Ketogenic diet vs. "my plate" for T2Ds
nvmomketo
Posts: 12,019 Member
Came across this today. They're starting to look into dietary treatments more for T2D. Pretty neat. Too bad it was such a small trial but it is still interesting results.
https://www.jmir.org/2017/2/e36/
"An Online Intervention Comparing a Very Low-Carbohydrate Ketogenic Diet and Lifestyle Recommendations Versus a Plate Method Diet in Overweight Individuals With Type 2 Diabetes: A Randomized Controlled Trial
Results: At 32 weeks, participants in the intervention group reduced their HbA1c levels more (estimated marginal mean [EMM] –0.8%, 95% CI –1.1% to –0.6%) than participants in the control group (EMM –0.3%, 95% CI –0.6% to 0.0%; P=.002). More than half of the participants in the intervention group (6/11, 55%) lowered their HbA1c to less than 6.5% versus 0% (0/8) in the control group (P=.02). Participants in the intervention group lost more weight (EMM –12.7 kg, 95% CI –16.1 to –9.2 kg) than participants in the control group (EMM –3.0 kg, 95% CI –7.3 to 1.3 kg; P<.001). A greater percentage of participants lost at least 5% of their body weight in the intervention (10/11, 90%) versus the control group (2/8, 29%; P=.01). Participants in the intervention group lowered their triglyceride levels (EMM –60.1 mg/dL, 95% CI –91.3 to –28.9 mg/dL) more than participants in the control group (EMM –6.2 mg/dL, 95% CI –46.0 to 33.6 mg/dL; P=.01). Dropout was 8% (1/12) and 46% (6/13) for the intervention and control groups, respectively (P=.07).
Conclusions: Individuals with type 2 diabetes improved their glycemic control and lost more weight after being randomized to a very low-carbohydrate ketogenic diet and lifestyle online program rather than a conventional, low-fat diabetes diet online program. Thus, the online delivery of these very low-carbohydrate ketogenic diet and lifestyle recommendations may allow them to have a wider reach in the successful self-management of type 2 diabetes."
https://www.jmir.org/2017/2/e36/
"An Online Intervention Comparing a Very Low-Carbohydrate Ketogenic Diet and Lifestyle Recommendations Versus a Plate Method Diet in Overweight Individuals With Type 2 Diabetes: A Randomized Controlled Trial
Results: At 32 weeks, participants in the intervention group reduced their HbA1c levels more (estimated marginal mean [EMM] –0.8%, 95% CI –1.1% to –0.6%) than participants in the control group (EMM –0.3%, 95% CI –0.6% to 0.0%; P=.002). More than half of the participants in the intervention group (6/11, 55%) lowered their HbA1c to less than 6.5% versus 0% (0/8) in the control group (P=.02). Participants in the intervention group lost more weight (EMM –12.7 kg, 95% CI –16.1 to –9.2 kg) than participants in the control group (EMM –3.0 kg, 95% CI –7.3 to 1.3 kg; P<.001). A greater percentage of participants lost at least 5% of their body weight in the intervention (10/11, 90%) versus the control group (2/8, 29%; P=.01). Participants in the intervention group lowered their triglyceride levels (EMM –60.1 mg/dL, 95% CI –91.3 to –28.9 mg/dL) more than participants in the control group (EMM –6.2 mg/dL, 95% CI –46.0 to 33.6 mg/dL; P=.01). Dropout was 8% (1/12) and 46% (6/13) for the intervention and control groups, respectively (P=.07).
Conclusions: Individuals with type 2 diabetes improved their glycemic control and lost more weight after being randomized to a very low-carbohydrate ketogenic diet and lifestyle online program rather than a conventional, low-fat diabetes diet online program. Thus, the online delivery of these very low-carbohydrate ketogenic diet and lifestyle recommendations may allow them to have a wider reach in the successful self-management of type 2 diabetes."
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I wonder how long it will be before doctors actually incorporate these ideas into their daily practice.....0
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They don't recommend this diet because it can be very hard on the kidneys. It can also raise your bad cholesterol.
In my humble opinion, any diet that strictly prohibits any food group, can't be that good for you. Sure you'll lose weight, but you may not get all the nutrients your body needs.
Just my opinion.1 -
In addition to the article @nvmomketo quoted, the books Blood Sugar 101, the Art and Science of Low Carbohydrate Living, and Dr. Bernstein's Diabetes Solution cite study upon study that should calm your fears.
While the population of T2Ds is extremely diverse, LC/ketogenic diets will significantly improve the metabolic health of a great many of us. They're not an all-or-nothing proposition; the net benefit will be smaller for some than for others.
* The common phobia that a well-formulated LC diet causes kidney problems is not well-founded.
* The fact that carbs raise BG (and the risk of heart disease, Alzheimer's, vascular damage, retinopathy,..., etc.) for the majority of T2Ds is a good reason to reduce (not eliminate) them, unless, through rigorous testing, you have determined that LC diets don't work for you.
(To use a crude comparison, everyone understands the need to avoid consuming alcohol if you're an alcoholic and to reduce grains if you have celiac disease or are gluten-intollerant. Glucose intolerance is the sad reality for many of us T2Ds.)
* It is not particularly difficult to make sure you consume all needed micronutrients (and many people on low-carb diets eat tons of vegetables!). Vegan diets, including vegan LC, require greater diligence but can still be successful.
* Obesity is a risk factor for many health problems, so absent a compelling reason to the contrary, losing weight is a good goal for many T2Ds.
* Lipid panels (particularly triglycerides and HDL) tend to improve for most T2Ds after BG and insulin levels have subsided and body weight has settled at a healthy level.
Does every type of LC diet work for every T2D? Well, no. But that's not a reason to dismiss LC entirely and avoid even investigating whether it would improve the health of a particular T2D.
For this particular T2D, I wish I had not spent years eating "wholesome" LF diets in a vain attempt to corral my rising BG, now that I've seen how immediate and dramatic my improvement has been simply from kicking my carb habit and giving LC a serious audition. YMMV, of course.
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judyvalentine512 wrote: »They don't recommend this diet because it can be very hard on the kidneys. It can also raise your bad cholesterol.
In my humble opinion, any diet that strictly prohibits any food group, can't be that good for you. Sure you'll lose weight, but you may not get all the nutrients your body needs.
Just my opinion.
It's not for everyone but it is a safe diet that can benefit T2D's who use it..
Fats are not hard on kidneys. I don't know if there are any situations where fewer carbs hurt kidneys... except maybe for those with very very damaged kidneys who can't handle the slight urine output increase caused by lowered insulin levels. I don't think so though.
Some think that a ketogenic diet is high in protein, which can be harder on people with kidney problems, but that's just an old misconception. Most people on a ketogenic diet use moderate protein. Mine is set at about 20% which is usually between 75-90 g per day.
All nutrients can be gained through quality animal products. Nutrients are actually more bioavailable when coming from animal products. We need less because we essentially absorb them better. Consider the Inuit, Canadian First Nations and Masai people, all are/were very healthy on a LCHF diet.
As for bad cholesterol, I assume you mean LDL? LDL usually does not change much on a ketogenic diet except that it tends to switch to the healthier less dense variety. In some it can go up a small amount, or down a small amount. HDL does tend to go up which affects total cholesterol (if you have an old fashioned doctor who still uses that), but triglycerides tend to go down.
If you have familial hypercholestetolemia, then you should probably not eat a high fat diet. That condition is fairly rare though. For everybody else, high fat does not raise cholesterol in harmful ways.
I do like that researchers are looking into a ketogenic diet for T2D's and those with IR. It's nice to have more treatment options - dietary changes - rather than just weight loss (which may not be doable or effective enough) or medication. A LCHF diet, or a ketogenic diet, is another treatment option that we can choose from.
More options are good. 1 -
I am starting week 3 of a ketogenic diet. I began out of desperation. Dieting was not improving my BG as it usually does. I have dropped 14 pounds and gone from a fasting BG of 171 to 138. I eat at 50 carbs or lower. I eat vegetables every day, a quarter to a half cup of berries, cheese for calcium and am usually not hungry. Just my expetience.2
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I am starting week 3 of a ketogenic diet. I began out of desperation. Dieting was not improving my BG as it usually does. I have dropped 14 pounds and gone from a fasting BG of 171 to 138. I eat at 50 carbs or lower. I eat vegetables every day, a quarter to a half cup of berries, cheese for calcium and am usually not hungry. Just my expetience.
Wow. Your blood glucose has dropped close to 20% already! Congratulations!2 -
Just clocking in with my anecdotal evidence here-- 3 weeks ago, 9.5 a1c, 204 fasting, 248 2h. pp. Today, fasting 89, 2h. pp 91. Eat less than 26g net carbs a day (subtract out sugar alcohol & dietary fiber.)1
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Just clocking in with my anecdotal evidence here-- 3 weeks ago, 9.5 a1c, 204 fasting, 248 2h. pp. Today, fasting 89, 2h. pp 91. Eat less than 26g net carbs a day (subtract out sugar alcohol & dietary fiber.)
Success!!
For those of us T2Ds who are insulin resistant / carb intolerant, sugars are poison.
(FYI, you may find that not all sugar alcohols are created equal. Erythritol seems to be the most benign for my system as far as BG and GI
consequences go.)
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I just hope the motivation to correct things stays there, actually seeing blood sugar numbers seems to help a bit.
The numbers are always there and reflect at least in some manner how your body is handling your diet and sugar and everything, its a metric I can go "That's pretty good" or "I need to do better" about.
Feels a bit less nebulous than weight... which plateaus and doesn't react how you'd expect at times... shorter time frame on BG numbers maybe.
Regardless, got a long long way to go. Need to lose significant weight, need to get my blood sugars consistently <100 fasting and 2h post meal. Need to get in some kind of exercise routine I can maintain long term. Was pondering C25K... never been a runner, but I'm so rural that gyms aren't terribly useful (too far away).1 -
I just hope the motivation to correct things stays there, actually seeing blood sugar numbers seems to help a bit.
The numbers are always there and reflect at least in some manner how your body is handling your diet and sugar and everything, its a metric I can go "That's pretty good" or "I need to do better" about.
Feels a bit less nebulous than weight... which plateaus and doesn't react how you'd expect at times... shorter time frame on BG numbers maybe.
Regardless, got a long long way to go. Need to lose significant weight, need to get my blood sugars consistently <100 fasting and 2h post meal. Need to get in some kind of exercise routine I can maintain long term. Was pondering C25K... never been a runner, but I'm so rural that gyms aren't terribly useful (too far away).
I liked exercise videos for convenience. I have kids ate home all day so videos worked well. I'm not very consistent though.
Testing BG really does help me too. It keeps me honest.@shadus, that's the spirit!
Until you know your pattern pretty well, you might want to consider testing 1 hour post-meal, too. (I seem to peak 60-75 minutes PP - down from 2 hours when I started...).
Me too. I peak within an hour PP.1 -
I'll give the 1h pp checks a shot and see what my numbers look like vs the normal 2h pp.0
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So did that this evening after the meal, think i'm going to get a 3h pp as well just outta curiosity, but --
12:50 - 103
1:00 - brunch
6:15 - dinner
7:00 - 86
7:15 - 100
8:15 - 1001 -
I was being really really lazy today, so -- tuna salad (3oz), chicken salad (10oz), mayo to make them, lemon juice, spices & some servings of beef jerky. cals: 910, carbs: 6g, fats: 43g, pro: 121g.
Generally speaking, I gotta have something to really chew to feel full... dunno why. So... since chicken and tuna salad don't really have much chewing needed something else to satisfy that urge.
Good day for my inner carnivore tho... chicken, beef, and fish. lol.1 -
As an update my numbers began to move back to the 140s and stuck. My first night off lo carb, my fasting was 110. T2 is fickle. Have gone to a bariatric clinic and will be working with them on diet and physio. Hope to get to try saxenda.0
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As an update my numbers began to move back to the 140s and stuck. My first night off lo carb, my fasting was 110. T2 is fickle. Have gone to a bariatric clinic and will be working with them on diet and physio. Hope to get to try saxenda.
You're off low-carb? Did something go wrong?0 -
As an update my numbers began to move back to the 140s and stuck. My first night off lo carb, my fasting was 110. T2 is fickle. Have gone to a bariatric clinic and will be working with them on diet and physio. Hope to get to try saxenda.
You're off low-carb? Did something go wrong?
I understand it as @tekwriter 's FBG crept back up to 140 so she quit LCHF. The next morning FBG was 110.
But last I'd heard FBG had fallen from 170's to 138, so I could be wrong.
I too hope all is okay.
My FBG tends to be higher than I'd like now that I've stopped losing weight. It is always my highest number of the day though so that's why I stick with LCHF. No BG spikes after meals. Just a small nudge upwards sometimes.0
