The primary problem sufferers from diabetes have is that their bodies don't handle sugar (glucose) well. Part of the issue here is that excess sugar in the body can attach itself to tissues, which damages them.
As a result, diabetics are at an increased risk of a variety of conditions including nerve damage, blood vessel damage, and kidney disease. Generally speaking, diabetes impacts both quality of life and longevity.
As I have pointed out before, official recommendations regarding what diabetics should eat have generally focused on the need to eat a low-fat diet, and to include starchy foods (like bread, potatoes, pasta, rice, and breakfast cereal) with every meal.
Because these foods tend to cause brisk and substantial release of sugar into the body, and because blood-sugar control is the primary underlying problem in diabetes, common sense would dictate that conventional nutritional advice for diabetics is somewhat misguided.
So for quite some time now, at least some practitioners and individuals with diabetes have been eschewing the low-fat, high-carb diets traditionally recommended to them. Instead, they've been opting for lower-carb regimens.
I am one of those practitioners, and my experience with carb-restricted diets is that they are generally effective for controlling blood sugar and reducing the need for medication. Sometimes, such diets eliminate the need altogether.
But those in the medical and scientific community are, I've found, not so interested in common sense and people's personal experience: What they want is science. I have noticed generally that for an approach that appears to be counter to conventional wisdom, doctors and scientists generally demand science that validates it. On the other hand, for approaches that are accepted as beneficial, no such demands are made.
I was interested to read a study published earlier this month, which assessed the effects of restricted-carbohydrate diets in the management of diabetes. This study amassed the data from 13 individual studies, in which a lower-carb diet was pitted against a higher-carb diet. Actually, the lower-carb diets used in these experiments ranged in carbohydrate content from 4 percent to 45 percent. So, while some were genuinely low in carbs, others were not.
Even so, this study found that compared to higher-carb diets, lower-carb regimens led to significant improvements in a number of measures, namely fasting blood glucose, levels of HBA1c (which gives an indication of blood sugar control over the last two to three months), and levels of unhealthy blood fats known as triglycerides.
Overall, blood sugar levels fell by 15 percent, HbA1c levels by 9.4 percent, and triglyceride levels dropped by a third. Do bear in mind that some of the diets that gave these results were not actually what some would term restricted-carbohydrate diets.
Nevertheless, the results speak for themselves. The authors of this study conclude that there is insufficient evidence for carbohydrate-restricted diets to be recommended. They also call for further research into the long-term safety of such diets. If the results had been different, and the study had found that higher-carb diets were superior, I wonder whether there'd be a call for further research. I think we know the answer.
When it comes to changing a paradigm in medicine, it seems that not only will common sense not suffice, good science won't do either.
Reference:
Kirk JK, et al. Restricted-carbohydrate diets in patients with type 2 diabetes: a meta-analysis. Journal of the American Dietetic Association. 2008; 108:91–100
Dr. John Briffa is a London-based doctor and author with an interest in nutrition and natural medicine.
Dr. Briffa's Web site
Feeds