Tuesday, December 27, 2005

Diabetics, Take Notice! Researchers conclude Low-Carb Diet is an Effective Treatment with 22-Month Data

Today an abstract poster was published on the Nutrition & Metabolism Society website that will be featured during the upcoming 2006 NMS Scientific Sessions: Nutritional & Metabolic Aspects of Carbohydrate Restriction - Lasting improvement of hyperglycemia and bodyweight after 22 months: low-carbohydrate diet in Type 2 diabetes. [Last poster abstract, bottom of the page]

Researchers from Sweden have been following the progress of two groups of Type II Diabetics assigned two different dietary approaches for 22-months. The first group was assigned a low-fat diet that consisted of 55-60% carbohydrate, 15% protein and 20-25% fat - this group served as the "control group." The second group was assigned a low-carbohydrate diet that consisted of 20% carbohydrate, 30% protein and 50% fat - this group served as the "study group."

The results after the first six months and one year were promising for the low-carb diet group - as the researchers stated in their conclusions at that point in time: A low-carbohydrate diet is an effective tool in the treatment of obese patients with type 2 diabetes.

This was based upon the finding that, [p]ositive effects on the glucose levels were seen very soon. After 6 months a marked reduction in bodyweight of patients in the low-carbohydrate diet group was observed, and this remained one year later. After 6 months the mean changes in the low-carbohydrate group and the control group respectively were (+/-SD): fasting blood glucose (f-BG): -3.4+/-2.9 and -0.6+/-2.9 mmol/l; HBA1c: -1.4+/-1.1 % and -0.6+/-1.4 %; Body Weight: -11.4+/-4 kg and -1.8+/-3.8 kg; BMI: -4.1+/-1.3 kg/m_ and -0.7+/-1.3 kg/m_.

But - the data was only for one year and thus not "long-term" and therefore summarily dismissed by many as irrelevant. It did not matter that those diabetic patients following the low-carb diet were doing BETTER than those assigned the low-fat diet - what mattered was that they hadn't followed the low-carb diet for more than a year.

Many within the diabetic healthcare community basically continued to advise their patients that low-carb diets were unsafe at worst, unproven at best. It didn't matter that after a year, across the board, on every measure, those following the low-carb diet did significantly better:
  • Lower fasting blood glucose
  • Lower HBA1c levels
  • Lost more body weight
  • Reduced BMI more

This did not discourage the researchers! And, I for one am glad they continued to follow these patients. Now, after 22-months, we have a better picture of just how well those following a low-carb diet are doing. They're not just doing well, they're still doing better than those following the low-fat diet!

As the researchers point out in their results section: The mean weight has increased from month 6 to months 22 by 2.7 ± 4.2 kg. Seven of the 16 patients retained the same bodyweight from 6 to 22 months or reduced it further. Mean HbA1c which, after 6 months, was 6.6 ± 1.0 %, was 6.9± 1.4 % after 12 months and was still 6.9 ± 1.1 % at 22 months.

Because of the reduction in bodyweight and insulin resistance, a reduction in cardiovascular risk would be expected at some point. We examined medical charts for episodes of cardiovascular disease from 3 months after the initiation of the diet therapy – when an effect might be detected -- and forward. Three episodes of cardiovascular disease occurred among the 5 patients that did not change their diet. The 16 patients in the LCG and the 10 from the CG that changed diet – totalling 26 patients -- have been free of cardiovascular disease during the follow-up period (p = 0.002. Fischer Exact).

Their conclusion again: A low-carbohydrate diet is an effective tool in the treatment of obese patients with type 2 diabetes.

I don't know about you, but if I were diabetic, I'd be asking my doctor why I'm being told to eat a low-fat diet and demanding to see the long-term data that shows it more effective than a low-carb diet. I'd be demanding to know why I'm being told to adjust my medications instead of my consumption of carbohydrate!

Then I'd be demanding the American Diabetic Association (ADA) start to take this dietary approach seriously and begin to craft an evidence-based guideline for my doctor to use in my treatment so I could reduce or eliminate many of the medications and/or insulin injections each day! I'd be telling them I'm tired of just managing my disease with pharmaceuticals - I want to be able to be free of the costly prescriptions and injections, and if a low-carb diet offers that as a possibility, it must be one of the options I am told about and offered as a management tool for my disease!

Folks, many believe the low-carb diet has been relegated to the dust-bin of fad diets that have come and gone. Nothing could be farther from the truth!

While the low-carb dietary approach may have lost its luster for the media it remains a strong candidate as a dietary approach for the management of diabetes, metabolic syndrome, high cholesterol and other metabolic disorders. It may have fallen out of favor with the popular press, but it is still going strong in research circles around the world.


It works!

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