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American Diabetes Association Low Carb Diet

Study Compares American Diabetes Association Low-fat Diet To High-fat Ketogenic Diet For Helping Diabetes: Ketogenic Diet Wins

Study Compares American Diabetes Association Low-fat Diet To High-fat Ketogenic Diet For Helping Diabetes: Ketogenic Diet Wins

Study Compares American Diabetes Association Low-fat Diet to High-fat Ketogenic Diet for Helping Diabetes: Ketogenic Diet Wins A study published in April 2014 compared two diets with overweight diabetic people. One group ate the standard recommended diet by theAmerican Diabetes Association, which was a low-fat, high carbohydrate, restricted calorie diet, as per the USDA dietary guidelines for a healthy diet. This group was assigned a registered dietician with several years of diabetes education experience. The group was encouraged to eat a diet that was45-50% carbohydrates, while restricting calories and fats. As per the study: the diet includes high-fiber foods (such as vegetables, fruits, whole grains, and legumes), low-fat dairy products, fresh fish, and foods low in saturated fat. The other group, almost in direct contrast to the ADA diet, was encouraged to eat aa very low carbohydrate, high fat, non calorie-restricted ketogenic diet. Their goal was to reach a state of ketosis,defined as a blood beta-hydroxybutyrate level between 0.5 and 3 mM, as measured twice a week at home using blood ketone test strips. So what results did this study find comparing these two contrasting diets? The ADA diet group, despite eating far fewer calories per day than the ketogenic diet group, did not lose as much weight as the ketogenic diet group. The ADA group lost an average of5.7 lbs., while the ketogenic diet group lost an average of 12.1 lbs. In terms of diabetic medication, the results were also quite different.7 out of 11 ketogenic dieters (64%) were able to reduce their anti-diabetic medications, whereas only 2 out of 13 ADA dieters did (15%). This study is simply another of many studies looking at the ketogenic diet and its effects on health, as compared to the standard USDA Continue reading >>

A Low-carbohydrate, Whole-foods Approach To Managing Diabetes And Prediabetes

A Low-carbohydrate, Whole-foods Approach To Managing Diabetes And Prediabetes

Diabetes is a systemic disease that has reached epidemic proportions worldwide during the past 30 years,1 and this trend shows no sign of slowing down. In the United States alone, it is estimated that almost 26 million people have diabetes, including 7 million not yet diagnosed.2 The statistics are even worse for prediabetes (impaired fasting glucose or impaired glucose tolerance), which is believed to affect 79 million Americans > 20 years of age.2 Risk factors for type 2 diabetes include, but are not limited to, family history, ethnicity, and obesity, whereas people with certain autoimmune conditions, pancreatic disease, and genetic predisposition are at increased risk for type 1 diabetes.3 Regardless of the type, individuals with diabetes experience abnormal carbohydrate metabolism because of a variety of factors, including impaired insulin secretion and insulin resistance. After carbohydrates were recognized as the macronutrient primarily responsible for increasing blood glucose, severe restriction was used to manage hyperglycemia before the discovery of insulin in 1922.4 Until the early 1970s, a lower-carbohydrate, higher-fat diet was considered appropriate for nutritional management of diabetes.5 In 1980, the first set of Dietary Guidelines for Americans included recommendations to adopt an eating pattern lower in fat to prevent chronic health conditions such as diabetes, cardiovascular disease (CVD), and hypertension.6 Although these guidelines state that they “do not apply to people who need special diets because of diseases or conditions,” many clinicians began recommending lower-fat eating patterns, and people with diabetes began adopting them. Although the American Diabetes Association (ADA) has recommended for more than 15 years that macronutrient compos Continue reading >>

Low-carb Diets — Research Shows They May Be More Beneficial Than Other Dietary Patterns

Low-carb Diets — Research Shows They May Be More Beneficial Than Other Dietary Patterns

Today’s Dietitian Vol. 15 No. 8 P. 12 RDs know how powerful nutrition therapy can be for managing diabetes and lowering the risk of its associated long-term complications. Since type 2 diabetes is characterized by elevated blood sugar levels caused by impaired insulin sensitivity, eventually accompanied by insufficient pancreatic insulin production, it seems intuitive that controlling dietary carbohydrates, the main nutrient that directly influences glycemia, would be a logical dietary approach for diabetes management. For that reason, low-carbohydrate diets have constituted the standard treatment for type 2 diabetes for centuries. Since the advent of insulin-sensitizing drugs and oral hypoglycemic agents, however, nutritional guidelines have evolved and the current diet for diabetes now is relatively high in carbohydrates. But could some patients and clients with type 2 diabetes benefit from adopting a lower-carbohydrate approach? Current Recommendations The American Diabetes Association (ADA) encourages individuals with diabetes to learn basic carbohydrate counting skills and aim for 45 to 60 g of carbohydrates per meal. The ADA approves the use of a low-carbohydrate diet in individuals with type 2 diabetes who are overweight or obese as a way to promote weight loss, although it cautions that this approach should be limited to one year, probably because of the sparse number of studies supporting the long-term safety when its nutritional recommendations were published in 2008.1 Low-Carb Approach There’s no consensus on the definition of a low-carb diet. This is why looking at the methodology of different scientific studies always is important to understand exactly what kind of low-carb diet was investigated, which can vary anywhere between 45% to less than 5% of it Continue reading >>

Low-carb Diets & Diabetes

Low-carb Diets & Diabetes

Today's Dietitian Vol. 18 No. 8 P. 24 Research shows they're effective in managing blood glucose in many patients, but they may not work for everyone. Toby Smithson, MSNW, RDN, LDN, CDE, was diagnosed with type 1 diabetes in the late 1960s when the exchange system was used to plan meals for people with diabetes. Smithson and her mother attended classes where she received an exchange booklet. "The exchange system was how I learned about meal planning," Smithson remembers. The exchange system organizes foods into lists by the amount of carbohydrate, protein, fat, and calories they contain. In the 1960s, experts were recommending that carbohydrate intake be limited to 40% of total calories—which was twice as much as previous recommendations. Advice on meal planning approaches and recommended carbohydrate intake for people with diabetes has gone through several cycles. In the 1990s, experts recommended using carbohydrate counting for meal planning and individualizing carbohydrate content of meals. As a dietitian, certified diabetes educator, and an individual living with diabetes, Smithson stays abreast of the latest diabetes research. After reading several studies on the benefits of low-carbohydrate diets for people with diabetes, she decided to "play around" with the carbohydrate content of her own diet. Smithson found that she was always hungry on the low-carbohydrate diet and observed no significant change in her triglycerides or HDL cholesterol. This isn't to say that Smithson's usual diet was high in carbohydrate, as she averages about 135 g per day. Smithson says, "I'm a hard dietitian on myself." She's diligent with monitoring her carbohydrate intake, uses very little insulin, and is proud to say she controls her blood sugar well and has no diabetes complications. Continue reading >>

American Diabetes Association Approves Low Carb Diets For Weight Loss

American Diabetes Association Approves Low Carb Diets For Weight Loss

In December 2008, the American Diabetes Association (ADA) issued its Clinical Practice Recommendations which included the option for Diabetics to follow low-carbohydrate diets as a weight-loss option. While this is obviously not ‘news’, it is important to note that the Canadian Diabetes Association – now called Diabetes Canada, does not as yet make the same recommendation. Why is that? Is there something inherently different about Diabetics in Canada than Diabetics in the United States? For the last 9 years the American Diabetes Association has given people the option of following what they call a “moderate“ carbohydrate diet by (a) omitting some of the carb-containing foods on their standard meal plan or (b) substituting them for much lower carb alternatives. They also (c) provide Americans with the option of following a low carb diet for weight loss. Let’s take a look at the American dietary recommendations compared with the Canadian ones. Dietary Recommendations of the American Diabetes Association On their web page, the American Diabetes Association states that their standard Meal Plans that are “moderate” in carbohydrates provide ~45% of calories from carbs, but they add; Your healthcare provider may ask you to limit carbohydrate more than our meal plan suggests. This means you should cut back on the carbohydrate foods that you eat throughout the day. To keep your calorie intake about the same, substitute sources of lean protein or healthy fats for those higher carbohydrate foods. Then they give some examples of how people can lower carbohydrate intake by making some adjustments to the posted meal plan, such as; omitting the slice of whole wheat toast at breakfast replacing the whole wheat wrap for a lettuce wrap at lunch skipping the serving of bro Continue reading >>

Diet Study: American Diabetes Association Vs. Low Carb Ketogenic

Diet Study: American Diabetes Association Vs. Low Carb Ketogenic

A randomized pilot trial of a moderate carbohydrate diet compared to a very low carbohydrate diet in overweight or obese individuals with type 2 diabetes mellitus or prediabetes (Saslow et al., 2014) Disclaimer: this study was not ground-breaking; it was confirmation of a phenomenon that is starting to become well-known, and soon to be the status quo. That is, advising an obese diabetic patient to reduce their carb intake consistently produces better results than advising them to follow a low fat, calorie restricted diet. : 45-50% carbs; 45 grams per meal + three 15 gram snacks = 165 grams per day; low fat, calorie restricted (500 Calorie deficit). Otherwise known as a low fat diet (LFD). In their words: Active Comparator: American Diabetes Association Diet. Participants in the American Diabetes Association (ADA) diet group will receive standard ADA advice. The diet includes high-fiber foods (such as vegetables, fruits, whole grains, and legumes), low-fat dairy products, fresh fish, and foods low in saturated fat. : Ketogenic; <50 grams of carb per day, no calorie restriction, just a goal of blood ketones 0.5 3 mM. In their words: Experimental: Low Carbohydrate Diet. Participants will be instructed to follow a low carbohydrate diet: carbohydrate intake 10-50 grams a day not including fiber. Foods permitted include: meats, poultry, fish, eggs, cheese, cream, some nuts and seeds, green leafy vegetables, and most other non-starchy vegetables. Because most individuals self-limit caloric intake, no calorie restriction will be recommended. Both groups were advised to maintain their usual protein intake. Food intake. Those assigned to LFD went above and beyond the call of duty and reduced Calories by 792. And as expected, those assigned to keto spontaneously reduced intake, b Continue reading >>

Health Effects Of Low-carbohydrate Diets: Where Should New Research Go?

Health Effects Of Low-carbohydrate Diets: Where Should New Research Go?

Health Effects of Low-Carbohydrate Diets: Where Should New Research Go? 1Albert Einstein College of Medicine 1300 Morris Park Avenue Bronx, NY 10461 2 [email protected] ; Phone: 718-430-3345 1Albert Einstein College of Medicine 1300 Morris Park Avenue Bronx, NY 10461 3 [email protected] ; Phone: 718-430-4072 1Albert Einstein College of Medicine 1300 Morris Park Avenue Bronx, NY 10461 4 [email protected]eb ; Phone: 908-331-0876 1Albert Einstein College of Medicine 1300 Morris Park Avenue Bronx, NY 10461 2 [email protected] ; Phone: 718-430-3345 The publisher's final edited version of this article is available at Curr Diab Rep See other articles in PMC that cite the published article. There has been considerable debate about the metabolic effects of restricting carbohydrate intake in weight and diabetes management. However, the American Diabetes Association has noted that weight and metabolic improvements can be achieved with low carbohydrate, low fat (implicitly higher carbohydrate), or a Mediterranean style diet (usually an intermediate level of carbohydrate). Our paper addresses variability in the definition for low or restricted carbohydrate, the effects of carbohydrate restriction on diabetes-related health outcomes, strategies for restricting carbohydrate intake, and potential genetic variability in response to dietary carbohydrate restriction. Issues for future research are also addressed. Keywords: diabetes, diet, nutrition, low carbohydrate, eating patterns, available carbohydrate, genetic variability, Paleolithic diet, nutrition guidelines, insulin resistance, gut hormones, health effects, diabetes, research There has been considerable debate about the effects of restricting carbohydrate intake in we Continue reading >>

“i Ignored The American Diabetes Association And The Dietitians”

“i Ignored The American Diabetes Association And The Dietitians”

Howard decided to ignore the advice on a high-carb diet to treat his type 2 diabetes. Here’s what happened when he did the opposite instead: The email In Nov 2013, my blood sugar went out of wack with an HbA1C of 16%. A friend steered me to your site. I ignored the American Diabetes Association and the dietitians with their high carb, low fat, reduced calorie intake diets. I went on a no sugar minimal carb intake (no grains, potatoes, rice, pasta, etc.). In nine months my HbA1C was down to 5.6% with the side effects of lost 55 pounds (25 kg), triglycerides dropped from 197 to 67 (2.2–0.76 mmol/l), HDL rose from 34 to 76 (0.88–1.96 mmol/l) without meds. My doctor is not a full believer so has put me on one 500 mg Metformin a day. No before, only the after. Congratulations Howard! More How to cure type 2 diabetes “I finally kept my promise to my mom” PS Do you have a success story you want to share on this blog? Send it (photos appreciated) to [email protected] Let me know if it’s OK to publish your photo and name or if you’d rather remain anonymous. Continue reading >>

Low-carb Diet Recommended For Diabetics

Low-carb Diet Recommended For Diabetics

A couple of months ago, a study in the journal Nutrition caught my eye. Titled “Low-carb diet recommended for diabetics,” the study laid out twelve pieces of evidence for why reducing carbs should be the first line of defense for all diabetics, potentially allowing people with type 2 to drop all diabetes medications, and those with type 1 to limit the amount of insulin they take and limit their episodes of high blood sugar. As one of the study’s authors explained to Science Daily: “Diabetes is a disease of carbohydrate intolerance. Reducing carbohydrates is the obvious treatment. It was the standard approach before insulin was discovered and is, in fact, practiced with good results in many institutions. The resistance of government and private health agencies is very hard to understand.” I’ve been seeing digital displays of how Bisi reacts to carbs for more than two years now, so this study comes as no surprise to me. When we cook at home and eat in a low-carb way (maybe a turkey cheeseburger with mushrooms and kale for dinner, along with a moderate treat for dessert like frozen blueberries and cream, or a small yogurt popsicle), Bisi’s blood sugar stays in range and is easy to manage. When she goes to a friend’s birthday party and has pizza and cake, we (or the parents who, in a real act of friendship, have miraculously agreed to let her sleep over) are up at least twice that night correcting her blood sugar, and trying to bring it down. When eating these high-carb meals, she is also at greater risk of scary lows, because she’s taking larger amounts of insulin, and, as any parent of someone with diabetes knows, it’s not always easy to get the timing of the dose or the calculation of the carbs exactly right. (I still get a pit in my stomach when I th Continue reading >>

Ada’s Latest Low-carb Stance Is Severely Flawed, Says Longtime Low-carb Advocate Dr. Bernstein

Ada’s Latest Low-carb Stance Is Severely Flawed, Says Longtime Low-carb Advocate Dr. Bernstein

Diabetes Health Pioneering low-carb diet advocate Dr. Richard K. Bernstein has responded to the American Diabetes Association’s recent support for low-carb diets with a critique of several of the ADA’s most cherished notions. In a recent “Ask Dr. Bernstein.com” tele-seminar presented to callers and listeners, he cited the ADA’s 2008 guidelines for doctors, disputing the association’s recommendations on several fronts: He said that the ADA’s definition of a low-carb diet as one with 130 or fewer grams of carbohydrates per day “is four times higher than what I recommend and makes it impossible to maintain [blood glucose] control.” He disputed the ADA’s contention that an A1c of less than 6 for people with diabetes increases the risk of hypoglycemia. “The risk is only to people taking the industrial insulin doses that the ADA recommends for covering their high-carbohydrate diets. Regarding the ADA’s recommendation that adults with diabetes shoot for blood sugar levels of 70 mg/dl to 130 mg/dl before meals and 180 mg/dl after meals – with even higher levels allowed for children – Dr. Bernstein said, “Children are not entitled to normal blood sugar levels? And neither are adults.” Those guidelines, he said, “were created by non-diabetics to be imposed upon diabetics.” Dr. Bernstein called the association’s recommendation that people with diabetes regularly see podiatrists to have their foot calluses debrided with a scalpel “the most dangerous thing you can do to a diabetic.” He said that 100 percent of the diabetic amputees he has ever interviewed in his university-based wound care clinic told him that their amputations arose from infections caused by an attempt to remove a callus – whether at the hands of a podiatrist, a family me Continue reading >>

Ada Now Supports Low-carb Diets

Ada Now Supports Low-carb Diets

The powerful but cautious American Diabetes Association has announced thatit now supports low-carbohydrate diets for people with diabetes who want to loseweight. In its 2008 Clinical Practice Recommendations, the ADA acknowledges increasingevidence that low-carb diets are as effective in leading to weight loss as dietsthat focus on lowering fat intake. Previously the ADA had been reluctant to support low-carb diets, citing a lackof "sufficient scientific evidence." But now, according to Ann Albright, PhD,RD, president of the ADA's Health Care & Education group, "The evidence isclear that both low-carbohydrate and low-fat calorie restricted diets result insimilar weight loss at one year." But she added that the ADA is not endorsingeither of these weight-loss plans over any other weight loss method. The ADA's "Standards of Medical Care in Diabetes2008" document states thatthere is now evidence that the most important determinant of weight loss is nota diet's composition, but whether the person dieting can stick with it. It alsonotes that some people will find it easier to follow a low-carb diet whileothers will find a low-fat, restricted-calorie diet easier to follow. The ADA is recommending that because people who follow low-carb diets are likelyto replace calories from carbohydrates with calories from fat and protein, theyshould monitor their lipid profiles. Also, diabetes patients with kidney diseaseshould be aware that high-protein diets can worsen kidney problems. Diabetes educators have welcomed the news, noting, however, that the ADA wasslow in getting there. "I was thrilled to finally see the ADA come around towhat many of us have known and seen in our patients for some time," saysDiabetes Health's clinical editor Joy Pape (RN, BSN, CDE, WOCN, CFCN). "Iunderstand Continue reading >>

Diabetes & Ketogenic Diet: Can You Manage Your Diabetes On A Ketogenic Diet?

Diabetes & Ketogenic Diet: Can You Manage Your Diabetes On A Ketogenic Diet?

In this article we will cover what a Ketogenic diet is and if you can manage your diabetes while on this diet. Ketogenic diet for diabetics is a highly controversial topic, but we will break down everything here for you! As a Certified Diabetes Educator (CDE), I have to tell you from the start I will have a biased view here. Sorry, but I feel that I need to be completely honest right up front! I will however, present all the evidence that is available currently on the subject. As a CDE, I have been taught to follow the American Diabetes Association Dietary Guidelines for Americans which is low in carbohydrates, high in fiber, with fresh vegetables, fruits and whole grains. The Ketogenic Diet this article will be discussing is much lower in carbohydrates, in order to promote the state of nutritional ketosis, or the fat burning state for weight loss. What is a Ketogenic Diet? The Ketogenic Diet is a low carbohydrate diet, consisting initially of less than 20 carbohydrates per day. Not per meal, yes, you heard me correctly, per day. It is not for the faint of heart and yes I am writing from experience. Of course I have tried it! Hasn’t everybody in America at some point who has wanted to lose weight? Does it work you ask? Of course it does! The problem is how long can you keep it up? Your body uses the carbohydrates you eat for energy, so if we restrict how many carbohydrates we eat, the body has to get its fuel source from fat. A byproduct of this fat burning state are ketones which are produced; this is called nutritional ketosis. You can determine if you are in this fat burning state by purchasing urine ketone testing strips from your local pharmacy. The Ketogenic Diet with Diabetes Some precautions must be made clear; this diet is not appropriate for people with any Continue reading >>

American Diabetes Association: Help For Diabetics?

American Diabetes Association: Help For Diabetics?

The American Diabetes Association was founded in 1940. Their mission is to prevent and cure diabetes and to improve the lives of all people affected by diabetes. Diabetes is a disease in which the body cannot metabolize blood sugar correctly, which leads to a buildup of excess sugar in the bloodstream. This excess sugar accelerates the symptoms of heart disease and damages other body systems. Let’s take a look at what the American Diabetes Association recommends in terms of nutrition, and see if these policies can be trusted as the best advice for diabetic care. On their website, the American Diabetes Association directs diabetics to eat between 45-60 grams of carbohydrates at each meal. Assuming a person eats three meals a day, this advice works out to telling diabetics to eat a minimum of 135 grams to a maximum of 180 grams of carbohydrates per day. Now, 180 grams of carbohydrates works out to 720 calories (1 gram of carb=4 calories). In a daily diet of 2000 calories, eating the minimum recommended carbs would set the daily percentage of carbs at 27% (540/2000) and the maximum carbs would be 36% (720/2000). But in addition, the American Diabetes Association recommends that diabetics reduce their intake of saturated fat and cholesterol, and eat more non-starchy vegetables. Although non-starchy vegetables are lower in carb than cereal foods, they still do have carbs in them, so the ADA diet is actually about 55 percent carbohydrate, 20 percent protein, and about 25 percent fat, expressed in a ratio of 55:20:25. Does the ADA Diet Help Diabetics Control Blood Sugar Levels? Let’s determine whether this diet composition of 55:20:25 is good advice for helping diabetics with controlling their blood sugar, one of the most critical components of managing diabetes. Below are Continue reading >>

Diabetes And Your Diet: The Low-carb Debate

Diabetes And Your Diet: The Low-carb Debate

A few years ago, Richard Kahn, the now-retired chief scientific and medical officer of the American Diabetes Association, was charged with organizing a committee to prescribe a diet plan for people with diabetes. He began by looking at the evidence for different diets, asking which, if any, best controlled diabetes. “When you look at the literature, whoa is it weak. It is so weak,” Dr. Kahn said in a recent interview. Studies tended to be short term, diets unsustainable, differences among them clinically insignificant. The only thing that really seemed to help people with diabetes was weight loss — and for weight loss, there is no magic diet. But people want diet advice, Dr. Kahn reasoned, and the association really should say something about diets. So it, like the National Institutes of Health, went with the Department of Agriculture’s food pyramid. Why? “It’s a diet for all America,” Dr. Kahn said. “It has lots of fruits and vegetables and a reasonable amount of fat.” That advice, though, recently came under attack in a New York Times commentary written by Sarah Hallberg, an osteopath at a weight loss clinic in Indiana, and Osama Hamdy, the medical director of the obesity weight loss program at the Joslin Diabetes Center at Harvard Medical School. There is a diet that helps with diabetes, the two doctors said: one that restricts — or, according to Dr. Hallberg, severely restricts — carbohydrates. “If the goal is to get patients off their medications, including insulin, and resolve rather than just control their diabetes, significant carb restriction is by far the best nutrition plan,” Dr. Hallberg said in an email. “This would include elimination of grains, potatoes and sugars and all processed foods. There is a significant and ever growing Continue reading >>

Navigating A Low-carb Eating Plan

Navigating A Low-carb Eating Plan

Some people are giving up bread, potatoes, and pasta in pursuit of better health. Should you? If you ask a dozen people, including medical professionals, to define a low-carb diet, youll likely hear 12 different answers. For some, its an eating plan that swaps refined grain products (such as white pasta) with their whole-grain cousins (such as whole-wheat pasta). Others say such a diet demands that you give up cereal, bread, potatoesand other carbohydrate-rich foodsaltogether. On the surface, it seems that a diet lower in carbohydratethe nutrient that has the biggest effect on blood glucose levelswould benefit people with diabetes, who need to manage those levels for optimal health. Cutting carbohydrate, particularly when it comes from sugar and refined grains, can help people with diabetes manage weight and their blood glucose. But the notion of a low-carb diet is poorly defined and commonly misunderstood. When people tell me they are following a low-carb diet, they are usually still eating fruit, dairy, beans, and even whole grainsin other words, not low carb at all, says Lori Zanini, RD, a registered dietitian based in Manhattan Beach, California, and a spokeswoman for the Association of Nutrition and Dietetics. To give you an idea of how carbs add up, consider that a medium apple has 25 grams of carbohydrate, a serving of cannellini beans (1/2 cup) has 18 grams, a serving of canned corn (1/2 cup) has 9 grams, and a small slice of whole-wheat bread has 15 grams. For people with diabetes, I define low carb as less than 120 grams a day, says Jessica Crandall, RD, the wellness director at food-service company Sodexo in Denver. That number isnt arbitrary; Crandall says this recommendation has been established through research as well as her own experience with adult cli Continue reading >>

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