Dan K.


I have heard from other diabetics about a low carb high fat diet. Is all that fat healthy?

Amy Campbell


Lower-carbohydrate eating plans can improve glycemic control and evidence shows that they can lead to weight loss. As a result, many people with diabetes have chosen to cut their carb intake. Recently, a Swedish study of people with type 2 diabetes found that a lower-carb diet helped to reduce inflammation, which is linked with a higher risk for heart disease. The American Diabetes Association states, in its recent nutrition recommendations, that a lower-carb eating plan may be beneficial for glycemic control and weight loss. While there is no consistent definition of what constitutes a “low carb diet”, diets that provide between 21 and 70 grams of carb per day are considered to be very low in carbohydrate (this may be too low for many people). A more moderate approach is to aim for about 30 to 40% of your daily calories from carbohydrate. However, there are some drawbacks to lower-carb plans. As you mentioned, when you cut back on carbs, you need to increase your protein and/or your fat intake. The risk of doing this is that you may end up choosing foods that are high in saturated fat, an unhealthy type of fat that may raise LDL (bad) cholesterol levels and possibly increase the risk of heart disease. This means eating less red meat (beef, pork, lamb, veal), cheese, whole milk/yogurt and butter) and making better choices, such as poultry, fish, eggs and tofu. In addition, it’s important to choose healthier fats, such as vegetable oils, nuts, seeds and avocado. Higher protein diets can lead to a condition called ketosis (not the same as diabetic ketoacidosis). Ketosis occurs when there isn’t enough carbohydrate (glycogen) to use for fuel. The body turns to its fat stores for energy, and this leads to a condition called ketosis which, in some people, can cause headaches, irritability, and heart palpitations. Ketosis also causes the kidneys to work harder than usual. A low- carb, high-fat diet can shortchange you on other important nutrients, including fiber and antioxidants, that you don’t get from eating animals products or fats. Finally, there isn’t much long-term data on low-carb diets. What are their effects five or ten years down the road? Scientists don’t have that information yet. If you’re thinking of trying this approach, avoid extremely low-carb diets. In other words, make sure you’re eating some carb (from whole grains, fruits, beans and low-fat dairy) every day. Work with a dietitian to develop an eating plan that is safe and palatable, and that is realistic for you to follow.

May 1, 2014 at 10:40 pm