Carbohydrate Debate: Are They Okay for Diabetes?


Experts agree that following a diabetes diet is one of the most important choices you can make to manage diabetes, and that is where the debate begins. What kind of diet is best to keep blood sugar in check? 

Since diabetes is a disorder of carbohydrate metabolism, are carbohydrates safe to eat? Should you follow an ultra-low-carb, ketogenic diet? Or are healthy carbs okay in moderation? Can you lose weight while eating carbs?

As you can see in this table, a “low-carb” diet has many possible definitions. 

Diet Type i Notes Carb Grams per Day Calories from Carbs
Ketogenic
Possible concerns in near and long term
20 to 50 grams
2-10% of total
Low-Carb
Lower than most people with diabetes
Under 130 grams
Under 26%
Moderate Low-Carb
Considered low-carb
130-230 grams
26-35%
High-Carb
Average American
Over 230 grams
Over 45%

The carbohydrate debate continues in the quest to find the best diabetes diet to lower high blood sugar. As research into diet and diabetes continues, here are some current thoughts on carbohydrates and the pros and cons of low-carb and high-carb diets. 

Good Carbs if You Have Diabetes

Less processed and high in protein and/or fiber, and portion-controlled

  • Non-starchy vegetables
  • Whole-grain bread and bread products, such as whole-grain bagels, pita, English muffins
  • Oatmeal and cold whole-grain cereal such as bran flakes
  • Brown rice, whole-grain pasta
  • Beans, lentils, split peas, tofu
  • Starchy vegetables, such as sweet potatoes, acorn squash, peas, corn
  • Fresh fruit
  • Frozen fruit (no sugar added)
  • Nuts and peanuts
  • Plain yogurt

Weight Loss


Low-Carb Pros: Some people lose weight faster when they first start on a low-carb diet compared to a high-carb one. These quick initial results can be motivating. A low-carb diet can lead to continued weight loss because the limited food choices and satisfying nutrients such as protein and fat can help you eat less.

Bad Carbs if You Have Diabetes

More processed, sugary or refined, and oversized portions

  • White bread and bread products, such as bagels, pita, English muffins, rolls
  • Refined breakfast cereal
  • White rice and pasta
  • Refined crackers, pretzels, potato and tortilla chips
  • Baked goods, such as cookies, cake, croissants, muffins, pies
  • Fruit juice and fruit drinks
  • Dried fruit
  • Sugar-sweetened beverages, such as soft drinks, coffee beverages, sports and energy drinks, sweet tea
  • Sugar-sweetened yogurt, oatmeal, condiments, cereal

High-Carb Pros: A high-carb diet may have slower initial weight loss, but weight loss may be steadier due to the loss of body fat. The rapid initial weight loss on a low-carb diet is often due to the loss of body water, not fat.

Bottom Line: Research suggests that weight loss over the course of a year or so is similar whether you go low-carb or high-carb.

 

Maintenance of Weight Loss


Low-Carb Pros: A low-carb diet can be simpler because it includes fewer foods and less decision-making. That simplicity can make it easier for a low-carb diet to become habitual for you. 

High-Carb Pros: A higher-carb diet can feel less restrictive in the long-term because you can eat a wider variety of foods. It gives you more flexibility in your diet choices, which makes it easier to fit in special occasions, such as restaurant meals and parties, into your eating plan in a positive way.

Bottom Line: The more flexible nature of a higher-carb diet can be the difference between a temporary low-carb “diet” that ultimately ends and leads to weight regain, and a longer-term higher-carb “way of life” that allows you to maintain that hard-earned weight loss.

 

Blood Sugar


Low-Carb Pros: A low-carb diet can lower high blood sugar levels within weeks. A ketogenic diet can be especially effective. The low amount of carbs, along with the high amount of protein and fat, helps prevent blood sugar spikes that eventually increase insulin resistance.

High-Carb Pros: While sugary foods and refined starches have earned their reputation as bad if you have diabetes, small portions of nutritious, high-fiber carbs are not likely to cause more severe blood sugar swings. Furthermore, red meat and saturated fat are likely to be lower than on a low-carb diet, and limiting them can be good for blood sugar.

Bottom Line: Low-carb or healthy-carb can each help control blood sugar, and each is more effective if your other food choices are healthy, too.

 

Diet Quality


Low-Carb Pros: A meal plan that limits sugar and refined starch can only be good, since cookies, chips, and white bread are not doing your body many favors – they are high in carbs and low in nutrients. If you go low-carb by choosing nutritious low-carb and carb-free foods, such as fish, avocados, and non-starchy vegetables, your diet quality can improve.

High-Carb Pros: It is more likely to include high-fiber, nutrient-dense carbs that are linked to better health. Beans, oatmeal, and apples are some nutritious superfoods. You are also less likely to select excessive amounts of butter, bacon, and other fatty foods that are linked to poorer insulin sensitivity, just because they are low in carbs.

Bottom Line: A higher-carb diet can include a wider variety of healthy foods if you choose carefully.

 

Everyday Energy


Low-Carb Pros: As a low-carb diet prevents blood sugar spikes and drops, it can prevent the energy roller coaster that goes with it. You could have fewer periods of severe fatigue and intense hunger during the day.

High-Carb Pros: A very low-carbohydrate diet can make you feel tired and sick in the beginning as your body shifts from using carbohydrates to fats as the main fuel source, while a high-carb diet avoids this trouble. Getting enough healthy carbs can help you feel more energetic for workouts and help you recover faster from them.

Bottom Line: This one is up to you, since individual people are different. Cut back on carbs if they make you feel like taking a nap instead of taking a walk, but help yourself to them if your body tells you that you need them to get through your workout. 

 

Long-Term Health Effects


Low-Carb Pros: Your health could improve in some ways if you replace sugary and refined starchy foods with nutritious proteins and healthy fats. 

High-Carb Pros: A higher-carb diet can have more of the nutrients and foods that are linked to better diabetes, heart, and other health outcomes based of plenty of long-term research. You are also less likely to depend on red meat and other not-so-good foods.  

Bottom Line: Since the jury is still out on the safety of a low-carb diet for the long haul, a higher-carb diet with healthy choices may be safest.

 

Our Recommendation: A “Healthy-Carb” Diet for Diabetes


Healthy carbs, in moderation, are okay for people with diabetes. Be sure to ask your doctor about any meal plan that you are planning to follow, and be sure to make any necessary adjustments to diabetes or blood sugar medications if your doctor suggests them. 

As you create your “healthy-carb” plan, try to aim for:

  • 2 to 3 servings (30 to 45 grams) of nutritious carbohydrates at each meal 

  • 1 to 2 servings (15 to 30 grams) of nutritious carbohydrates at each snack 

  • Some lean protein at each meal and most snacks

  • Small servings of healthy oils instead of artery-clogging fats

Here is a sample day’s menu with about 1,800 calories. You may need more or fewer calories, depending on your size, age, gender, weight loss goals, and activity levels.

Meal/Snack Foods
Breakfast
½ cup oats and ½ sliced banana mixed into 1 cup yogurt
Morning Snack
1 medium apple in slices with 2 tablespoons peanut butter
Lunch
Taco salad with romaine lettuce, ½ cup fat-free refried beans, ½ cup cooked brown rice, 3 ounces cooked chicken breast, ¼ avocado in slices, diced tomatoes, and salsa
Afternoon Snack
Pizza with ½ whole-grain English muffin, tomato sauce, 1 ounce mozzarella cheese, olive slices, and bell pepper slices
Dinner
4 ounces of tilapia, ½ cup diced onion, and 1 cup sliced mushrooms sauteed in 1 teaspoon olive oil with thyme and black pepper to taste. Serve with ½ baked acorn squash and 1 cup of steamed broccoli

Lark can coach you as you follow a healthy diet and make other healthy decisions to prevent or manage diabetes. Your personal health coach can be with you 24/7 to help you develop habits that can benefit you for years.

 


Reference

  1. Dyson P. Low Carbohydrate Diets and Type 2 Diabetes: What is the Latest Evidence?. Diabetes Ther. 2015;6(4):411-424. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4674467/

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