“Global dietary guidelines have been updated to align with scientific evidence. The American Diabetes Association (ADA), The British Diabetes and Dietetic Associations, Diabetes Canada and Diabetes Australia have included carbohydrate reduction (CR) in their official T2DM dietary guidelines.(1,2)”
While the above statement is true, there are still reservations about the long-term viability of very low carbohydrate diets in the long term. In both the policy papers below, there is confusion not only about carbohydrate intake, but also about saturated fat, meat and salt in the diet. There’s recognition that very low carbohydrate diets work to lessen the need for medication in diabetes care. There is recognition that very low carbohydrate diets help people lose weight. There is recognition that very low carbohydrate diets improve all blood markers except for LDL-Cholesterol. So, dieticians are told that a low carbohydrate diet should be offered as an option to people with Type II Diabetes.
Yet, in both the papers below, many hang-over ideas from the past still intrude into the statement that muddy the waters. Lipo-phobia still exists. If you eat less carbohydrate, you MUST replace it with something. “Something” can only be protein and fat. Most people, certainly most older people don’t eat enough protein, and the best quality protein is in meat and fish. Yet the guidelines say that meat should be restricted. There is a limit to how much protein you can eat, also, if you attempt to overeat steaks, your body will very quickly tell you when you’ve had enough. Many modern studies have shown that saturated fats are not a problem in a very-low carbohydrate diet because these fats become the main energy source for living. Many studies are also showing that the seed oils often recommended by guidelines are in fact damaging to health.
Association of British Dieticians
Policy Statement
(1) Low Carbohydrate Diets for the Management of Type 2 Diabetes in Adults.
Available at https://www.bda.uk.com/uploads/assets/03128bac-0a39-4e4d-a23fd440a97b1396/policystatement-lowcarbohydratedietsforthemanagementoftype2diabetesinadults.pdf [accessed January 2024].
This paper is 6 pages plus 19 references. They are still trying to have it both ways, recommending the standard diet, but saying that low-carbohydrate diets are also an option, especially in the short term, and particularly for weight loss and the treatment of Type II Diabetes.
They say:
Patients should be given a choice.
Patients should be supported to lose weight.
Patients should be supported to maintain their weight loss.
Patients should be supported to increase their physical activity.
Patients should have access to a dietitian and other trained professionals.
Diabetes Canada
(2) Low carbohydrate diets for adults with diabetes: summary.
Available at https://www.diabetes.ca/advocacy—policies/our-policy-positions/low-carbohydrate-diets-for-adults-with-diabetes–summary [accessed January 2024]
This short, 2 page statement says that reserch supports “lower carbohydrate diets” for BOTH the treatment of Type I Diabetes and Type II Diabetes.
They quite rightly say that if one is taking medication to control your blood glucose levels, as you begin a lower-carbohydrate diet you need to reduce your medication or low blood glucose (hypoglycemia) may become an issue.
Ketoacidosis is also a potential problem for Type I Diabetics, but also for Type II Diabetics using SGLT2 inhibitors.
New American Dietary Guidelines and Why They Matter
Open Future Health believes that there is much misleading information in this new video about the 2020 American Guidelines. Yet is sounds good because it says what we expect it to say.
Note that the 2020 guidelines are built on the previous guidelines. Many of the dietary prejudices and political choices contained in the old guidelines remain, even though after strong criticism (See Nina Teicholz below) that the guidelines were not science based has been reluctantly accepted.
The new guideline for infants and toddlers up to 24 months are important..
A key question remains. What is “Nutrient Dense Food”? That’s still in dispute. Open Future Health believes that protein and saturates fats are more nutrient dense than vegetables, fruit and grains.
Notice that the new guidelines are still lipophobic, they talk about low-fat dairy foods and lean meat, and you need to use “oils” avoiding the use of the term “fat”. If you are eating the standard high carbohydrate diet then it makes sense to limit added sugar, excessive fats, and maybe to limit salt. But if you are on a very-low carbohydrate diet, saturated fats and more salt are necessary in your diet. (Note that the “heart healthy” seed and vegetable oils, still being recommended are now considered unhealthy fats by many sources.)
‘The Real Food Politics: Institutional Defense of the Status-Quo’
Low-fat and Low-carb are diametrically opposed eating proposals.
You can’t pick what you like from each and pretend that will work for you. You’ll starve if you try low-carb AND low-fat, and rapidly become obese if you choose high-carb AND high-fat. The latter is what we do when we eat hamburgers and fried chicken or chips. Most fast food is high-carb AND high-fat, and is best avoided.
Nina Teicholz explains that because of the Guidelines first established in the 1980’s there has been a huge shift in the macro nutrients Americans are eating. But over the same time period public health has got worse.
She goes on to explain the many forces that prevent the adoption of a diet that is healthier and based on better science.
One of the techniques is to claim that the science is settled, and another is to find research that supports your claims, and to exclude any research that shows the opposite. As recently as 2015, the American Guidelines Panel claimed that they could find no relevant research supporting a low carbohydrate diet. (Which of course raise a storm of protest, confirming that the Guidelines were not scientific.)
Open Future Health has been documenting these debates for more than 10 years now, and in the main website you will find the stories of Tim Noakes, Jennifer Elliot, Garry Fettke, and Caryn Zinn, and about 50 others including Nina Teicholtz.
Canadians Call for New Policy on Diabetes.
This short video tells us that Diabetes is a problem, and that policy change is required. The Parliamentary Inquiry in Australia seems to point in the right direction. See the video below.
The Australian Parliamentary Inquiry into Diabetes
With one in twenty Australians living with diabetes, it has become one of Australia’s leading chronic health conditions. The House Health Committee has commenced and inquiry into diabetes in Australia.
Reversing Type 2 diabetes starts with ignoring the guidelines
The Late Sarah Hallberg, giving her famous TED Talk, in 2015.
More than half the population in America is overweight, and they either have Type II Diabetes or are standing in line to become diabetes patients. In addition, maybe 20% of people who have normal weight are also insulin resistant, which is the first stage of a 20 year process that will become metabolic dysfunction, obesity, diabetes, fatty liver, loss of eyesight, cardiovascular disease, loss of feeling in your feet, amputation of toes and feet, and Alzheimer’s disease.
Don’t say; “I’ve got a little bit of diabetes, but my doctor says I’m doing fine, my blood sugars are under control. ” I’ve heard that story once too often from a friend now deceased. Diabetes is serious, and it can be avoided by lifestyle changes. If you have diabetes it can be reversed by lifestyle changes.
Sarah Hallberg’s Rules:
Don’t buy foods that are “Lite” of “Low-fat” or “Reduced fat”.
Eat real food. Real food never comes on a box.
Eat when you are hungry, (but only nutrient dense foods).
NO grains, no potatoes, no bread, no rice and no SUGAR or it’s many (50+) alternatives.
