Carbohydrate-restricted eating is slowly gaining mainstream acceptance as treatment for type 2 diabetes and metabolic syndrome. I thought it would be useful to present one of the watershed reports that summarize the potential benefits. The article is from 2008. Among the co-authors are some of the brightest names in this field: Richard K. Bernstein, Annika Dahlqvist, Richard Feinman, Eugene J. Fine, Robert Lustig, Uffe Ravnskov, Jeff Volek, Eric Westman, and Mary C. Vernon.
These are not wild-eyed, bomb-throwing radicals. They are on faculty at some of the best institutes of higher learning. They note that while many of the national diabetes organizations downplay the benefits of carb restriction, we have enough evidence now to warrant careful reconsideration.
Here are some of their major points, all backed up by references (68) from the scientific literature:
- Glucose (blood sugar) is a “major control element,” whether directly or indirectly through insulin, in glycogen metabolism, production of new glucose molecules, and in formation and breakdown of fat.
- The potential adverse effects of dietary fat are typically seen with diets high in carbohydrate.
- Carb restriction improves control of blood sugars, a major target of diet therapy. Many of the supportive studies were done with overweight or obese people (85% of type 2 diabetics are overweight). Very low-carb diets are often so effective that diabetic medications have to be reduced at the outset of the diet.
- For weight loss, carb-restricted diets work at least as well as low-fat diets. They are usually superior.
- Carb-restricted diets usually replace carbs with fat, resulting in improve markers for cardiovascular disease (lower serum triglycerides and higher HDL cholesterol levels). Replacing dietary fat with carbohydrate—the goal of many expert nutrition panels over the last 40 years—tends to increase the amount of artery-damaging “small, dense LDL cholesterol” in most of the population.
- Carbohydrate restriction improves all five components of the metabolic syndrome: obesity, low HDL cholesterol, high triglycerides, high blood pressure, elevated blood sugar.
- Beneficial effects of carbohydrate restriction seem to occur even without weight loss.
- Still worried about excessive fat consumption? Many low-carb dieters demonstrate a significant increase in the percentage of total calories from fat, but without an increase in the absolute amount of fat eaten. That’s because they simply reduced their total calories by reducing carb consumption.
The authors in 2008 called for a widespread reappraisal of carbohydrate restriction for type 2 diabetes and metabolic syndrome. It’s been happening, and many patients are reaping the benefits.
Reference: Accurso A, Bernstein RK, Dahlqvist A, Draznin B, Feinman RD, Fine EJ, Gleed A, Jacobs DB, Larson G, Lustig RH, Manninen AH, McFarlane SI, Morrison K, Nielsen JV, Ravnskov U, Roth KS, Silvestre R, Sowers JR, Sundberg R, Volek JS, Westman EC, Wood RJ, Wortman J, & Vernon MC (2008). Dietary carbohydrate restriction in type 2 diabetes mellitus and metabolic syndrome: time for a critical appraisal. Nutrition & metabolism, 5 PMID: 18397522
Diabetic Mediterranean Diet 