Diabetes Myth #5 – The Diabetic Diet

Of course one of the main concerns of a newly-diagnosed diabetic is food.  What can and can’t I eat?  What should and shouldn’t I eat?  As previously discussed, many people start off with “avoid sugar” but of course there is more to it than that.

Dietary advice in the UK stems from the British Dietetic Association – the professional body of dietitians, in conjunction with the Department of Health.  Since this is the official source, most other sources of advice (doctors, nurses, Diabetes UK etc) follow the guidance given out by these two bodies.  After all they are the experts.

When looking at diet, the content of food can be broadly summarised as: Carbohydrates, fat, protein, fibre, vitamins and minerals.

Now there is no denying that much of the advice is good to follow, making sure that we are taking in enough vitamins and minerals and so on.  The sources for these are generally unprocessed fruit & vegetables, so that tends to be a main focus.  This also tends to cover our needs for fibre.

The problem with the official advice lies with protein, fat and carbohydrates (carbs).  These are the 3 elements which have an effect on the blood glucose, to varying degrees.  Carbohydrates raise the blood glucose level and controlling the blood glucose level is the main concern for a diabetic.  Fats slow down the effects of carbohydrates on the blood glucose although how much of a difference they make is up for debate.  Protein does not have that much effect on blood glucose except under certain circumstances.

The official dietary advice for diabetics regarding these three is exactly the same as for non-diabetics – “base your meals on starchy carbohydrates”   This makes no allowance for the fact that carbohydrates raise your blood glucose.  Furthermore, the advice is to eat as little fat as possible and not overdo the protein.

If you are thinking “that will just push my blood glucose up too high” you’re right.  So why do they recommend a diet which seems completely contrary to all common sense?

The simple answer is that they are terrified of fat.  This seemed to start in earnest in the early 80s with the publication of a report which claimed to prove that in countries where the population ate less fat, there was less heart disease.  Almost overnight most of the western dietary organisations and governments seem to have changed their policy based on the idea that fat is evil.

It sounds pretty convincing until you take a look at this report in more detail and discover that it appears the report’s author threw away all the numbers he didn’t want to see.  The report is the “Seven Countries” study and when you realise that he started out with data from 22 countries, you get an idea of how much got thrown away to come up with the “fat is evil” conclusion.

Studies since then have been very weak with the most convincing ones showing improvements in heart health from reducing fat a little bit while keeping everything else the same.  However, studies where the carbohydrates are reduced instead and even increase the fat intake considerably, show far better results.

We have all been conditioned over the years to think of fat as evil, but the more you look at it in detail (not just a report’s conclusion), the less it seems to be true.  In the meantime this leads our official dietary advisors to tell us to load up on the very things that push our blood glucose up

So we need to look at things in a different way.  What can we eat without pushing our blood glucose up?  Well the simple answer to that is to try eating different things and see what happens to the blood glucose.  Then learn from that process to work out what foods and in what quantities we can eat without affecting the blood glucose too much.  Since we know that fat slows down the effects of carbohydrates on the blood glucose and ignore the “fat is evil” message, we can see the effects of increasing and decreasing fat on our blood glucose as well.

Over time we build up a picture of what works for us.  Everyone is slightly different in the way that their body reacts to food and although we can get a rough idea of what works for everyone most of the time, things might be a little different for each one of us.

What happens when people give this a serious try is as follows:
1)  Their blood glucose is lower and easier to control.
2)  Their risk of complications fall considerably.
3)  Their cholesterol improves, reducing their risks of heart disease even if they are eating more of the “evil” fat
4)  They end up eating things they like rather than what some book says they should eat.
5)  They usually lose weight despite increasing their calories if they are overweight (see myth #3).
6)  They feel better generally day to day because their blood glucose is more stable and not being “spiked” by carbohydrate-heavy meals.

I should also mention protein.  It has been found that people with kidney problems should avoid protein.  Since people with diabetes are prone to get kidney problems, advice has sprung up that diabetics should avoid protein.  However, there is no danger from eating protein until the kidney problems actually start, so there is no reason for most people to avoid protein in order to protect their kidneys.  As it happens protein has been found to reduce hunger so it makes you feel fuller for longer and if you are trying not to overeat, thats a useful bonus.

So when we are diagnosed we are all looking for easy answers and the dietary advice is right there from all the official sources.  It may be a little more effort, but trying things out for yourself and learning from the process is far more effective.

So the final question has to be “if we know this works, why do they keep giving us the wrong advice?”.  There are various theories on this and certainly the research has been done, but some biased research has been done as well.  Studies into “low carb” diets place the goalposts in very different places.  The standard official advice is to eat 230g of carbohydrate per day.  Some “low carb” studies test as much as 210g of carbohydrate per day.  Others go as low as 50g of carbohydrate per day.  So the results from these studies are bound to be very different and the conclusions they reach are also very different.

So if you have been conditioned to believe that fat is evil and look at research, you are far more likely to focus on the studies with 210g of carbohydrate per day, which will favour your position.  You will ignore the study on 48000 canadian women over 8 years on a low fat diet who had no improvement in heart disease risk and many others.  So the argument continues to rage on.

In the meantime, the only way to be sure is to try things out for yourself, learn from the results and find a diet which suits you.  Your dietitian/doctor/nurse may not like it, but its not their body they’re playing with.

And someday they may actually try it for themselves, instead of just repeating what their book says.

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