Dietary carbohydrate restriction in type 2 diabetes mellitus and metabolic syndrome: time for a critical appraisal

Abstract

Current nutritional approaches to metabolic syndrome and type 2 diabetes generally rely on reductions in dietary fat. The success of such approaches has been limited and therapy more generally relies on pharmacology. The argument is made that a re-evaluation of the role of carbohydrate restriction, the historical and intuitive approach to the problem, may provide an alternative and possibly superior dietary strategy. The rationale is that carbohydrate restriction improves glycemic control and reduces insulin fluctuations which are primary targets. Experiments are summarized showing that carbohydrate-restricted diets are at least as effective for weight loss as low-fat diets and that substitution of fat for carbohydrate is generally beneficial for risk of cardiovascular disease. These beneficial effects of carbohydrate restriction do not require weight loss. Finally, the point is reiterated that carbohydrate restriction improves all of the features of metabolic syndrome.

DOWNLOAD: Study by 24 Doctors and Researchs ADA Rebuttal for Stancy on Low Carb

How To: Learn About Metabolic Syndrome

This section lists some of the medical conditions that can occur with excess abdominal fat. This will be of interest to anyone who is overweight or whose parents and grandparents had diabetes, high blood pressure or cardiovascular disease. After completing this section please proceed to the How to follow a low carbohydrate diet section.

You can skip this section if you are thin AND your parents and grandparents were thin and lived to ripe old ages. You may like to proceed to the How To: Follow a Low Carbohydrate Diet.



Metabolic syndrome is a collection of disorders of metabolism which share a common outcome – much earlier deterioration of your blood vessels.

The major factors related to metabolic syndrome are insulin resistance, hypertension, low HDL, high triglycerides, high oxidised LDL, atheroma formation, gout, polycystic ovary syndrome, renal disease, ischaemic heart disease, dementia, peripheral vascular disease, central obesity, high inflammatory markers in the blood stream, non alcoholic fatty liver disease, and defective insulin secretion or action so that blood sugars rise too high particularly after meals.

Some of these effects you will see, some your doctor has to pick up doing tests and some are illnesses in their own right.

The problem is that if you have one of these you are more likely to get others.

So how do you improve things or stop them getting worse?
Broadly diet and excercise.

For most people wanting to lose weight they can restrict fat or calories as they like. For people with metabolic syndrome or diabetes there are considerable benefits to be had from a low carbohydrate, moderate protein, high fat diet. This is because other factors such as insulin resistance, high blood pressure and  lipids also get better on such a diet. These factors are even independent of weight loss.

Exercise can be geared to activities to improve your cardiovascular fitness such as brisk walking or cycling and also for muscle building activities such as weight training as this particularly improves insulin resistance.

To know what a low carbohydrate diet is all about you need to know what sorts of food contain carbohydrates, protein and fats. What can you eat freely? What can you eat in small amounts?  What do you have to avoid?


Quick Quiz:
1. Three of these are features of metabolic syndrome…
a High blood pressure.
b Fat round the middle.
c Thirst.
d High triglycerides.

2. You are more at risk of metabolic syndrome or type two diabetes if your parents or grandparents had one of these..
a Type two diabetes.
b Type one diabetes.
c Osteoarthritis.
d Hearing Loss.

3. Insulin resistance causes three of these…
a Heart disease.
b Lung cancer.
c Fluid retention.
d Low levels of HDL (good cholesterol).

Have you got it?
1. ABD are correct. Thirst is more associated with the high blood sugars that occur in diabetes types one and two.

2. A is correct.  It has also been recently discovered that tinnitus (ringing in the ears) and hearing loss are strongly correlated with metabolic syndrome and type two diabetes.

3. ACD are true. Smoking is a major cause of lung cancer. An association between type two diabetes and various types of cancer is emerging eg colon cancer. Type ones have recently been found to be at higher risk of pancreatic cancer.

Reference Info:

Where to Next?
Head on over to the How To: Follow a Low Carbohydrate Diet section.