Low Carbohydrate Diet
Because carbohydrates affect the blood sugar, it is intuitive that diabetics need to limit their carbohydrate intake. Some may want to minimize carbohydrate consumption. The problem is that there is no universal definition of “low” (or “moderate” or “high”) carbohydrate diets. Each research study has its own definition.
In an extensive review of randomized controlled trials published between 2010 and 2015, the effects of low carbohydrate diets (<130 gm carbohydrate/day or <26% total kcals/day) on weight, HbA1c, and lipids were compared to those of high carbohydrate diets (>230 gm carbohydrate/day or >45% total kcals/day). A low carbohydrate diet was found to improve blood sugar control in the short term, but the change was not sustained in the long run. Low carbohydrate diets were also not found to be superior to other diets in achieving controlling blood sugar. In fact, a recent trial comparing low and high carbohydrate diets with the same calories resulted in similar improvement in HbA1c and fasting glucose.
In addition, low carbohydrate diets may be more detrimental to health than expected. Low carbohydrate diets tend to be higher in protein, which may harm kidney function. In addition, long-term low carbohydrate diets may also adversely affect calcium metabolism, the adequacy of essential nutrients found in carbohydrates, and risk of cardiovascular disease. In fact, a review and meta-analysis reported that low-carbohydrate diets were associated with a significantly higher risk of all-cause mortality. All these indicate the inappropriateness of following a low carbohydrate diet for the long term without medical supervision, especially when there are no clear guidelines as to how much carbohydrates is considered “low.”
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