The relationship between eating carbohydrates and type 2 diabetes is complex. While eating carbohydrates increases the need for insulin to keep blood sugar normal, diets high in total carbohydrates do not necessarily increase the risk of type 2 diabetes.2 3 Researchers have found that diets very high in sugar may worsen glucose tolerance in nondiabetic animals and humans.4 5 However, the amount of sugar used in these studies in proportion to other foods was much larger than is typically found in human diets.
Eating carbohydrate-containing foods, whether high in sugar or high in starch (such as bread, potatoes, processed breakfast cereals, and rice), temporarily raises blood sugar and insulin levels.6 The blood sugar�raising effect of a food, called its �glycemic index,� depends on how rapidly its carbohydrate is absorbed. Many starchy foods have a glycemic index similar to table sugar (sucrose).7 People eating large amounts of foods with high glycemic indexes have been reported to be at increased risk of type 2 diabetes. 8 9 On the other hand, eating a diet high in carbohydrate-rich foods with low glycemic indexes is associated with a low risk of type 2 diabetes. 10 11 12 Beans, peas, fruit, and oats have low glycemic indexes, despite their high carbohydrate content, due mostly to the health-promoting effects of soluble fiber.
Diabetes disrupts the mechanisms by which the body controls blood sugar. Until recently, health professionals have recommended sugar restriction to people with diabetes, even though short-term high-sugar diets have been shown, in some studies, not to cause blood sugar problems in people with diabetes.13 14 15 Currently, the American Diabetic Association (ADA) guidelines do not prohibit the use of moderate amounts of sugar,16 as long as blood levels of glucose, triglycerides, and cholesterol are maintained within normal levels.
Most doctors recommend that people with diabetes to reduce the amount of sugar eaten in snacks and processed foods, and replace these foods with high-fiber, whole foods. This tends to lower the glycemic index of the overall diet and has the additional benefit of increasing vitamin, mineral, and fiber intake. Other authorities also recommend lowering the glycemic index of the diet to improve the control of diabetes.17
A high-fiber diet has been shown to work better in controlling diabetes than the diet recommended by the ADA, and may control blood sugar levels as well as oral diabetes drugs.18 In this study, the increase in dietary fiber was accomplished exclusively by eating foods naturally high in fiber�such as leafy green vegetables, granola, and fruit�to a level beyond that recommended by the ADA. No fiber supplements were given. All participants received both the ADA diet (providing 24 grams of fiber per day) and the high-fiber diet (providing 50 grams of fiber per day) for a period of six weeks. After six weeks of following each diet, tests were performed to determine blood glucose, insulin, cholesterol, triglyceride, and other values. When glucose levels were monitored over a 24-hour period, participants eating the high-fiber diet had an average glucose level that was 10% lower than participants eating the ADA diet. Insulin levels were 12% lower in the group eating the high-fiber diet compared to the group eating the ADA diet, indicating a beneficial increase in the body�s sensitivity to insulin. Moreover, people eating the high-fiber diet experienced significant reductions in total cholesterol, triglycerides, and LDL (�bad�) cholesterol compared with those eating the ADA diet. They also had slight decreases (improvements) in glycosylated hemoglobin levels, a measure of long-term blood glucose regulation.
High-fiber supplements, such as psyllium,19 guar gum (found in cluster beans),20 pectin (from fruit),21 oat bran,22 and glucomannan,23 24 have improved glucose tolerance in some studies. Positive results have also been reported with the consumption of 1 to 3 ounces of powdered fenugreek seeds per day.25 26 A review of the research revealed that the extent to which moderate amounts of fiber help people with diabetes in the long term is still unknown, and the lack of many long-term studies has led some researchers to question the importance of fiber in improving diabetes.27 Nonetheless, most doctors advise people with diabetes to eat a diet high in fiber. Focus should be placed on fruits, vegetables, seeds, oats, and whole-grain products.
Eating fish also may afford some protection from diabetes.28 Incorporating a fish meal into a weight-loss regimen was more effective than either measure alone at improving glucose and insulin metabolism and high cholesterol.29
Vegetarians have been reported to have a low risk of type 2 diabetes.30 When people with diabetic nerve damage switch to a vegan diet (no meat, dairy, or eggs), improvements have been reported after several days.31 In one trial, pain completely disappeared in 17 of 21 people.32 Fats from meat and dairy may also contribute to heart disease, the leading killer of people with diabetes.
Vegetarians also eat less protein than do meat eaters. Reducing protein in the diet has lowered kidney damage caused by diabetes and may also improve glucose tolerance.33 34 and may also improve glucose tolerance.35 However, in a group of 13 obese males with high blood-insulin levels (as is often seen in diabetes), a high-protein, low-carbohydrate diet resulted in greater weight loss and control of insulin levels, compared with a high-carbohydrate diet.36 Switching to either a high- or low-protein diet should be discussed with a doctor.
Diets high in fat, especially saturated fat, worsen glucose tolerance and increase the risk of type 2 diabetes,37 38 39 40 an effect that is not simply the result of weight gain caused by eating high-fat foods. Saturated fat is found primarily in meat, dairy fat, and the dark meat and skins of poultry. In contrast, glucose intolerance has been improved by diets high in monounsaturated oils,41 42 which may be good for people with diabetes.43 The best way to incorporate monounsaturates into the diet is to use olive oil, especially extra virgin olive oil, which has high antioxidant values.
Eating carbohydrate-containing foods, whether high in sugar or high in starch (such as bread, potatoes, processed breakfast cereals, and rice), temporarily raises blood sugar and insulin levels.6 The blood sugar�raising effect of a food, called its �glycemic index,� depends on how rapidly its carbohydrate is absorbed. Many starchy foods have a glycemic index similar to table sugar (sucrose).7 People eating large amounts of foods with high glycemic indexes have been reported to be at increased risk of type 2 diabetes. 8 9 On the other hand, eating a diet high in carbohydrate-rich foods with low glycemic indexes is associated with a low risk of type 2 diabetes. 10 11 12 Beans, peas, fruit, and oats have low glycemic indexes, despite their high carbohydrate content, due mostly to the health-promoting effects of soluble fiber.
Diabetes disrupts the mechanisms by which the body controls blood sugar. Until recently, health professionals have recommended sugar restriction to people with diabetes, even though short-term high-sugar diets have been shown, in some studies, not to cause blood sugar problems in people with diabetes.13 14 15 Currently, the American Diabetic Association (ADA) guidelines do not prohibit the use of moderate amounts of sugar,16 as long as blood levels of glucose, triglycerides, and cholesterol are maintained within normal levels.
Most doctors recommend that people with diabetes to reduce the amount of sugar eaten in snacks and processed foods, and replace these foods with high-fiber, whole foods. This tends to lower the glycemic index of the overall diet and has the additional benefit of increasing vitamin, mineral, and fiber intake. Other authorities also recommend lowering the glycemic index of the diet to improve the control of diabetes.17
A high-fiber diet has been shown to work better in controlling diabetes than the diet recommended by the ADA, and may control blood sugar levels as well as oral diabetes drugs.18 In this study, the increase in dietary fiber was accomplished exclusively by eating foods naturally high in fiber�such as leafy green vegetables, granola, and fruit�to a level beyond that recommended by the ADA. No fiber supplements were given. All participants received both the ADA diet (providing 24 grams of fiber per day) and the high-fiber diet (providing 50 grams of fiber per day) for a period of six weeks. After six weeks of following each diet, tests were performed to determine blood glucose, insulin, cholesterol, triglyceride, and other values. When glucose levels were monitored over a 24-hour period, participants eating the high-fiber diet had an average glucose level that was 10% lower than participants eating the ADA diet. Insulin levels were 12% lower in the group eating the high-fiber diet compared to the group eating the ADA diet, indicating a beneficial increase in the body�s sensitivity to insulin. Moreover, people eating the high-fiber diet experienced significant reductions in total cholesterol, triglycerides, and LDL (�bad�) cholesterol compared with those eating the ADA diet. They also had slight decreases (improvements) in glycosylated hemoglobin levels, a measure of long-term blood glucose regulation.
High-fiber supplements, such as psyllium,19 guar gum (found in cluster beans),20 pectin (from fruit),21 oat bran,22 and glucomannan,23 24 have improved glucose tolerance in some studies. Positive results have also been reported with the consumption of 1 to 3 ounces of powdered fenugreek seeds per day.25 26 A review of the research revealed that the extent to which moderate amounts of fiber help people with diabetes in the long term is still unknown, and the lack of many long-term studies has led some researchers to question the importance of fiber in improving diabetes.27 Nonetheless, most doctors advise people with diabetes to eat a diet high in fiber. Focus should be placed on fruits, vegetables, seeds, oats, and whole-grain products.
Eating fish also may afford some protection from diabetes.28 Incorporating a fish meal into a weight-loss regimen was more effective than either measure alone at improving glucose and insulin metabolism and high cholesterol.29
Vegetarians have been reported to have a low risk of type 2 diabetes.30 When people with diabetic nerve damage switch to a vegan diet (no meat, dairy, or eggs), improvements have been reported after several days.31 In one trial, pain completely disappeared in 17 of 21 people.32 Fats from meat and dairy may also contribute to heart disease, the leading killer of people with diabetes.
Vegetarians also eat less protein than do meat eaters. Reducing protein in the diet has lowered kidney damage caused by diabetes and may also improve glucose tolerance.33 34 and may also improve glucose tolerance.35 However, in a group of 13 obese males with high blood-insulin levels (as is often seen in diabetes), a high-protein, low-carbohydrate diet resulted in greater weight loss and control of insulin levels, compared with a high-carbohydrate diet.36 Switching to either a high- or low-protein diet should be discussed with a doctor.
Diets high in fat, especially saturated fat, worsen glucose tolerance and increase the risk of type 2 diabetes,37 38 39 40 an effect that is not simply the result of weight gain caused by eating high-fat foods. Saturated fat is found primarily in meat, dairy fat, and the dark meat and skins of poultry. In contrast, glucose intolerance has been improved by diets high in monounsaturated oils,41 42 which may be good for people with diabetes.43 The best way to incorporate monounsaturates into the diet is to use olive oil, especially extra virgin olive oil, which has high antioxidant values.
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