Low-carb
dieter and popular type 2 blogger David
Mendosa recently wrote an article about
chronic systemic inflammation and low-carb dieting inHealth
Central. He referred to another inflammation piece he wrote
in Health Central in 2009. They were
both interesting, but what really caught my attention was a link Mendosa
provided to a PubMed abstract titled, “Advice to follow
a low-carbohydrate diet has a favourable impact on low-grade inflammation in
type 2 diabetes compared with advice to follow a low-fat diet.” The full
text is available from the Annals of
Medicine here.
Mendosa
begins his 2009 piece with this: “More and more research pinpoints inflammation
as a root cause of type 2 diabetes.” He added, “Type 2 diabetes generally
results from the combination of impaired beta cell function and insulin
resistance acting on susceptible genes.” In his 2014 piece Mendosa relates
these two disparate phenomena with a quote from Dr. Richard K. Bernstein, the
pied piper of very low carb dieting and blood glucose monitoring to manage
diabetes.
“To simplify somewhat, inheritance plus inflammation
plus fat in the blood feeding the liver causes insulin resistance, which causes
elevated serum insulin levels, which cause the fat cells to build even more
abdominal fat, which raises triglycerides in the liver’s blood supply and
enhances inflammation, which causes insulin levels to increase because of
increased resistance to insulin.”
If that
vicious cycle is too “geeky” and confusing for you – it is to me, then this new
Swedish study – the “Advice to follow…” link above – is not. The headline says
it simply: A low-carb diet has a favorable
impact on low-grade inflammation in type 2 diabetes compared with a low–fat
diet.
The
Abstract’s BACKGROUND sets up the
study: “Inflammation may play an important role in type 2 diabetes. It has been
proposed that dietary strategies can modulate inflammatory activity.”
The
low-carb diet used in the study was 20% carbohydrates. That’s 100 grams of
carbohydrate a day on a 2,000 calorie a day eating plan. The low-fat diet was
55-60% carbohydrate, or 275 to 300 grams of carbohydrate a day. This is the
amount, if you didn’t know, that the Dietary Guidelines for Americans
recommends and the amount on which the Nutrition Facts panel of packaged and
processed foods is based. That’s stunning to most people. If you don’t believe
me, check it out for yourself.
In “my
book,” 100 grams of carbohydrate a day is very
high-end low-carb. Perhaps it was chosen as the “low-carb” amount for the study
so as to be seen as an “achievable” amount by people just starting out in the
low-carb Way of Eating. It is certainly achievable by anyone who gives it a
good faith try. But, it must be said that cutting carbohydrate consumption by
two-thirds (from 300g/day) is no small feat. It is undoubtedly a sufficient
reduction for the majority of people who are not already diagnosed type 2s. It
would make management with medications for diagnosed type 2s so much easier.
And it may make reversal of pre-diabetes possible for people whose
glucose tolerance is not already too badly impaired.
So, what
did this randomized, real-world study reveal? RESULTS: “Both the low fat diet and low carb diets led to similar
reductions in body weight, while beneficial effects on glycemic control were
observed in the low carb group only.” In addition, using various clinical
laboratory measures, after 6 months, inflammatory markers “were significantly
lower in the low- carb group than in the low-fat group.”
Table IV
from the full-text of the study, showing data for all the inflammation markers
tested, is reproduced here. Note the CRP
of the low-fat dieters actually increased
18% from1.41 to 1.67mg/L, while the CRP of the low carb dieters decreased 22% from 1.12 to 0.87mg/L.
CONCLUSION: “To conclude, advice to follow a
low carb diet or a low fat diet had similar effects on weight reduction while
effects on inflammation differed. Only the low carb diet was found
significantly to improve the subclinical inflammatory state in type 2
diabetes.”
Wikipedia tells us
that CRP has a half life of 48 hours, so the anti-inflammatory effects of a
diet change can begin quickly. Have your CRP levels been checked?
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