It might be a delicious, steaming bowl of spaghetti, or toast in the morning. Perhaps it’s a jacket potato for lunch, a couple of biscuits, or a banana and a glass of milk before bed. All are dietary staples enjoyed by millions of Britons.
But would you give them all up if it could ‘cure’ your type 2 diabetes, or prevent it from happening it the first place?
The answer might well be yes. Or at least, ‘I’ll give it a go.’ And some experts now advise just this, as part of a so-called low-carb diet.
It might be a delicious, steaming bowl of spaghetti, or toast in the morning. Perhaps it’s a jacket potato for lunch, a couple of biscuits, or a banana and a glass of milk before bed. All are dietary staples enjoyed by millions of Britons
For those facing a lifetime of medication, with the threat of illness, disability and an early death looming due to the blood sugar condition, the promise is persuasive – no matter if it means giving up a few of life’s pleasures.
In April, it was announced that one such diet plan, The Low Carb Program, had received approval to be prescribed by NHS GPs to people with type 2 diabetes and also those with pre-diabetes.
Half of a typical meal would be vegetables, while carbohydrates (favouring wholegrains, rather than ‘white’ carbs) and protein would each make up a quarter.
But the Program also gives advice to those who might want to cut carbs drastically – sometimes dubbed the ketogenic, or keto diet approach – to as little as 30g a day. That’s less than two medium slices of Hovis wholemeal bread.
Low-carb diets like the Atkins, Dukan and South Beach Diet have long been popular. Overall, there is a spectrum – officially, low carb can range from 130g a day to just 30g. And a slew of diet books and trendy websites now recommend the best way to beat diabetes and control blood sugar is by swapping pasta for strings of courgette, rice for finely shredded cauliflower, and bread for lettuce leaves. As for pudding, don’t even think about it.
It is restrictive, undoubtedly. Some might say the low end of the scale is extreme. But are such measures completely necessary? Not so, according to the experts who have devoted decades to researching blood sugar and its effect on the body. In fact, you can beat diabetes – or stop it before it strikes – with just a few tweaks.
Shed pounds... without missing the foods you love
At present, the only proven way to get diabetes under control is to shed pounds and slim down. And as long as you stick to a low-calorie diet, it doesn’t matter – within reason – whether or not those calories come from carbs.
This message underpins the exclusive recipes in today’s Mail on Sunday. They are designed to help you lose weight and improve your health – which does mean eating less. But it does not involve cutting out pasta, bread, rice or potatoes, and you can even have a pudding.
Dr Michael Mosley has developed a range of recipes - including this steak and carrot dish - which has less than 450 calories per serving and can aid weight loss
If you could do with losing a few pounds, then you aren’t alone. A third of British adults are overweight – and a further 25 per cent of the population is obese, which is a medical term for very overweight.
Public Health England says that the average adult consumes up to 300 more calories a day than is recommended – which is 2,500 a day for men, and 2,000 for women.
Type 2 diabetes and pre-diabetes are predominantly linked to weight gain.
But, as one of the UK’s foremost researchers into diet explains, it’s not what you eat, it’s just eating too much of anything that makes you gain weight.
Professor Michael Lean, chair of human nutrition at the University of Glasgow, says: ‘The scientific evidence is extensive, consistent and very clear. The cause of type 2 diabetes, in susceptible people, is weight gain and specifically waist-size increase – which indicates fat accumulation in the vital organs, and particularly fat in the liver.
‘The specific diet has little influence. It is weight gain that matters, and you don’t need to be very overweight or obese to be affected.’
The exact way diet reverses type 2 diabetes and pre-diabetes is just as simple, he adds. ‘It happens if there is weight loss of 10kg to 15kg – or 1st 8 lb to 2st 5 lb – whatever the starting point. This leads to loss of the excess fat in the liver.’
It’s the age old equation – consume fewer calories than you burn. ‘The diet composition does not matter as long as there is weight loss,’ Prof Lean says.
Busting the myths of going low-carb
The idea that very-low-carb diets are good for those with type 2 diabetes – or those at risk of the condition – comes from the theory that carbs raise the amount of insulin produced by the body.
Raising insulin increases the appetite, and reduces the body’s natural ability to burn off fat, or so it’s often claimed. If we believe the theory, it means that eating fewer carbs should cause us to lose weight. However, the problem is it has never been proven.
Professor Gary Frost, chair of nutrition and dietetics at Imperial College London says: ‘There is no good scientific evidence that shows increased carbohydrate intake leads to high levels of insulin that, in turn, drives up appetite.’
And according to Prof Lean, the idea that low-carb diets have a magical advantage over other weight-loss methods is a myth. Individual studies have suggested that going low-carb shifts weight fast, and significantly reduces blood sugar.
Current healthy eating guidelines suggest carbs should make up about a third of meal – about 260g of carbohydrate a day
But in the longer term, there is no advantage to the approach over many other diets, according to the best evidence. ‘There is no unique effect from low-carb diets on body fat, diabetes, blood pressure or cholesterol,’ Prof Lean adds.
Current healthy eating guidelines suggest carbs should make up about a third of meal – about 260g of carbohydrate a day.
The new Low Carb Program suggests initially limiting carbs to between 130g and 150g a day. This isn’t all that restrictive when you consider a bowl of porridge contains about 35g of carbs and a Tesco chicken sandwich has 42g. ‘Following a diet like this may well result in weight loss,’ says Prof Frost. ‘But that’s because by limiting carb intake, you’ll also limit calories.’
The Low Carb Program also offers advice on reducing carbs further, to 30g a day. However, Prof Frost points to studies that suggest very low-carb diets can increase cholesterol – and, therefore, the risk of heart disease – because people consume a greater proportion of their calories from fat. One large study in April found that people who ate the least amount of carbs