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Benefits and Downsides of a Low Carb Diet

It seems like fad diets pop up every year. Some stick around and some are discovered to be dangerous or at the best unhealthy. One diet that has gained traction in the mainstream and has grown in popularity is the low carb diet. The effectiveness of the diet and its quick results has fed the growth of the acceptance of the low-carb diet. In this article, I break down the everyday benefits and potential downsides of eating a low carb diet. First, what do I consider a low carb diet? It's typically when you reduce the calories from carbs you consume to between 10-30 percent. Although if you eat a 90% carb diet and reduce it to 50-60%, you will notice positive results in your health and body.

Good Carbohydrates and Bad Carbohydrates

When reducing carbs as a method for diet, I am typically referring to sugars and grains and not carbs found in vegetables like green beans, spinach, legumes, lentils and other healthy vitamin rich foods. Carbohydrates lower on the glycemic index won't spike your insulin as much as foods higher on this index and won't result in the negative effects carbohydrates might have on your body.

A Large portion of your diet should consist of eating healthy greens, vegetables, and legumes that are low on the glycemic index.

Benefits of a Low-Carbohydrate Diet

  • Fewer cravings
    • Eating more fat and protein instead of carbohydrate helps your body turn-off ghrelin, also known as the hungry hormone.
    • Carbs spike insulin which will cause hunger as the blood sugar drops and ghrelin increases. The blood sugar drops because the insulin spike causes the glucose in the blood to be pushed into muscle and fat cells.
  • Faster Weight Loss
    • Carbs cause insulin, the "fat-storage hormone" to be released and signaling cells to store as much available energy as possible. This energy is stored as glycogen which is from the glucose you get from carbs. Less insulin means the body uses up the glycogen then burns body fat for fuel instead.
  • Increasing Healthy Fats and Protein in Diet
    • It's true that the more carbohydrates someone consumes, the less healthy fats and protein they eat. This inverse relationship causes those who reduce carbs to consume more healthy fats and protein to satiate themselves in a more healthy way. Fat and protein provides the body essential nutrients while processed carbohydrates, grains and sugars do not.
  • Natural Diabetes Treatment
    • Studies show that a low-carb diet helps to prevent type 2 diabetes. Since type 2 diabetes (a root cause in many deaths around the world) is related to blood sugar which is directly related to our diet, eating a low carbohydrate diet can greatly prevent or treat this particular disease.
  • General Key Indicators of Health Improve
    • Very important indicators of health, such as triglycerides  (lowers), blood pressure (lowers), LDL (low-density lipoprotein increases) will improve.

Downsides of A Low Carb Diet

  • The downside of reducing carbs is often the difficulty of maintaining a diet that eliminates refined carbs, something most of us grew up eating. Much of this difficulty is reduced once your body and habits adapt to the new low carb diet.
  • If your carb consumption is too low or your body goes into ketosis, you may feel ill from the extreme change in diet. It's up to you at this point whether you want to push through the pain and (most often) temporary side effects of the diet or increase the carbs you eat to a more comfortable level.
  • You may find it difficult to substitute all the refined carbohydrate calories you used to consume with other more healthy alternatives in fat and protein and carbs from vegetables. However difficult this may be, it is essential that you do so as replacing a high carb diet with a diet high in other junk food will most likely be detrimental to your health.

Are Fruits Bad For You

fruits

  • Many fruits contain  fructose which is a type of sugar but since they are also high in fiber, vitamins, and minerals, eating fruits is generally a good idea. There is also very little evidence that being overweight and getting fat is correlated solely to a high fruit diet.

Science

 Examiner
Title
Details
Conclusion
Publication
Year
   Link to Study
Foster GD, et al
A randomized trial of a low-carbohydrate diet for obesity
63 individuals were randomized to either a low-fat diet group, or a low-carb diet group. The low-fat group was calorie restricted. This study went on for 12 months.
There was more weight loss in the low-carb group, significant at 3 and 6 months, but not 12. The low-carb group had greater improvements in blood triglycerides and HDL, but other biomarkers were similar between groups.
New England Journal of Medicine
2003
   http://www.nejm.org/doi/full/10.1056/NEJMoa022207
Samaha FF, et al
A low-carbohydrate as compared with a low-fat diet in severe obesity
132 individuals with severe obesity (mean BMI of 43) were randomized to either a low-fat or a low-carb diet. Many of the subjects had metabolic syndrome or type II diabetes. The low-fat dieters were calorie restricted. Study duration was 6 months.
The low-carb group lost significantly more weight (about 3 times as much). There was also a statistically significant difference in several biomarkers
New England Journal of Medicine
2003
   http://www.nejm.org/doi/full/10.1056/NEJMoa022637
Sondike SB, et al
Effects of a low-carbohydrate diet on weight loss and cardiovascular risk factor in overweight adolescents
30 overweight adolescents were randomized to two groups, a low-carb diet group
and a low-fat diet group. This study went on for 12 weeks. Neither group was instructed to restrict calories.
The low-carb group lost significantly more (2.3 times as much) weight and had significant decreases in Triglycerides and Non-HDL cholesterol. Total and LDL cholesterol decreased in the low-fat group only.
The Journal of Pediatrics
2003
   http://www.sciencedirect.com/science/article/pii/S0022347602402065
Brehm BJ, et al
A randomized trial comparing a very low carbohydrate diet and a calorie-restricted
low fat
diet on body weight and cardiovascular risk factors in healthy women
53 healthy but obese females were randomized to either a low-fat diet, or a low-carb diet. Low-fat group was calorie restricted. The study went on for 6 months.
The low-carb group lost more weight (2.2 times as much) and had significant reductions in blood triglycerides. HDL improved slightly in both groups.
The Journal of Clinical Endocrinology & Metabolism
2003
   http://jcehttp://archinte.jamanetwork.com/article.aspx?articleid=217514m.endojournals.org/content/88/4/1617.long
Aude YW, et al
The national cholesterol education program diet vs a diet lower in carbohydrates and higher in protein and monounsaturated fat
60 overweight individuals were randomized to a low-carb diet high in monounsaturated fat, or a low-fat diet based on the National Cholesterol Education Program (NCEP).
The low-carb group lost 1.8 times as much weight. There were also several changes in biomarkers that are worth noting:
* Waist-to-hip ratio is a marker for abdominal fat. This marker improved slightly in the LC group, not in the LF group.
* Total cholesterol improved in both groups.
* Triglycerides went down by 42 mg/dL in the LC group, compared to 15.3 mg/dL in the LF group.
* LDL particle size increased by 4.8 nm and percentage of small, dense LDL decreased by 6.1% in the LC group, while there was no significant difference in the LF group.
* Overall, the low-carb group lost more weight and had much greater improvements in several important risk factors for cardiovascular disease.
Archives of Internal Medicine
2004
   http://archinte.jamanetwork.com/article.aspx?articleid=217514
Yancy WS Jr, et al
A low-carbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia
120 overweight individuals with elevated blood lipids were randomized to a low-carb or a low-fat diet. The low-fat group was calorie restricted.
Study went on for 24 weeks.
The low-carb group lost significantly more weight and had greater improvements in blood triglycerides and HDL cholesterol.
Annals of Internal Medicine
2004
   http://annals.org/article.aspx?articleid=717451
JS Volek, et al
Comparison of energy-restricted very low-carbohydrate and low-fat diets on weight loss and body composition in overweight men and women
A randomized, crossover trial with 28 overweight/obese individuals.
Study went on for 30 days (for women) and 50 days (for men) on each diet, that is a very low-carb diet and a low-fat diet. Both diets were calorie restricted.
The low-carb group lost more weight. The men on the low-carb diet lost three times as much abdominal fat as the men on the low-fat diet.
Nutrition & Metabolism (London)
2004
   http://www.ncbi.nlm.nih.gov/pmc/articles/PMC538279/
Meckling KA, et al
Comparison of a low-fat diet to a low-carbohydrate diet on weight loss, body composition, and risk factors for diabetes and cardiovascular disease in free-living, overweight men and women
40 overweight individuals were randomized to a low-carb and a low-fat diet for 10 weeks. The calories were matched between groups.
Both groups lost a similar amount of weight.
A few other notable differences in biomarkers:
* Blood pressure decreased in both groups, both systolic and diastolic.
* Total and LDL cholesterol decreased in the LF group only.
* Triglycerides decreased in both groups.
* HDL cholesterol went up in the LC
group, but decreased in the LF group.
* Blood sugar went down in both groups, but only the LC group had decreases in insulin levels, indicating improved insulin sensitivity.
The Journal of Clinical Endocrinology & Metabolism
2004
   http://jcem.endojournals.org/content/89/6/2717.long
Nickols-Richardson SM, et al
Perceived hunger is lower and weight loss is greater in overweight premenopausal women consuming a low-carbohydrate/high-protein vs high-carbohydrate/low-fat diet
28 overweight premenopausal women consumed either a low-carb or a low-fat diet for 6 weeks. The low-fat group was calorie restricted.
The low-carb diet caused significantly more weight loss and reduced hunger compared to the low-fat diet.
Journal of the American Dietetic Association
2005
   http://www.sciencedirect.com/science/article/pii/S000282230501151X
Daly ME, et al
Short-term effects of severe dietary carbohydrate-restriction advice in Type 2 diabetes
102 patients with Type 2 diabetes were randomized to a low-carb or a low-fat diet for 3 months. The low-fat group was instructed to reduce portion sizes.
The low-carb group lost more weight and had greater improvements in the Total cholesterol/HDL ratio. There was no difference in triglycerides, blood pressure or HbA1c (a marker for blood sugar levels) between groups.
Diabetic Medicine
2006
   http://onlinelibrary.wiley.com/doi/10.1111/j.1464-5491.2005.01760.x/abstract
McClernon FJ, et al
The effects of a low-carbohydrate ketogenic diet and a low-fat diet on mood, hunger, and other self-reported symptoms
119 overweight individuals were randomized to a low-carb, ketogenic diet or a calorie restricted low-fat diet for 6 months.
The low-carb group lost almost twice the weight and experienced less hunger.
Obesity (Silver Spring)
2007
   http://www.ncbi.nlm.nih.gov/pubmed/17228046
Gardner CD, et al
Comparison of the Atkins, Zone, Ornish, and LEARN diets for change in weight and related risk factors among overweight premenopausal women: the A TO Z Weight Loss Study
311 overweight/obese premenopausal women were randomized to 4 diets: A low-carb Atkins diet, a low-fat vegetarian Ornish diet, the Zone diet and the LEARN diet. Zone and LEARN were calorie restricted.
The Atkins group lost the most weight, although the difference was not statistically significant. The Atkins group had the greatest improvements in blood pressure, triglycerides and HDL. LEARN and Ornish (low-fat) had decreases in LDL at 2 months, but then the effects diminished.
The Journal of The American Medical Association
2007
   http://jama.jamanetwork.com/article.aspx?articleid=205916
Halyburton AK, et al
Low- and high-carbohydrate weight-loss diets have similar effects on mood but not cognitive performance
93 overweight/obese individuals were randomized to either a low-carb, high-fat diet or a low-fat, high-carb diet for 8 weeks. Both groups were calorie restricted.
The low-carb group lost more weight. Both groups had similar improvements in mood, but speed of processing (a measure of cognitive performance) improved further on the low-fat diet.
American Journal of Clinical Nutrition
2007
   http://ajcn.nutrition.org/content/86/3/580.long
Dyson PA, et al
A low-carbohydrate diet is more effective in reducing body weight than healthy eating in both diabetic and non-diabetic subjects
13 diabetic and 13 non-diabetic individuals were randomized to a low-carb diet or
a 'healthy eating' diet that followed the Diabetes UK recommendations (a calorie restricted, low-fat diet). Study went on for 3 months.
The low-carb group lost more weight (about 3 times as much). There was no difference in any other marker between groups.
 Diabetic Medicine
2007
   http://onlinelibrary.wiley.com/doi/10.1111/j.1464-5491.2007.02290.x/full
Westman EC, et al
The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus
84 individuals with obesity and type 2 diabetes were randomized to a low-carb, ketogenic diet or a calorie restricted low-glycemic diet. The study went on for 24 weeks.
The low-carb group lost significantly more weight than the low-glycemic group. There were several other important differences:
* Hemoglobin A1c went down by 1.5% in the LC group, compared to 0.5% in the low-glycemic group.
* HDL cholesterol increased in the LC group only, by 5.6 mg/dL.
* Diabetes medications were either reduced or eliminated in 95.2% of the LC group, compared to 62% in the low-glycemic group.
* Many other health markers like blood pressure and triglycerides improved in both groups, but the difference between groups was not statistically significant.
Nutrion
& Metabolism (London)
2008
   http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2633336/
Shai I, et al
Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet
322 obese individuals were randomized to three diets: a low-carb diet, a calorie restricted low-fat diet and a calorie-restricted Mediterranean diet.
Study went on for 2 years.
The low-carb group lost more weight than the low-fat group and had greater improvements in HDL cholesterol and triglycerides.
 New England Journal of Medicine
2008
   http://www.nejm.org/doi/full/10.1056/NEJMoa0708681
Keogh JB, et al
Effects of weight loss from a very-low-carbohydrate diet on endothelial function and markers of cardiovascular disease risk in subjects with abdominal obesity
107 individuals with abdominal obesity were randomized to a low-carb or a low-fat diet. Both groups were calorie restricted and the study went on for 8 weeks.
The low-carb group lost more weight and there was no difference between groups on Flow Mediated Dilation or any other markers of the function of the endothelium (the lining of blood vessels). There was also no difference in common risk factors between groups.
American Journal of Clinical Nutrition
2008
   http://ajcn.nutrition.org/content/87/3/567.long
Tay J, et al
Metabolic effects of weight loss on a very-low-carbohydrate diet compared with an isocaloric high-carbohydrate diet in abdominally obese subjects
88 individuals with abdominal obesity were randomized to a very low-carb or a low-fat diet for 24 weeks. Both diets were calorie restricted.
The low-carb group lost more weight. Triglycerides, HDL, C-Reactive Protein, Insulin, Insulin Sensitivity and Blood Pressure improved in both groups. Total and LDL cholesterol improved in the low-fat group only.
Journal of The American College of Cardiology
2008
   http://www.sciencedirect.com/science/article/pii/S0735109707032597
Volek JS, et al
Carbohydrate restriction has a more favorable impact on the metabolic syndrome than a low fat diet
40 subjects with elevated risk factors for cardiovascular disease were randomized to a low-carb or a low-fat diet for 12 weeks. Both groups were calorie restricted.
The low-carb group lost almost twice the amount of weight as the low-fat group, despite eating the same amount of calories.
This study is particularly interesting because it matched calories between groups and measured so-called “advanced” lipid markers. Several things are worth noting:
* Triglycerides went down by 107 mg/dL on LC, but 36 mg/dL on the LF diet.
* HDL cholesterol increased by 4 mg/dL on
LC, but went down by 1 mg/dL on LF.
* Apolipoprotein B went down by 11 points on LC, but only 2 points on LF.
* LDL size increased on LC, but stayed the same on LF.
* On the LC diet, the LDL particles partly shifted from small to large (good), while they partly shifted from large to small on LF (bad).
Lipids
2009
   http://link.springer.com/article/10.1007%2Fs11745-008-3274-2
Brinkworth GD, et al
Long-term effects of a very-low-carbohydrate weight loss diet compared with an isocaloric low-fat diet after 12 months
118 individuals with abdominal obesity were randomized to a low-carb or a low-fat diet for 1 year. Both diets were calorie restricted.
The low-carb group had greater decreases in triglycerides and greater increases in both HDL and LDL cholesterol, compared to the low-fat group.
American Journal of Clinical Nutrition
2009
   http://ajcn.nutrition.org/content/90/1/23.long
Hernandez, et al
Lack of suppression of circulating free fatty acids and hypercholesterolemia during weight loss on a high-fat, low-carbohydrate diet
32 obese adults were randomized to a low-carb or a calorie restricted, low-fat diet for 6 weeks.
The low-carb group had greater decreases in triglycerides (43.6 mg/dL) than the low-fat group (26.9 mg/dL). Both LDL and HDL decreased in the low-fat group only.
American Journal of Clinical Nutrition
2010
   http://ajcn.nutrition.org/content/91/3/578.long
Krebs NF, et al
Efficacy
and
safety of a high protein, low carbohydrate diet for weight loss in severely obese adolescents
46 individuals were randomized to a low-carb or a low-fat diet for 36 weeks. Low-fat group was calorie restricted.
The low-carb group had greater reductions in BMI. Various biomarkers improved in both groups, but there was no significant difference between groups.
Journal of Pediatrics
2010
   http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2892194/
Guldbrand, et al
In type 2 diabetes, randomization to advice to follow a low-carbohydrate diet transiently improves glycaemic control compared with advice to follow a low-fat diet producing a similar weight loss
61 individuals with type 2 diabetes were randomized to a low-carb or a low-fat diet for 2 years. Both diets were calorie restricted.
There was no difference in weight loss or common risk factors between groups. There was significant improvement in glycemic control at 6 months for the low-carb group, but compliance was poor and the effects diminished at 24 months as individuals had increased their carb intake.
Diabetologia
2012
   http://link.springer.com/article/10.1007%2Fs00125-012-2567-4

    Glycemic Index 
    • The glycemic index chart below shows the index and the foods associated with it. Foods that are low on the glycemic index won't spike your insulin as high and are safer to eat if you are trying to comply with a low-carb diet.
     Food Glycemic index (glucose = 100) Serving size (grams) Glycemic load per serving Type of Food
    Banana cake, made with sugar 47 60 14 Bakery Products and Breads
    Banana cake, made without sugar 55 60 12 Bakery Products and Breads
    Sponge cake, plain 46 63 17 Bakery Products and Breads
    Vanilla cake made from packet mix with vanilla frosting (Betty Crocker) 42 111 24 Bakery Products and Breads
    Apple muffin, made with rolled oats and sugar 44 60 13 Bakery Products and Breads
    Apple muffin, made with rolled oats and without sugar 48 60 9 Bakery Products and Breads
    Waffles, Aunt Jemima® 76 35 10 Bakery Products and Breads
    Bagel, white, frozen 72 70 25 Bakery Products and Breads
    Baguette, white, plain 95 30 14 Bakery Products and Breads
    Coarse barley bread, 80% kernels 34 30 7 Bakery Products and Breads
    Hamburger bun 61 30 9 Bakery Products and Breads
    Kaiser roll 73 30 12 Bakery Products and Breads
    Pumpernickel bread 56 30 7 Bakery Products and Breads
    50% cracked wheat kernel bread 58 30 12 Bakery Products and Breads
    White wheat flour bread, average 75 30 11 Bakery Products and Breads
    Wonder® bread, average 73 30 10 Bakery Products and Breads
    Whole wheat bread, average 69 30 9 Bakery Products and Breads
    100% Whole Grain® bread (Natural Ovens) 51 30 7 Bakery Products and Breads
    Pita bread, white 68 30 10 Bakery Products and Breads
    Corn tortilla 52 50 12 Bakery Products and Breads
    Wheat tortilla 30 50 8 Bakery Products and Breads
    Coca Cola® (US formula) 63 250 mL 16 Beverages
    Fanta®, orange soft drink 68 250 mL 23 Beverages
    Lucozade®, original (sparkling glucose drink) 95 250 mL 40 Beverages
    Apple juice, unsweetened 41 250 mL 12 Beverages
    Cranberry juice cocktail (Ocean Spray®) 68 250 mL 24 Beverages
    Gatorade, orange flavor (US formula) 89 250 mL 13 Beverages
    Orange juice, unsweetened, average 50 250 mL 12 Beverages
    Tomato juice, canned, no sugar added 38 250 mL 4 Beverages
    All-Bran®, average 44 30 9 Breakfast Cereals And Related Products
    Coco Pops®, average 77 30 20 Breakfast Cereals And Related Products
    Cornflakes®, average 81 30 20 Breakfast Cereals And Related Products
    Cream of Wheat® 66 250 17 Breakfast Cereals And Related Products
    Cream of Wheat®, Instant 74 250 22 Breakfast Cereals And Related Products
    Grape-Nuts® 75 30 16 Breakfast Cereals And Related Products
    Muesli, average 56 30 10 Breakfast Cereals And Related Products
    Oatmeal, average 55 250 13 Breakfast Cereals And Related Products
    Instant oatmeal, average 79 250 21 Breakfast Cereals And Related Products
    Puffed wheat cereal 80 30 17 Breakfast Cereals And Related Products
    Raisin Bran® 61 30 12 Breakfast Cereals And Related Products
    Special K® (US formula) 69 30 14 Breakfast Cereals And Related Products
    Pearled barley, average 25 150 11 Grains
    Sweet corn on the cob 48 60 14 Grains
    Couscous 65 150 9 Grains
    Quinoa 53 150 13 Grains
    White rice, boiled, type non-specified 72 150 29 Grains
    Quick cooking white basmati 63 150 26 Grains
    Brown rice, steamed 50 150 16 Grains
    Parboiled Converted white rice (Uncle Ben's®) 38 150 13 Grains
    Whole wheat kernels, average 45 50 15 Grains
    Bulgur, average 47 150 12 Grains
    Graham crackers 74 25 13 Cookies And Crackers
    Vanilla wafers 77 25 14 Cookies And Crackers
    Shortbread 64 25 10 Cookies And Crackers
    Rice cakes, average 82 25 17 Cookies And Crackers
    Rye crisps, average 64 25 11 Cookies And Crackers
    Soda crackers 74 25 12 Cookies And Crackers
    Ice cream, regular, average 62 50 8 Dairy Products And Alternatives
    Ice cream, premium (Sara Lee®) 38 50 3 Dairy Products And Alternatives
    Milk, full-fat, average 31 250 mL 4 Dairy Products And Alternatives
    Milk, skim, average 31 250 mL 4 Dairy Products And Alternatives
    Reduced-fat yogurt with fruit, average 33 200 11 Dairy Products And Alternatives
    Apple, average 36 120 5 Fruits
    Banana, raw, average 48 120 11 Fruits
    Dates, dried, average 42 60 18 Fruits
    Grapefruit 25 120 3 Fruits
    Grapes, black 59 120 11 Fruits
    Oranges, raw, average 45 120 5 Fruits
    Peach, average 42 120 5 Fruits
    Peach, canned in light syrup 52 120 9 Fruits
    Pear, raw, average 38 120 4 Fruits
    Pear, canned in pear juice 44 120 5 Fruits
    Prunes, pitted 29 60 10 Fruits
    Raisins 64 60 28 Fruits
    Watermelon 72 120 4 Fruits
    Baked beans 40 150 6 Beans And Nuts
    Black-eyed peas 50 150 15 Beans And Nuts
    Black beans 30 150 3 Beans And Nuts
    Chickpeas 10 150 3 Beans And Nuts
    Chickpeas, canned in brine 42 150 9 Beans And Nuts
    Navy beans, average 39 150 12 Beans And Nuts
    Kidney beans, average 34 150 9 Beans And Nuts
    Lentils 38 150 5 Beans And Nuts
    Soy beans, average 15 150 1 Beans And Nuts
    Cashews, salted 22 50 3 Beans And Nuts
    Peanuts 13 50 1 Beans And Nuts
    Fettucini 32 180 15 Pasta And Noodles
    Macaroni, average 50 180 24 Pasta And Noodles
    Macaroni and Cheese (Kraft®) 64 180 33 Pasta And Noodles
    Spaghetti, white, boiled, average 46 180 22 Pasta And Noodles
    Spaghetti, white, boiled 20 min 58 180 26 Pasta And Noodles
    Spaghetti, whole-grain, boiled 42 180 17 Pasta And Noodles
    Corn chips, plain, salted 42 50 11 Snack Foods
    Fruit Roll-Ups® 99 30 24 Snack Foods
    M & M's®, peanut 33 30 6 Snack Foods
    Microwave popcorn, plain, average 65 20 7 Snack Foods
    Potato chips, average 56 50 12 Snack Foods
    Pretzels, oven-baked 83 30 16 Snack Foods
    Snickers Bar®, average 51 60 18 Snack Foods
    Green peas 54 80 4 Vegetables
    Carrots, average 39 80 2 Vegetables
    Parsnips 52 80 4 Vegetables
    Baked russet potato 111 150 33 Vegetables
    Boiled white potato, average 82 150 21 Vegetables
    Instant mashed potato, average 87 150 17 Vegetables
    Sweet potato, average 70 150 22 Vegetables
    Yam, average 54 150 20 Vegetables
    Hummus (chickpea salad dip) 6 30 0 Miscellaneous
    Chicken nuggets, frozen, reheated in microwave oven 5 min 46 100 7 Miscellaneous
    Pizza, plain baked dough, served with parmesan cheese and tomato sauce 80 100 22 Miscellaneous
    Pizza, Super Supreme (Pizza Hut®) 36 100 9 Miscellaneous
    Honey, average 61 25 12 Miscellaneous