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Therapeutic Low-Carb Diet for Diabetes and Weight Loss
By Valeria Mallett, RD, CDCES

Low-carbohydrate diets have been used for decades and have been quite controversial amongst health professionals. There have been numerous researches over the years that show that Therapeutic Low carb diets improves A1C, triglycerides, raised HDL-C (good cholesterol), improved blood pressure, and shows greater reductions in diabetes medication.

In fact, in 2019 the American Diabetes Association recognized low-carbohydrate diets as a therapy for type 2 diabetes, stating “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” (Evert et al., 2019)

How many carbs to eat?
It differs for everyone based on age, preference, blood sugar levels, physical activity, etc. Guidelines can range from intake of 50-150 grams of carbohydrates per day (Western Diet usually consumes >250 grams/day). Generally, consuming around 20-30 grams of carbohydrates per meal. This would be equivalent to eating ½ banana with plain yogurt or 1 small corn tortilla with ½ cup of beans.

What should you consume on this diet?
The focus of this diet is to consume a balanced diet, increasing the intake of non-starchy vegetables and paying attention to the quality and quantity of carbohydrates. Tracking calories is not necessary. Elimination of saturated fats are not necessary, although intake of high-quality unsaturated fats is encouraged.  A well-formulated low-carb diet includes adequate energy, protein, fat, vitamins, and minerals.

Why does this diet work for diabetes management and weight loss?
Individuals of obesity and type 2 diabetes are often resistant to their own insulin. Consuming less carbohydrates allows the body to decrease the need of insulin in the body, which improves many hormonal regulations including appetite and satiety hormones. Very low carbohydrates diets have been shown to contribute to remission of type 2 diabetes. It is important to know the low-carb diet is a tool one can use, not a “cure” for diabetes or obesity.

It is important to consult with a Registered Dietitian who is a Certified Diabetes Care and Education Specialist who can translate these guidelines for you and ensure you can do this safely, especially if you are on certain medication for diabetes and high blood pressure or is pregnant or nursing.

Do not implement low-carbohydrate diets if you have the following rare disease:
-von Gierke disease
-carnitine deficiency
-carnitine palmitoyltransferase (CPT) deficiency
-carnitine translocase deficiency,
-pyruvate carboxylase deficiency
-acyl-CoA dehydrogenase deficiency
-acute intermittent porphyria.

Reference:
1.      Evert, AB, Dennison M, Gardner CD, et al, Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report, Diabetes Care, Ahead of Print, published online April 18, 2019, https://doi.org/10.2337/dci19-0014
2.      van Zuuren  EJ, Fedorowicz  Z, Kuijpers  T, Pijl  H. Effects of low-carbohydrate- compared with low-fat-diet interventions on metabolic control in people with type 2 diabetes: a systematic review including GRADE assessments. Am J Clin Nutr 2018;108:300–331pmid:3000727 
https://pubmed.ncbi.nlm.nih.gov/30007275/
3.      Sainsbury  E, Kizirian  NV, Partridge  SR, Gill  T, Colagiuri  S, Gibson  AA. Effect of dietary carbohydrate restriction on glycemic control in adults with diabetes: a systematic review and meta-analysis. Diabetes Res Clin Pract 2018;139:239–252pmid:29522789
https://pubmed.ncbi.nlm.nih.gov/29522789/
4.      
www.lowcarbusa.org
5.      
Effects of a low carbohydrate diet on energy expenditure during weight loss maintenance: randomized trial (BMJ, 2018) https://www.bmj.com/content/363/bmj.k4583