Posted by: Chris Maloney | June 1, 2012

Should Diabetics Eat Carbohydrates? ADA Says Yes. Others Say No.

English: Diagram shows insulin release from th...

English: Diagram shows insulin release from the Pancreas and how this lowers blood sugar leves. (Photo credit: Wikipedia)

A visit to the American Diabetes Association can be confusing.  Most disease sites look like disease sites.  There’s a section on the “search for the cure” or at least research in that direction.  The ADA site looks like a Women’s Monthly magazine site, full of recipes and fun things to do.  It makes diabetes seem like something fun and festive, not a disease that will take your eyes, your kidneys, and your feet.

So when the ADA promotes carbohydrates, it’s hard not to get on the bandwagon.  Just eat healthy carbs, take a walk a day and…well, that’s pretty much the message.  There’s even a chirpy “Diabetes Myths” section where they say the following:

Myth: Eating too much sugar causes diabetes.   Fact: No, it does not.”

Whoa!  That’s a load off my mind.  Eating sugar has nothing to do with a disease of sugar imbalance in the body.  Really?

Compare that to the lengthy, well-researched diatribe on Surviving Diabetes, and it’s a little shocking.  Surviving Diabetes is fighting the ADA even if they aren’t fighting back.  According to this site and many like it, eating carbohydrates is about as smart as eating uranium ore.  Avoid Carbs and live.

So who’s right?

Before we dig in a bit deeper, let’s start by saying the experts don’t agree – because the studies don’t agree– on even what the best medications are for diabetes.  So if you want a final judgment on the best diet for diabetes, it isn’t here.

In terms of monunsaturated fats in the diet, they help diabetics.  So the olive oil is in.  But for preventing diabetes, lower fat diets do better.

In simplest terms, if I take an alcoholic and feed him sugar, I will help him lower his sugar load.  (Headline reads:  sugar lowers diabetes’ risk in alcoholics)  Alcohol is absorbed faster than straight sugar.  If I take a sugarholic and feed her whole wheat, she will lower her sugar load.  Unrefined carbs are slower to absorb than refined carbs.  (Headline reads:  whole wheat lowers diabetes’ risk among candy eaters).   If I take a carboholic and feed her vegetables, she will lower her sugar load because of the increase in fiber.  And if I take a vegan and feed him meat and oil, he will have better blood sugar because the fat and protein will convert to ketones over sugar.  (Headline:  vegan diabetics do better on meat).

So meat and oil are best?  In terms of straight blood sugar, in a vacuum, probably.  But many diabetics will get SERIOUSLY hypoglycemic on that diet.  Which means they cheat.  Which throws out the whole nice diet spectrum.  (Headline:  cheating dieters don’t do better on meat and oil.)

An Atkins dieter who cheats is going to wreak havoc on his blood sugar.  A vegan who cheats with a few carob chips is going to be much better off.  All that fiber in his system will buffer the sugar absorption, and his body is used to some carbohydrate exposure.  So if we include cheating as part of a diabetic’s diet, vegan is better.

A low glycemic diet will lower the number of hypoglycemic events in a diabetic, but we have no evidence that it affects the disease.  Diet plus exercise does reduce the incidence of diabetes compared to standard recommendations, but neither exercise alone or diet alone made a significant impact.

So should diabetics eat Carbs?  We have no proof either way.  But claiming that sugar doesn’t affect diabetes is like claiming cigarettes don’t cause forest fires.  Yes, many if not most forest fires are caused by things other than cigarettes, but don’t tell people it’s ok to toss butts out the window.  Especially if you claim to be Smokey the DiabeticBear, as the ADA claims to be for diabetics.  If you want to educate people, first tell them not to eat sugar and then give your educational talk.  Otherwise, ten minutes in they’ll still be trying to wrap their heads around the fact that the ADA spokesperson just gave them a free pass to go gorging in the Twinkie aisle for life.

English: idealized curves of human blood gluco...

English: idealized curves of human blood glucose and insulin concentrations during the course of a day containing three meals; in addition, effect of sugar-rich meal is highlighted; (Photo credit: Wikipedia)

 

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