[ Diabetes Solutions ]

What is the best diet for type 2 diabetes?

Fiber is a type of carbohydrate that the body can’t digest. For reasons that are not entirely clear, some people develop a condition called insulin resistance in which the body’s tissues begin to ignore insulin, driving up blood glucose levels, and in some cases leading to type 2 diabetes. One of the most efficient ways to control this is by monitoring carb intake. A diagnosis of diabetes tends to be a big shock for most of us. Also, just being generally more active can help a lot. Diet and nutrition play a central role for the wellbeing of all those people. Foods with soluble fiber include oatmeal, nuts, beans, lentils, apples and blueberries.

The effect of food on health may be related to more than just calories. Whether a carb is simple or complex is determined by its molecular structure and how long it will take for the body to digest the sugars inside. It’s a daily task but it’s within our reach and it’s well worth the effort. The amount of reduction that is optimal for you will depend partly one how impaired your own glucose tolerance is. Glucose is the body’s main source of fuel. Both Harvard studies—of female nurses and of male health professionals—found that this type of diet more than doubled the risk of type 2 diabetes when compared to a diet high in cereal fiber and low in high-glycemic-index foods. Glucose comes from two major sources, food and the liver.

Then, it is up to you to monitor your daily carb intake. What works for one person may not work so well for another. Insulin enables sugar to enter the cells of the body where it is used for energy production. Without insulin, or when insulin resistance is present, glucose builds up in the blood stream. 19. Elevated levels of blood glucose may cause a number of symptoms, and increase the risk of developing heart disease and stroke. Most do.

You may also be interested to read questions to ask at a diabetic clinic. However, many overweight and obese individuals never have diabetes, and many people with type 2 diabetes are not overweight or obese. If our body stores fat primarily in the abdomen, the risk of diabetes is higher than if the body stores fat elsewhere such as on our hips and thighs. McKeown NM, Meigs JB, Liu S, Saltzman E, Wilson PW, Jacques PF. The risk of type 2 diabetes increases with age. This article contains general information about medical conditions and treatments. The main goals of therapy are to improve glucose metabolism and thereby reduce blood sugar levels, and to reduce the risk factors for the main complications of diabetes, heart disease and stroke.

Overweight often contributes significantly to the development of type 2 diabetes, therefore weight loss often plays a large role for the treatment of the disorder. Prediabetes is a condition in which blood sugar level is higher than normal, but not high enough to be classified as diabetes. A prospective study of dietary glycemic load, carbohydrate intake, and risk of coronary heart disease in US women. There is good evidence showing that dietary modification can prevent the progression from prediabetes to type 2 diabetes. Howvever, the optimal dietary approach to type 2 diabetes is  less clear. Before I discuss the recent study by Ajala and coworkers, let´s have a look at the background stage. For some years, experts and scientists have debated what dietary approach is best to control and treat type 2 diabetes.

Most regulatory authorities, like the British Diabetic Association, European Association for the Study of Diabetes (EASD), American Diabetes Association (ADA), Canadian Diabetes Association and many more usually recommend a carbohydrate intake of 50-60% of total energy intake, total fat intake less than 30% of energy, with restriction of saturated and trans fat intake. Am J Clin Nutr. In the recent systematic review by Ajala and coworkers, data was collected from all studies published up to July 2011 that compared low carbohydrate, vegetarian, vegan, low glycemic index (GI), high fiber, Mediterranean, and high protein diets with control diets including low-fat, high-GI, ADA diet, EASD diet, and low-protein diets. Only randomized controlled trials with an intervention lasting longer than six months were selected. A total of 20 studies including 3073 individuals fulfilled the defined criteria, and were selected for the metaanalysis. Measured outcomes were HbA1c (which reflects glucose control), difference in weight loss, and changes in HDL-cholesterol (“good cholesterol”), LDL-cholesterol (“bad cholesterol”) and triglycerides. The low carbohydrate, low-GI, Mediterranean, and high protein diets all led to a greater improvement in blood glucose control (HbA1c) compared with their respective control diets, with the largest effect seen with the Mediterranean diet.

2007;167:2304-9. Low carbohydrate, low-GI, and Mediterranean diets all led to an elevation of HDL-cholesterol. Only the Mediterranean diet led to a significant reduction in triglycerides. High protein diets had no effects on markers of lipid profile. One study from their review compared the effects of a vegan diet to the low fat ADA diet. The vegan arm had a significantly lower levels of total cholesterol, LDL-cholesterol and HbA1c, indicating better glycemic control by the vegan diet. Similar results were obtained in one study that compared the effect of a vegan diet with the EASD diet, with more weight loss on the vegan diet.

Ajala and coworkers conclude that their review provides evidence that modifying the amount of macronutrients can improve glycemic control, weight and lipids in type 2 diabetes. In their analysis, low carbohydrate diets appeared to provide superior weight loss, better control of blood glucose, and better lipid profile, compared with low fat diets. The authors also conclude that vegan and vegetarian diet may improve glucose control and promote weight loss in type 2 diabetes. The Mediterranean diet is rich in olive oil, legumes, unrefined cereals, fruit and vegetables, low in meat and meat products, and with moderate contents of dairy products (mostly cheese and yogurt), fish and wine. The total fat in this diet is typically 25-35% of calories, with saturated fat less than 8% of calories. The metaanalysis indicates that a Mediterranean diet provides better control of blood glucose, greater weight loss and a more favorable lipid profile compared with a conventional diet and ADA diet. A metaanalysis of such widely different studies may be problematic.

For example the control diets differed significantly between studies and the duration of the studies ranged between six months and four years. The definition of a low carbohydrate diet varies between studies. While the authors acknowledge the limitations of their study, they believe that low carbohydrate, low-GI, Mediterranean and high-protein diets should be considered in the overall strategy of diabetes management. What is the best diet for type 2 diabetes? Although, there is probably not a simple answer, the question reflects one of the main challenges of modern medicine. It is likely that our dietary recommendations will have to be tailored to the needs of the individual. A one-size-fits-all approach is unrealistic.

Although not providing any definitive answers, the study by Ajala and coworkers is an important contribution to our understanding of this highly important issue.

Tags: , ,