If you’re a type 2 diabetic, I’m sure you’ve heard of the low carb diet. And even if you’re not, you still might have heard of it. There are diets for everything out there. Unfortunately, the rate of success is low for the majority of diets. If you’ve tried any sort of diet before, you might realize they are not sustainable most of the time. Many of these diets don’t commonly have scientific data to back them up.

The low carb diet, as stated in it’s name, requires a person to eat a low amount of carbohydrates. Some popular examples of low carb diets are the Dukan, Paleo, and Atkins diet. These diets aim to minimize carbohydrates by consuming more protein and fat, frequently with the goal of weight loss. The American Diabetes Association states that, “carbohydrates are the primary nutrient affecting glycaemic control in people with diabetes.” So, according to that statement, one can conclude that a low carb diet would be useful to diabetics.

However, let’s go into some considerations about low carb diets based upon some scientific studies.

9 Essential Areas to Consider Before Starting a Low Carb Diet

1) What Exactly is a Low Carbohydrate Diet?

The definition of a low carb diet is inconsistent. A recent meta-analysis definition of a low carb diet is one that has less than 45% of the total energy intake (TEI) from carbohydrates. Others argue that such an intake is too high and advocate very low-carbohydrate ketogenic diets of roughly less than 50 grams per day of carbohydrates (or 10% of TEI for a 2000 kcal diet.)

2) What to Eat Instead of Carbohydrates?

If a person is to stop eating carbohydrates, he or she must replace it with something else. This leaves two categories in the macronutrient department: fat and protein. However, increasing protein intake may increase kidney related illness. Also, protein isn’t a great energy source. One gram of protein contains 4 calories, whereas one gram of fat contains 9 calories. That means a person would have to eat more than twice the protein compared to fat to meet the necessary caloric needs he or she may have.

Now that we know that it’s a better idea to increase fat over protein, you might be thinking that there are more than one type of fat. Generally, it is better to consume more monounsaturated fat than saturated fat as they have been related to lowering cholesterol and heart disease. Monounsaturated fat can be found in many nuts such as cashews or macadamia nuts or almonds.They can even be found in most oils like olive oil or avocado oil or sesame oil. There are many more sources of monounsaturated available, so you won’t be bored with it any time soon. And some natural saturated fat is okay. However, it is of great importance that one must avoid trans fat. It is known to increase disease dramatically while also promoting weight gain. Trans fat is not found in nature.  It comes from processed oil. So, if you’re buying a bottle of olive oil or such at your grocery store, then you should have nothing to worry about. However, if you are going to buy some packaged convenience food with a long list of ingredients, you should check for trans fat. Look through the ingredients list for hydrogenated or partially hydrogenated oils. If it contains either one, it has trans fat.

3) Glycemic Control:

Glycemic control refers to the glucose, or blood sugar in a diabetic person. This is of importance to diabetics because the pancreas not producing enough insulin for the body anymore. The result of this is a higher amount of sugar in the bloodstream than necessary. The recent meta-analysis shows only one out of 12 studies had a significant reduction in HbA1c. HbA1c is a term used for glycated hemoglobin. Measuring this will give a rather precise measurement of what your average blood sugar levels have been for about the last three months of your life.  In this one study, the low-carbohydrate Mediterranean diet showed greater improvements in HbA1c compared with the American Diabetes Association diet. For the other diets, no difference was shown in the HbA1c levels in the low carb diet compared to the high carb diet.

4) Changes in Diabetic Medication

Although there was not much change in glycemia control, it was noted that 95.2% of the people on the low carb diet reduced or stopped using insulin and sulfonylurea compared to 62% of the people on the high carb diet. Doing the math, the low carb diet was 33.2% more effective for reducing diabetic medication.

5) Weight Loss:

Many people try to reduce their weight by limiting their carbohydrates. However, studies from the meta-analysis do not show a significant difference in body mass index or waist circumference. Sometimes studies showed a slight improvement at first, but by the final follow up there was no notable improvement.

6) Cholesterol Control:

Unfortunately, studies do not show much difference in cholesterol either. Sometimes a low carb diet seems to have slightly decreased cholesterol at first, but in the end there is no significant help to the cholesterol levels from the low carb diet.

7) Insulin Changes:

Insulin is a hormone produced by the pancreas and necessary for regulating blood sugar levels, but diabetics may need this hormone from an outside source. While the low carb diet and the high carb diet were both useful for reducing medication, neither showed a significant difference in insulin sensitivity or insulin secretion in any of the studies.

8) Blood Pressure:

Just like the many other categories gone over before this one, no significant difference was shown in blood pressure.

9) C-Reactive Protein:

Lastly, C-reactive protein is protein that usually won’t be found in a person’s bloodstream, except in case of injury or some sort of infection. Then a measurable amount of C-reactive protein can be found in the bloodstream until their body is done healing. Therefore, a measurement of C-reactive protein can tell people of any inflammation they may have and also their risk of cardiovascular risk. Unfortunately, there were no notable changes found in the C-reactive protein for either the low carb or high carb diet in the meta-analysis.

Summary

After putting it all together, the low carb diet isn’t helpful for the majority of the population. It isn’t effective in any of the above categories besides one.In the end, it all comes down to the total energy intake. This means all three of the macronutrients in combination (carbohydrates, fat, and protein.) However, there are different low carb protocols out there with different numbers, so perhaps it can be beneficial, but under less carb intake. The meta-analysis allowed up less than 45% carbohydrates for the diet. As otherwise argued, one may need to decrease carbohydrates to 10% to call it a ketogenic diet.

Also, individuality is likely key. Some may respond to this diet more than others, but this is what we know regarding the low carb diet and type II diabetes.

References:

  1. Van Wyk, H.J., Davis, R.E., Davies, J.S. A critical review of low-carbohydrate diets in people with Type 2 diabetes. Diabetic Medicine. 23 September 2015. doi: 10.1111/dme. 12964.

Written by Parth Rajput