As primary care becomes a larger part of the obstetrician/gynecologist's practice, we are beginning to be relied upon to address and manage fundamental primary care issues such as nutrition, obesity, hypertension, and the risk assessment for heart disease, cancer, and diabetes. Evidence is now showing that insulin in chronically excessive amounts plays a significant role in the pathophysiology of these illnesses as well as in polycystic ovarian syndrome and infertility. The recent trend in low-carbohydrate, high-protein dieting may prove to play a significant role in the management of these illnesses. This review will discuss the pathophysiology of hyperinsulinemia as is supported heavily in the literature. It will explain the effects of a low-carbohydrate diet in relation to hyperinsulinemia and how it compares with the more widely accepted high-carbohydrate/low-fat diet regimen. It will also address many of the commonly held concerns regarding low-carbohydrate/high-protein diets and provide a brief overview of the typical low-carbohydrate/high-protein diet regimen.