High-fat, low-carbohydrate diets are a feasible long-term treatment for type 1 diabetes

This study was published in Upsala Journal of Medical Science 2005;110(3):267-73

Study title and authors:

A low carbohydrate diet in type 1 diabetes: clinical experience--a brief report.

Nielsen JV, Jönsson E, Ivarsson A.

Department of Medicine, Blekingesjukhuset, Karlshamn, Sweden. jorgen.vesti-nielsen@ltblekinge.se

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/16454166

This study examined the effects of a high-fat, low-carbohydrate, diet on 22 patients with type I diabetes who were failing to control fluctuations in their blood sugar levels in higher carbohydrate diets. The diet was limited to around 70-90 grams a day of carbohydrate and excluded potatoes, rice, pasta, bread and cereals. The diet consisted of 20% carbohydrate, 30% protein and 50% fat.

After 12 months on the high-fat, low-carbohydrate, diet, the study found:
(a) Hypoglycaemic episodes (where the blood glucose levels drop to abnormally low dangerous values) decreased from 2.9 episodes per week to 0.5 episodes per week.
(b) Meal insulin requirements decreased from 21.1 Iu per day to 12.4 Iu per day.
(c) Unhealthy high triglyceride levels decreased by 33%.

This study shows that a high-fat, low-carbohydrate, diet is a feasible long-term treatment of type 1 diabetes and leads to improved blood glucose control.

Links to other studies:
Reduced saturated fat consumption has led to vitamin D deficiency
The beneficial effects of a low carbohydrate diet for diabetes
Type I diabetics have better blood sugar control on a high fat diet

Low carbohydrate diets improve blood glucose control in patients with Maturity Onset Diabetes of the Young.

This study was published in the Journal of International Medical Research 2011;39(6):2296-301

Study title and authors:

The Influence of Dietary Carbohydrate Content on Glycaemia in Patients with Glucokinase Maturity-onset Diabetes of the Young.

Klupa T, Solecka I, Nowak N, Szopa M, Kiec-Wilk B, Skupien J, Trybul I, Matejko B, Mlynarski W, Malecki MT.

Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland; Krakow University Hospital, Krakow, Poland.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/22289546

Maturity Onset Diabetes of the Young (MODY) is a group of diabetes disorders that affects about 2% of people with diabetes. MODY is often not recognised and people may be treated as Type 1 or Type 2 diabetes by their doctors. 

MODY has the following characteristics:

(i) Diabetes presents at a young age, usually less than 25 years of age.

(ii) MODY runs in families through several generations. A parent with MODY has a 50% chance of passing on MODY to their child. 

(iii) People with MODY do not produce enough insulin; this is different to Type 2 diabetes where people frequently produce lots of insulin but don't respond to their insulin.

There are six varieties of MODY:

MODY 1 Rare form of MODY. Similar effects to MODY 3.

MODY 2 Causes between 10-65% of MODY. Causes mild diabetes. Often diagnosed in childhood or pregnancy.

MODY 3 Causes between 20-75% of MODY. Causes progressive diabetes and patients may get diabetes complications. Usually diagnosed after puberty.

MODY 4 Rare form of MODY. Seems to produce relatively mild diabetes.

MODY 5 Rare form of MODY. Associated with kidney disease that is often diagnosed before diabetes.

MODY 6 Extremely rare form of MODY. Severity of diabetes unknown as yet. 

This study concerns MODY 2 which is a mutation in the glucokinase gene on chromosome 7. Glucokinase is an enzyme that acts as a glucose sensor so the beta cells in the pancreas produce the correct amount of insulin after a meal. However in MODY 2 the mutated glucokinase enzyme is less responsive to glucose entering the blood stream which results in continuously elevated high blood glucose levels.

This study evaluated the effect of the quantity of dietary carbohydrate on glucose levels in 10 glucokinase mutation carriers: seven with MODY and three with prediabetes. The patients were exposed to a 60% high-carbohydrate diet for two days and then switched to 25% low-carbohydrate diet for another 2 days.

The study found:

(a) On the high-carbohydrate diet, glucose levels were significantly higher compared with the low-carbohydrate diet.

(b) On the high-carbohydrate diet, spikes in glucose levels occurred significantly more frequently compared with the low-carbohydrate diet.

This study suggests that diets with a low carbohydrate content may improve blood glucose control in patients with Maturity Onset Diabetes of the Young.

Links to other studies:

The case for high fat/low carbohydrate diets in diabetes management

High fat/low carbohydrate diet decreases risk of heart disease

Diabetes patients health benefits from a high fat/low carbohydrate diet

High fat/Low carbohydrate diets are particularly effective in reducing the dangerous visceral fat in type II diabetics

This study was published in Diabetes Metabolic Syndrome and Obesity 2011;4:167-74

Study title and authors:

Effects of a moderate low-carbohydrate diet on preferential abdominal fat loss and cardiovascular risk factors in patients with type 2 diabetes.

Sasakabe T, Haimoto H, Umegaki H, Wakai K.

Department of Clinical Nutrition, Haimoto Clinic, Yayoi, Kasugai, Aichi, Japan;

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/21779148

Visceral fat refers to the fat that surrounds the internal organs. Subcutaneous fat is body fat that is close to the skin's surface and is considered less dangerous, and easier to lose than visceral fat.

Studies have shown that those with visceral fat are more susceptible to heart disease, stroke, diabetes and high blood pressure.

This study examined the effects of a low carbohydrate diet on visceral fat, subcutaneous fat and heart disease risk factors in patients with type II diabetes. The study included 52 type II diabetes patients who consumed a high fat/low carbohydrate diet for six months.

The main principle of the low carbohydrate diet used in the study was to eliminate carbohydrate-rich foods depending on each patient’s HbA1c levels:

(i) Patients with HbA1c levels less than 9.0% eliminated carohydrate-rich foods from their dinner. 

(ii) patients with an HbA1c level more than 9.0% were asked to eliminate carbohydrates from breakfast and dinner. 

Patients were allowed to eat as much protein and fat as they wanted, including saturated fat. There were no other dietary restrictions.

The study found:

(a) The high fat/low carbohydrate diet resulted in a 14.2% visceral fat loss in men and an 18.9% visceral fat loss in women, as well as a 9.0% subcutaneous fat loss in men and an 8.8% subcutaneous fat loss in women. 

(b) Men lost 2 kg in weight and women lost 1.7 kg in weight.

(c) The unhealthy high HbA1c levels decreased by 1.9% in men and by 1.6% in women.

(d) The unhealthy high fasting glucose levels decreased by 21 mg/dl (1.16 mmol/l) in men and by 20 mg (1.11 mmol/l) in women.

(e) The unhealthy high triglyceride levels decreased by 16 mg/dL (.18 mmol/l) in men and by 7 mg/dL (.08 mmol/l) in women.

(f) The levels of high density lipoprotein (HDL) cholesterol rose by a healthy 5 mg/dL (.13 mmol/l) in men and 1 mg/dL (.03 mmol/l) in women.

The results of the study suggest that as well as been effective for absolute fat loss, the high fat/low carbohydrate diet is particularly effective in reducing the dangerous visceral fat. Additionally the diet reduced the values of many risk factors of heart disease and diabetes complications.

Links to other studies:
As children eat less saturated fat and cholesterol - their obesity rates have soared
Obese and diabetic patients lose more weight on a high fat diet compared to a high carbohydrate diet
High-fat diets are better than high-carbohydrate diets in the treatment of type 2 diabetes

Diets high in fat and low in carbohydrate may decrease the risk of diabetes

This study was published in the American Journal of Clinical Nutrition 2008 Feb;87(2):339-46

Study title and authors:
Low-carbohydrate-diet score and risk of type 2 diabetes in women.

Halton TL, Liu S, Manson JE, Hu FB.
Department of Nutrition, Harvard School of Public Health, Boston, MA 02215, USA.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/18258623

The study examined the association of dietary carbohydrate, protein and fat with type II diabetes. The study included 85,059 women and lasted for 20 years.

The study found:
(a) Those that ate the most carbohydrate had a 26% increased risk of type II diabetes compared to those who ate the least carbohydrate.
(b) Those that consumed diets with the highest glycemic load had an 147% increased risk of type II diabetes compared to those who consumed the lowest glycemic load.
(c) Those that ate the most fat had a 9% decreased risk of type II diabetes compared to those who ate the least fat.
(d) Those that ate the most animal fat had a 4% decreased risk of type II diabetes compared to those who ate the least animal fat.

This study shows that diets high in fat and low in carbohydrate may decrease the risk of diabetes.

Professor says that low-carbohydrate, high-fat diets are the preferred method for treating type 2 diabetes

This paper was published in the Scandinavian Cardiovascular Journal 2008 Aug;42(4):256-63

Study title and authors:

Carbohydrate restriction as the default treatment for type 2 diabetes and metabolic syndrome.

Feinman RD, Volek JS.

Department of Biochemistry, SUNY Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, New York 11203, USA. rfeinman@downstate.edu

This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/18609058

Professor Richard Feinman reviews the role of low carbohydrate diets in relation to treatment of diabetes and metabolic syndrome.

He found:

• Dietary carbohydrate restriction in the treatment of diabetes and metabolic syndrome is based on an underlying principle of control of insulin secretion and the theory that insulin resistance is a response to chronic high blood glucose levels and high insulin levels.
• This theory has substantial experimental support.
• This theory has generally been opposed by health agencies because of concern that carbohydrate will be replaced by fat, particularly saturated fat, thereby increasing the risk of heart disease as dictated by the so-called diet-heart hypothesis. However recent data shows that, in fact, substitution of fat for carbohydrate generally improves heart disease risk factors.
• Removing the barrier of concern about dietary fat makes carbohydrate restriction the preferred method for treating type 2 diabetes and metabolic syndrome.
• Low carbohydrate, high fat diets are shown to improve blood glucose control, lower HbA1C levels and reduce the need for diabetes medication.

This review find that a low carbohydrate, high fat diet is the preferred method for treating type 2 diabetes.

Low carbohydrate diets diets are a viable option in reversing diabetes mellitus, heart disease, and the epidemic of obesity

This post includes a synopsis of a paper published in Nutrition in Clinical Practice 2011 Jun;26(3):300-8 and a recipe for ground lamb and pumpkin.

Study title and authors:
Low-carbohydrate diet review: shifting the paradigm.
Hite AH, Berkowitz VG, Berkowitz K.
Valerie Goldstein-Berkowitz, 7 West 51st Street, New York, NY 10019;

This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/21586415

Books:

This review examined and compared the safety and the effectiveness of a low carbohydrate diet as an alternative to a low-fat, high-carbohydrate diet, which is the current standard for weight loss and/or chronic disease prevention.

The review found:
(a) In short-term and long-term comparison studies, low carbohydrate diets performed as well as or better than comparable low fat diets with regard to weight loss, cholesterol levels, glucose and insulin response, blood pressure, and other important cardiovascular risk markers in both normal subjects and those with metabolic and other health-related disorders.
(b) The metabolic, hormonal, and appetite signaling effects of carbohydrate reduction suggest an underlying scientific basis for considering it as an alternative approach to the low fat, high-carbohydrate recommendations in addressing overweight/obesity and chronic disease.

Hite concludes: It is time to embrace low carbohydrate diets diets as a viable option to aid in reversing diabetes mellitus, risk factors for heart disease, and the epidemic of obesity.

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Recipe of the day

Ground Lamb and Pumpkin

Food Mall: Ground Lamb

Ingredients:

1 lb ground lamb

1 zucchini, diced
1/2 red onion, diced
2 tbsp fresh parsley, minced
1 tbsp fresh mint, minced
3 cloves garlic, crushed
1 tbsp coconut oil
1/2 tsp sea salt
1 tsp paprika
1 tsp ground cumin
1/2 tsp allspice

Instructions:
Black pepper to taste

Heat oil in a large skillet, add onion and garlic and saute for 1 minute. Add lamb and cook until the lamb is almost done. Add the remaining ingredients, mix well, cover and let simmer together for 2 minutes or until the zucchini is tender but not mushy.

For the pumpkin, use 1 small sugar pumpkin. Cut the pumpkin in 1/2 and remove the seeds (save them to roast)! Place the pumpkin in your pressure cooker with about 2 cups of water and cook for 6-7 minutes.

Scoop out the pumpkin and serve with a sprinkle of cinnamon with the lamb.

Ground Lamb and Pumpkin



Diets high in cholesterol and saturated fat lower the risk of heart disease and diabetes

This post includes a synopsis of a paper published in the American Journal of Clinical Nutrition 2002 Dec;76(6):1214-21and a recipe for the quickest breakfast.

Study title and authors:
Dietary and plasma lipid, lipoprotein, and apolipoprotein profiles among elderly Hispanics and non-Hispanics and their association with diabetes.
Bermudez OI, Velez-Carrasco W, Schaefer EJ, Tucker KL.
Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111, USA. bermudez@hnrc.tufts.edu

This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/12450885

The objective of the study was to assess the dietary and cholesterol risk factors for cardiovascular disease and their relationship to diabetes. The study involved 490 Hispanics and 163 non-Hispanic whites aged 60-98 years.

Bermudez found that:                                                                                                          Books: 

(a) Intakes of carbohydrate and polyunsaturated fat were higher in Hispanics than in non-Hispanic whites.

(b) Intakes of cholesterol and saturated and monounsaturated fat were lower in Hispanics than in non-Hispanic whites.

(c) Concentrations of (good) HDL cholesterol, and (good) apolipoprotein A-I were significantly lower among Hispanic women than among non-Hispanic white women
(d) Concentrations of (good) HDL cholesterol, and (good) apolipoprotein A-I were lower among Hispanic men than among non-Hispanic white men.
(e) High levels of (bad) triglycerides and low levels of (good) HDL cholesterol were more prevalent among Hispanics with than without diabetes.

The study results indicate that a diet high in cholesterol, saturated and monounsaturated fat, and low in carbohydrate and polyunsaturated fat lower the risk of heart disease and diabetes.

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Recipe of the day

Quickest Breakfast
                                                                                                                               Food Mall: Eggs
Ingredients:
butter
4 eggs
salt and pepper to taste

Instructions:
Firstly, switch on the frying pan (skillet) and put about 1 ounce (25g) of butter in it to melt.

While the pan is heating up, get out 4 eggs, a plate and cutlery.

By this time, the butter in the pan should be melted and starting to bubble. If it is, just break the eggs into the pan and stir, using a moderate heat, until cooked to your satisfaction.

Serve and add salt and pepper to taste.

Diabetics and non diabetics on a higher fat/low carbohydrate diet lose over 3 times as much weight as those on a "healthy-eating" (high carbohydrate/lower fat) diet

This post includes a synopsis of a study published in Diabetic Medicine 2007 Dec;24(12):1430-5 and a recipe for Tomato, chili pepper, and sweet onion frittata.

Study title and authors:
A low-carbohydrate diet is more effective in reducing body weight than healthy eating in both diabetic and non-diabetic subjects.

Dyson PA, Beatty S, Matthews DR.

Books:

Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford, UK. pam.dyson@orh.nhs.uk

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/17971178

This study of 13 diabetic and 13 non diabetic subjects evaluated whether a low carbohydrate diet could allow diabetic and non diabetic subjects to lose weight.

Subjects followed either a higher fat/low carbohydrate diet or a "healthy eating" (higher carbohydrate/lower fat) diet following Diabetes UK nutritional recommendations.

After 3 months both diabetics and non diabetics on the low carbohydrate diet lost over 3 times as much weight as those on the "healthy-eating" (high carbohydrate) diet.

Obesity is linked to diabetes so the weight reducing higher fat/low carbohydrate diet is more effective at treating diabetes than the Diabetes UK "healthy eating" diet.

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Recipe of the day

Tomato, Chili Pepper, and Sweet Onion Frittata

Ingredient list:
1 10-ounce can of diced tomatoes and chilies

Food Mall: Eggs

Three fresh eggs

Sweet yellow onion
Garlic powder
Black pepper
Dried cilantro
Salt
Extra virgin olive oil

Directions:
Pre-heat oven to 350 degrees. Chop enough onion to cover the bottom of a small frying pan. Open can and transfer tomatoes and chilies to an air-tight container to refrigerate leftovers. Crack three eggs into a small mixing bowl. Add salt, black pepper, garlic powder, and dried cilantro to taste. I’ve been on a cilantro-kick lately and have been adding it heavily. Stir with a fork or whisk to mix well.

Heat one tablespoon of oil in the bottom of a small frying pan over medium heat on the stove top. Add onion and let cook in the hot oil. Add tomatoes and chilies to the frying pan using a fork or slotted spoon to reduce the transfer of liquid. I need 2 fork full’s to cover the surface of the skillet. Let the mixture cook a bit, and then pour eggs over the vegetables and let cook until the edges begin to brown and can be edged away from the sides of the pan with a spatula (one or two minutes). Move the frying pan to the oven and let bake about six minutes until the eggs set fully and the top becomes firm to the touch. When done, remove from the oven and transfer to a plate.

Tomato, Chili Pepper, and Sweet Onion Frittata

Review of six studies finds that reduced carbohydrate diets are safe and effective for people with type 2 diabetes

This post includes a summary of a paper published in the Journal of Human Nutrition and Dietetics 2008 Dec;21(6):530-8 and a recipe for chili colorado.

Study title and author:

Books:

A review of low and reduced carbohydrate diets and weight loss in type 2 diabetes.

Dyson PA.

Oxford Centre for Diabetes, Endocrinology & Metabolism, Churchill Hospital, Headington, Oxford, UK. pamela.dyson@ocdem.ox.ac.uk

This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/18759958
 
This review of six studies found that reduced carbohydrate diets are safe and effective for people with type 2 diabetes.

All six studies also reported reductions in body weight.

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Recipe of the day

Chili Colorado

Ingredients:

Food Mall: Beef Stew Meat

4 cups water

7 dried New Mexico chilies
3 dried California chilies
3 dried Chile de Arbol
1 yellow onion, diced
5 garlic cloves, minced or 2 teaspoons crushed garlic
2 tablespoons coconut oil
2.5 lbs beef stew meat
2 tablespoons ground cumin
2 tablespoons dried oregano
2 cups beef broth
2 – 6oz cans of tomato paste
Black pepper and sea salt to taste

Instructions:
Rinse the dried chilies and place them in a pot with the 4 cups of water. Bring to a boil, turn the heat off and let the chilies soak in the water for 30 minutes. While the chilies are soaking, dice your onion and garlic. Heat the oil in a large soup pot and add the onions. Cook the onions until they start to brown. Add the garlic and the beef to the onions and brown the beef for 7-10 minutes. Add the beef broth, tomato paste, cumin, oregano, salt and pepper to the beef. Bring to a boil, turn down to medium low or low and let simmer. While the beef is simmering, it’s time to prepare the peppers. Remove the stems from the peppers and place the peppers in a food processor with half of the liquid that the peppers were boiling in. Pulse the peppers until smooth. Using a sieve, pour the ground peppers through the sieve and into the pot with the beef. Use a spoon to help the contents through the sieve, leaving behind the seeds and any of bits of pepper skin. Pour the remaining cooking liquid through the sieve as well into the pot. Bring to a boil, turn back down to low and let the Colorado simmer for 2 hours or until your meat is tender. Serve with avocado and cilantro.

Chili Colorado



Saturated fat shown to be beneficial in the fight against diabetes

This post includes a summary of a paper published in Current Diabetes Reports 2011 Jan 15 and a recipe for roasted veal shanks.

Study title and author:
Fad Diets in the Treatment of Diabetes.
Feinman RD.
Department of Cell Biology, SUNY Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, NY, 11203, USA, richard.feinman@downstate.edu.

This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/21234818

Books:

The author concludes: "Use of the term "fad diet" reflects the contentious nature of the debate in the treatment of diabetes and generally targets diets based on carbohydrate restriction, the major challenge to traditional dietary therapy. Although standard low-fat diets more accurately conform to the idea of a practice supported by social pressure rather than scientific data, it is suggested that we might want to give up altogether unscientific terms like "fad" and "healthy." Far from faddish, diets based on carbohydrate restriction have been the historical treatment for diabetes and are still supported by basic biochemistry, and it is argued that they should be considered the "default" diet, the one to try first, in diseases of carbohydrate intolerance or insulin resistance. The barrier to acceptance of low-carbohydrate diets in the past has been concern about saturated fat, which might be substituted for the carbohydrate that is removed. However, recent re-analysis of much old data shows that replacing carbohydrate with saturated fat is, if anything, beneficial. The dialectic of impact of continued hemoglobin A(1c) versus effect of dietary saturated fat in the risk of cardiovascular disease is resolved in direction of glycemic control. Putting biased language behind us and facing the impact of recent results that point to the value of low-carbohydrate diets would offer patients the maximum number of options".

 
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Recipe of the day

Roasted Veal Shanks

Ingredients:

Food Mall: Veal

6 pieces veal shanks, each about 2 1/2 inches long

3 Tbsp olive oil
2 Tbsp lemon juice
1/4 tsp pepper
1 onion, cut up
3-5 Tbsp hot water

Instructions:
Place veal in single layer in heavy roasting pan. Sprinkle with oil, lemon juice, and pepper. Arrange onion on top. Cover and cook in 350F oven for 1 1/2 hours or until tender. Uncover and brown for 30 minutes longer, adding water to increase natural juices, if necessary.

This recipe can be used with a veal roast. Substitute shoulder or rump roast for the shanks and proceed as above.

Low carb diets lower the risk of heart disease compared to high carb diets

This post includes a synopsis of a paper published in Lipids Volume 45, Number 10, 907-914 and a recipe for sweet potato cayenne battered sea bass.

Study title and author:
Atherogenic Dyslipidemia: Cardiovascular Risk and Dietary Intervention

Kiran Musunuru

Books:

This paper can be accessed at: http://www.springerlink.com/content/20u44k0741h4v375/

Atherogenic dyslipidemia comprises a triad of increased blood concentrations of small, dense low-density lipoprotein (LDL) particles, decreased high-density lipoprotein (HDL) particles, and increased triglycerides. A typical feature of obesity, the metabolic syndrome, insulin resistance, and type 2 diabetes mellitus, atherogenic dyslipidemia has emerged as an important risk factor for myocardial infarction and cardiovascular disease.

Low-carbohydrate diets appear to have beneficial lipoprotein effects in individuals with atherogenic dyslipidemia, compared to high-carbohydrate diets, whereas the content of total fat or saturated fat in the diet appears to have little effect.

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Recipe of the day

Sweet Potato Cayenne Battered Sea Bass

Food Mall: Sea Bass

Ingredients:

■1/2 pound fresh sea bass, without skin

■3/4 tbsp Irish or other organic butter
■pinch of pink Himalayan sea salt
■1/4 tsp cayenne –
■1/8 – 1/4 tsp cinnamon
■1/8 cup Sweet Potato flour

Instructions:
This will be best if you use a cast iron pan. Heat pan on medium – high and melt 1/2 tbsp butter. Rub cayenne and cinnamon very gently onto “only” one side of your sea bass, cautiously wet with some water sprinkles. (Make sure that you don’t rub the cayenne and the cinnamon off.)

Now batter sea bass with sweet potato flour and carefully pat to get rid of excess flour. Carefully place the fish into the golden bubbling butter, reduce heat to medium, cook for 3 – 5 minutes on each side and enjoy with some fresh vine ripe tomato and a Thai chili or your favorite side dish. Put the other 1/4 of the butter on top of the side that you’ll flip.

Sweet Potato Cayenne Battered Sea Bass