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Keto, low carbohydrate, low glycemic index, Mediterranean, DASH diet, low fat: there is a dizzying array of plans that claim to optimize health. Some are based on reliable scientific data and others do not.
For people with type 2 diabetes, a disease that affects about one in 12 people worldwide, determining what to eat can be even more confusing because their body has difficulty transforming sugars .
When they eat carbohydrates – the sugars and starchy foods that are found in many foods -, their blood sugar levels increase dramatically. Poor glycemic control by the body can damage organs, especially blood vessels, eyes and kidneys.
The goal of my research lab at the Okanagan Campus of the University of British Columbia is to research diet and exercise interventions for the treatment and prevention of type 2 diabetes. We are conducting studies on the human to determine the impact of different lifestyle strategies on the control of blood glucose and on other important health markers for the management of this disease.
What does our science say about some of these miracle diets? What are the simple strategies that people with type 2 diabetes can use to reduce hype and improve their health?
The first is probably the simplest and easiest to implement: restrict foods containing carbohydrates, such as oatmeal and toast, to breakfast.
Inverted circadian rhythm
I've been using continuous glucose monitoring for 10 years to study the influence of diet and exercise on controlling blood sugar. In studying hundreds of people with type 2 diabetes, I can say a constant: breakfast is the biggest glucose peak of the day.
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I've always thought that this was due to the fact that typical Western foods for breakfast, such as cereals, toast, oatmeal and fruit, are high in carbohydrates.
However, it could also be that the circadian rhythm – the internal clock that governs our metabolism over 24 hours – is "reversed" in type 2 diabetes.
Instead of waking up and being very glucose-tolerant and insulin-sensitive early in the day, the circadian rhythm is disrupted in people with type 2 diabetes, so their body is still less able to handle carbohydrates in the morning. If they eat a typical breakfast, they get a very pronounced glucose spike.
This led us to conduct our recent study, published in The American Journal of Clinical Nutrition, who asked the simple question: "What would happen to the overall control of blood glucose if people with type 2 diabetes avoided carbohydrates at breakfast?"
Desire to sweeten foods
As expected, we completely eliminated the high glucose level of breakfast by offering a breakfast with low carbohydrates including an egg, cheese and spinach omelette.
In addition, the peaks after lunch and dinner were the same regardless of breakfast. Thus, overall exposure to damaging glucose peaks has been improved and markers of glucose volatility have been improved by simply switching to a breakfast containing very little carbohydrate.
We also found that hunger before meals and the desire to eat sugary foods were less strong at dinner on a breakfast day with low carbohydrates.
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This suggests that having a breakfast containing low carbohydrates could reduce energy intake and help reduce cravings cravings later in the day. A simple and powerful strategy, not only for type 2 diabetics, but for all those who wish to improve their diet.
It should be noted that the encouraging results are preliminary and that we do not know if all low carbohydrate breakfast foods would have the same effects.
Read more:
Does the food industry conspire to make you fat?
You may also be wondering if peaks at breakfast are such a problem, so why did not you ask participants to just skip breakfast? Previous research has taught us that skipping breakfast was probably not the best idea for a person with type 2 diabetes because it caused exaggerated blood sugar spikes at lunch and dinner, as well as during breakfast. metabolic compensation, so that people eat more or spend less energy. later in the day.
Diabetes "remission" with keto diet
The second strategy, especially for type 2 diabetics, is to follow a low carbohydrate or ketogenic diet.
Evidence of the benefits of a keto diet for type 2 diabetes is accumulating, and studies have shown that with proper medical support and advice, more than 50% of patients could possibly to have their condition "in remission".
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This means that their blood glucose control has returned to normal and they no longer need to take hypoglycemic agents. This is a staggering and life-changing result for many people who have become dependent on daily medications such as insulin or metformin.
However, in the real world, restrictive diets are generally not respected. Some people may stick to it, but at least half of the participants at least fall off the wagon within six to twelve months of starting a new diet, whether it is low in carbohydrates or not .
One or two low carb meals
An approach based on a hardened ketogenic diet may also involve some risk. A recent study from my lab also warns that the occasional "cheat day" under a strict ketogenic diet can damage blood vessels.
Going from one or two meals a day to a low carb diet could be a workable goal that maximizes benefits while minimizing potential risks for many people with type 2 diabetes.
At a time when pharmaceuticals are the norm for managing most diseases, I am encouraged to discover simple alternatives that can be tested in scientific research studies. It's not every day that, in the area of health, we see apparently opposite diseases in our patients.
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Since normal circadian rhythm indicates that humans are more tolerant of glucose in the morning, this strategy may not be optimal for a non-diabetic person. However, the slightest feeling of hunger later in the day, when a low-carb breakfast is consumed, could be appealing to many people trying to control their weight.
We hope to test some of these ideas in the years to come while continuing our research on optimizing lifestyle approaches for type 2 diabetes.
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