Ruth Buttigieg, BSC (Hons), MSc, ANutr is a qualified nutritionist who works at Natural Ketosis, where she helps people to better their health by changing their diet and lifestyle by following a low-sugar, low-starch approach. Ruth read biochemistry for her undergraduate degree and she also has a Masters in Public Health Nutrition from Queen Margaret University. Here she blogs for us on a question that often comes up when it comes to diabetes and nutrition – are starchy foods really needed for a healthy diet?
Not a day goes by without a news piece covering the diabetes epidemic within the UK population or news coverage regarding new and exciting research looking at new interventions to either prevent or manage diabetes.
Yet what is diabetes, and can diet help prevent and manage the condition?
Diabetes is not a new medical phenomenon. The first reference to this condition can be traced back to an Egyptian papyrus dating back to c1550BC. Yet, if this condition has been present since early human civilisations, what has changed over the last few years that has led to it becoming an epidemic?
Statistics published in February 2014 by Diabetes UK  reveal that the number of people diagnosed with diabetes in the UK totals 3.2 million (6 percent of the population).
Minimising Sugar and Starches
Individuals suffering from diabetes (both type 1 and type 2) have elevated blood sugar levels due to metabolic insulin dysfunctions. Due to this, diabetics struggle to manage their insulin secretion and need pharmaceutical interventions (either orally or intravenously) to help manage their condition.
Consuming lower amounts of carbohydrates in the diet will help to manage the majority of insulin metabolic dysfunctions as:
- There will be less sugar in the blood
- Due to lower levels of blood sugar, insulin levels will be decreased
- Lower levels of insulin means that a lower dose of diabetic drugs will be needed to manage the body’s blood sugar homeostasis feedback loop.
What does the Science say?
A number of dietary intervention studies have compared the effect of carbohydrate restriction (minimising the amount of sugars and starches in one’s diet) and its effect on blood sugar levels when compared to a low fat low calorie diet – the standard dietary prescription for diabetics.
In all these studies, carbohydrate restriction came out as the clear winner showing it to be the more effective dietary treatment for the management of diabetes.
In the UK, the SIGN (2010)  guidelines have now acknowledged the safe use of low carbohydrate diets for the treatment of diabetes in the short term. And in 2013 the American Diabetes Association (ADA)  recognised that carbohydrate restriction is indeed a viable therapy for managing diabetes.
The key points of these studies include [4-13]:
- A low carbohydrate lifestyle dramatically lowers both fasting blood glucose levels and glycosylated haemoglobin levels (HbA1c).
- A low carbohydrate lifestyle can offer a reduction in, or complete elimination of, all types of anti-diabetic medications.
- Individuals with diabetes experienced a greater overall improvement in Quality of Life (QOL) following a low carbohydrate lifestyle.
- It lowers inflammation levels in individuals suffering from diabetes.
A low carbohydrate lifestyle is about being healthy, eating real food and making the right choices for long-term health.
- Diabetes UK. 2014. Diabetes Prevalence 2013. [online] http://ow.ly/wPqUR
- SIGN, 2010. Management of Diabetes: A National Clinical Guideline. [online] http://ow.ly/wPrfQ
- Evert, A.B. et al., 2013. Nutrition therapy recommendations for the management of adults with diabetes. Diabetes care, 36(11), pp.3821–3842.
- Rossi M, Turati F, Lagiou P, Trichopoulos D, Augustin LS, La Vecchia C, Trichopoulou A .2013. Mediterranean diet and glycaemic load in relation to incidence of type 2 diabetes: results from the Greek cohort of the population-based European Prospective Investigation into Cancer and Nutrition (EPIC). Diabetologia.56(11):2405-13
- Gardner CD, Kiazand A, Alhassan S, Kim S, Stafford RS, Balise RR, Kraemer HC, King AC: Comparison of the Atkins, Zone, Ornish, and LEARN diets for change in weight and related risk factors among overweight premenopausal women: the A TO Z Weight Loss Study: a randomized trial. JAMA 2007, 297(9):969-977.
- Jenkins, D.J.A. et al., 2008. Effect of a low-glycemic index or a high-cereal fiber diet on type 2 diabetes: a randomized trial. JAMA: the journal of the American Medical Association, 300(23), pp.2742–2753.
- Guldbrand, H. et al., 2012. In type 2 diabetes, randomisation to advice to follow a low-carbohydrate diet transiently improves glycaemic control compared with advice to follow a low-fat diet producing a similar weight loss. Diabetologia, 55(8), pp.2118–2127.
- Yamada, Y. et al., 2014. A non-calorie-restricted low-carbohydrate diet is effective as an alternative therapy for patients with type 2 diabetes. Internal medicine , 53(1), pp.13–19.
- Saslow, L.R. et al., 2014. A randomized pilot trial of a moderate carbohydrate diet compared to a very low carbohydrate diet in overweight or obese individuals with type 2 diabetes mellitus or prediabetes. PloS one, 9(4), p.e91027.
- Daly M.E, Paisey R, Millward B.A et al. Short-term effects of severe dietary carbohydrate-restriction advice in type 2 diabetes-a randomized controlled trial. Diabetic Medicine, 2006, 23: 15-20.
- Dyson P.A., Beatty S., & Matthews D.R. A low-carbohydrate diet is more effective in reducing body weight than healthy eating in both diabetic and non-diabetic subjects. Diabetic Medicine, 2007, 24: 1430-1435.
- Boden G, Sargrad K, Homko C, Mozzoli M, Stein TP. Effect of a low-carbohydrate diet on appetite, blood glucose levels, and insulin resistance in obese patients with type 2 diabetes. Annals of Internal Medicine, 2005, 142: 403–411
- Jonasson, L. et al., 2014. Advice to follow a low-carbohydrate diet has a favourable impact on low-grade inflammation in type 2 diabetes compared with advice to follow a low-fat diet. Annals of medicine, 46(3), pp.182–187.
Pic thanks to Geralt on Pixabay.