Low-Carb Diet May Lead To Similar Benefits As Weight Loss Medication Combined With A Low-Fat Diet

A low-carbohydrate diet appears to be associated with substantial weight loss similar to that produced by a combination of the weight-loss drug orlistat and a low-fat diet, but may be more effective in reducing blood pressure. William S. Yancy Jr., M.D., M.H.S., and colleagues at the Department of Veterans Affairs Medical Center and Duke University Medical Center, Durham, N.C., examined body weight, metabolic and adverse effects in obese or overweight outpatients ages 18 to 70 who were randomly assigned to one therapy or the other for 48 weeks.

Of the participants, 57 in the low-carb diet group and 65 in the orlistat and low-fat diet group completed the study. Weight loss was similar for both groups (an average of 8.5 percent to 9.5 percent of body weight), but the low-carb diet resulted in greater reductions to systolic (top number) and diastolic (bottom number) blood pressures. High-density lipoprotein cholesterol and triglyceride levels improved similarly in both groups.

"In conclusion, the low-carbohydrate ketogenic diet and the orlistat plus low-fat diet were equally effective for weight loss and several cardiovascular disease risk factors, although the low-carbohydrate diet was more effective for lowering blood pressure," the authors conclude. "Efforts should be made to incorporate similarly intensive weight loss programs into medical practice."

Arch Intern Med. 2010;170[2]:136-145.

Source
Archives of Internal Medicine

Diabetes UK Position Statement On Low Carbohydrate Diets

Diabetes UK, the UK's leading charity for people with diabetes, has released their position statement on low carbohydrate diets for people with Type 2 diabetes. This was needed as they have not previously given specific recommendations on this topic, and low carbohydrate diets continue to be a very popular method of weight loss.

Previous dietary recommendations have focused on the type of carbohydrate in the diet of people with diabetes said that meals should be based on starchy foods. People with type 2 diabetes are often told that they need to lose weight but struggle to do so on traditional high carbohydrate, low fat diets.

This new statement makes it clear that the priority for people with Type 2 diabetes wanting to lose weight should be reducing overall energy intake whilst ensuring that the diet still provides all essential nutrients. A number of different diets can achieve this aim, and Diabetes UK recommend that a range of approaches should be considered, because the most appropriate method is different for different people. This statement does not say that low carbohydrate diets are best for all people with Type 2 diabetes, but that it may be suitable for some.

The evidence that they reviewed suggests that low-carbohydrate diets can reduce weight and lead to improvements in blood glucose control. They only found convincing evidence that this was effective for up to 1 year, and point out that there is currently insufficient evidence to support the safety and benefit of low-carbohydrate diets in the longer term.

Diabetes UK recommend that a person wanting to lose weight on a low carbohydrate diet discuss this with their dietitian and that they are aware of the possible side effects. They stress that blood glucose levels should be closely monitored and medications adjusted where necessary.

There are many different reasons why people become overweight and it makes sense that there are also different ways to lose weight. Whilst wholegrain starchy foods are healthy inclusions to the diet, few people today are basing their diets on these foods. A sedentary lifestyle and eating too much refined carbohydrate from heavily processed foods is

undoubtedly a major cause of weight gain for many people. Reducing these foods that provide excess calories but little quality nutrition is an easy way to lose weight. Carbohydrate foods mainly provide energy for physical activity, so it is sensible to tailor the amount of the foods to how much exercise you do. Few people today get recommended daily minimum amount of physical activity, so it is little wonder that the old advice to eat more starchy foods would lead to weight gain for many.

This represents a change in that it takes the emphasis away from eating more starchy foods, and less fat. However it is important to realise that this statement does not change the advice that a healthy diet for people with and without diabetes is one that is low in saturated fats and salt, and rich in vegetables and fruits and includes wholegrains and oily fish.

This is a balanced statement from a trusted charity. I expect that many people with diabetes who are struggling to lose weight will be glad to know that they can safely try a reduced carbohydrate diet and are likely to see the benefits that their peers on similar diets have experienced. This is a relatively new area of research and the relationships between human health and diet takes a long time to study. I expect that as more evidence accumulates showing the safety and benefits of low carbohydrate diets, and we have more long term studies, dietary advice from Diabetes UK and other organisations will be further modified to take this into account.

Disclaimer: The views expressed here are the views of All About Weight. All About Weight supports the work of Diabetes UK. Diabetes UK does not specifically endorse All About Weight plans.

Reference

Diabetes UK (2011). Position statement on low carbohydrate diets for people with Type 2 Diabetes. Available here on [24/4/11]

Source:
Diabetes UK

Killer Carbs: Scientist Finds Key To Overeating As We Age

A Monash University scientist has discovered key appetite control cells in the human brain degenerate over time, causing increased hunger and potentially weight-gain as we grow older. The research by Dr Zane Andrews, a neuroendocrinologist with Monash University's Department of Physiology, has been published in Nature.

Dr Andrews found that appetite-suppressing cells are attacked by free radicals after eating and said the degeneration is more significant following meals rich in carbohydrates and sugars.
"The more carbs and sugars you eat, the more your appetite-control cells are damaged, and potentially you consume more," Dr Andrews said.

Dr Andrews said the attack on appetite suppressing cells creates a cellular imbalance between our need to eat and the message to the brain to stop eating.

"People in the age group of 25 to 50 are most at risk. The neurons that tell people in the crucial age range not to over-eat are being killed-off.

"When the stomach is empty, it triggers the ghrelin hormone that notifies the brain that we are hungry. When we are full, a set of neurons known as POMC's kick in.

"However, free radicals created naturally in the body attack the POMC neurons. This process causes the neurons to degenerate overtime, affecting our judgement as to when our hunger is satisfied," Dr Andrews said.

The free radicals also try to attack the hunger neurons, but these are protected by the uncoupling protein 2 (UCP2).

Dr Andrews said the reduction in the appetite-suppressing cells could be one explanation for the complex condition of adult-onset obesity.

"A diet rich in carbohydrate and sugar that has become more and more prevalent in modern societies over the last 20-30 years has placed so much strain on our bodies that it's leading to premature cell deterioration," Dr Andrews said.

Dr Andrews' next research project will focus on finding if a diet rich in carbohydrates and sugars has other impacts on the brain, such as the increased incidences of neurological conditions like Parkinson's disease.

Insomnia Linked to High Insulin Resistance in Diabetics

ScienceDaily (May 2, 2011) — In the largest study of it kind to establish a link between sleep and diabetes, researchers found that people with diabetes who sleep poorly have higher insulin resistance, and a harder time controlling the disease.

The findings, published in the June issue of Diabetes Care, suggest that poor sleep may contribute to worse outcomes in people with diabetes.

"Poor sleep quality in people with diabetes was associated with worse control of their blood glucose levels," said Kristen Knutson, PhD, assistant professor of medicine and lead author of the study. "People who have a hard time controlling their blood glucose levels have a greater risk of complications. They have a reduced quality of life. And, they have a reduced life expectancy."

People with diabetes generally have poorer sleep than the general population, and poor sleep has been proposed as a risk factor for developing the disease. Sleep disorders, such as obstructive sleep apnea, are more prevalent in people with type 2 diabetes, Knutson said.

For the study, researchers monitored the sleep of 40 people with diabetes for six nights. The subjects also reported if they generally suffered from symptoms of sleep disturbances like insomnia, snoring or sleep apnea. At clinical examinations, they gave blood samples to allow researchers to measure insulin and glucose levels.

The subjects wore activity monitors on their wrists at night, which measure their wrist movements throughout the night. Poor sleep, or insomnia, was determined by both poor sleep quality based on the activity monitors and the subject telling the researchers that they often had a hard time falling asleep or woke up during the night.

Among the diabetics, poor sleepers had 23% higher blood glucose levels in the morning, and 48% higher blood insulin levels. Using these numbers to estimate a person's insulin resistance, the researchers found that poor sleepers with diabetes had 82% higher insulin resistance than normal sleepers with diabetes.
Knutson said the next step for researchers is to see if treating poor sleep can improve long-term outcomes and quality of life for diabetics. "For someone who already has diabetes, adding a sleep treatment intervention, whether it's treating sleep apnea or treating insomnia, may be an additional help for them to control their disease," Knutson said.

In fact, restoring a healthy amount of sleep may be as powerful an intervention as the drugs currently used to treat type 2 diabetes. "This suggests that improving sleep quality in diabetics would have a similar beneficial effect as the most commonly used anti-diabetes drugs," said Eve Van Cauter, PhD, professor of medicine and co-author of the study.

Further investigation into which leads to the other -- the chronic poor sleep or chronic insulin resistance -- could improve the quality of life for people with type 2 diabetes. "Anything that we can do to help people improve their ability to control their glucose will help their lives in the long run," Knutson said.
The data was collected as part of the CARDIA study, an ongoing longitudinal study of the heart health. It has tracked thousands of people for over 20 years.

The study, "Cross-sectional associations between measure of sleep and markers of glucose metabolism among persons with and without diabetes" was published online March 16, 2011, in the journal Diabetes Care. In addition to Drs. Knutson and Van Cauter, authors include Phyllis Zee and Kiang Liu at Northwestern University, and Diane Lauderdale at the University of Chicago Department of Health Studies.
The research was funded by a grant from the National Institute on Aging at the U.S. National Institutes of Health. The CARDIA study is supported by the National Heart, Lung, and Blood Institute.