Fad Diets in the Treatment of Diabetes

Abstract

Use of the term "fad diet" reflects the contentious nature of the debate in the treatment of diabetes and generally targets diets based on carbohydrate restriction, the major challenge to traditional dietary therapy. Although standard low-fat diets more accurately conform to the idea of a practice supported by social pressure rather than scientific data, it is suggested that we might want to give up altogether unscientific terms like "fad" and "healthy." Far from faddish, diets based on carbohydrate restriction have been the historical treatment for diabetes and are still supported by basic biochemistry, and it is argued that they should be considered the "default" diet, the one to try first, in diseases of carbohydrate intolerance or insulin resistance. The barrier to acceptance of low-carbohydrate diets in the past has been concern about saturated fat, which might be substituted for the carbohydrate that is removed. However, recent re-analysis of much old data shows that replacing carbohydrate with saturated fat is, if anything, beneficial. The dialectic of impact of continued hemoglobin A(1c) versus effect of dietary saturated fat in the risk of cardiovascular disease is resolved in direction of glycemic control. Putting biased language behind us and facing the impact of recent results that point to the value of low-carbohydrate diets would offer patients the maximum number of options.

Three-graded stratification of carbohydrate restriction by level of baseline hemoglobin A1c for type 2 diabetes patients with a moderate low-carbohydrate diet

“…A low-carbohydrate diet (LCD) is defined as strict carbohydrate restriction to less than 130 g/day or less than 30% carbohydrate [1,2]. LCDs have beneficial effects on glycemic control, weight loss and serum lipid profiles compared to high-carbohydrate low-fat (energy-restricted) diets [2-4].…”

“…LCDs have beneficial effects on glycemic control, weight loss and serum lipid profiles compared to high-carbohydrate low-fat (energy-restricted) diets [2-4]. Although long-term safety has not been proved by interventional studies, no serious harm has resulted from following LCDs for several years [2,5-7]. …”

Low-carbohydrate and high-fat intake can manage obesity and associated conditions: Occasional survey

“…[26] In contrast, a HCLF diet produces changes [30][31][32][33] that are considered to be atherogenic. The evidence that the LCHF produces the greatest benefits in the most unhealthy (Cases 1-4) suggests that the LCHF is the safer option for those who are the most ill. [28,29,31,34] Proposition 3: A high-fat diet will elevate blood pressure in those with hypertension and worsen blood glucose control in those with T2DM…”

“…That the LCHF improves glucose control more effectively than does the HCLF diet is well established in the literature. [27,31,[34][35][36] The role of sloth and gluttony in the development of obesity and related co-morbidities The energy balance model of human obesity [9][10][11][12]37] predicts that the overweight are consciously slothful and gluttonous. This information shows that many presumed slothful and gluttonous persons have a remarkable capacity to lose weight on the LCHF eating plan.…”

“…This report, backed by extensive published evidence, [6,9,20,21,[23][24][25][26][27][28][29]31,[34][35][36]38] suggests that we need to start radically re-thinking the advice that we give to patients. The Swedish National Board of Health and Welfare has concluded that 'low carb diets can today be seen as compatible with scientific evidence and best practice for weight reduction for patients with overweight or diabetes type 2, as a number of studies have shown effect in the short term and no evidence of harm has emerged … ' .…”