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Lose weight with low carb or low fat: which nutritional therapy works best for diabetes

Lose weight with low carb or low fat: which nutritional therapy works best for diabetes


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Clear winners when comparing different diet forms

The number of people suffering from diabetes is constantly increasing. In many cases, the disease can be managed without medication. A healthy diet is particularly important here. Health experts are now reporting which diet is more suitable for diabetics.

Healthy lifestyle helps

According to health experts, around 425 million adults worldwide suffer from diabetes mellitus. Around 7.5 million people are affected in Germany. 95 percent of them have type 2 diabetes. In a large number of these patients, the disease can be controlled well even without medication. It is important to have a healthy lifestyle with sufficient exercise and a balanced diet. Experts are now reporting which nutritional therapy is more suitable for diabetes.

Dietary recommendations do not have to be reinvented

At the 35th spring conference of the Austrian Diabetes Society (ÖDG), hundreds of participants discussed the paradigm shift that has taken place in diabetology on several levels in recent years under the motto "rethink diabetes".

According to a message from the ÖDG, a central session dealt with the topic of nutritional therapy.

"A lot can be achieved with healthy eating and exercise, diabetes can be prevented by up to 60 percent," said ÖDG President and Endocrinologist, Univ.-Prof. Dr. Dr. Alexandra Kautzky-Willer (MedUni Vienna).

"A temporary, significant reduction in calories with a restriction in carbohydrate intake (low carb) enables patients to remission diabetes in addition to losing weight," the expert said.

"However, support, support and motivation of those affected by the diabetes training team is necessary for an ongoing lifestyle change, as detailed in the new patient-centered guidelines," said Kautzky-Willer.

The nutritional scientist Univ.-Doz.in Dr.in Ingrid Kiefer, who heads the Risk Communication department at AGES - Austrian Agency for Health and Food Security, added:

"Dietary recommendations do not have to be reinvented specifically for people with diabetes, the same principles apply to them as to all people."

Low carb diets are more beneficial

Dr. Stefan Kabisch, from the German Institute for Nutritional Research Potsdam-Rehbrücke and the Charité Berlin, presented the comprehensive evidence that is already available for the discussion of carbohydrate-reduced and fat-reduced diet forms.

As stated in the communication, it can be clearly said that low carb diets are more beneficial on many levels.

According to the information, numerous laboratory values ​​associated with diabetes in the narrower and broader sense are clearly shown to be better in the comparative studies and in meta-analyzes if savings are made on carbohydrates.

Kabisch explained: “Carbohydrates make you happy, but not very filling! Carbohydrates are dispensable in our diet, but fats and proteins are sometimes essential. ”

And: "Diets with fewer carbohydrates lead to more weight loss and lower the body fat percentage faster."

Don't eat meat that often

When comparing the diets, there was a difference in mortality between animal and vegetable low carb diets.

Mortality is therefore high in animals and lower in plants, although the increased mortality is not clearly attributable to meat, since these are exclusively cross-sectional studies (cohort data).

In plant-based low carb diets, healthy legumes are used as protein suppliers instead of meat.

“The message that meat should not be on the menu as often has not been received for decades. Meat consumption rose steadily, even though clear evidence was already available, ”explained Kiefer.

"The currently much discussed topic of climate protection could now contribute to reducing meat consumption, so this discourse also represents an opportunity for healthier nutrition."

Mediterranean or Nordic diet

Prim. Univ.-Prof. Dr. Bernhard Ludvik, from the 1st medical department with diabetology, endocrinology and nephrology at the Rudolfstiftung hospital, saw the greatest advantages in two moderate low-carb diets:

"Evidence-based is particularly beneficial for the Mediterranean diet and the perhaps not yet well-known 'New Nordic Diet'. Both have a particularly favorable effect on fat distribution and the particularly risky abdominal circumference - especially in men. "

Both the Mediterranean diet and the "Nordic diet" are based on a reduction in simple carbohydrates and at the same time bring diversity to the table.

The "New Nordic Diet" relies a little more on fish (three times a week), but is otherwise very similar to the Mediterranean diet.

“Individual advice is the core. A Mediterranean diet can usually be recommended, with particular emphasis on reducing carbohydrates and, of course, in combination with exercise, ”says Ludvik.

"It is important that people in the Mediterranean diet are told that they should still leave out pasta and pizza," said the expert, adding that you can move on from the "fat versus carbohydrates" discourse.

The most important thing is that the chosen diet should be based on personal preferences. “We have to make the nutritional recommendations as simple and low-threshold as possible, because changing your diet is best when you can keep it up.

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Diabetes remission can be achieved through weight loss

"Diabetes is not irreversible," said Prim. Bernhard Paulweber from the University Clinic for Internal Medicine I, with gastroenterology-hepatology, nephrology, metabolism and diabetology at the University Hospital Salzburg.

The expert pointed out that a “Very Low Calories Diet” (VLCD), in which around 800 kilocalories a day - consisting of fully balanced food - are consumed, can achieve a remission of the diabetes.

“The diabetes indicators return to a normal range, like in a healthy person. The magic threshold seems to be a weight reduction of at least 15 kg, from which the remission can be achieved, ”says the expert.

“However, it should be emphasized that the longer diabetes has lasted, the less likely such remission is. In the past, in the 1970s, there was still a risk of malnutrition with low-calorie diets, modern VLCDs are safe, ”said Paulweber.

Coconut fat and birch sugar

As the message goes on, diabetics keep coming to the doctor to ask if they can use the latest trend foods to get rid of their nutritional and weight problems.

In most cases, it can be clearly stated that it is never just about one food, but always about the entire eating habits.

For example, the coconut fat trend was specifically addressed. "Coconut fat mainly consists of saturated fatty acids, which are clearly rated as unhealthy, just like in palm fat or the fat in animal products," says Dr. Kabisch.

“They enrich the adipose tissue and support inflammatory processes in the body. Therefore, the following applies to coconut oil or fat: do not consume in excess! It's okay as part of a few meals, but cooking shouldn't be geared towards that, ”said the expert.

And about the just so popular birch sugar, Kiefer stated: "The birch sugar that sounds so 'natural' is the sugar substitute xylitol, which is made very elaborately from tree components."

This "sugar" is "by no means calorie-free, but provides 2.4 kcal / g."

Some trendy foods are characterized by a high fiber content, but here too the variance is better than the concentration on one food.

“Unfavorable carbohydrates are those with a low fiber content. The fiber content should be over 8 percent, ”emphasized Paulweber.

"Colorful" food

Various types of presentation are used to illustrate a healthy diet. The most famous are the food pyramid and the healthy plate.

"Both have their justification: the pyramid shows the prioritization of food better. The healthy plate shows what a single meal should contain," the experts confirmed.

Ludvik recommended that patients be advised that they should eat "colorful" food, because colorful means that many foods contain many phytochemicals.

Stay away from highly processed foods

Another point of discussion was fructose, since it is probably the main cause of fatty liver. According to the experts, fructose is only in order in fruits!

The added fructose is dangerous, for example corn syrup, which can be found in many processed foods.

Kabisch stated that the simplest form of dietary recommendation was: "Ban highly processed foods with unnecessary additives from your menu, because they often contain senseless sugar and unhealthy fat."

In conclusion, Kautzky-Willer summarized: “Low fat is out! Carbohydrate-limited diets rich in fiber with healthy vegetable fats work better. No single food brings salvation. "

And further: "Only a consistent change in diet that can be maintained for a lifetime brings an advantage and this applies to people with diabetes as well as to everyone else." (Ad)

Author and source information


Video: Stanford Dietitian on Eating Well for Your Blood Glucose and Loving It! (June 2022).


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