Can a Low Carbohydrate Diet Help?
When you have diabetes or pre-diabetes, carbohydrates are often a topic of contention and a hot topic among the many type 2 diabetes community members. I have been inspired by our community members to learn more about the benefits of a carbohydrate-restricted diet.
Many of you recommended reading a book titled, Dr. Bernstein’s Diabetes Solution, a book written by Richard K. Bernstein, MD, in which he promotes following a very low carbohydrate diet as a method for optimizing diabetes management. In addition to reading Dr. Bernstein’s book, I have also spent time reviewing several research articles on the topic of carbohydrate restriction.
Prior to 1922, when insulin was discovered, a very low carbohydrate diet was used to manage hyperglycemia. A low carbohydrate diet was considered to be appropriate nutritional treatment for diabetes through the 1970’s up until the 1980’s when the USDA came out with the first set of Dietary Guidelines for Americans. A low fat diet was promoted due to the concern that a high fat diet may increase the risk of cardiovascular disease. As a result, carbohydrates began to take the place of fat in our diet. The rate of obesity, heart disease and diabetes has been on the rise since that time.
This has made many of us, researchers included, question current dietary guidelines and ADA recommendations2015 Dietary Guidelines carbohydrate recommendation:130 grams carbohydrate/day45-65 % of total energy intakeAmerican Diabetes Association (ADA) The ADA typically recommends a starting point of 45-60 grams of carbohydrate at each mealA 2014 article from Diabetes Care Journal, an ADA publication, titled: Nutrition Therapy Recommendations for the Management of Adults With Diabetes, made the following statement, “Evidence is inconclusive for an ideal amount of carbohydrate intake for people with diabetes. Therefore, collaborative goals should be developed with the individual with diabetes.”The goal of this article is not to tell you that carbohydrates are horrible and that all carbohydrates should be eliminated, but rather to share with you what I have learned from my own personal research and what suggestions/recommendations I have based on what I have learned.What I have learned from my own research:There is evidence from current and older research that a low carbohydrate diet may help improve blood glucose control, help reduce insulin resistance, reduce obesity and improve cardiovascular disease risk markers.In Dr. Bernstein’s Diabetes Solution book, he explains the vicious cycle of insulin resistance (a characteristic feature of type 2 diabetes). Those with abdominal obesity most likely have some amount of insulin resistance.As a result, additional insulin must be released every time a carbohydrate food is consumed in order to keep blood sugars in check.Extra insulin increases hunger, which can result in overeating, weight gain and thus worsening obesity.There will be a reduced amount of insulin released to keep blood sugar levels in a safe range by eating fewer carbohydrates.Lower insulin levels allow for fat to be burned and used as energy.The above process is somewhat simplified and can be read about in great detail at one’s leisure.There is no universal definition for a carbohydrate-restricted diet. Some proposed definitions include: 21-70 grams of carbohydrate per day (very low carbohydrate diet)30-40% of total calories from carbohydrate (moderately low carbohydrate diet)Here are some of my personal recommendations on how to apply the above information:If you are considering a carbohydrate-restricted diet, make sure to have a discussion with your diabetes doctor (Endocrinologist) first. He/she may want to adjust your medication, especially if you take mealtime insulin or an oral medication that increases insulin release.Once you have gotten the “ok” from your physician, consider starting your carbohydrate restriction with breakfast. Breakfast is usually a more challenging time of day to control blood sugar due to the hormones released in the early morning hours. Consider eating half as much carbohydrate at your breakfast meal as you would at your lunch or dinner meals.Consider cutting back to 130 grams of carbohydrate per day. This amounts to approximately 43 grams of carbohydrate at each meal. At this amount, you will be meeting the current Dietary Guideline recommendations while ensuring that your brain gets the 100 grams of glucose (broken down carbohydrate) it requires on a daily basis.Not ready to restrict carbohydrates from your diet? Consider replacing high glycemic index foods with low glycemic index foods. Low glycemic index foods typically are higher in fiber and are less processed. Check out the following link from the ADA to learn more: Glycemic Index and DiabetesLastly, don’t forget about the protein! Protein plays an important role in assisting with blood sugar control, as well as keeping you satisfied longer.
Did you know that diabetes is a risk factor for developing chronic kidney disease?