New study falsely claims low carb worsens diabetes
A new study getting headlines claims that low-carbohydrate, high-fat diets worsen diabetes.
This is contrary to much of what we know from randomized controlled trials and nonrandomized intervention trials testing low-carb and ketogenic diets. Should these new results force us to question the prior studies showing LCHF is beneficial for type 2 diabetes?
Absolutely not. The new trial is an observational trial of individuals with a mean carbohydrate intake of 48%, with fat averaging 35%. The authors crunched the data and noted that for every 5% decrease in carbs or increase in fat, there was a 12-17% increased risk of diabetes.
Let’s think about that for a moment. Most reputable low-carb studies allow less than 50 grams of carbs per day, and keto diet studies typically allow less than 20 grams per day. That’s at most 10% of calories from carbs. But this study started at 48%, which would equate to about 240 grams of carbs each day!! These aren’t even on the same planet let alone in the same ball park.
In addition, when we have high-quality evidence from randomized controlled trials, systematic reviews of these trials, or even well-conducted non-randomized studies, why would we pay any attention to lower-quality observational studies? Poor data collection, healthy user bias, confounding variables and more make the observational data compromised and far less consequential than the higher quality evidence.
The answer is simple. We shouldn’t pay any attention to this study. If you want real evidence about how actual low-carb diets impacts type 2 diabetes, please see our science of low carb and keto page, and please disregard low-quality nutritional epidemiology studies.
Thanks for reading,
Bret Scher, MD FACC
Earlier
Prescribing low-carb diets for type 2 diabetes: many approaches can work
New study: Reduced-carb diet beats conventional diabetes diet
Pharmacists learn to dispense a different Rx: low-carbohydrate diets
That’s when I got serious and have started doing LCHF OMAD and in less than a week and a half my blood glucose two hours after my evening meal was 95 mg/dL and my morning fasting glucose was 94 mg/dL. Numbers I haven’t seen in over a year. My blood pressure has also dropped in the same timeframe from around 138/78 to 125/52.
LCHF works and I’m also dropping weight and inches very quickly. Combined from the science and my own anecdote.
Mike
From a Type 1 feeling better on LCHF
My doctor strongly recommends to continue this kind of eating. In the beginning I lost a lot of weight, but because of other autoimmune issues and meds I have to take, my weight now is stagnating. But I still feel better than in years, and my friends say I look younger than 10 years ago. Don´t believe the crap that is published by incompetent socalled "researchers" !
Do you use a continuous glucose monitor? If not I would recommend doing so. The abbot free style libre is inexpensive and gives you 24/7 data on what your glucose is doing. You may just have a dawn issue as you mentioned or perhaps you will find some carb creep where you least expect it.
All I know is that in the year I've been following a LCHF diet I've lost weight, feel good, am no longer pre-diabetic and all my blood markers are now in the normal range. Anecdotal stories like mine individually prove nothing, of course, but may add to overall experiential knowledge.
PS My total cholesterol dropped 15 points, while my good and bad cholesterol numbers are getting closer to where the doc wants them. The best news was my Triglycerides dropped from 136 to 83!
I guess article is more towards increase in chances of diabetes with LCHF diet if you are not diabetic.
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Dr. Richard Horton, editor-in-chief of the Lancet, published a statement declaring that 50% of published peer-reviewed research is fake.
Collective-evolution.com reports: “The case against science is straightforward: much of the scientific literature, perhaps half, may simply be untrue. Afflicted by studies with small sample sizes, tiny effects, invalid exploratory analyses, and flagrant conflicts of interest, together with an obsession for pursuing fashionable trends of dubious importance, science has taken a turn towards darkness.”
"
Marcia Angell similarly said:
“
It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of the New England Journal of Medicine
”
is stated right in the published papers.
Knew that my days were numbered as did my husband and doctors only wanted me admitted to hospital which I refused. My normal sugar readings vary between 4.3 and 5.7. However, whenever I get stressed it can go up at a frightening speed. Common sense says that it has nothing to do with diet but with the way my body handles stress as within 20 minutes of taking a herbal calmative (passiflora) blood sugar is back to normal. Just wondered wether some people who struggle with their readings should not look at stress levels if their diet is within LCHF or Keto rather then blaming the diet. Am now 66 and have lost about 40kg, bad health, high blood pressure (195/130) and medical bills and nothing could get me off LCHF, least of all articles based on bad research and no experience.
For five years two Metformin tabs have been taken by me. My last blood labs were October 2019; all my numbers are now normal; I am off of Metformin entirely; and my PCP is using the Ketogenic diet for herself.
I may cheat occasionally, but have no intentions of going off the diet.
That study you referenced is garbage!
The authors were not totally ignorant:
"This study has limitations that must be considered when evaluating its findings. This study could not refer to very low-carbohydrate ketogenic diets, as there are no data on ketosis status for this dataset. Notably, there is no standardized definition of LCHF diets, although < 26%E CHO has been proposed as a cut-off value [44]. Only 0.24% of the study sample (n = 8/3234) consumed carbohydrates below this threshold..."
But either the authors, the peer reviewers, the journal editors or the media (probably all of them) were a combination of ignorant and disingenuous - because of the title and soundbite message the study gives out to the wider world. It will probably influence a few thousand diabetics eventually with deleterious consequences for those people in turning them away from the low-carb metabolic correction they need.
However - you did not mention that this research was funded by pharma....no surprise.
Below is the disclosure taken from the article:
Conflict of interest
MEJL has received departmental research support from Diabetes UK, Cambridge Weight Plan and Novo Nordisk and consultancy fees and support for meeting attendance from Novo Nordisk, Eli Lilly, Novartis, Counterweight Ltd and Eat Balanced. EC declares no conflict of interest.
The low carb/high fat diet made my diabetes worse in the long term.
I now aim for a low fat but plant based vegetable/fruit diet. I occasionally eat good fat or unprocessed meat and rarely bread.
I mostly eat vegetables, fruit, whole foods and brown rice.
I feel fantastic and young again.
My morning fasting numbers are lowered by 60-100.
When I tried keto years ago, I had little energy and I craved carbs. 30 grams a day of carbs is crazy low. I felt horrible when eating a lot of meat or dairy. Desserts made with the artificial sweetener “swerve” gave me a headache.
Eating a lot of fat makes diabetes worse in the long term and leads to more insulin resistance.
It is not unusual to eat 150 to 350 grams of carbohydrates on a plant based diet. This study was not about ‘low carb’. It was about increasing fat and decreasing carbs.
You should not dismiss this study that you are criticizing.
People should focus on eating natural vegetables and fruits and stay away from refined or processed foods; lessening high-fat meat products.
Dr. Neal Barnard book:
“Program for Reversing Diabetes”
or:
Mastering Diabetes website
https://diabetesstrong.com/mastering-diabetes/
You can also find their book used very cheaply.
Although the bulk of my diet is plant based/ low fat: I occasionally enjoy foods I like such as cheese or meat but they are not a main part of what I eat.
If you are wondering why your glucose numbers are getting so much worse long term, please consider these resources I just listed above.
This way of eating is also helpful for rheumatoid arthritis and other ailments.
You can enjoy all the vegetables, fruits, legumes and spices that the world has to offer.