A Diet for Managing the Most Common Condition of Diabetes

Almost all of us who have diabetes have to deal with other medical problems too. But none of these conditions affects more of us than obesity and the problems that come with it.

More than 85 percent of adults with diabetes were overweight in the U.S. government’s Third National Health and Nutrition Examination Survey. And 54.8 percent of the adults with diabetes were obese.

That’s why a study that a journal of the American College of Physicians will publish tomorrow is so important to us even though it specifically excluded people with diabetes. The study also excluded anyone who had heart or kidney disease, but it did include 119 men and women with a body mass index of 30 to 45.

When people have a BMI of 30 or higher, they are considered obese. If their BMI is above 40, they are commonly considered severely or morbidly obese.

Researchers from Tulane University’s School of Public Health and Tropical Medicine studied these people for one year, randomly assigning them to either a low-carbohydrate or low-fat diet. The abstract of the Annals of Internal Medicine report is free online at “Effects of Low-Carbohydrate and Low-Fat Diets,” but last week a representative of the American College of Physicians provided me with an advance copy of the full-text under embargo until this afternoon.

Different people define low-carb differently, but this study really was low-carb. The people assigned to the low-carbohydrate diet were told to eat less than 40 grams of digestible carbohydrate — total carbs less fiber — per day.

Those assigned to the low-fat diet were told to eat less than 30 percent of their calories from total fat and less than 7 percent from saturated fat with 55 percent from carbohydrates. These are the guidelines of the National Cholesterol Education Program.

Serious questions now attend those guidelines. In every respect the people in this study following the low-carb diet did better than or equally well as those following that standard American diet.

At each step of the way — at 3, 6, and 12 months into the study — the participants on the low-carb diet lost more weight than those on the low-fat diet. At the end of the year-long study those in the low-carb group lost an average of 7.7 pounds more than those in the low-fat group.

The low-carb group also had better levels of serum lipids. HDL cholesterol — known as the good cholesterol — was significantly more in the low-carb group. Likewise, the triglyceride levels — where lower is better — were significantly lower among the participants in the low-carb group. And the levels of C-reactive protein, which rises in response to inflammation, were significantly lower among those eating a low-carb diet.

I am not surprised. Why? Because of my personal experience of switching to a low-carb diet more than six years ago. My weight went down to my current BMI of about 19, my HDL went way up, and my triglycerides plummeted. I now have a low CRP level.

Since then, several studies have indicated that nothing works better for weight loss than a low-carb diet. Maybe this randomized study will put the last nail in low-fat’s coffin so all of us can live healthier lives.

This article is based on an earlier version of my article published by HealthCentral.