Remembering Kevin Moore

No-Gl Low-Carb Diet Better Than Low-GI Calorie-Restricted Diet For Controlling Diabetes, Duke Study Shows

Duke researcher Dr. Eric Westman can control diabetes without drugs

Our generation is at one of the most critical moments in the history of health the world has ever seen. Preventable diseases are running amok and much of the blame can be placed on the flawed nutritional advice people have been following from those who are supposed to be authority figures when it comes to diet and disease. Despite all of their best efforts to convince us that eating higher amounts of “healthy” whole grains, lowering our fat intake, and cutting back on calories is the optimum diet, where has it gotten us? Fatter and sicker than ever!

As of research released in 2006, the number of people who have Type 2 diabetes or are considered pre-diabetic based on their insulin resistance reached an unbelievable 73.3 million Americans and the number has no doubt grown exponentially from there in the past few years. That’s already over one-third of the population and it doesn’t even include those who are walking around with the disease and don’t even know about it yet. All of this is taking a toll on the American healthcare system to the tune of $132 billion annually based on added medical expenses and missed time from work in 2002 alone. We are reaching the breaking point where something dramatic needs to happen very soon with the way diabetes is treated and educate people on what they can do to control this awful disease.

That day may come sooner than we think thanks to a new six-month study released by Duke University Medical Center lead researcher Dr. Eric Westman this week. Dr. Westman placed 84 predominantly obese women with a mean age of 52 who have Type 2 diabetes on a randomized version of one of two diet:

LCKD: A low-carb ketogenic diet with 20g carbs or less daily
LGRC: A low-glycemic, reduced-calorie diet with a 500 calorie deficit

The LCKD group (38 patients) followed the principles of the Atkins diet as outlined in Dr. Atkins New Diet Revolution by Dr. Robert C. Atkins while the LGRC group (46 patients) were instructed on The GI Diet by Rick Gallop.

The study participants on the low-carb ketogenic diet were allowed to eat as many calories as they would like of meat and eggs while restricting their carbohydrate intake to 20g daily consisting of limited amounts of hard cheese, soft cheese, salad vegetables, and non-starchy vegetables. Meanwhile, the low-GI patients were told to reduce their calories by 500 from what the amount that would maintain their weight to produce a calorie deficit and 55 percent of their daily calories were required to come from low-glycemic index carbs.

Participants in both of these groups showed up at regular meetings with dietitians to discuss their diet with doctor’s supervision, were provided glucose-lowering nutritional supplements to go along with their eating plan, and given an exercise routine to follow (30 minutes, three times a week) for a period of 24 weeks. At the end of the study, blood tests were run to measure their hemoglobin A1c (HgA1c) levels, a marker used to determine how well blood sugar is controlled in diabetic patients.

Interestingly, only 58.3 percent of the participants in both groups completed the study–the biggest complaints were refusal to do the diet as written, difficulty adhering to the diet, and time constraints. For those who did stay in the study, the low-carb ketogenic diet group consumed an average of 49g total carbohydrates daily compared with 149g total carbohdyrates eaten by the low-glycemic diet group.

The LCKD group showed greater improvements in their HgA1c levels than the LGRC group did. In fact, diabetes medications were either reduced or completely eliminated in 95 percent of the low-carb diet participants compared with just 62 percent who ate a calorie-restricted low-glycemic index diet.

The HDL “good” cholesterol in the LCKD group increased 5.6 compared to zero for the LGRC group. And the HgA1c levels dropped sharply from 8.8 percent down to 7.3 percent in the low-carb group while there was little statistical change in the low-glycemic diet group dipping down from 8.3 percent to 7.8 percent.

Finally, despite the fact that the low-carb study participants ate 215 more calories per day than their low-glycemic counterparts (1,335 compared with 1,550), there was greater weight loss in the low-carb group (averaged an 11-pound reduction) versus the low-glycemic (averaged just under a 7-pound drop).

Dr. Westman, who is no stranger to conducting quality research on low-carb diets and their impact on diabetes, concludes the answer to treating diabetes is a “simple” one that has long been overlooked and ignored by physicians treating diabetic patients.

“If you cut out the carbohydrates, your blood sugar goes down, and you lose weight which lowers your blood sugar even further,” he said. “It’s a one-two punch.”

For far too long, the diabetes problem has been getting worse while the low-carb answer has been virtually ignored. Although he admits following a low-carb diet may not be be easy, Dr. Westman explains this is a “therapeutic diet” essential for people who are “sick” with diabetes.

“These lifestyle approaches all have an intensive behavioral component,” he added. “In our program, people come in every two weeks to get reinforcements and reminders. We’ve treated hundreds of patients this way now at Duke and what we see clinically and in our research shows that it works.”

The study was funded by The Robert C. Atkins Foundation, but they were not involved in the planning, design or conduct of the study and had no involvement in the interpretation of the data, or the preparation and approval of the manuscript. The results of this research were published in the December 19, 2008 issue of the scientific journal Nutrition and Metabolism.

While many diabetes educators these days are catching on to the need for lowering glycemic carbohydrates for blood sugar control, Dr. Westman has shown an even greater improvement by eliminating the supposedly “healthy” carbs as well.

“Low glycemic diets are good, but our work shows a no-glycemic diet is even better at improving blood sugar control,” he noted. “We found you can get a three-fold improvement in type 2 diabetes as evidenced by a standard test of the amount of sugar in the blood. That’s an important distinction because as a physician who is faced with the choice of drugs or diet, I want a strong diet that’s shown to improve type 2 diabetes and minimize medication use.”

Interestingly, when the researchers analyzed the changes in blood glucose control that occurred during the study, they found it probably had very little to do with the weight loss and more likely a result of the diet composition.

“This supports the concept that weight change and glycemic control are not serially linked but rather may be the result of the same pathophysiologic process, such as abnormal insulin metabolism,” the researchers explained.

Although there are many people who regularly begin a low-carb diet on their own and call it the “Atkins diet,” Dr. Westman warns diabetics against starting such a dietary regimen without the express supervision of a trained medical professional. You can find a doctor who specializes in low-carb diets by clicking here.

This new study coincides well with previous research that has released in the past few years, including this September 2008 study from Israel that found low-carb is best at controlling insulin in obese youth, a May 2007 study from Harvard researchers detailing why a high-carb, low-fat diet is ineffective in people with high insulin levels, and a landmark March 2006 study from Dr. Mary Gannon and Dr. Frank Nuttall that revealed Type 2 diabetes could be controlled with a low-carb diet without weight loss. The research continues to swell and it’s only a matter of time before it is embraced fully by the diabetic leaders at the American Diabetes Association.

I hope to have Dr. Westman on my my podcast show in the coming months to extrapolate more about what his study means for people with Type 2 diabetes. Christine and I have met with him at his office in Durham, North Carolina and we know he has his patient’s best interests in mind with all that he does as their physician. Now if we can only get more doctors to follow his lead.

  • I’m proud of Dr. Westman because I’m from North Carolina. It’s such a basic message! You can control diabetes without drugs! It angers me to think of all the people who don’t research this stuff and just accept that they have to take drugs the rest of their life. They can do so much to control their situation without living on carrots and celery the rest of their lives! Who could stand that??! I pray lots of people are finding your site, Jimmy. It’s needed!!