Category Archives: Carbohydrate

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

low-carb mediterranean diet

Click the pic to purchase at Amazon.com in the U.S.

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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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Low-Carb Diet Works In Overweight Japanese Type 2 Diabetes

This meal is low-carb, and probably low-calorie too

This meal is both low-carb and low-calorie

A randomized controlled clinical trial found superior results in diabetes with a moderate low-carb diet, judging from weight loss and hemoglobin A1c.

I don’t know how many carbs the typical Japanese person eats in a day. In the U.S., it’s 250-300 grams. Here’s how the study at hand was done:

“This prospective, randomized, open-label, comparative study included 66 T2DM patients with HbA1c >7.5% even after receiving repeated education programs on Calorie-Restricted Dieting (CRD). They were randomly allocated to either the 130g/day Low-Carb Diet (LCD) group (n = 33) or CRD group (n = 33). Patients received personal nutrition education of CRD or LCD for 30 min at baseline, 1, 2, 4, and 6 months. Patients of the CRD group were advised to maintain the intake of calories and balance of macronutrients (28× ideal body weight calories per day). [If I understand correctly, a 170-lb (77.2 kg) person would be recommended to eat 2160 calories/day.] Patients of the LCD group were advised to maintain the intake of 130 g/day carbohydrate without other specific restrictions. Several parameters were assessed at baseline and 6 months after each intervention. The primary endpoint was a change in HbA1c level from baseline to the end of the study.

At baseline, body mass index (BMI) and HbA1c were 26.5 and 8.3, and 26.7 kg/m2 and 8.0%, in the CRD and LCD, respectively. At the end of the study, HbA1c decreased by −0.65% in the LCD group, compared with 0.00% in the CRD group (p < 0.01). Also, the decrease in BMI in the LCD group [−0.58 kg/m2] exceeded that observed in the CRD group (p = 0.03).

Conclusions: Our study demonstrated that 6-month 130 g/day LCD reduced HbA1c and BMI in poorly controlled Japanese patients with type 2 diabetes. LCD is a potentially useful nutrition therapy for Japanese patients who cannot adhere to CRD.”

Source: A randomized controlled trial of 130 g/day low-carbohydrate diet in type 2 diabetes with poor glycemic control – Clinical Nutrition

The calorie-restricted diet did nothing for these folks in terms of glycemic  control.

Steve Parker, M.D.

PS: In case you’re wondering, the Low-Carb Mediterranean reduces digestible carbs to 20-100 grams/day.

low-carb mediterranean diet

Front cover of book

 

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Dr. Fung’s Quick Start Guide to Diabetes Reversal

Dr. Fung is a nephrologist and huge advocate of intermittent fasting. He has an article over at DietDoctor that you may find interesting (link below). Beware: at the link you will find an accurate photo of a gangrenous foot that you may find nauseating or disturbing.

I see gangrene in the hospital once a month. It’s one of the things that keeps me motivated to help PWDs (people with diabetes) learn to conquer diabetes.

Another caveat. If you take drugs that have the potential to cause hypoglycemia, you may indeed suffer life-threatening hypoglycemia if you drastically cut back on sugar and other refined carbohydrates. You better know what you’re doing.

Dr. Fung writes:

“Once we understand type 2 diabetes, then the solution becomes pretty bloody obvious. If we have too much sugar in the body, then get rid of it. Don’t simply hide it away so we can’t see it. There are really only two ways to get rid of the excessive sugar in the body.

  1. Don’t put sugar in [nor refined starches]
  2. Burn it off

That’s it. That’s all we need to do. The best part? It’s all natural and completely free. No drugs. No surgery. No cost.”

Source: How to Reverse Type 2 Diabetes – The Quick Start Guide – Diet Doctor

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New Evidence Supports Extreme Carbohydrate Restriction in Type 2 Diabetes

Low-Carb Spaghetti Squash With Meat Sauce

Diabetes is a disease of carbohydrate intolerance. Doesn’t that suggest to you that diabetics should reduce or avoid dietary carbohydrates?

The new study at hand was done in Indiana, involving 262 folks with type 2 diabetes. Characteristics of the study subjects:

  • average age 54
  • 66% women
  • BMI 41 (very fat)
  • average Hemoglobin A1c 7.6%

The authors don’t use the term “ketogenic diet,” preferring instead “a diet designed to induce nutritional ketosis” (I’m paraphrasing). For most folks, that’s a diet with under 30 grams of carbohydrate daily, according to the researchers. The study lasted for only 10 weeks.

The drop-out rate was about 10% (25 participants), which is not bad.

Results:

  • Hemoglobin A1c (a test of diabetes control) dropped to 6.5%, a move in the right direction and equivalent or better than that seen with many diabetes drugs.
  • Average weight loss was 7.2% of initial body weight.
  • No severe symptomatic hypoglycemic events.
  • Number and dose of necessary diabetes drugs were reduced “substantially.”

What’s not to love? Why isn’t this the standard of care?

Click the link below to look for details of the Virta Clinic program used in this study.

I put together a Ketogenic Mediterranean Diet for my patients with diabetes. It reduces dietary carbs to 20-30 grams/day. There’s a free version, but consider the low-cost version that includes recipes and extensive initiation and management advice.

Steve Parker, M.D.

McKenzie AL, Hallberg SJ, Creighton BC, Volk BM, Link TM, Abner MK, Glon RM, McCarter JP, Volek JS, Phinney SD
A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes
JMIR Diabetes 2017;2(1):e5
DOI: 10.2196/diabetes.6981

low-carb mediterranean diet

Front cover of book

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How Walter White lost weight in “Breaking Bad”

Raw Brussels Sprouts, one of many low-carb vegetables.
Photo Copyright: Steve Parker

In 2014 Howard Stern interviewed Bryan Cranston and asked how he lost weight so quickly for his role as Walter White on Breaking Bad:

“Stern: When you had chemo and was getting sick playing the part of Walter White, in order to go through rapid weight loss you deliberately didn’t eat for 10 days? True or false?

Cranston: False.

Stern: How’d you lose all that weight?

Cranston: No carbohydrates. I just took out all the carbohydrates.

Stern: How much weight did you drop?

Cranston: 16 pounds, in ten days.

Stern: Painful?

Cranston: No. The first three days are really hard, ’cause your body’s changing and craving sugar and wants, you know, and then you deprive it of the sugar and it starts burning fat.”

Source: How Walter White lost weight in Breaking Bad, it wasn’t chemo – High Steaks

h/t Tom Naughton

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