Eating fewer carbohydrates may not be the answer to diabetes prevention and management. A balance of healthy fats and fewer refined grains and added sugars may reduce risk.
It's becoming clearer that among the macronutrients — carbohydrates, protein and fat — some impart more health benefit than others. For example, whole grains are superior to refined grains. There is still much to figure out in the amounts or balance of nutrient that is optimal in disease prevention and treatment.
While there is increasingly strong evidence that replacing saturated fat with unsaturated fats provides cardiovascular benefits, there is controversy around amounts and types of carbohydrates and fats for blood glucose management in the prevention or management of diabetes.
Researchers at Tufts University analyzed results of 102 trials, which included 4,660 adults, to evaluate how saturated fat, mono- and polyunsaturated fats and carbohydrates affected key risk factors for type 2 diabetes. Specifically, the researchers assessed how these macronutrients affected blood sugar and insulin levels, as well as insulin sensitivity and production.
A common practice in diabetes management is to significantly reduce all carbohydrates. This often leads to consumption of more animal protein and fat, especially saturated fat. This study suggests it is not reduction in carbohydrates alone that improves outcomes. Rather it is the inclusion of healthy fats, such as those from fish, nuts, seeds and oils, eaten in place of refined grains, added sugars and animal fats that may offer the greatest reduction in risk.
Per the study analysis, a 5 percent increase in calories from healthy fats (and similar reduction in calories from refined carbohydrate and saturated fat) resulted in improved hemoglobin A1C (a marker of blood glucose control) by 0.1 percent. While this is not a large number itself, it could reduce the incidence of type 2 diabetes by 22 percent and cardiovascular disease by almost 7 percent.
How could you translate this to your diet? Swap your high saturated fat, sugary dessert or snack with moderate portions of fruit and nuts. Eat fish instead of red meat once to twice a week. Put seeds or nuts in a salad, smoothie or home-baked goods. Make dips and spreads with oils, nuts, seeds, avocados and beans.
Aug. 17, 2016
- Imamura F, et al. Effects of saturated fat, polyunsaturated fat, monounsaturated fat, and carbohydrate on glucose-insulin homeostasis: A systematic review and meta-analysis of randomised controlled feeding trials. PLoS Med. 2016;13:e1002087.
- Healthy fats can help prevent type 2 diabetes: Study. https://consumer.healthday.com/diabetes-information-10/diet-diabetes-news-178/study-healthy-fats-can-help-prevent-type-2-diabetes-712980.html. Accessed Aug. 16, 2016.