Dietary carbohydrate restriction as the first approach in diabetes management: Critical review and evidence base

TY - JOUR

T1 - Dietary carbohydrate restriction as the first approach in diabetes management

T2 - Critical review and evidence base

AU - Feinman, Richard D

AU - Pogozelski, Wendy K

AU - Astrup, Arne

AU - Bernstein, Richard K

AU - Fine, Eugene J

AU - Westman, Eric C

AU - Accurso, Anthony

AU - Frassetto, Lynda

AU - Gower, Barbara A

AU - McFarlane, Samy I

AU - Nielsen, Jörgen Vesti

AU - Krarup, Thure

AU - Saslow, Laura

AU - Roth, Karl S

AU - Vernon, Mary C

AU - Volek, Jeff S

AU - Wilshire, Gilbert B

AU - Dahlqvist, Annika

AU - Sundberg, Ralf

AU - Childers, Ann

AU - Morrison, Katharine

AU - Manninen, Anssi H

AU - Dashti, Hussain M

AU - Wood, Richard J

AU - Wortman, Jay

AU - Worm, Nicolai

N1 - CURIS 2015 NEXS 001

PY - 2015

Y1 - 2015

N2 - The inability of current recommendations to control the epidemic of diabetes, the specific failure of the prevailing low-fat diets to improve obesity, cardiovascular risk, or general health and the persistent reports of some serious side effects of commonly prescribed diabetic medications, in combination with the continued success of low-carbohydrate diets in the treatment of diabetes and metabolic syndrome without significant side effects, point to the need for a reappraisal of dietary guidelines. The benefits of carbohydrate restriction in diabetes are immediate and well documented. Concerns about the efficacy and safety are long term and conjectural rather than data driven. Dietary carbohydrate restriction reliably reduces high blood glucose, does not require weight loss (although is still best for weight loss), and leads to the reduction or elimination of medication. It has never shown side effects comparable with those seen in many drugs. Here we present 12 points of evidence supporting the use of low-carbohydrate diets as the first approach to treating type 2 diabetes and as the most effective adjunct to pharmacology in type 1. They represent the best-documented, least controversial results. The insistence on long-term randomized controlled trials as the only kind of data that will be accepted is without precedent in science. The seriousness of diabetes requires that we evaluate all of the evidence that is available. The 12 points are sufficiently compelling that we feel that the burden of proof rests with those who are opposed.

AB - The inability of current recommendations to control the epidemic of diabetes, the specific failure of the prevailing low-fat diets to improve obesity, cardiovascular risk, or general health and the persistent reports of some serious side effects of commonly prescribed diabetic medications, in combination with the continued success of low-carbohydrate diets in the treatment of diabetes and metabolic syndrome without significant side effects, point to the need for a reappraisal of dietary guidelines. The benefits of carbohydrate restriction in diabetes are immediate and well documented. Concerns about the efficacy and safety are long term and conjectural rather than data driven. Dietary carbohydrate restriction reliably reduces high blood glucose, does not require weight loss (although is still best for weight loss), and leads to the reduction or elimination of medication. It has never shown side effects comparable with those seen in many drugs. Here we present 12 points of evidence supporting the use of low-carbohydrate diets as the first approach to treating type 2 diabetes and as the most effective adjunct to pharmacology in type 1. They represent the best-documented, least controversial results. The insistence on long-term randomized controlled trials as the only kind of data that will be accepted is without precedent in science. The seriousness of diabetes requires that we evaluate all of the evidence that is available. The 12 points are sufficiently compelling that we feel that the burden of proof rests with those who are opposed.

U2 - 10.1016/j.nut.2014.06.011

DO - 10.1016/j.nut.2014.06.011

M3 - Review

C2 - 25287761

SN - 0899-9007

VL - 31

SP - 1

EP - 13

JO - Nutrition

JF - Nutrition

IS - 1

ER -