New research validates Low Carb Diet as a good approach to reduce medication for Type II Diabetes: CSIRO

Do we know the best dietary approach for managing diabetes? The answer might not be “the one best diet for all”, but rather one of a few approaches may just be the better option for you. We explore how the latest nutrition science research in Adelaide has uncovered some interesting findings that have already changed the way diabetes is managed in Australia. By latest research I mean research data released this week! and when I say "Changed the way diabetes is managed" what I mean is I know that I’ve changed the way in which I treat my clients with type II diabetes and numerous other Dietitians have followed suit. Changing practice is not because a new diet is "trendy", but because as good quality evidence emerges, it helps us to understand the science, which gets us closer to "truths" about the biological world and that informs our practice as dietitians. Opinions don’t count for much if you are a nutrition scientist. It’s evidence that drives us all.

Traditionally, we have used the Australian Dietary Guidelines, developed by the NHMRC, to guide us into dietary advice for managing diabetes (The NHMRC is the peak council for funding health research in Australia). This approach is absolutely useful. It achieves great health outcomes for blood sugar control, blood pressure, blood lipids, weight management, mood and general well-being. It is an absolute gift to the people of Australia. But it doesn’t work for everybody with diabetes. In their defence, those with the worst insulin resistance will not be able to process the carbohydrate dose recommended by the guidelines. So what is someone to do in this situation?

There are numerous ways you could eat to achieve good outcomes in diabetes. There are so many approaches to try, it is hard to know where to start. Even if you are motivated to try something, it feels like it would be more of an experiment. An experiment that could take years to find the answer. When we think about the range of dietary labels out there, we are not short of choices: Low GI, Paleo, Low-fat, Mediterranean, Low Carb, Less processed foods, Flexitarian, Pescetarian, Vegan, etc. Details of each approach can be found on social media and throughout the internet, awash with passionate followers that spruik the great cause of their dietary label. The most avid followers will spruik their dietary label as the best approach for basically “anything” remotely health related. But don’t upset them. They have invested their time, money, effort and reputation in their ideas (and social media posts). Any evidence-based criticism of their ideas and they will “go bananas”. To be a true dietary spruiker, you’ve got to defend your “dietary label” like Donald Trump defends the need for a wall on the Mexican border. To me, that confirms that rational discussion with a dietary spruiker is out the window. They are so conflicted in their messaging that they may even bend the truth to keep you “believing”. So where does that leave us? If social media is awash with conflicts of interest, then we can’t rely on social media-based opinions about diet. What we can rely on is high-quality research trials. And we’ve found a good one…

Can I use the low carb diet for better blood sugar control?

The CSIRO Nutrition Health Department have used a $1.3 million grant from the NHMRC to investigate whether people with Type II diabetes do better on a low carb diet versus the traditional low-fat approach created by the NHMRC and recommended widely across a range of professional health organisations in Australia.

Over the past 6 years, the CSIRO have studied numerous health effects of the low carb diet on 120 participants in a well-executed clinical trial. Their report after the first year of investigation shows 80% of their participants have completed the first year of the dietary intervention. I’ve run dietary research trials and drop-outs are a problem when people can’t stick to the protocol that you have assigned them. 80% is a remarkably good achievement for a dietary intervention. Anyway, although weight loss did not differ between the groups, participants on both dietary approaches achieved significant weight loss of 10-11% body weight (an average of approximately 12kg). Again, a really impressive achievement. Weight loss is difficult. The key for those two great outcomes was not the dietary approach, but the support provided. Each participant was given fortnightly access to an Accredited Practising Dietitian for the first 3 months and then monthly access after that. Both diets improved a range of metabolic functions favourable to good health in diabetes: weight, blood pressure and HbA1c (the blood sugar indicator doctors use for diabetes diagnosis and management).

However, the dietary approaches did differ slightly in a few parameters. Let’s look closely at the most interesting of those finding. The low carb diet did more to address post meal blood sugar rises and falls and they say that this reduced the need for medications such as oral hypoglycaemic agents (i.e. Metformin) in certain individuals. Those certain individuals were the ones that had really bad blood sugar control before the study began (i.e. they had more insulin resistance).

So it turns out that in an individual with HbA1c greater than 7.8%, that person faired better following the low carb diet. In those that had better control, the traditional approach worked more to their favour.  It turns out that certain individuals do better on certain approaches to eating. This study has highlighted something significant for all people wanting to achieve better health when living with diabetes. That significant finding is what will be known as the dawn of personalised nutrition. The ability to trial different approaches to find which is right for you is the future of achieving the best health in diabetes. 

In our next post, we will be discussing 5 things to consider on the low carb diet, so be sure to follow Nutrition Health Experts on facebook for more great articles written with evidence at the core of all our messaging.  

The final word

Only one person gets to determine their diet and that is you. Although numerous people will try to influence that, it's you that has the final say. When you're being influenced to change your eating, you should be getting credible information. The very nature of credibility comes from well-researched evidence and above was an example of well-executed and credible research. There are numerous dietary strateges you can use in diabetes, but only through personalised nutrition can you work out your best approach when blood sugar control isn't quite right. Any advice you get should reflect the evidence and be personalised to your individual needs. If you have diabetes, know why you follow a chosen dietary approach and if you need support, keep in mind your decision could be favouring 'personal opinion' (it worked for one) or 'evidence-based truths' (it worked for many). As always, choose wisely, eat more plants and less processed food.