Why a low-carb diet may not always prevent Type 2 diabetes

A new study has shown that it is not a low-carbohydrate diet but the type and mix of non-carbohydrates that a person eats that affects the risk of developing Type-2 diabetes. In fact, a low carb diet was not at all beneficial for the primary prevention of diabetes unless it emphasises the quality of the macro nutrients. The study, conducted by the Harvard T.H Chan School of Public Health, has pointed out to the need for looking at our proteins and other nutrients as an equal factor in diabetes management.

Explaining the correlation, Dr Sweta Budyal, Consultant Endocrinologist and Diabetologist, Fortis Hospital, Mulund, says that the problem happens because a “low-carbohydrate diet results in an increase in total and saturated fat intakes and a decrease in consumption of whole grains, fibres fruits, and vegetables.”

What is a low-carbohydrate diet?

Our food has three types of macronutrients, namely carbohydrates, proteins and fats. Carbohydrates constitute an important part of our meals and are an instant source of energy for our bodies. When carbohydrates provide less than 25 per cent of the total calories that we derive from our diet, it is considered a low-carbohydrate diet (LCD). As carbohydrates are restricted in LCD, naturally the proportion of fats and proteins goes up.

Studies have shown that a low carb diet may not always work with Type 2 diabetes. Why?

The research about the association of low carb diets and the risk of Type 2 diabetes is highly variable and the broad consensus is that the proportion of carbohydrates in our diet is not linked to Type 2 diabetes. However, it is well-proven that consumption of certain carbohydrates (known as simple carbs) like sugar-sweetened drinks, white rice and refined flour are associated with an increased risk of Type 2 diabetes. In fact, some of the LCDs which contained more animal fats increased the risk of Type 2 diabetes in one of the recently published studies in the reputed medical journal Circulation. Low-carbohydrate diets result in an increase in total and saturated fat intakes and a decrease in consumption of whole grains, fibre, fruits and vegetables.

The research in the field of diet and nutrition should be taken with a lot of caution due to confounding factors and the heterogeneity in the quality of studies. Also, what is applicable to the Western population may not suit Indians exactly as we are genetically different. The Indian diet is rich in carbohydrates, which constitute almost 60 to 80 per cent of our calories. Hence reducing carbohydrates and increasing proteins and replacing unhealthy carbs by complex carbs is recommended. Fad diets or eliminating a group of macronutrients from a diet is generally harmful in the long run.

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How should a person with Type 2 diabetes choose his/her diet?

Individuals with Type 2 diabetes should develop healthy eating habits rather than focussing on a single macro nutrient. Reducing carbohydrates certainly helps patients with Type 2 diabetes to achieve better sugar control with less medicines, but eliminating them does not give consistent results, nor does it have proven safety with respect to heart health.

Individuals with diabetes are recommended to minimise their consumption of simple carbohydrates like sugar, rice, potato, and refined flour. The carbohydrates in diet should come from whole grain cereals, vegetables, low fat milk and fruits. Each meal should have proteins and consumption of fats should be limited. The permitted consumption of oil is less than 0.5 liters per person per month. Also, modest weight loss by reducing the total consumption of calories and fats along with regular physical activity will go a long way in the management of Type 2 diabetes.

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