Yet another study showing better blood sugar for diabetics on a lower-carb diet


  1. charles grashow
    @Diet Doc

    The study was sponsored by Jenny Craig.

    "New study results published in the April 23, 2014 online issue of Diabetes Care found that Jenny Craig, a proven solution to weight loss and a leader in the weight loss and weight management industry, helped people with type 2 diabetes lose more weight than those who were provided with "Usual Care" which consists of two counseling sessions and instructions. Participants also significantly lowered HbA1c (a measure of blood sugar controls) and reduced levels of heart disease-related risk factors such as serum triglycerides. Participants who used a lower-carbohydrate Jenny Craig menu had more significant improvement in blood glucose control than those who followed the standard Jenny Craig menu."

    "About the Take Charge Study

    The study evaluated whether participation in a commercial weight loss program promotes greater weight loss compared to a usual care condition and to examine effects of study participation on markers of glycemic control and cardiovascular disease risk. A total of 227 men and women with type 2 diabetes and a body mass index (BMI) of 25-45 kg/m2 were enrolled at two study sites and assigned to either the Jenny Craig program, which includes diet and exercise counseling, with prepackaged foods in a planned menu during the initial weight loss phase, or diet according to the usual standard of care. Participants in the Jenny Craig program were either assigned a lower carbohydrate, higher fat, or a higher carbohydrate, lower fat (standard) plan. Follow-up measurements were assessed at three, six and 12 months"

  2. Eric Anderson
    Read Doctor Richard K Bernstein on T1 and T2 Diabetics.
    Years of his own T1 experiance and many patients should remove doubt about low carb versus eat the bagel and inject more insulin ala ADA and standard approach to diabetics.


  3. Boundless
    The full text of the trial is apparently pay-walled, but this looks to me very much like the ADA is trying to synthesize plausible deniability for why they are so late to low carb.

    They can now slowly shift to a low carb stance for T2D, and say it's due to "recent science" (when in fact it's been known for a nearly a century, when the objective is to avoid this optional ailment rather than promote it and prescribe insulin).

    They knew exactly what the outcome of this trial would be before it was commissioned.

  4. Scott UK
    The study was funded by Jenny Craig BUT they were comparing two of their own products: a low-fat diet and a low-carb diet. So, in a sense, the study controls for the commercial bias -- it keeps everything the same across the two JC diets except for the macro-nutrient ratios.

    The results are a modest win for low-carb… BUT the low-carb diet is still pretty high-carb: "The LF diet plan provided 60% energy from carbohydrates, 20% from fat, and 20% from protein. The LC diet plan provided 45% energy from carbohydrates, 30% from fat, and 25% from protein". So, 60% versus 45%. Imagine what would have happened if they had gone truly low-carb…

    Industry funding tells me that industry is starting the transition to low-carb… it is beginning the process of legitimizing low-carb high-fat (after years of demonising it). And as goes industry, so goes government regulations. This will be good for people's health in general… even if it irks us early-adopters.

    Reply: #5
  5. Boundless
    > The study was funded by Jenny Craig BUT they were comparing two of their own products ...

    Thanks for digging that up. JC has the same problem the ADA does, plus some extra liability exposure. These hi-gly idiots and charlatans need to very carefully fill in the hole they've dug themselves into, lest they be re-buried by lawyers representing those who have been victimized by their advice.

    Commercial diet plans are at greater legal risk that the ADA, because money has changed hands, with an implicit or explicit assurance that the nutritional advice was at least harmless.

    So don't be surprised if JC parrots this trial report as "new information" when it's nothing of the sort.

  6. Mark.
    I never got HbA1c under 10 with my type 1 reliably until I went low-carb. My doctor was pleased until I told him how. He insisted my brain needs over 100g of carbs a day or something horrible would happen. Board-certified endocrinologist.
  7. Paul the rat
    Curr Opin Clin Nutr Metab Care. 2014 Apr 23. [Epub ahead of print]

    Dietary carbohydrates and intestinal lipoprotein production.
    Morgantini C1, Xiao C, Dash S, Lewis GF.
    Author information

    To review new evidence that dietary monosaccharides enhance intestinal chylomicron secretion.
    There is abundant evidence linking diets that are high in carbohydrate content with hypertriglyceridemia. In addition, epidemiological studies reveal that the increase in dietary sugars and refined carbohydrates are associated with the rising prevalence of the metabolic syndrome and type 2 diabetes. Association studies, however, cannot prove causation. Mechanistic studies to date have focused on the link between carbohydrate ingestion and hepatic very low-density lipoprotein metabolism, with very little appreciation that dietary carbohydrates may also regulate intestinal lipid absorption and chylomicron secretion. We have recently studied this phenomenon in healthy humans and have shown that both glucose and fructose, infused concomitantly with a lipid emulsion directly into the duodenum and under conditions of a pancreatic clamp, stimulate chylomicron particle secretion. There are a paucity of data regarding the cellular and molecular mechanisms of this effect, which remains largely unknown and a matter of speculation.
    Sugar in the diet enhances dietary fat absorption and chylomicron secretion. Whether this phenomenon contributes quantitatively to the well described hypertriglyceridemia that occurs with diets high in carbohydrate and low in fat requires further investigation, as does the underlying cellular mechanism. A thorough understanding of this phenomenon could provide useful information to optimize dietary guidelines.

  8. Stella
    Does 'Dawn phenomenon' ever diminish on LCHF? I've cut out so many foods and still I am plagued. Weight loss has been sooooooo slooooooooowwwww - 50lbs in three years - The next step is living on one meal a day of steamed cabbage and butter.
  9. Alan J. Steinberg
    Wife has gall bladder removed. Told only to follow low fat diet. She was formerly LCHF. Now what?
    Reply: #15
  10. Mari
    Personally, I don't care who funded the study. Any study showing lower carb eating helps with diabetes is a step forward.
  11. Jo tB
    Stella, the problem is that you've cut so many foods out and not replaced them with something else. You've gone into what is called "starvation mode" which will slow your metabolism down and so it becomes much harder to lose weight. Every morsel you eat is added to the fat stores in order to get you through the "winter." ,

    I know, because that has been happening to me. And now decades later I have gut flora that is up shit creek.

    I don't know if you have been reading up on Resistant Starches on internet, then you will know what the consequences are of cutting them out of your diet. It's not just a question of going low carb, you could end up eating the wrong carbs.

    The dawn phenomenon is your body responding to low Sugar levels during the night. It is trying to get you ready for movement (you have to go hunting for your food). The glucogen being released by your liver is an endogenic (internal) process, which won't stimulate the pancreas to release insulin and so your sugar levels stay high until your next meal (which you say may become one a day). It is only with exogenic (external) glucagen release by something that you eat that stimulates the pancreas to release insulin. My response to high morning Sugar levels is NOT to eat. It is counter productive. It has taken me quite a while to get my head around this.

    At the moment I am concentrating on getting my gut flora in optimal condition and alleviating chronic constipation for around 40 years.

    Reply: #12
  12. Stella
    Jo tB - thank you so much for your kind and helpful response which has prompted me to read up 'Resistant Starch 101' on as well as re-reading the recent item elsewhere on this website.

    Although I sing the praises of LCHF it is disappointing to me that I am not a good advert due to my sluggish weight loss. However, it has definitely killed cravings and improved general health. If adding some potato starch to the mix can get things moving and reduce the effects of 'Dawn Phenomenon' it will add credibility to my promotion of this way of eating.

    Reply: #13
  13. sten
    Yes Stella, I agree with Jo tB, RS is worth a try. At least we try it now!
    Use pure potato starch never warmed more than body temp. We mix a heaped teaspoon in some cold water every night before bed. My morning sugar is coming down after hoovering around 6.5 to 5.5 and now 5.0. My wife's IBS or colitis or thin walls or what it is/was seem to become history now, but early days yet.

    RS produces SCFA -short chain fatty acids - which can be converted to glucose in liver but apparently one secret (?) is that they are also used directly as energy INSTEAD of glucose which means then no effect on blood glucose at all. Even used by the brain. Difference to ketones, don't know!

    Since we during evolution had "tonnes" of RS in our diets compared to "refined times" today, the SCFA-propulsion may well be the standard "stand by " mode between feeds, while glucagon triggered protein-to-glucose conversion in the liver is a luxury emergency option that was never fine tuned as wasteful when the cheaper fuels -SCFA - always were available.

    Potato flour (starch only - no protein in it!) is not natural but it is the cheapest and safest way to replace the "final stage" in a older / paelo-diet without getting stomach upsets from unknown plants and semi prepared foods. But add some good (?) probiotics at least the first week and then once in a while in case there are none of the good biotics around to use the resistant starch. And Good Luck!

    Reply: #14
  14. Paul the rat
    More or less on target sten. Bacteria, mostly Bifidobacter sp. produce butyric acid as a by-product of resistant starch metabolism. Butyrate serves as a ( preferred to glucose) energy source for colonocytes, however latest research indicate that it is ketone bodies, which play a key role in ameliorating symptoms of IBD. Ketones are even better energy than butyrate for colonocytes, plus participate in regulation of gene expression and several biochemical pathways. This is why our group have success with IBD patients, who went into full ketosis - colonocytes get ketones from blood rather than gut lumen, plus these cells can utilize other fatty acids for energy.

  15. sten
    Sorry about that. The amounts of fat in LCHF after a standard low fat diet must be ramped up over a few weeks or months to allow for a thickened bile in gall ducts to gradually dilute.
    Then the thinner bile can dissolve what can cause blockages like thick sludge and stones.
    If not increased slowly blocked high flow will increase pressure and can cause gall bladder pain, just like eating one high fat meal at a special occasion could do on low fat diet. Dubbed "gall bladder weekends" by surgeons.

    Every day our livers produce some "effluent" mixed in bile acid from used up blood platelets and from taking out unwanted parts/toxins from our blood.
    The average bile flow depends however on fat intake while the "effluent" is more or less constant causing thickening of bile, if fat consumption goes below some seemingly unknown threshold.

    Your wife can likely eat LCHF again but she should increase the fat slowly as channels in the liver that were feeding the gall bladder also may be blocked....
    If she stays on a low fat diet, how can she keep her liver clean ?
    Good Luck!

  16. stefan
    SATURDAY, May 3, 2014 (HealthDay News) -- Rates of diabetes in U.S. children have jumped sharply in just eight years, according to new research.

    The prevalence of type 1 diabetes increased 21 percent between 2001 and 2009. At the same time, rates of type 2 diabetes rose 30.5 percent, the study found.

  17. Nicole
    I wonder if anyone could help. T1 and I've been following this diet for 3 weeks now. I'm in ketosis and eating no more than 30g carb a day, sometimes less. I'm sticking to very moderate protein - around 66% fat at least. However my bg is still spiking - up to 15 during the afternoon and first thing in morning. I'm exercising to burn it off which is works fine for a time. What I'm really worried about is that my body is drawing protein from my (hardly existent) muscles or lean body mass and converting to glucose in liver as I've been warned by my endocrinologist, eye doctor, nutritionist and numerous others?? I'm still battling to become adapted I think - still have fatigue, headaches and sore throat but hoping that will go soon - I've done this before and was happy but somewhere along the line fell off the wagon. On the social side I feel terrible going to dinner parties and the like and refusing the carbs. People on special diets get on my nerves and I'm worried I get on theirs - but I mostly blame it on the diabetes.
    Reply: #18
  18. Zepp
    First of all Im no doctor.. nor any sort of healt educated!

    But.. type 1 is for life.. one cant revert it.. but one can make it easyer to handle.

    Swinging blood sugar is a bad thing.. both for diabetics and for non diabetics.. its this one should focus on.. and you still need to take your insulin.

    Dr Bernstein is the best known expert on low carb and type 1, he is one him self!

    Take more advices from him.. he know!

    And I have some comnts too.. and that its the differents about type1 and type2.. T2 often get bettter result of cuting out as much carbs as they can.. becuse they are insulin resistante!

    Moste T1 is not IR.. but they can be.. if they persist to counter high blood sugar whit a lot of insulin!

    Soo.. you need to take insulin anyhow, and you need it for a lot of things.. for instance protein.. and it take a lot of time to convert a body to use more fat as predominante fuel.. soo take one step at a time.

    And as your body converts.. you got a new situation.. new doses of insulin.. and i read about T1 that have to strugle a year befor they are fully adapted.. and have predictable glucose levels.

Leave a reply

Reply to comment #0 by

Older posts