Atkins for Diabetics

Over the past few years, a significant amount of research- much of it reported in this newsletter- has shown that low-carb diets are effective not only for weight loss, but for improving many measures of risk for heart disease and diabetes. Now a new study from the prestigious Albert Einstein College of Medicine shows that a low-fat diet has no advantage over a low-carb diet modeled on the Atkins Advantage program in the treatment of diabetes. In fact- as we’ve said before- the low-carb diet actually has some significant advantages.

This is important news since many conventional doctors have continued to believe- despite considerable evidence to the contrary- that low-carb diets are “dangerous”.

In the current study, researchers studied 105 adults with type ll diabetes. The participants had a body mass index of 25 or more (overweight to obese) and Hemoglobin A1C levels between 6-11%. Hemoglobin A1c is a measure of blood sugar control over time, and a reading of over 6% is generally considered problematic and a good indication of diabetes.

Half the subjects were put on a low-fat diet modeled after the standard diet outlined in the Diabetes Prevention Program, while the other half were put on a diet modeled after the Atkins program.

Both groups lost weight and reduced their A1c levels. The low-fat diet- long considered the ‘gold standard’ in the treatment of diabetes- had absolutely no advantage over the Atkins program. Both groups of patients lost a similar amount of weight, but the Atkins dieters had an additional benefit- their HDL (“good”) cholesterol went up.

Both groups saw the most weight loss- and the most reduction in their hemoglobin A1c levels- in the first three months. There was no significant reduction in A1c levels after a year, but this doesn’t tell the whole story. Fully one third of the subjects had been on medication before starting the study, but stopped once the study started. The fact that their A1c did not rise even though they were no longer taking medication, is a good indication that the diet was working.

Though there was some weight regain over the course of the year, this was believed to be because many of the subjects stopped following the diet, or followed it less strictly, something that has been observed in other studies as well.

We suspect the results would have been even more dramatic if the participants had followed their program a bit more carefully. Even so, the study shows clearly that low-fat diets have no advantage over low-carb diets and should help low-carb programs gain more acceptance as a viable alternative to low-fat diets, not only for weight loss, but for overall health benefits.

Many people report that lower carb programs like Atkins are far easier to stick with than low-fat diets which frequently leave dieters feeling unsatisfied and hungry. Patients in previous studies have reported that hunger was generally absent on an Atkins-like diet and only returned after increasing dietary carbohydrates.(2). In addition, low-carb approaches like Atkins virtually always improve important measures of risk for heart disease like triglycerides, and frequently improve HDL cholesterol (as the Atkins diet did in this study.)

In 2006, researchers reported that a 20% carbohydrate diet was significantly superior to a 55–60% carbohydrate diet with regard to bodyweight and glycemic control in 2 groups of obese diabetes patients observed closely over 6 months(3). Last year, a follow-up study with the original participants found that despite some weight regain, overall weight, BMI and Hemoglobin A1c were still significantly lower 44 months later(4).

1) Davis, et al Diabetes Care 2009; 32:1147-1152
2) Johnstone AM, Horgan GW, Murison SD, Bremner DM, Lobley GE: Effects of a high-protein ketogenic diet on hunger, appetite, and weight loss in obese men feeding ad libitum.
Am J Clin Nutr 2008, 87:44-55.
3) Nielsen JV, Joensson E: Low-carbohydrate diet in type 2 diabetes. Stable improvement of bodyweight and glycemic control during 22 months follow-up.
Nutr Metab (Lond) 2006, 3:22
4) Nielsen, Joensson, Nutrition and Metabolism, 2008

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