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Category: Nutrition

Low Carb = Low Diabetes Risk

Type 2 diabetes now affects some 26 million Americans. The mainstay of treatment remains pharmaceutical with an unfortunately small dedication to getting the word out that lifestyle changes, like diet and exercise, matter on whole lot as it relates to the actual treatment of this disorder.

But let’s take a step back and review pertinent literature that relates diet not to the actual treatment of the disease, but to risk for becoming a type II diabetic in the first place.

In a study appearing in the American Journal of Clinical Nutrition, risk for developing diabetes was evaluated in more than 85,000 women who were followed over a 20 year period of time. In this group of women, 4670 cases of diabetes appeared. The researchers did an analysis of the diets of each of the participants and specifically determined the amounts of carbohydrate fat and protein that these subjects consumed. In addition, they applied an analysis called glycemic load to the diets with the understanding that diet higher in glycemic load foods are those which tend to increase blood sugar.

This is an extensive study with an incredibly large number of participants carried out over two decades, and the results are therefore very meaningful. What the researchers found was that a “higher dietary glycemic load was strongly associated with an increased risk of diabetes.” In fact, comparing those whose diets were lowest in glycemic load foods compared to those consuming the highest glycemic load diets, risk for type 2 diabetes was found to be increased about 250% in the latter.

This is striking information for a number of reasons. First, it is very empowering in that it indicates that a diet that is higher in fat, for example, while lower in carbohydrate, is a diet that is associated with reduced risk for becoming diabetic. Moreover, as I alluded to above, becoming a type II diabetic significantly increases a person’s risk for all kinds of other problems, many of which are devastating.

Second, it seems to be taking a long time for the science to catch up to the various popular diabetes related organizations in terms of what they are putting out with reference to dietary recommendations. Science is telling us that we need to eat less carbohydrates – food’s lower on the glycemic load scale, and welcome healthful fat back to the table, if we want to reduce our risk for diabetes. So please take a look at the report as it offers up some very valuable information

  • Lynn Dell

    I will never forget the first time I heard you on Neal Boortz’ radio show. A few weeks prior I started to take fasting glucose readings and discovered I was pre diabetic. When I heard that even a consistent reading of 105 was associated with an increased risk of dementia and that it was carbs, not cholesterol that posed the real threat to health, and that whole wheat raises blood sugar more than most other foods, it suddenly all made sense to me and gave me a direction out of the fog. I had not realized how much whole grain bread was not only the main culprit here, but that it was addictive to boot, keeping me locked on a path of self destruction.

    • David Perlmutter

      I’m thankful that appearance could bring us together Lynn.

      • Lynn Dell

        I bet you are glad you were on his show, too, because on a subsequent appearance we learned where extra virgin olive oil comes from! Thought I was going to bust a gasket, laughing.

  • Eve-Loraine

    Can anyone tell me why when eating 19g average
    carbs, 40g average protein, 76g average fat my fasting morning glucose is 113 average.
    I am not diabetic. My a1c of 5.7 hasn’t changed since I started the diet. I
    have lost the weight. My BMI is 22. Mostly intermittent fasting.

    • Vincent

      Perhaps this will guide you to find the reason why.
      https://www.youtube.com/watch?v=jCPD7sjHfqY

      • Eve-Loraine

        Thank you Vincent. That’s a lot of good information.

        • Vincent

          You’re Welcome. Be sure to watch Part 2 also. https://www.youtube.com/watch?v=mQ2eFEnfp3A#t=235

          • Eve-Loraine

            I have been on Blood Pressure meds for 30years

          • Vincent

            I would suggest finding what you are deficient in by taking SpectraCell’s MNT blood test. A rep from there can help you find a doctor who can read the results of the test. My insurance, Aetna, covers most of the cost so it cost me about $88. Good luck in finding the cause(s) of your problem.

          • Eve-Loraine

            Thank you. I don’t think that test is available where I live but I have increased my basic nutrients supplements and vit D. I couldn’t even get a vit D test. I will make an effort to exercise more. When I saw how the mechanism worked I marvelled that any blood sugar was regulated.

          • Lynn Dell

            http://nyp.org/advances/blood-sugar-memory.html

            The article above taught me more about the hippocampus and memory, but more to your question it underscores the point in the videos that exercise is crucial. Dr. Perlmutter once said he considered exercise to be the most important supplement, followed by vitamin d. The videos Vincent provided surely explain Dr. Perlmutter’s recommendations for exercise and vitamin d taking this priority.

            As a caveat, borne out in my experience, Dr. Myers,in a summation of her auto immune summit said exercise is important, but overdoing it will be pro inflammatory, so each person needs to be cautioned to learn what their threshold is for exercise and not to overdo it. For me, that means I can walk but not run or bike very hard. Too much exercise is too stressful. Speaking of stress, Dr. Myers also pointed out the importance of stress management and that breathing exercises,relaxation, having a grateful attitude, etc. are all allies of improving health.

          • Lynn Dell

            Also want to add something here. I almost completely fasted 24 hours and then have just completely finished a total water fast of 48 hours. That makes three days of a nearly complete fast. This morning when I woke up, my fasting glucose was 119. After taking in some water and organic probiotic foods, coconut oil, and kale, including lipoic acid and carnitine, it rose to 140. Around 9am I had organic eggs, turmeric and pepper, coffee with full fat cream and cinammon, and finished off the “7 super supplements.” less than two hours later after that, and blood glucose is 100. And I expect it to be better for the rest of December, as long as I behave myself.

            There are reasons this happened to me, not the least of which I am still exiting metabolic syndrome, but also to say fasting can be stressful. Also, the process of normal aging itself seems to make us all more fragile when it comes to glucose regulation. All this to say, hang in there with the diet.

          • Vincent

            Getting “normal” blood test is getting easier. If there is a Lab Corp or Quest Diagnostics center near you, you can order blood work with http://www.lef.org and http://www.saveonlabs.com. Could be a convenient alternative for you. Also, seems to me you are eating for a dietary ketosis. You may have not allowed enough time to pass before taking your HbA1c test. Also, getting into dietary ketosis could take some time. The body has to adjust to burning ketones. Same goes for when you come out of a dietary ketosis, you body now has to start producing insulin. It’s not as simple as turning on and off a light switch. I believe you are moving in the right direction by learning as much as you can. Best wishes.

          • Eve-Loraine

            I am in New Zealand. They consider Hba1c of 39 (5.7) to be normal. I can go to the hospital and pay for blood tests. I thought if I got into ketosis my blood sugar would come right but it is a lot harder to get into ketosis. than I thought. I was doing 20 carbs but have been trying to reduce to 15. I have just bought a keto meter. It didn’t register in the morning and 0.4 in the afternoon. I suspect I have made my FBS worse. About 6.5 (117)

          • Eve-Loraine

            I checked at 4pm. My keytones were 1.7 and my BS was 4.9. That is a good result. I have kept my carbs down to 8 and upped my fat. Hope it continues to work. That is with no exercise. My intentions were good BUT!

          • Vincent

            Learned something new … “dawn phenomenon”. It takes a few weeks to get your liver to function properly after you start a ketogenic diet. With my personal experience, I was more attuned to logging my daily food intake and keeping that in check. Your carbs / protein / fat ratio intakes seem to be good. A rule of thumb for protein is about 1 gram protein for every kg of lean body weight. This is so you don’t have your protein convert to glucose which I assume you already know. My FBS never got anywhere near as high as yours. Since blood test are difficult for you to get, if I was in your shoes I might add supplements based on what Dr Osbourne said in his video about some medications and then in about a couple months take a FBS reading and HbA1c to see if they have dropped. Also as was mentioned, exercise is good to incorporate. Take a look at intermittent fasting too. This should help to stabilize your blood sugar levels and help in other ways as well even though you are already in ketosis. You can find much on this on the internet. Dr Mercola is one of many good sources I would check out. Also I like Dr Terry Wahls food recommendations for dietary ketosis since they are high with nutrients.

          • Eve-Loraine

            Yesterday my carbs were 12, my protein, 32 and my fat was 72 but my FBS 126 this morning. I have been doing this diet for 6 mths. I have lost weight and expected really good BS. The only way I could find out was to buy a glucose monitor. I was shocked at how high they were. Nothing makes sense.

          • Eve-Loraine

            I read where intermittent fasting was not good if you had blood sugar problems so I stopped and retuned to breakfast. I thought that Dr Mercola recommended it. I may have to give up coffee. That doesn’t leave me much pleasure.

          • David Perlmutter

            I would consult with a physician before fasting if there exist other health concerns Eve-Loraine.

          • Eve-Loraine

            Thank you David. It’s a matter of finding one who will discuss a keto diet. I think cortisol may be the problem as I wake up hungry and panicky

          • Eve-Loraine

            My body should be producing key tone by now. 6 mths. My a1c was 5.7 so I am not diabetic.

          • Vincent

            Well, hang in there Eve-Loraine. As Dr David Perimutter suggested in his post to consult with a physician sounds like a good idea. Eat clean healthy nutrient dense foods while you are figuring out your issues.

          • Eve-Loraine

            Thank you Vincent. I think the diet has stressed me, especially that it didn’t work. I am just eating what I feel like. Trying for nutrient dense food.

          • Vincent

            You can always give it a go another time. Next time, you might do some reading on Therapeutic Fasting (TF) prior to dietary ketosis (DK). Important in TF to drink just water, no food and rest/relax during this time. 3 – 5 day period. I don’t know if you can experiences a Dawn Phenomenon” with TF. Also read on how to transition to the KD from a TF state. Also, check with a doctor to make sure you don’t have any conditions that would not be good for TF. I don’t believe hypertension is an issue for TF. I believe it actually helps hypertension. Do your own due diligence and I think you will be successful next time.

          • Eve-Loraine

            Thank you Vincent. I wish I could find a Dr who could advise me. They are only interested in cholesterol. Even though I had gestational diabetes, they say a1c of 5.7 is normal so I am not entitled to blood tests. I think cortisol is the problem. I live in a fight or flight state. I also need to make more effort with exercise. I have good intentions -ha ha! Deep breathing needed. Thanks for all your help.

          • David Perlmutter

            Have you tried this resource from the IFM Eve-Loraine? https://www.functionalmedicine.org/practitioner_search.aspx?id=117

          • Eve-Loraine

            I am in New Zealand. It didn’t work. I will talk to my Osteo. He told me about the diet in the first place. He might know if there is anyone. Meanwhile I will continue with low carb adding in more coconut oil to encourage ketosis. Thanks.

          • Luciano

            Hi Eve-Loraine,
            I’m just a guest on this site (just Passing) thought this link may help you find a NZ Keto friendly Doc’
            http://www.lowcarbnz.com/
            you may already know about it?
            Good luck,
            Regards,
            Luciano

          • Eve-Loraine

            Thanks

          • shirleycolee

            I can relate. I’m a caregiver to a loved one with a chronic illness. My diet is pretty pristine. I think it’s stress and cortisol that inhibits glucose results, and that exercise and mindfulness meditation are the answers. Also, venting with trusted friends, a support group, or a counselor is a good thing.

          • Eve-Loraine

            I have come to the same conclusion. Cortisol is a huge influence. However, on the LCHF my Hba1c has gone down to 5.4 (wonderful) in spite of the cortisol. I need to practice slow deep breathing and spend time resting in Jesus. I have also taken extra magnesium. I am working on exercise. The wrong exercise will push the cortisol up. What a blessing the internet is. I am learning so much. A
            support group is a blessing.

          • Lynn Dell

            Vincent, those videos were fantastic! I hope to watch them both several times over. Thank you so very much!

          • Eve-Loraine

            They certainly were. Thanks so much.

    • Sandy

      I had a a similar problem even after losing 50 pounds. Look up the words “dawn phenomenon” on the Internet. It may explain your high morning numbers even after diet, and exercise.

      • Eve-Loraine

        Thanks for that. I keep learning. Maybe the LC diet is causing the dawn phenomenon. Everything is much more complicated than I thought.

        • Eve-Loraine

          I assumed that if I was in ketosis my body wouldn’t be craving glucose. Wouldn’t my body be burning fat.

        • Lynn Dell

          The more I read, the more I find people who are not diabetic, who go on a ketogenic diet, and then venture into eating more carbohydrates again, experience high blood sugars, the same as a person with diabetes. I know this has happened to Jimmy Moore, for he shared his numbers online after eating what he called “safe starches.” What he shared was a post prandial reading suggestive of diabetes, but he says he’s not diabetic.

          Some people say that skeletal muscles develop an insulin resistance (not related to diabetes) when one goes into ketosis, in order for the brain to be able to utilize all the glucose available, and that this is what causes high numbers if you go out of ketosis. I don’t know if that has any bearing in reality or not, but the fact that people going out of ketosis for whatever reason spikes their blood glucose levels has been reported by many. And it’s happened to me as well.

  • Dr Prakash

    Pumpkin has very high GI but very low glycemic load, is it advisable to eat for a diabetic person?

  • Hans
  • Hans
  • Dr Prakash Chhajed

    Is there any authenticate source to find out Glycemic load of most common food. Also pumpkin has very high GI but very low glycemic load, is it advisable to eat for a diabetic person?

    • Andrea

      I would recommend accessing the information at http://ginews.blogspot.com/
      This is the GI newsletter from the University of Sydney (Australia). They publish multiple guides and offer information on books and articles on the Glycemic Index from the Glycemic Index Foundation. I am impressed at the progressive Australian food labeling process for low glycemic load on their processed foods. While not perfectly aligned with Dr. Perlmutter’s Grain Brain, it offers much information.

  • frownie

    I am somewhat new to Dr Perlmutter’s research. I am very concerned, my fasting glucose levels are high, 112 to 122 sometimes higher in the mornings, I have a few readings in the 90’s. I do notice the higher readings come after eating something sweet or higher carbs the night before. My AIc levels are normal but the high end. I am female 59 and I have 100lbs to lose. I am trying to avoid becoming diabetic and dementia. My father and grandfather both had Alzheimer’s. I have researched other doctors on the subject and some contradict each other, But DR Perlmutter’s findings standout to me. When I avoid grains and I eat lower glycemic foods I feel better. I just struggle with not having sweets every day, I have an overwhelming urge in the afternoon and evening that I must have something sweet, it’s scary just how strong this desire is, I can’t avoid sugar.

    So my question is, if any you have suggestions on how to kickstart me on this program, what tools or literature should I be reading, I have to be honest I am desperate, I took care of my father for two and half years until we were basically forced to put him into an Alzheimer’s unit, that was devastating. I want to do all I can to avoid that fate. and to be healthy. Any help is appreciated. Thank you

    • Ken

      Sugar is an addiction that affects the majority of people. To lose the weight (and more important improve your health) you have to kick the sugar habit. Do some research on LCHF diets. You will lose weight and your health will improve. To reduce temptation purge your kitchen of all sweets and bread, potatoes, i,e., white starches as these are as addictive as sugar and are quickly converted to sugar (glucose). Sugar Busters is one of several good books on the subject. Good luck to you.

      • frownie

        Thanks Ken, yes, I have done that, I have tried and had a few days success only to give in, I have an amazing homemade bakery several blocks from my home (my late husband call that place my drug dealer!) ! When my grandkids come over they want to bake cookies, not to mention when I go to my kids home and all the snacks there!! I will be successful, I just need to find some new ways. I am going to research LCHF diet, thanks again.

    • Lynn Dell

      I recommend the books Wheat Belly and Grain Brain. I wish you great success!

  • Kathy

    I have completely reversed T2 diabetes on a low carb, high fat diet in only a couple of months! After reading “Grain Brain” (especially the section entitled “The Death Knell of Diabetes”), I was motivated to remove all grains from my diet and follow your recommendation of a LCHF diet. The results have been dramatic, including stopping insulin and all other prescription drugs! Even my doctor was amazed. Thank you for continuing to empower people with the knowledge about how food can be more effective than medicine.

    • frownie

      Thanks Kathy, I am going read Dr Perlmutters book on grain brain, and your story is amazing and it gives me hope. Someone else mentioned LCHF diet, I will be looking into it.

  • Linda S

    I went on a LCHF eating plan in May and have dropped 26 pounds. My a1c went from 6.7 to 5.8. I am thrilled!

    I love the two videos as they explain what should and may not be happening very clearly.

    I’ve read Brain Drain and Wheat Belly and love what I learned. I’d appreciate any other great resources you want to share.

  • Amar

    Dear Dr. Perlumutter,
    I was wondering if the type of fat you consume is important. For example, isn’t a healthy balance of fat one that mainly consists of monounsaturated and some polyunsaturated and saturated? Also, aren’t some carbohydrates necessary for creating energy, producing serotonin, and other functions in the body and are, therefore, necessary for life?
    Thanks

    • David Perlmutter

      Yes, this diet focuses not on all fats, but healthy fats.

  • Mario Turchi

    For 67 years I have been trying to lose weight. I am..was diabetic after reading Grain Brain and listening to you speak.. It all happened in a short time. Thanks Thanks Thanks. ( from Hamilton Canada )

  • Hans

    I would like to ask: what is a good balance in calorie intake between carbs (10%?) protein(25%?) en fat(65%)?

    • David Perlmutter

      This blog post can offer insight Hans: http://www.drperlmutter.com/grain-brain-math

      • Hans

        Thank you for the answer: I understand that you recoment 60% fat, 20- 30% protein and 10-20% carbs. I use 55% fat, 35% protein and 11% carbs for a year now. This week I was diagnosed with kidney stones . Could you commend, is their a possible connection? Thanks.

  • bigals

    I thoroughly enjoyed your book and started eating according to its recommendations – high on protein including eggs and meat. That was in June. In September I started feeling numbness in my hand and by November I was in hospital being diagnosed with multiple sclerosis. Since then I’ve read the diets that are recommended for helping to prevent the onset of MS or of MS relapses and they recommend the exact opposite of the Grain Brain diet (pretty much zero saturated fat). Is it possible that perhaps if someone is at an increased risk of developing MS they might be better off not going for quite the extreme of the Grain Brain diet? Since there is an MS epidemic in the developed world it’s interesting that already I have found others that were on similar high saturated fat diets before experiencing their first attack of MS.

    • David Perlmutter

      Consider investigating the work of Terry Wahls.

      • bigals

        Thank you Dr Perlmutter – I really appreciate your taking the time to recommend this.

  • Hans

    I understand that you recoment 60% fat, 20- 30% protein and 10-20% carbs. I use 55% fat, 35% protein and 11% carbs for 2 year now. This week I was diagnosed with kidney stones . Could you commend, is their a possible connection? Thanks

  • Hans

    Is this discussion dead?

  • Susan

    My partner (who was diagnosed with dementia in 2012) and I have been trying to remove as much sugar as we can from our diet. Currently we are using a sweetner called Truvia ( a stevia -based sugar substitute). My questions is are we better off just using small amounts of regular sugar when we want to sweeten the frozen blueberries and frozen raspberries we consume each day? At this time we use 3 teaspoons of Truvia to sweeten the blueberries and 3 teaspons of Truvia to sweeten the raspberries. My partner’s blood sugar level is still at 121 even though we have removed most all carbohydrates from our diet. When a person wants to sweeten food what is the best option?

  • Uncle Buck

    Dr. Atkins advocated pork rinds as a snack food. What is your opinion of this as a gluten free snack?

  • ConroyDawn

    Hi. I come from a family full of diabetics. Both sides, including parents, grandparents and a brother. However, my sister and I both follow a low carb lifestyle and have both avoided it.

  • patvass

    I was reading your Grain Brain book when I had a medical massage therapist trained under Dr. Ross Turchanonov. As he worked on me I told him of my severe pain from fibromyalgia and myofascial pain. He got the book he had studied with and gave me the info about fibromyalgia theory of it coming from ATP problem in the mitochondria instead of from trauma or illness. I had just read in your book about the grain brain diet helping with the ATP on the mito. level. Could this be a possible link? Could you diet help with fibromyalgia pain?
    Since then I have been on your diet and exercising as well as exercising carefully due to my back. Just wondering if these two issues could be linked.
    BECAUSE my mom had fibromyalgia, ate Southern, and got Altzheimers for 12 years before she died. Just wondering.

  • MAS

    How do you interpret these researchers’ recommendations:

  • MAS

    Study was published online January 5, 2015, in
    JAMA Internal Medicine: “Each daily whole-grain serving was associated with a 5% lower risk of
    total mortality and a 9% lower risk of cardiovascular mortality, but no
    change in overall cancer mortality, during a follow-up of up to 26
    years, Dr Hongyu Wu (Harvard School of Public Health, Boston, MA) and
    colleagues write.”
    How do you interpret these findings?

  • shirleycolee

    I have eliminated virtually all bread, flour, cereal, crackers, corn, potatoes, rice. I eat vegetables, fruit, a little meat, a little eggs, fish, dairy, flax, chia seeds, nuts, etc. thanks to Dr. Perlmutter’s books. I don’t have any diagnoses or diseases/disorders, but I want to keep it that way! My husband has reduced carbs significantly. He has diabetes, but has been able to reduce his meds. So disappointing that the physicians don’t guide us to disease preventative lifestyles. I used to give wellness seminars for Cigna back in the 90’s. They emphasized that the majority of problems we face were from ‘lifestyle factors.’

  • disqus_pFomH2XM20

    One thing is clear, this diet is incompatible with the Esselstyn diet:

    https://en.wikipedia.org/wiki/Caldwell_Esselstyn

    https://www.youtube.com/watch?v=sl97IvbfUNQ

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