Category Archives: Carbohydrate

ADA Is Starting to Embrace Low-Carb Eating

 

Beautiful, huh? Radishes are a non-starchy vegetable.

From Diabetes Care

Consensus recommendations:

A variety of eating patterns (combinations of different foods or food groups) are acceptable for the management of diabetes.

Until the evidence surrounding comparative benefits of different eating patterns in specific individuals strengthens, health care providers should focus on the key factors that are common among the patterns:

○ Emphasize nonstarchy vegetables.

○ Minimize added sugars and refined grains.

○ Choose whole foods over highly processed foods to the extent possible.

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.

For select adults with type 2 diabetes not meeting glycemic targets or where reducing antiglycemic medications is a priority, reducing overall carbohydrate intake with low- or very low-carbohydrate eating plans is a viable approach.

Source: Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report | Diabetes Care

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Do Diabetics Need as Many Carbs as Other Folks?

From Diabetes Care:

Do carbohydrate needs differ for people with diabetes compared with the general population?

Carbohydrate is a readily used source of energy and the primary dietary influence on postprandial blood glucose. Foods containing carbohydrate—with various proportions of sugars, starches, and fiber—have a wide range of effects on the glycemic response. Some result in an extended rise and slow fall of blood glucose concentrations, while others result in a rapid rise followed by a rapid fall. The quality of carbohydrate foods selected—ideally rich in dietary fiber, vitamins, and minerals and low in added sugars, fats, and sodium— should be addressed as part of an individualized eating plan that includes all components necessary for optimal nutrition.The amount of carbohydrate intake required for optimal health in humans is unknown. Although the recommended dietary allowance for carbohydrate for adults without diabetes (19 years and older) is 130 g/day and is determined in part by the brain’s requirement for glucose, this energy requirement can be fulfilled by the body’s metabolic processes, which include glycogenolysis, gluconeogenesis (via metabolism of the glycerol component of fat or gluconeogenic amino acids in protein), and/or ketogenesis in the setting of very low dietary carbohydrate intake.

Source: Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report | Diabetes Care

low-carb mediterranean diet

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What’s the Optimal Diet for Type 1 Diabetes?

A mess of Bacon Bit Brussels Sprouts: 6 grams of fiber per serve

Dr. Muccioli over at Diabetes Daily posted a brief article on a recent research study. A snippet:

The authors found that a higher intake of fiber was associated with lower average blood glucose values. In contrast, a higher intake of carbohydrate, alcohol, and monounsaturated fat was negatively associated with glycemic control (these patients typically experienced more variability in their blood glucose levels). Finally, the analysis revealed that “substituting proteins for either carbohydrates, fats, or alcohol, or fats for carbohydrates, were all associated with lower variability in the measured blood glucose values.”

Source: Which Dietary Patterns Are Best for Type 1 Diabetes Control? – Diabetes Daily

Eaton and Konner figured the Paleolithic diet provided over 70 g/day of fiber. How much are we in the West eating now? Something like 15–20 grams.

Steve Parker, M.D.

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Very Low Carbohydrate Diets for Diabetes (ADA 2018)

This Avocado Chicken soup is low-carb. Use the search box to find the recipe.

Over at Diabete Daily, Dr Maria Muccioli wrote about recent low-carb diet research as applied to diabetes. A couple excerpts to whet your appetite:

Dr. Tay stated that a very low carbohydrate diet offers a considerable advantage over a high carbohydrate approach for patients with type 2 diabetes.She noted that reducing medication use is not only cost-effective but can also safeguard from the considerable side effects of some second-line medications. She also explained that achieving less glycemic variability, which may be an independent risk factor for the development of diabetes-associated complications, is “of great clinical importance.”“It is a good diet to have if you have diabetes, and the data support that,” she concluded.

  *   *   *

What about VLC diet for children with type 1 diabetes?

Dr. de Bock does not deny that a VLCD for children with type 1 diabetes can help to achieve exceptional glycemic control, as recently demonstrated in a study showing normal average A1c levels in a large cohort of patients. The speaker remarked that the patients in that study had very low glycemic variability.

He believes that more research needs to be conducted to evaluate the relevance of the potential concerns that he outlined. Until then, he advises parents of children who follow a VLCD to work closely with their medical care providers to monitor growth, cardiac, nutritional, and mental/emotional parameters.

Source: Very Low Carbohydrate Diets for Diabetes (ADA 2018)

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Dr Maria Muccioli: The Low-Carb Diabetes Revolution (Part I) – Type 1 Diabetes 

Published at Diabetes Daily:

Not long ago, low-carbohydrate diets were considered to be on the fringes of medically-recommended strategies for diabetes control. Long regarded as a “fad diet” and with the health effects often called into question, many patients were routinely discouraged from attempting such an approach. However, in recent years, as more and more research demonstrated the potential benefits of a low-carbohydrate approach for people with diabetes and prediabetes, we have seen a rapid change in the nutritional guidelines and the professional recommendations for patients.

At the 79th American Diabetes Association (ADA) Scientific Sessions, we saw a symposium addressing the changes in the nutrition consensus report for adults with diabetes. Notably, a one-size-fits-all approach is no longer recommended, with experts suggesting now that various eating strategies and macronutrient distributions can work well for patients from a nutritional and glycemic control perspective. Moreover, low-carbohydrate diets were explicitly addressed as a relevant and effective strategy, that is “garnering more attention and support”, as per Dr. William S. Yancy, MD, MHS, who chaired the symposium titled “Providing Options – Using a Low-Carbohydrate or Very Low-Carbohydrate Diet with Adults with Type 1 Diabetes, Type 2 Diabetes or Prediabetes”. In this series, we explore the research and surrounding conversations regarding low-carbohydrate approaches for these distinct patient subgroups.

RTWT!

Source: The Low-Carb Diabetes Revolution (Part I): Type 1 Diabetes (ADA 2019) – Diabetes Daily

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Can Diet Reduce Your Gingivitis and Periodontitis?

Yes...at least according to a tiny short-term study done in Germany. Only 10 experimental subjects.

Here’s their description of the food: “…low in carbohydrates, rich in Omega-3 fatty acids, and rich in vitamins C and D, antioxidants and fiber for four weeks.” How low in carbs? To a level “as far as possible to a level < 130 grams/day.” Click the link above for full diet details. It looks to me like a paleo diet.

Certified paleo-compliant, plus high omega-3 fatty acids and low-carb

The researchers note in the body of their report that they can’t tell for sure which components of the experimental diet were most helpful, but they suspect it’s 1) the carbohydrate restriction, 2) increased omega-3 fatty acids, and 3) reduced omega-6 consumption.

Those three factors are at play in the both the Paleobetic Diet and Low-Carb Mediterranean Diet.

Here’s the study’s abstract for you science nerds:

Background

The aim of this pilot study was to investigate the effects of four weeks of an oral health optimized diet on periodontal clinical parameters in a randomized controlled trial.

Methods

The experimental group (n = 10) had to change to a diet low in carbohydrates, rich in Omega-3 fatty acids, and rich in vitamins C and D, antioxidants and fiber for four weeks. Participants of the control group (n = 5) did not change their dietary behavior. Plaque index, gingival bleeding, probing depths, and bleeding upon probing were assessed by a dentist with a pressure-sensitive periodontal probe. Measurements were performed after one and two weeks without a dietary change (baseline), followed by a two week transitional period, and finally performed weekly for four weeks.

Results

Despite constant plaque values in both groups, all inflammatory parameters decreased in the experimental group to approximately half that of the baseline values (GI: 1.10 ± 0.51 to 0.54 ± 0.30; BOP: 53.57 to 24.17 %; PISA: 638 mm2 to 284 mm2). This reduction was significantly different compared to that of the control group.

Conclusion

A diet low in carbohydrates, rich in Omega-3 fatty acids, rich in vitamins C and D, and rich in fibers can significantly reduce gingival and periodontal inflammation.

Thanks to BioMed Central for making the entire report available for free.

Reference:

An oral health optimized diet can reduce gingival and periodontal inflammation in humans – a randomized controlled pilot study

  • J. P. WoelberEmail author,
  • K. Bremer,
  • K. Vach,
  • D. König,
  • E. Hellwig,
  • P. Ratka-Krüger,
  • A. Al-Ahmad and
  • C. Tennert
BMC Oral Health 2016, 17:28

https://doi.org/10.1186/s12903-016-0257-1

Published: 26 July 2016

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Short-Term Metabolic Effects of Low-Carb Versus High-Carb Diet In Type 1 Diabetes

Shrimp Salad

A scientific study published 2017 compared a high-carb (at least 250 grams/day) to low-carb diet (50 grams or less) in 10 patients with type 1 diabetics. The low-carb diet yielded more time in the normal blood sugar range, less hypoglycemia, and less variability of glucose levels.

I assume the low-carb diet required less insulin, but I don’t know since I haven’t seen the full article. Let me know if you can confirm.

In case you’re wondering, the Paleobetic diet provides about 60 grams of carb daily, and the Low-Carb Mediterranean Diet ranges from 20 t0 100 grams.

Here’s the abstract:

The aim of the present study was to assess the effects of a high carbohydrate diet (HCD) vs a low carbohydrate diet (LCD) on glycaemic variables and cardiovascular risk markers in patients with type 1 diabetes. Ten patients (4 women, insulin pump-treated, median ± standard deviation [s.d.] age 48 ± 10 years, glycated haemoglobin [HbA1c] 53 ± 6 mmol/mol [7.0% ± 0.6%]) followed an isocaloric HCD (≥250 g/d) for 1 week and an isocaloric LCD (≤50 g/d) for 1 week in random order. After each week, we downloaded pump and sensor data and collected fasting blood and urine samples. Diet adherence was high (225 ± 30 vs 47 ± 10 g carbohydrates/d; P < .0001). Mean sensor glucose levels were similar in the two diets (7.3 ± 1.1 vs 7.4 ± 0.6 mmol/L; P = .99). The LCD resulted in more time with glucose values in the range of 3.9 to 10.0 mmol/L (83% ± 9% vs 72% ± 11%; P = .02), less time with values ≤3.9 mmol/L (3.3% ± 2.8% vs 8.0% ± 6.3%; P = .03), and less glucose variability (s.d. 1.9 ± 0.4 vs 2.6 ± 0.4 mmol/L; P = .02) than the HCD. Cardiovascular markers were unaffected, while fasting glucagon, ketone and free fatty acid levels were higher at end of the LCD week than the HCD week. In conclusion, the LCD resulted in more time in euglycaemia, less time in hypoglycaemia and less glucose variability than the HCD, without altering mean glucose levels.

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