Overall, Brinkworth’s team found, low-carb diets were winning at the six-month mark: People on those plans had lost, on average, about 7.5 pounds more than those on comparison diets, and their triglycerides (a type of blood fat) were lower.
In trials that looked at diabetes remission, 57% of people on low-carb plans had gone into remission, versus 31% of people on other diets. Remission meant that a person’s average blood sugar in the past three months was below the threshold for diagnosing diabetes.
By the 12-month point, however, most of the advantages of low-carb diets had vanished.
“Despite the benefits for blood-sugar control that very low-carb diets can offer, they can be very difficult to adhere to,” said Julie Stefanski, a registered dietitian and certified diabetes educator. She was not part of the study.
The fact is, carb-rich foods are pleasurable, hard to avoid and offer “emotional connections to our pasts,” said Stefanski, who is also a spokeswoman for the Academy of Nutrition and Dietetics.
Beyond those hurdles, Stefanski said, tight limits on carbs can end up depriving people of some nutrients, including fiber and certain vitamins.
“To be successful on a very low-carbohydrate diet, people really need a game plan to tackle all of the issues that come up,” Stefanski said.
She agreed, though, that starting with a strict low-carb plan, then transitioning to a moderate diet, can work. Stefanski also agreed that people with type 2 diabetes should first talk to their doctor — and possibly consult a dietitian about crafting a low-carb diet.
Across the studies, low-carb plans did appear safe in the short term. The one red flag appeared at the one-year point, when people on the diets tended to show an increase in their LDL cholesterol (the “bad” kind).
It’s unclear, though, what that could mean for their health, Brinkworth said.
In the end, Stefanski said, there is no one-size-fits-all diet for people with diabetes.
Nor are all carbohydrates created equal. Stefanski said that a diet high in vegetables and other fiber-rich foods may help ease inflammation and benefit people with diabetes.
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