It seems like so many people are on these low-carb diets these days. Are these
safe for someone with diabetes?
DR. ALAN GREENE:
Linda, that is an excellent question and one I am sure many people with diabetes
are asking. The popularity of very low carbohydrate, high-protein diets has
increased in recent years. The media (and probably some of your friends) make
claims about how much weight you can lose if you follow such a plan. Since
weight loss is a main goal for treating type 2 diabetes, the idea of eating
few carbohydrates and making up calories with high-protein foods (which are
often also high in fat) may have some theoretical appeal.
However, you should know that low-carbohydrate diets (restricting total
carbohydrate) to less than 130 grams a day) are not recommended in the management
of diabetes, according to the2006 Clinical Practice Guidelines, which are
the official standards of medical care in diabetes.
Examples of low carbohydrate diets include Dr. Atkins' New Diet Revolution,
The Zone, The South Beach Diet, Protein Power, The Carbohydrate Addict's Diet
and Sugar Busters. The levels of fat and carbohydrate vary with each diet,
but in general, all of these diets limit carbohydrate intake and are low in
Here are some areas of concern with low-carbohydrate diets:
- They can provide low levels of vitamins, minerals, and other important
phytonutrients from food.
- They may (although they don't have to) provide high levels of unhealthy
- Your cholesterol levels may increase if you don't reduce calories.
- They are often very low in fiber.
- They provide low levels of vitamins and minerals.
- High protein diets may increase your risk of diabetic kidney disease.
On the other hand, there are some possible benefits of low-carbohydrate diets:
- They may promote short-term weight loss.
- They may reduce total calorie intake -- at least short term. This reduction
may improve blood sugar control.
- Healthy fat choices can replace refined carbohydrates.
- Triglyceride levels may go down while the diet is followed.
While no single diet is advocated specifically for type 2 diabetes, the current
American Diabetic Association (ADA) guidelines emphasize working with a registered
dietician familiar with diabetes medical nutrition therapy (MNT). With this
help you can learn the best types and amounts of carbohydrates for you. You
will want to limit saturated fat to less than 7% of total calories, to minimize
or eliminate trans fats, and to avoid too much protein (especially if you already
have any chronic kidney problems). If you choose to use alcohol, this should
be limited to a moderate amount (less than one drink per day for adult women
and less than two drinks per day for adult men).
Perhaps what you include is even more important than what you limit. You will
want to be sure to include plenty of vegetables, fruits, legumes, fiber-rich
cereals, and whole grain foods in your diet.
In general, the ADA suggests that half of your plate should be vegetables
and salad greens, ¼ of your plate should be lean protein, and ¼ of
your plate should be whole grains, fruits, or other healthy carbohydrates
Alan Greene, M.D. earned a Bachelor's degree from Princeton University
and graduated from medical school at University of California at San Francisco.
Upon completion of his pediatric residency program at Children's Hospital
Medical Center of Northern California in 1993, he served as Chief Resident.
During his Chief year, Dr. Greene passed the pediatric boards in the top
5 percent of the nation.
Dr. Greene entered primary care pediatrics in January 1993. He is on the
Clinical Faculty at Stanford University School of Medicine where he sees
patients and teaches Residents. He serves as the Chief Medical Officer of
A.D.A.M., Inc., a leading provider of consumer health information, and helps
direct A.D.AM.'s editorial process. As A.D.A.M.'s CMO, he served as a founding
member of Hi-Ethics (Health Internet Ethics) and helped URAC develop its
standards for eHealth accreditation. He is also the Founder & CEO of
DrGreene.com. Dr. Greene was also named Intel's Internet Health Hero for
children's health. He is an author, medical expert, and a media personality.
He is the author of The Parent's Complete Guide to Ear Infections (People's
Medical Society, 1997). Dr. Greene has appeared in numerous publications
including the Wall Street Journal, Parenting, Parent, Child, American Baby,
Baby Talk, Working Mother, Better Home's & Gardens, and Reader's Digest.
He also appears frequently on television and radio shows as a medical expert.
Review Date: 5/1/2006
Reviewed By: Alan Greene, M.D., F.A.A.P., Department of Pediatrics, Packard Children's Hospital, Stanford University School of Medicine; Chief Medical Officer, A.D.A.M., Inc.
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