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Diabetic Diet: Important Dietary Advice For Type 2 Diabetics


Date: 13/10/04
 
For many HSI members, the 'news' that a low-carbohydrate diet may help type 2 diabetics manage blood sugar levels won't be news at all. Nevertheless, there are many who are still not aware of this important information. Any diabetic who consults dietary advice given by the government will find good general advice mixed in with some very questionable carbohydrate advice.

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Move over, US Food Guide Pyramid... that's also followed here in the UK. There's a new pyramid in town.

That's right. While a select panel of nutritionists busy themselves with the finishing touches on the revised dietary guidelines (due to be revealed next January), someone has already beaten them to the punch with a food guide pyramid that actually makes good nutritional sense. And more importantly, it was created without the input of powerful food lobbies. Imagine that.

But before we take a look at this alternative pyramid, I'll tell you about a recent study that offers some basic and useful nutritional advice for type 2 diabetics and anyone who would like to avoid type 2 diabetes. And coincidentally, the new pyramid serves as a handy companion to the nutritional guidance this study offers.

Potatoes panned

For many HSI members, the 'news' that a low-carbohydrate diet may help type 2 diabetics manage blood sugar levels won't be news at all. Nevertheless, there are many who are still not aware of this important information. Any diabetic who consults dietary advice given by the government will find good general advice mixed in with some very questionable carbohydrate advice.

For instance, diabetics are advised to eat more starches (such as potatoes), but no distinction is made between nutrient-poor refined starches and unrefined starches. And nearly all our starches today are refined! According to HSI Panellist Dr Allan Spreen, it's very difficult (if not impossible) to find 100 per cent unrefined pastas, breads or cereals.

In a past e-alert, Dr. Spreen explained that nutrients and fibre are often stripped from starches during food processing. Without those two important elements, the sugars become as concentrated as simple, refined carbs, which diabetics should strictly avoid. And potatoes? Here's Dr. Spreen's take on spuds: 'The baked potato is as close to a pure, refined starch as you can get without actually refining it.'

In the BAG

The new diabetic dietary research comes from the Metabolic Research Laboratory at the VA Medical Centre in Minneapolis in the US. Researchers designed a high-protein/low-carb diet they call LoBAG (low-biologically-available glucose) that breaks down like this: 20 per cent carbs, 30 perc ent protein, 50 percent fat.

As reported in the journal Diabetes, eight subjects with untreated type 2 diabetes began the test by first eating a high-carb diet (55 per cent carbs, 15 per cent protein, and 30 per cent fat) for five weeks. After this first phase, subjects returned to their normal diets for five weeks, and then began five weeks on the LoBAG diet. The average 24-hour glucose levels were tracked throughout, as were the haemoglobin A1c (HbA1c) percentages, which measure the severity of hyperglycaemia.

The result: With the LoBAG diet, circulating glucose concentration was reduced 'dramatically.' And the authors of the report add, 'Potentially, this could be a patient-empowering way to ameliorate hyperglycaemia without pharmacological intervention.'

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Bottom to top

Now to the existing food pyramid.

At the base: plenty of bread, cereal, rice and pasta, eat all you want. At the apex: fats and oils, to be used sparingly. In other words, it recommends a diet that is nearly the opposite of the LoBAG diet.

When the new US dietary guidelines are announced next January, we may find that the pyramid has been scrapped in favour of some other graphic metaphor. Which would be just fine, because we now have a much more sensible pyramid to guide food choices, courtesy of the faculty of the Harvard School of Public Health in the US.

The Harvard faculty members call their structure the Healthy Eating Pyramid, and here are some of the key ways it contradicts the US government's structure:

  • At the base: Daily exercise and weight control. (Not a dietary suggestion, but good advice, especially for diabetics)
  • At the cap: Foods to use sparingly include potatoes, pasta, white rice and white bread
  • Plant oils: Near the bottom instead of the top


Perhaps the most surprising item on this pyramid is the suggestion to take a multi-vitamin, as well as a calcium supplement. I would have added a few more supplements to that list (vitamins C and E, along with some fish oil, just to get started), but the fact that supplements made the list at all is impressive.

I don't agree with everything on the Harvard pyramid. For instance, I don't think red meat and butter belong in the 'use sparingly' category. But this pyramid has one very important advantage over the 'official' pyramid. Using the current pyramid guide, you could actually harm your health, especially if you're diabetic.

But no more. Bring in the LoBAG renovating crew. Save the genuine whole grains, and then trade the space where fats used to be for rice and pasta and potatoes.

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Comments

dr shabir ahmad Posted 23/04/2009

I am type 2 diabetic and for the last two years I have been taking high protein diet with less carbohydrate and less saturated fats and your recommendations has re-enforced my own strategy for controlling the blood sugar.

Mrs Shelagh Gibson Posted 25/04/2009

I found the article and Dr Ahmad's comments very interesting. However, if someone is meant to eat 50% fat, which foods do you recommend apart from nuts, as my husband, who is border line diabetic, cannot eat nuts?

Cheryll Gilbert Posted 18/10/2009

I am a newly diagnosed type 2 diabetic who has been referred to "Slimming World" for weight loss. No problem so far. I have been advised to use the "green" diet in common with other diabetics using this plan - more carbs than protein - but am now discovering that the jacket (baked) potato I am told I can eat lots of may actually be harmful to my health! I am getting next to no support from my GP surgery so to whom can I turn for proper dietary advice? Can you help me, please?

Hana Rous Posted 10/02/2010

I'm a T2 diabetic diagnosed 6 years. I follow a low carb moderrate fat( including saturated), moderate protein diet.( with SMALL portions) I don't weigh anything, just avoid all refined carbs. I have an A1c in the middle of the non-diabetic range and mean to get it down further.

To Cheryll that baked potato will be blood glucose, instants after you eat it. Do you check to see what effects foods have?( or are you one of those who ius discouraged from doing so?) Slimming World Green isn't a good plan for diabetics. Atkins is far better. He was ridiculed and maligned and now is being proved RIGHT.



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