Navigating the world of diet culture and nutrition can be a daunting task, especially when you’re living with type 2 diabetes. With a multitude of options out there, from keto to intermittent fasting, Atkins to low carb, it’s no wonder you might feel overwhelmed and confused. But fear not! In this comprehensive breakdown, we’ll shed light on these popular diets and provide you with the knowledge you need to make informed choices about your nutrition.
The Quest for Trustworthy Information
In today’s digital age, information is just a click away. However, not all sources are created equal. Social media, blogs, and personal websites can provide useful information, but they may not always be scientifically accurate or evidence-based. When seeking information online, it’s crucial to ensure that it comes from credible references, qualified professionals, and aligns with established guidelines from reputable health organizations.
This is where registered dietitians come in to play. Registered dietitians are healthcare professionals who have completed specific education and training in nutrition. They are the most qualified to offer individualized nutrition advice that is evidence based. Additionally, they can create tailored nutrition recommendations based on your unique needs.
Should I Start a Diet if I Have Diabetes?
You may have heard about keto, intermittent fasting and Atkins and wondered if it’s something you should do to improve your blood sugar levels. We don’t blame you, but we also don’t recommend it.
Diets are considered restrictive because they limit intake of food in some way, whether it’s calories, macronutrients (like carbs), amount or size of meals, or certain foods all together. On paper, it seems very straightforward: restrict your intake of [insert food or nutrient here] to obtain the desired outcome [weight loss, disease management, etc].
In practice though, cutting a food or nutrient out of your life is not sustainable long term, which means that whichever benefit you may get from the diet won’t last forever and you will end up even worse off than before! That’s why we take an anti-diet approach. We teach you how to listen to your body and make balanced choices to promote health and manage diabetes.
Now let’s do a deep-dive!
Is There a Best Diet for Type 2 Diabetes?
1. The Ketogenic Diet:
Also referred to as keto, has gained popularity because it promotes weight loss and blood sugar control. It is a high-fat, low-carbohydrate diet where the goal is to shift the body into a state of ketosis, where it primarily uses fat for energy instead of glucose. By drastically reducing carbohydrate intake and increasing fat consumption, keto claims to help regulate blood sugar levels (2).
The keto diet requires strict adherence and monitoring and it’s incredibly challenging to sustain long-term. As far as evidence of long-term use of the keto diet, there isn’t any. Studies show waning commitment to the protocol at the 2 year mark that most studies reach. If commitment to the diet slows after 2 years, it’s unrealistic to prescribe this diet as a sustainable lifestyle change to manage disease. Potential risks include nutrient deficiencies, constipation, and increased cholesterol levels.
2. Intermittent Fasting (IF):
Intermittent fasting involves cycling between periods of fasting and eating. The most common approach is the 16/8 method, where people fast for 16 hours and have an eight-hour eating window each day. An example would be starting fasting after dinner around 8:00 PM, fasting for 16 hours overnight and during the morning and then eating meals and snacks at 12:00 PM (noon) through 8pm.
Research regarding the efficacy of IF for diabetes management is limited. One study highlighted by the American Diabetes Association (1) boasts benefits in lowering A1C, but highlighted that only 20 out of 22 participants were able to follow the protocol 75% of the time. When we’re thinking about long term behavior change, intermittent fasting does not fit the equation.
To make matters worse, if you are taking medication for diabetes, you can easily get hypoglycemia during the fasting period and may be more likely to experience large blood sugar fluctuations, which can negatively impact your overall health.
3. The Atkins Diet:
Developed in the 70’s, Atkins is a low-carbohydrate, high-protein diet that aims to control insulin levels by limiting carbohydrate intake. It consists of four phases, starting with a very low carbohydrate intake and gradually increasing the allowance over time. This approach claims to help with weight loss and blood sugar control, however, long-term sustainability and potential nutrient deficiencies should be taken into account.
As with any restrictive diet, any benefits will only last as long as the rules can be followed. Following a diet is also unnecessary as diabetes can be managed and health can be improved by eating balanced meals regularly throughout the day. This type of plan can be done for life, not just a month or a year at best.
4. Low-Carb Diets:
Low-carbohydrate emphasize reducing carbohydrate intake while increasing the consumption of fats and proteins. While there is no single “low-carb” diet, popular variations include the Mediterranean diet, the DASH (Dietary Approaches to Stop Hypertension) diet, and the South Beach diet.
Carbohydrates have a bad reputation when it comes to diabetes because carbohydrates cause the biggest increase in blood glucose, but they are actually an important part of a balanced diet. Carbohydrates are a piece of the puzzle when it comes to balancing blood sugar and work best when combined with protein, fat, and fiber.
Carbohydrates are converted to glucose to provide energy that our body thrives off of, so much so that if we don’t eat carbohydrates our body undergoes a complicated pathway to make glucose from other nutrients.
Grains and starchy vegetables, both sources of carbohydrates, contain important nutrients that other foods can’t give us. It’s also important to remember that restriction doesn’t work long term, so it may be best to skip this and go straight to sustainable lifestyle changes.
In short, there is no one-size-fits-all approach for managing diabetes. What works for one person may not work for another. The best eating pattern for type 2 diabetes is one that you can sustain long-term and that supports your health goals.
It should prioritize whole, nutrient-dense foods and align with your individual preferences and cultural considerations. In addition to diet, it is essential to incorporate other lifestyle factors into your diabetes management plan. Regular physical activity, stress management, and adequate sleep can all contribute to improved blood sugar control and overall well-being.
Instead of jumping on a diet trend, we recommend working with a healthcare professional, such as a registered dietitian or endocrinologist, who can provide personalized guidance and support. They can assist you in managing type 2 diabetes, ensuring your nutritional needs are met while minimizing potential risks.
Do you need help managing your diabetes or prediabetes? Get started with one of our diabetes and prediabetes trained registered dietitian nutritionists today!
REFERENCES
- Anna Obermayer, Norbert J. Tripolt, Peter N. Pferschy, Harald Kojzar, Faisal Aziz, Alexander Müller, Markus Schauer, Abderrahim Oulhaj, Felix Aberer, Caren Sourij, Hansjörg Habisch, Tobias Madl, Thomas Pieber, Barbara Obermayer-Pietsch, Vanessa Stadlbauer, Harald Sourij; Efficacy and Safety of Intermittent Fasting in People With Insulin-Treated Type 2 Diabetes (INTERFAST-2)—A Randomized Controlled Trial. Diabetes Care 1 February 2023; 46 (2): 463–468. https://doi.org/10.2337/dc22-1622
- Hussain M. Dashti, Thazhumpal C. Mathew, Naji S. Al-Zaid; Efficacy of Low-Carbohydrate Ketogenic Diet in the Treatment of Type 2 Diabetes. Med Princ Pract 30 June 2021; 30 (3): 223–235. https://doi.org/10.1159/000512142
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