ADA has added LCHF to its llist of recommended diets for T2Ds
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nvmomketo
Posts: 12,019 Member
ADA has recently added LCHF to its list of diets that T2Ds should consider (along with Mediterranean, DASH and vegetarian (which I've never quite understood why that one is in there knowing vegetarian diets are often higher in carbs).
http://care.diabetesjournals.org/content/early/2018/09/27/dci18-0033.full-text.pdf
I'm glad they finally added LCHF! No keto, and they don't admit it is fine for long term, but it's a start.
Medical Nutrition Therapy
MNTcomprises education and support to
help patients adopt healthy eating pat-
terns. The goal of MNT is to manage
blood glucose and cardiovascular risk
factors to reduce risk for diabetes-related
complications while preserving the plea-
sure of eating (21). Two basic dimensions
ofMNT include dietary quality and energy
restriction. Strategies directed at each
dimension can improve glycemic control.
Dietary Quality and Eating Patterns.
There isno single ratio of carbohydrate, proteins,
and fat intake that is optimal for every
person with type 2 diabetes. Instead,
there are many good options and pro-
fessional guidelines usually recommend
individually selected eating patterns that
emphasize foods of demonstrated health
benefit, that minimize foods of demon-
strated harm, and that accommodate
patient preference and metabolic needs,
with the goal of identifying healthy di-
etary habits that are feasible and sustain-
able. Three trials of a Mediterranean
eating pattern reported modest weight
loss and improved glycemic control
(66
–
68). In one of these, people with
new-onset diabetes assigned to a low-
carbohydrate Mediterranean eating pat-
tern were 37% less likely to require
glucose-lowering medications over 4
years compared with patients assigned
to a low-fat diet (HR 0.63 [95% CI 0.51,
0.86]). A meta-analysis of RCTs in pa-
tients with type 2 diabetes showed that
the Mediterranean eating pattern re-
duced HbA1cmore than control diets
(69). Low-carbohydrate,
low glycemic index, and high-protein diets,
and the Dietary Approaches to Stop Hyper-
tension (DASH) diet all improve glycemic
control, but the effect of the Mediterra-
nean eating pattern appears to be the
greatest (70–72). Low-carbohydrate diets
(,26% of total energy) produce substan-
tial reductions in HbA1c at 3 months and
6 months , with diminishing effects at 12
and 24 months; no benefit of moderate
carbohydrate restriction (26–45%) was
observed (73). Vegetarian eating pat-
terns have been shown to lower HbA1c,
but not fasting glucose, compared with
nonvegetarian ones (74). Very recent tri-
als of different eating patterns in type 2
diabetes have typically also included
weight reduction, hindering firm con-
clusions regarding the distinct contribu-
tion of dietary quality
http://care.diabetesjournals.org/content/early/2018/09/27/dci18-0033.full-text.pdf
I'm glad they finally added LCHF! No keto, and they don't admit it is fine for long term, but it's a start.
Medical Nutrition Therapy
MNTcomprises education and support to
help patients adopt healthy eating pat-
terns. The goal of MNT is to manage
blood glucose and cardiovascular risk
factors to reduce risk for diabetes-related
complications while preserving the plea-
sure of eating (21). Two basic dimensions
ofMNT include dietary quality and energy
restriction. Strategies directed at each
dimension can improve glycemic control.
Dietary Quality and Eating Patterns.
There isno single ratio of carbohydrate, proteins,
and fat intake that is optimal for every
person with type 2 diabetes. Instead,
there are many good options and pro-
fessional guidelines usually recommend
individually selected eating patterns that
emphasize foods of demonstrated health
benefit, that minimize foods of demon-
strated harm, and that accommodate
patient preference and metabolic needs,
with the goal of identifying healthy di-
etary habits that are feasible and sustain-
able. Three trials of a Mediterranean
eating pattern reported modest weight
loss and improved glycemic control
(66
–
68). In one of these, people with
new-onset diabetes assigned to a low-
carbohydrate Mediterranean eating pat-
tern were 37% less likely to require
glucose-lowering medications over 4
years compared with patients assigned
to a low-fat diet (HR 0.63 [95% CI 0.51,
0.86]). A meta-analysis of RCTs in pa-
tients with type 2 diabetes showed that
the Mediterranean eating pattern re-
duced HbA1cmore than control diets
(69). Low-carbohydrate,
low glycemic index, and high-protein diets,
and the Dietary Approaches to Stop Hyper-
tension (DASH) diet all improve glycemic
control, but the effect of the Mediterra-
nean eating pattern appears to be the
greatest (70–72). Low-carbohydrate diets
(,26% of total energy) produce substan-
tial reductions in HbA1c at 3 months and
6 months , with diminishing effects at 12
and 24 months; no benefit of moderate
carbohydrate restriction (26–45%) was
observed (73). Vegetarian eating pat-
terns have been shown to lower HbA1c,
but not fasting glucose, compared with
nonvegetarian ones (74). Very recent tri-
als of different eating patterns in type 2
diabetes have typically also included
weight reduction, hindering firm con-
clusions regarding the distinct contribu-
tion of dietary quality
6
Replies
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Awesome news. I think when the medical industry starts being paid based on low cost yet positive outcomes the LCHF/Keto diets will go mainstream even more so. Some locally are moving early metabolic syndrome patients to LCHF or Keto directly. It the patients do not comply they are at least on record prescribing it before Rx Meds.1
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I wonder about the diminishing effects observed with the LC diets for the research. It is complex of course if there has been weight loss as well, and there is more than one factor involved.0
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Awesome!0
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I wonder about the diminishing effects observed with the LC diets for the research. It is complex of course if there has been weight loss as well, and there is more than one factor involved.
I wonder about that too.
I've seen a few studies with diminishing effects as the other dieters lost weight and their results start to look as good as a LCHF diet result. It could be slowed weightloss, but most diets get that too. I've also seen some studies that allow for carb creep and they still call it low carb.
The ADA calls it low carb when carbs are 26% of calories (as I understand it). If someone is eating about 2000 kcal a day, a quarter of that is 500kcal, or 125g of carbs. That's towards the higher end of what most consider to be low carb. If there is much carb creep, it could land people in moderate carb. But that's just a guess. I could be completely wrong1 -
I don't see anything in that study that specifically indicates the combination of Low Carb High Fat (LCHF per the title of the thread). The "High Fat" part is what I am not seeing in the article. Where is low carb recommended in conjunction with high fat? I see where it recommends low carb and/or high protein and/or low glycemic, etc but no specific reference to LCHF. Point me in that direction please. I must be missing it. The list of diets was on page 13 (Table 2) but did not state LCHF unless one assumes "other" includes LCHF. Thanks!
I'm not being contrary. I favor high fat diets and choose that for myself (never was TD1, TD2). ETA @nvmomketo2 -
No, you are right, The focus is low carb, and not high fat. Mediterranean low carb especially.
Not sure how they want people to hit low carb without raising fat somewhat, unless you plan on being hungry and in a large calorie deficit.
Fat is still (relatively) evil....
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Yes. I'll concur with the relatively "still evil" perspective on saturated fat specifically. It has nothing to do with the article/study sited but rather just my general reading of info that spans all diet philosophies.
Fewer seem opposed to UNsaturated fats except for perhaps the calorie amount as it pertains to weight loss, recognizing fats are essential.
Saturated fats? For every article I read indicating they are "good" I can provide an article indicating they are "bad".
I do still contend that the population was sadly mislead regarding all fat being bad for our health but that is just my opinion.1 -
I'm of the same opinion. It's just not a majority opinion. 1
