A low-carb diet can prevent and treat diabetes

The expert: Magali Walkowicz, dietician-nutritionist, author of My Keto Journal and the Keto Diet from A to Z

Diabetes and pre-diabetes

In France in 2020, more than 3.5 million people are treated with medication for diabetes, or 5.3% of the population. But a significant number of people, unaware of their condition, are not medically monitored. “Type 2 diabetessays Magali Walkowicz, can seriously affect quality of life with symptoms such as blurred vision, numb hands and feet and general fatigue and can cause other serious health problems like heart disease, vision loss and kidney disease.”

Prediabetes, which is characterized by fasting blood sugar levels (blood sugar levels) of between 1.10 g/l and 1.25 g/l, affects 6% of the population, or nearly 4 million people. It can be accompanied by weight gain, hypertension, and often progresses to diabetes.

Low-carb or low-carb diets

Low-carbohydrate or low-carb diets are increasingly recommended for diabetics, at least in the United States. “The reason issays Magali Walkowicz, that in May 2019, the American Diabetes Association (ADA) released a consensus statement that recommends that people with diabetes be offered individualized medical nutrition therapy. Low-carbohydrate diets are among the options that should be offered to patients.”

This is a major change from the recommendations previously issued by the ADA, which considered that “ Low-carbohydrate diets (limiting total carbohydrates to less than 130 g/day) are not recommended (because) they eliminate many foods that are important sources of energy, fiber, vitamins, and minerals and are important in dietary palatability. » The ADA also expressed, before the 2019 declaration, the fear that low-carb diets are dangerous because the brain “needs” 130 grams of dietary carbohydrates per day. An argument taken up in Europe by certain doctors who ignore the metabolic pathways of the brain in a context of limited carbohydrate intake. The new ADA report clearly states that in this case the brain’s need for glucose is met by the body’s metabolic processes. The report also offers recommendations for people diagnosed with prediabetes: those who wish to stop the progression of prediabetes by using a low-carbohydrate diet can do so, if necessary with the assistance of a dietician-nutritionist.

“Despite everything, although there is now ample evidence of the benefit of low-carbohydrate diets for treating or even reversing diabetes, this was not the case for prediabetes, where there was a lack of firm data.“, explains Magali Walkowicz. This is why researchers at Tulane University (New Orleans) conducted a randomized clinical trial in people with diabetes or prediabetes not treated with medication.

What the researchers found

Their study, published in the journal JAMA Network Open, a included 150 people aged 40 to 70 years who had untreated prediabetes (glycated hemoglobin or HbA1C between 6 and 6.9%).

The volunteers were randomly assigned a low-carb diet, or their usual diet for six months.

During the first three months, people in the low-carb group ate less than 40 grams of carbohydrates per day. For the next three months, they ate less than 60 grams per day.

Foods low in carbohydrates include vegetables, meats, eggs, cheeses, nuts, and of course fats. People in the low-carb group received dietary advice and received recipes for low-carb meals. They also received basic foods such as nuts, olive oil and other items to help them prepare their meals.

Researchers assessed participants 3 months and 6 months after the start of the study.

After 6 months, people in the low-carb group saw an average decrease in glycated hemoglobin or HbA1c (which reflects blood sugar levels over the last 3 months) of 0.23%, a drop described by the researchers as “modest but clinically relevant.” In contrast, in people following their usual diet, HbA1c decreased by an average of 0.04 percentage points.

The low-carb group also lost weight (-5.9 pounds) and had lower fasting blood sugar (-10.3 mg/dL).

For Magali Walkowicz“the key message is that a low-carbohydrate diet, if maintained, is a useful approach to preventing and treating type 2 diabetes.”