Lori Shemek, PhDGarland
119Utah Tomeika Ulett-Garcia (Nurse Practitioner)American Fork
120Dr. Rohn RigbyLayton
121VirginiaJennifer BrownStafford
122Dr. Stephen MillerHaymarket
123Dr. Susan WolverRichmond
124Dr. Karen OaksDanville
125Dr. Munazza AnisRichmond
126John BarnesCentreville
127WashingtonDr. Daryl DetwilerSeattle
128Dr. Christopher StadtherrGig Harbor
129Dr. Debbie NighswongerPort Townsend
130Brandy Wiltermuth (Nurse Practitioner)Edmonds
131Dr. William ErricoOmak
132Dr. Eric WilliamsBellingham
133West VirginiaDr. Mark CucuzzellaMartinsburg
134Wisconsin Dr. Mikko ZuchnerWausau
135Dr. Paul SpottswoodKenosha


136ArgentinaDr. Carolina Goic
137AustraliaDr. Joe Kosterich
138Dr. John O’Donnell
139Dr. Penny Figtree
140Dr. Andrew McIntyre
141Dr. Gary Fettke
142BahrainDr. Saji Kumar
143CanadaDr. Rick Zabrodski
144Dr. Cathryn Zapf
145David Zapf, PhD
146Heather Wiersma (Pharmacist)
147Dr. Kim Stepney
148Dr. Charlene Kotze
149Diana Mundiyamkal (Pharmacist)
150Dr. Samantha Lamont
151Dr. Sophie Ruffet
152Dr. Anne-Isabelle Dionne
153Dr. John Allen
154Dr. Tharina Uys
155Dr. Julie Carrier
156Dr. Hala Lahlou
157Dr. Alexandra Albert
158Dr. Ellen Jost
159Dr. Erin Jamieson
160Dr. Jason Murdoch
161Dr. Jodie Wang
162Dr. Adam Norris
163Dr. Rebecca Stacpoole
164Dr. Carol Loffelmann
165Dr. Virginie Dubuc
166Dre Marie-Pierre Chabot
167Dr. Marie Lesperance
168Alain Levesque (Pharmacist)
169Dr. Evelyne Bourdua-Roy
170Dr. Catherine Bouchard
171Dr. Mathieu Bernier
172Dr. Linda Bernier
173Dr. Bridget Reidy
174Dr. Geneviève Mathieu
175Dr. Taranum Sultana
176Angela Martens (Dietitian)
177FranceDr. Frederic Duval-Levesque
178GermanyDr. Antti Heikkila
179Dr. Johannes Scholl
180IcelandDr. Kjartan Loftsson
181IndiaDr. Amutha Kanagasabai
182Gopi Chandran Ramachandran, PhD
183Dr. Muthumperumal Thirumal Pillai
184Dr. Karuna Singh
185Dr. Karthi Subramaniam
186Dr. Harit Bansal
187Dr. Paramesh S
188Dr. Raja Ekambaram
189Dr. Siva Kumar
190Dr. Raju Kuppusamy
191Dr. Prema Vivekanandan
192Dr. Muthusamy Chinnasamy
193Dr. Santhana Kumaran
194Dr. Keerthi Mani
195Dr. Tharangini Shanmugam
196Dr. Arunkumar Anbazhagan
197Dr. Lalithambika Rajeswari
199Dr. Major Sekar Narayanasamy
199Dr. Parikshit Bhattacharyya
200IraqDr. Atheer Kurdi
201IrelandDr. Gitte Wieneke
202Dr. Ahmad Alshammara
203KenyaDr. Daniel Kiningu
204Mary Obade, PhD
205MexicoDr. Carlos Zumarraga Novelo
206New ZealandDr. Christopher Leathart
207OmanDr. Suzeth Encarndo
208PhilippinesDr. Reynaldo Villanueva
209Dr. Renacito Ramos
210Dr. Archibald Conan Ut
211Dr. Benigno Agbayani
212Dr. Denis Cosgrove
213Dr. Rene Wilson Veneracion
214Dr. Jylene Janorabon
215South AfricaNomautanda Siduna (Nurse)
216Dr. Tasneem Mahomedy
217Dr. Hemant Kumar Vallabh
218SpainDr. Pentti Raaste Platan
219Sri LankaDr. Janaka Wannaku
220SwitzerlandDr. Olivia Stanimirov Rossi
221United KingdomDr. James Salvin-Keech
222Dr. Campbell Murdoch
223Dr. Billal Patel
224Dr. Katharine Morrison
225Dr. Kim Andrews
226Dr. David Oliver
227Dr. Donal Collins
228Dr. Simon Tobin
229Dr. David Unwin
230Dr. Mike Keen
231Dr. Talal AlWisabi
232Dr. Neil Upton
233Catherine Cassell (Nurse)

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