Federal guidelines and common conceptions about a “healthy diet” are partly to blame for these statistics. For years, people concerned about their health have been taught to reduce fat and increase carbohydrates, especially complex carbohydrates. But new research shows that these guidelines are not optimal for diabetics. It’s time to move away from these recommendations and begin promoting diets that may better improve health for people with diabetes.
Diabetes is dangerous. People with the condition are two to four times more likely to have a stroke or develop cardiovascular disease than those without it. The condition can also result in blindness, limb amputation and kidney failure.
Moreover, the disease is tremendously expensive to treat. Every year, diabetes and prediabetes cost New Mexico $2 billion in medical expenses and lost productivity.
Since the 1960s, Americans have been encouraged to eat diets high in carbohydrates – such as bread, pasta and grains – and low in fat. Americans dutifully followed this advice. From 2001 to 2010, for instance, Americans’ consumption of whole grains surged 33 percent, and since 1970, consumption of corn products, both directly and as sweeteners, increased nearly 30 percent, to an estimated 34 pounds per American per year. American corn and grain agriculture certainly benefited, but American health did not. Diabetes rates rose steadily.
Research shows that these carb-heavy diets can be suboptimal for type 2 diabetics. To give just one recent example: an article published in the journal Nature last year studied adults diagnosed with diabetes or prediabetes. The control group ate the standard diet recommended by the American Diabetes Association: moderate in carbohydrates, low in fat, and calorie restricted, while the experimental group ate a diet low in carbohydrates, higher in protein and fat, and without caloric restriction. Both groups received the same advice about other lifestyle modifications considered important for diabetics, such as exercise, sleep improvement, and mindful eating.
After only three months, the low-carbohydrate group saw greater reductions in average blood sugar, known as HbA1c, lost about twice as much weight, and had greater reductions in their use of diabetic medication. These differences remained significant at one year.
As a doctor in Albuquerque, I have personal experience with this very issue. For years I ate a diet low in fat and heavy in complex carbohydrates such as whole grains and fruits – just as official guidelines recommend. Yet to my intense frustration, both my HbA1c and weight steadily climbed over the years. Finally, I realized that by my next checkup, I would be diabetic.
I decided to try a new approach. Reluctantly, I cleared all the bread, pasta, tortillas, fruit and sugary foods out of the house and embraced healthy fats and proteins. It worked. At my next check-up my HbA1c had fallen into the healthy range. Five years later, it’s still there.
A fast-growing body of research shows that many cases of type 2 diabetes can be effectively treated with low-carb diets – with less reliance on medication or none at all. It’s time for dietary guidelines to reflect this latest research. And health care professionals should know how to counsel their patients about safe, effective low-carb diets.
Of course, a perfect diet is difficult to attain. I’m an enthusiastic resident of New Mexico, and the occasional plate of chile rellenos with rice and beans will always be part of my life. But if we have a clearer idea what kind of diet is likely to lower blood sugar and keep it in a healthy range, we can improve our health and reduce the appalling burden of diabetes in our state.
Dr. Heather Wood is a psychiatrist in Albuquerque and is affiliated with New Mexico Veterans Affairs Health Care System-Raymond G. Murphy Medical Center. The opinions expressed here are those of the author and do not necessarily represent the opinions of the V.A. Medical Center or its affiliates.