Popular Diets and Diabetes

An image of Savory Stuffed Mushroom

Low carbohydrate diets such as The “New” Atkins Diet, The South Beach Diet and The Zone are currently popular. In the short term, people do lose weight on a low carbohydrate diet. In a study in the New England Journal of Medicine people on a low carbohydrate diet were compared to people on a low fat diet. At 6 months people on the low carbohydrate diet had lost more weight, but at 1 year there was no difference between the two groups in weight loss. In both groups people had difficulty staying on the diet and about half dropped out of the study before it was over.

Popular diets may claim success in short term weight loss, but the challenge is weight loss maintenance. The National Weight Control Registry follows people who have lost weight and maintained their weight loss. The average weight loss of people in the registry is 60 pounds and on average they have maintained their weight loss for 6 years.

People who have maintained their weight loss have the following behaviors in common:

  • Their daily food intake is low in calories (1,381 calories per day)
  • They monitor their weight frequently; 44% weigh themselves daily and 31% weigh themselves weekly
  • Almost 80% eat breakfast every day and few eat less than two times a day
  • They average one hour a day of moderate physical activity

The National Institute of Health has a campaign “Aim for a Healthy Weight”. Key recommendations are:

  • The initial goal is weight loss of 10%
  • Weight loss should be gradual
  • Follow a low calorie diet
  • Physical activity should be part of weight loss therapy

The long term effects of low carbohydrate, high protein diets are not known. Concerns are bone changes and kidney function. High levels of protein make the kidneys work harder and can cause calcium loss in bone. People with diabetes on a low carbohydrate diet need to have kidney function monitored. People with diabetes who take insulin or diabetes medicines need to talk to their health care providers before going on a low carbohydrate diet. Cutting back drastically on carbohydrates can cause low blood sugar.

Hopefully, the popularity of “low carbohydrate” diets can make us look at the quality of carbohydrates as well as quantity. Soft drinks sweetened with sugar and fruits and vegetables all contain carbohydrates. However, the soft drink has no nutritive value; it contains no vitamins or minerals. Vegetables and fruits contain vitamins and minerals. For example sweet potatoes, carrots, spinach and cantaloupe contain vitamin A. Broccoli, strawberries, green bell pepper and citrus fruits contain vitamin C. Whole grain products contain more fiber, vitamins and minerals. Recent studies have shown a reduced risk for diabetes with an increased intake of whole grains and dietary fiber. So while it makes sense to eliminate or reduce foods that contain carbohydrates but no or few other nutrients, cutting out or drastically reducing carbohydrates reduces the intake of vitamins, minerals and fiber.

People who are attempting to lose weight need to consider appropriate portion sizes. Over the years the portion sizes in restaurants have drastically increased. Read Nutrition Labels carefully. Check what is considered one serving. For example on a 20 oz. soft drink, 8 oz. is listed as one serving. One serving has 100 calories. Therefore, the entire 20 oz. soft drink contains 250 calories.

Calories still count. Compare the number of calories in a “low carbohydrate” product to the number of calories in the “regular” version of the same product. The same thing happened a few years ago in the “low fat” craze. “Low fat” cookies contained about the same amount of calories as “regular” cookies. But because they were advertised as “low fat” people thought they could eat as many as they wanted.

The “New” Atkins Diet extremely restricts carbohydrates. The Zone Diet and the maintenance phase of the South Beach Diet emphasize vegetables, fruits, whole grain foods, lean proteins and dairy foods and unsaturated fats. However, “diets” of any kind are hard to maintain. Lifestyle changes, which are made gradually and can be maintained long term are usually the best choice to consider for people who want to lose weight and keep it off long term.

Submitted by Karen Halderson, MPH, RD, LD
Extension Diabetes Coordinator
Adapted from a presentation on Alternative Diets given by Brenda Broussard RD, CDE, BC-ADM, MPH, MBA and Popular Diets Reviewed, a nutrition fact sheet from the American Dietetic Association

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