0
0
Ongoing Discussion Among Experts in the Diabetes Field: Low-Carb Diets for Individuals With Diabetes
Within the realm of diabetes, an ongoing dialogue revolves around the question of whether it is more advantageous to adopt an extremely low carbohydrate diet or to opt for a moderate intake of healthful carbohydrates.
At the recent 83rd Scientific Sessions of the American Diabetes Association (ADA), Carol F. Kirkpatrick, PhD, RDN, initiated the discussion by advocating for diets featuring moderate and high-quality carbohydrate content.
On the opposing side, Dina Hafez Griauzde, MD, argued that individuals with diabetes, particularly type 2 diabetes, benefit more from adhering to very low carbohydrate diets.
Both presenters grounded their arguments in published research, yet ultimately concurred that individual dietary preferences should significantly influence the final decision-making process.
Optimal Consumption Lies in Moderate Carbohydrate Intake Kirkpatrick’s opening remarks addressed the challenge posed by varying definitions of “low carb” in scientific literature, which complicates cross-study comparisons. According to a review she co-authored in 2019, “moderate” carbohydrate consumption was defined as a diet where 26% to 44% of daily caloric intake is from carbohydrates. “Low” carbohydrate consumption was classified as a diet where 10% to 25% of calories came from carbohydrates. Consumption of less than 10% was categorized as a very low carbohydrate diet, often referred to as a ketogenic diet.
Her presentation highlighted that in the initial six months, weight loss tends to be more substantial with carbohydrate-restricted diets compared to higher-carbohydrate alternatives. However, beyond the one-year mark, the difference in weight loss between the two approaches tends to level out.
Kirkpatrick acknowledged the challenges individuals face in maintaining such stringent dietary restrictions. She emphasized that by the 12-month milestone, the discrepancy in weight loss between the two approaches diminishes.
Research has indicated that carbohydrate-restricted diets commonly result in lower triglyceride levels and higher high-density lipoprotein (HDL) cholesterol levels. Nevertheless, Kirkpatrick underlined that the most notable reduction in low-density lipoprotein cholesterol (LDL-C) occurred with a diet consisting of around 40% carbohydrate intake.
Moreover, Kirkpatrick highlighted two large randomized controlled trials, PREDIMED and CORDIOPREV, which showed cardiovascular benefits linked to the Mediterranean diet – a diet moderately rich in carbohydrates.
The Value of Very Low Carbohydrate Diets Griauzde, replacing William S. Yancy, Jr, MD, last-minute, advocated for very low carbohydrate diets as a more effective means to improve glycemia. She argued that these diets do not exacerbate cardiovascular risks; in fact, they might even reduce them.
Griauzde stressed the historical use of very low carbohydrate diets for people with type 1 diabetes prior to insulin’s discovery. She presented evidence from a small study demonstrating that a very low carb diet led to notable decreases in total glucose areas under the curve and A1c levels.
She proposed the carbohydrate-insulin model as an explanation for the metabolic and weight-related benefits of carbohydrate-restricted diets. This model posits that a diet low in carbohydrates reduces serum glucose and insulin levels, leading to increased fat burning, lower body weight, and improved glycemic control.
Griauzde also noted that various trials and analyses support the efficacy of very low carbohydrate diets in improving A1c levels and overall glycemic control for individuals with diabetes.
Ultimately, the experts agreed on the significance of individualized dietary choices and patient-centered approaches. The goal, they noted, is to identify the most suitable dietary approach for each individual’s needs and preferences.
Source: This text is a paraphrased and condensed version of an article from the American Diabetes Association (ADA) 83rd Scientific Sessions. The original article was titled “Experts Debate Low-Carb Diets for People With Diabetes” and was published on June 23, 2023.
Medscape news
