ADA Now Supports Low-Carb Diets

| Jan 9, 2008

The powerful - but cautious - American Diabetes Association has announced that it now supports low-carbohydrate diets for people with diabetes who want to lose weight.

In its 2008 Clinical Practice Recommendations, the ADA acknowledges increasing evidence that low-carb diets are as effective in leading to weight loss as diets that focus on lowering fat intake.

Previously the ADA had been reluctant to support low-carb diets, citing a lack of "sufficient scientific evidence." But now, according to Ann Albright, PhD, RD, president of the ADA's Health Care & Education group, "The evidence is clear that both low-carbohydrate and low-fat calorie restricted diets result in similar weight loss at one year." But she added that the ADA is not endorsing either of these weight-loss plans over any other weight loss method.

The ADA's "Standards of Medical Care in Diabetes—2008" document states that there is now evidence that the most important determinant of weight loss is not a diet's composition, but whether the person dieting can stick with it. It also notes that some people will find it easier to follow a low-carb diet while others will find a low-fat, restricted-calorie diet easier to follow.

The ADA is recommending that because people who follow low-carb diets are likely to replace calories from carbohydrates with calories from fat and protein, they should monitor their lipid profiles. Also, diabetes patients with kidney disease should be aware that high-protein diets can worsen kidney problems.

Reactions from CDEs

Diabetes educators have welcomed the news, noting, however, that the ADA was slow in getting there. "I was thrilled to finally see the ADA come around to what many of us have known and seen in our patients for some time," says Diabetes Health's clinical editor Joy Pape (RN, BSN, CDE, WOCN, CFCN). "I understand that they have to wait for the evidence, but it's too bad so many people with diabetes had to wait so long before they could be taught something that can really help them."

Karen LaVine, RN, CDE, who works for a disease management company, LifeMasters Supported SelfCare in Albuquerque, N.M., says, "It's about time. Hopefully this announcement will open the door a little further on low-carb diets. The ADA is acknowledging that if low carb works for somebody, they should go for it. They're taking a good, pragmatic approach."

Pape says that although she has personally been a proponent of lower-carb plans, her experience leads her to agree with the ADA's statement that whether a person can stick with a diet is more important than the diet's theme. "This makes me hopeful that medical nutritional therapy will now truly be based on individualized plans that take the nuances of each person with diabetes into consideration.

"That would be far better than just playing lip service to the idea of individual differences and continually recommending pretty much the same for everyone."

Judi Wilcox, RD, LDN, CDE, a registered dietician at Memorial Regional Hospital in Hollywood, Fla., says that in view of the fact that "both low carbohydrate and low fat diets are shown to promote weight loss, now is the time to for practitioners to end the debate and to allow patients to have an active role in choosing a low-carbohydrate diet. The diets do work and should be recommended as a viable option for weight loss." She says low-carbohydrate diets are an effective option for weight loss which has been shown to help improve insulin resistance, delay the onset of diabetes and help prevent complications.

Wilcox adds that the ADA recommends that low-carbohydrate diets should be used for one year and that patients should have their lipid profiles, renal functions, and, in cases of neuropathy, protein intake routinely monitored. "Individualized medical nutrition therapy should be administered by a certified diabetes educator or registered dietitian to teach a low carbohydrate diet that includes foods high in fiber and low glycemic index foods."

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Categories: Diabetes, Diabetes, Diets, Food, Insulin, Losing weight, Low Carb

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Posted by Ladybird on 9 January 2008

Many of us have been on low carbs lifestyle for some time already, having read many health studies showing that this the "best" way to beat Diabetes. As the CDE's have said, The ADA been very late coming out supporting this type of eating, but better later than never! And good for those diabetics who follow the ADA's rules religiously.

Posted by Anonymous on 12 January 2008

Too much information. ADA is woefully unaggressive.

Posted by ndocroth on 14 January 2008

Welcome to the 21st century - this is a brave and timely step. Now we need to get the word out to those millions at risk of developing diabetes. - Rivkah Roth DO DNM, author of the forthcoming At Risk?--A Natural Medicine Look at Early Risk Recognition of Pre-Diabetes and Diabetes.

Posted by Anonymous on 14 January 2008

The ADA catches on so slowly. I can only give them a big ole "DUH!"

Posted by Anonymous on 26 January 2008

I don't live in America and have been diabetic for 3 rebellious weeks. It took only a few blood tests to realise I can't eat carbs. At least, very little. GI or no GI ... I am Blood Type O, and what D'Adamo said in his book "Eat Right for Your Type" seems to be true for me. (Everyone is different: keep that in mind).

Type O is, according to this doc, ancient blood from the primitive hunter-gatherers. They ate the animals they caught, and maybe berries and a few roots. We are the protein-eaters! Well, as far as bs levels go, that seems to hold true for me.

I've never bothered much about eating low-fat either. I do not go overboard, but I believe the dangers of fat are over-emphasized. Without realising I had diabetes I've been eating merrily away at all kinds of saturated fats, crisp chicken skin, cheese and pork crackling among my favourites, and strangely enough my cholesterol dropped, all by itself, remarkably, from high to just above normal.

CAVEAT: I HAVE also been using Diabecinn, the cinnamon capsule, for about a year. That certainly could have influenced my cholesterol levels.

I fully endorse a very low carb, high protein diet for diabetics -- IF IT SUITS YOU. At least there's less hunger!!

Posted by Anonymous on 27 January 2008

Holy cow anonymous! I could have written your post! Same as you I am Type O but I didn't know the significance of this, thanks for the theory, sounds plausible. I just found out about my diabetes 3 weeks ago too - and while I was given the usual 'calories in, calories out - eat no fat - eat 2 servngs of carbs 3 times a day(!!) - use margarine not butter etc etc etc' advice, I knew better instinctively. So I did my own research and it was eye opening! My 'old' diet has also, like yours, been full of lovely bacon, butter, cheese, eggs, fish, steak and pork etc., all nice natural foods which humans are designed to eat - but of course including refined products using lots of white flour and fake ingredient as well. Therein the problem! My new diet is very very different.

All I did starting 2 weeks ago was to take out the bad stuff, the carbs and starches and goodies and guilty pleasures except what was available in certain fruits and veggies. Here's what has happened in only 2 weeks: I have lost 5 pounds without even thinking about it, and my blood sugar is all of a sudden returning to normal levels, all day long, from meal to meal to meal, slight improvements every day.

It's about time the ADA caught up with things. They may SAY they 'cautiously endorse a low carb diet' however their website still features their old food pyramid, with carbs at the bottom (eat much more of these, in fact - 6 to 11 servings a day!). How does that compute????

At least they are getting somewhere, FINALLY.

Posted by Anonymous on 30 January 2008

They've been giving us bad advice about dieting for years, and now they want us to use them for advice. Also, what do they expect after one year? Do they think people are going to switch to a low-fat high-carb diet afterwards? There's some serious self assessment needed at ADA.

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