17 Jul Type 2 Diabetes – Part 1

Why are people with type 2 diabetes advised to eat the very foods that made them sick and will continue to keep them sick?

Background

Since the early 1980’s eating guidelines have focused on low fat and high carbohydrate eating. The primary reason for such eating guidelines was based on assumption that fat (especially saturated fat) “supposedly” caused heart disease and increased cholesterol levels resulting in  “clogged up arteries” causing heart and or vascular disease.  At the same time guidelines advised to reduce fat intake, they also started to emphasise the increased consumption of carbohydrates as a way to make up for the reduction in food considered “too fatty and unhealthy”.

Over recent years numerous studies have failed to prove an association between dietary fat and cardiovascular disease. In a recent review analysing the evidence the low fat dietary guidelines were based upon,  the findings concluded “RCT evidence did not support the introduction of dietary fat guidelines”.  Click on link to read ⇒ Open Heart 2015 Harcombe Review.

These “fat” facts the dietary guidelines were based upon,  have now been debunked and the science behind the initial recommendations were:

  • Never proven
  • Never tested, and
  • Politically motivated.
What has happened since the low fat and high carbohydrate dietary recommendations?
  • Global obesity rates have soared.
  • Australia’s overweight and obesity rates have risen significantly with 63% of the adult population now being overweight or obese which is 2 in 3 adults.
  • Unfortunately, 25% of Australian children are now considered overweight or obese which is 1 in 4 children.
  • At the same time Australia’s waistlines have expanded the incidence of type 2 diabetes have also significantly increased. In Australia nearly 1 million people are registered with type 2 diabetes and the number is increasing.
  • On top of the registered cases of type 2 diabetes in Australia it is estimated that half a million people are currently undiagnosed.
  • It is estimated that an additional 2 million Australian’s are at risk of developing type 2 diabetes.
In a nutshell what is type 2 diabetes?

People with type 2 diabetes can not regulate blood sugar levels.

Foods that contain carbohydrate stimulate the pancreas to release the hormone insulin to signal cells to uptake sugar however, the cells of people with type 2 diabetes become resistant to insulin and are unable to uptake sugars effectively, resulting in elevated blood sugar levels.

What is the standard management option for type 2 diabetes?

This is primarily using a combination of medication (such as metformin) and lifestyle changes such as diet and exercise.

After 6 – 10 years 50% of people with type 2 diabetes will need to use insulin. This is a result of the pancreas producing less and less insulin to help regulate blood sugar levels.

What is the typical dietary advice for people with type 2 diabetes?

Low fat and high carbohydrate. Below is a standard recommended meal plan for a person with type 2 diabetes.

Standard Diet for T2D

Just a couple of points:

  • Low fat or reduced fat options only.
  • Saturated fats from whole foods do not raise blood saturated fatty acid levels, however the introduction of carbohydrate into the diet is associated with incremental increases. Click on link to read ⇒ Effects of Step-Wise Increases in Dietary Carbohydrate on Circulating Saturated Fatty Acids and Palmitoleic Acid in Adults with Metabolic Syndrome.
  • Most meals are comprised of approximately 50% carbohydrate some even more, a person with type 2 diabetes is insulin resistance and unable to regulate blood sugars. Foods that will cause a significant surge in insulin and blood sugar levels are carbohydrate based.
  • Focuses on portion control.
  • Recommends the use of industrial processed oils in the form of margarine.

The below foods in the healthy eating plan are either a direct added sugar or the body will breakdown very easily into sugar:

  • Cereals, grains and pasta.
  • Dried fruit such as sultanas, prunes and fruits found in fruit breads.
  • Liquidising fruit such as a bananas into a smoothie makes sugar from that fruit increasing available for the body to absorb.  (Note: the riper the banana the higher sugar content)
  • Breads.
  • Fruit breads.
  • Starchy (breaks down into sugars) vegetables such as potato, sweet potato and corn.
  • Low fat fruit yoghurt which are often heavily loaded with sugars especially low fat yoghurt with fruit. (1 x 200gram low fat strawberry flavoured tub of yoghurt may have over 4 teaspoons of added sugar!)
  • Low fat ice cream and custard.
  • Fruit jam.
  • Canned fruit in natural juices (some serves have between 4 – 5 teaspoons of sugar!)
  • Processed breakfasts cereals.

Like myself and many health professionals around Australian and around the globe it is difficult to understand the current dietary advice given to people with type 2 diabetes, given we know the type of foods that cause blood sugar regulation issues.

Is there a better way?

Yes.

If you are type 2 diabetic and a low fat and high carbohydrate diet is working for you then keep doing what your doing. However, if you are struggling to stabilise blood sugar levels, reduce your HBA1c, reduce your triglyceride levels, improve your cholesterol readings, lose weight especially around the middle and having to increase or modify your medications to try to improve your diabetic control, then you need to read my Part 2.

Coming Soon – Type 2 Diabetes: Low carbohydrate and healthy fat eating – Part 2

Evidence supporting a low carbohydrate and healthy fat nutritional medicine for people with type 2 diabetes has been around for decades. In recent years this evidence has strengthened and become increasingly conclusive, yet the Australian public health system will not support this  nutritional medicine for type 2 diabetes.

More and more experts from around the globe are in support of low carbohydrate and healthy fat eating for the management and prevention of obesity and type 2 diabetes. In part 2 I will outline this evidence, provide some guidelines and give you some references to read, then you can make up your own mind.