A low carbohydrate diet is generally recommended for people with type 2 diabetes or at risk of developing the disease. But there’s no general agreement on reducing carbohydrate intake or which carbohydrate foods to include, and little research is available to help people make informed decisions.
A new trial led by Stanford Medicine researchers compared two popular low-carb diets – ketogenic and Mediterranean – in their effect on blood sugar levels, cardiometabolic risk factors, weight loss and nutrition, as well as ease with which people can join.
The ketogenic diet is an ultra low-carb, very high-fat diet that involves a drastic reduction in carbohydrate intake. The Mediterranean diet is a low-carb, moderately high-fat diet that emphasizes vegetables, legumes, fruits, whole grains, olive oil, and fish.
Both diets received high marks for controlling blood sugar and aiding weight loss, but the ketogenic diet was lower in several nutrients, especially fiber, and was harder for study participants to follow. long term, according to the results published on May 31 in the American Journal of Clinical Nutrition.
Low carb diets for diabetes
The main problem with diabetes is the inability to manage your blood sugar, and the biggest effect on your blood sugar is your diet.”
Christopher Gardner, PhD, Professor Rehnborg Farquhar, Professor of Medicine and Director of Nutrition at Stanford Prevention Research Center, lead study author
Americans get about half of their daily calories from carbs, with about 80% of those calories coming from added sugars and refined grains — think sodas, candy, bagels, pastries and pizza crust.
To manage or prevent diabetes, the American Diabetes Association recommends the Mediterranean diet and other low-carb diets, as long as they minimize added sugars and refined grains and include non-starchy vegetables.
The very-low-carb ketogenic diet meets these criteria. But its growing popularity in recent years has nutritionists like Gardner worried.
Gardner, CD, et al. (2022) Effect of a ketogenic diet compared to the Mediterranean diet on glycated hemoglobin in people with prediabetes and type 2 diabetes mellitus: the Keto-Med interventional randomized crossover trial. American Journal of Clinical Nutrition. doi.org/10.1093/ajcn/nqac154.