Dr John Briffa: Carb crash

With its incidence predicted to double over the next decade, diabetes has attracted more medical and media attention of late. Last month, press reports appeared after doctors recommended more regular blood-sugar level checks for diabetics. Diabetics have also been urged to have more frequent assessments of a blood component known as HbA1c (glycosylated haemoglobin), the level of which gives a good guide to blood-sugar control over the preceding few months. This call has come as a result of recent research published in the Annals of Internal Medicine which shows a strong link between raised levels of HbA1c and increased risk of killer conditions common in diabetes, namely heart disease and stroke.

According to a review in the Journal of the American College of Nutrition, one key to keeping blood-sugar and HbA1c levels in check is to avoid foods that give brisk and extensive release of sugar into the bloodstream. Such foods (with a 'high glycaemic index') include the normal fare viewed as undesirable for diabetics, such as sweet drinks, chocolate, biscuits and cakes.

Instead, diabetics are advised to eat starchy carbohydrates such as bread, potatoes, rice, pasta and cereals. Unfortunately, almost all such foods have glycaemic indices on the high side. Also, when refined or processed, they tend to be bereft of fibre, which is beneficial for tempering blood-sugar and HbA1c levels. Bearing in mind the disruptive effects of foods with a high glycaemic index and low in fibre, it seems odd that these are the very foods advocated for diabetics.

Those looking to get fibre-rich and low-glycaemic fuel for their bodies may get them from starches such as oats and wholewheat pasta, in addition to beans, lentils, and green and salad vegetables. The high-protein, low-carb nature of chicken (preferably organic), lamb, fish, nuts and seeds makes them unlikely to contribute to elevated levels of blood sugar or HbA1c.

Last month, the journal Diabetes published a study in which a higher-protein diet was pitted against a traditional carb-rich diet in a group of diabetics. Despite the relatively short duration of each diet (five weeks), the protein-based diet led to reduced levels of both blood-sugar and HbA1c. It was estimated that such a diet would lead to normalisation of HbA1c levels.

The application of the findings of the recent Annals study reveals that this would be expected to reduce the risk of heart disease and stroke by 40 per cent. This latest research utterly mirrors my experience in practice: a diet based on meat, fish, beans, lentils, nuts and vegetables other than the potato - not starchy carbohydrates - enables diabetics to ward off bad blood.

Thanks to guardian.co.uk who have provided this article. View the original here.


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