Suggestion that high fat diet could reduce type 2 diabetes risk: Diabetes UK's response

[jack412]

Why do you think that ? Their reports are well referenced and seem to follow from the available evidence.
In the 2008 version the ADA was summarising effects of poly and mono saturated fats favourably and sat fats less so. That hasn't changed.. Since then there have been a couple of big Mediterranean diet trials that have emphasised this )
The most recent report though is I would say easier to read. al

I said it because it's not the usual low fat recommendation that is given to diabetics in the UK and Aus and I anticipated resistance to giving up that idea

 

[Lesleywo]

Or "one" could see DUK's approach is that it may be better to take a more moderate approach to both carbs and fat?

Personally I would say that a very high fat diet is no better than a very high carb diet but for different reasons. As a very high fat diet will cause more insulin resistance and therefore is counter productive for diabetics on the other hand a very high carb diet is going to be disastrous for bg levels so my opinion is that a reduced carb diet with no added fat is the more sensible approach.

I dont expect you to agree with me but as I said it is my opinion.

My thoughts exactly

 

[Brunneria]

Or "one" could see DUK's approach is that it may be better to take a more moderate approach to both carbs and fat?

Personally I would say that a very high fat diet is no better than a very high carb diet but for different reasons. As a very high fat diet will cause more insulin resistance and therefore is counter productive for diabetics on the other hand a very high carb diet is going to be disastrous for bg levels so my opinion is that a reduced carb diet with no added fat is the more sensible approach.

I dont expect you to agree with me but as I said it is my opinion.

Do you have any stats on the high fat diet causing insulin resistance? I'd be fascinated to read your source.

It's something I only heard about very recently, and I think in my case my fasting and pre-prandial BG readings rose a fraction (less than 0.2mmol, as far as I can tell) when raising my fat intake. So I certainly think there is something in it.

At least they did rise, but then I switched to an even lower carb intake, keeping the fat the same, and suddenly my readings have dropped by about 0.8! Which is fantastic.

So I'm really interested in whether anyone has produced actual figures on how much a high fat diet raises insulin resistance. And whether it is just the fat, or the raised protein intake that has an effect too. And how that compares with reduced HbA1cs, over time.

 

[tonyS54]

@SidBonkers. I really didn't know that a Lchf diet can make insulin resistance worse? Is this correct? Getting concerned now.

After five years of LCHF I'd say quite the opposite my IR has not deteriorated, It was getting worse when I was a good boy and following the DUK recommendations though

There's another new study that seems to have gone under the radar.

Associations between dairy intake and metabolic risk parameters in a healthy French-Canadian population

http://www.nrcresearchpress.com/doi/full/10.1139/apnm-2014-0154#.VBsOfvldXqs

 

[Brunneria]

After five years of LCHF I'd say quite the opposite my IR has not deteriorated, It was getting worse when I was a good boy and following the DUK recommendations though

There's another new study that seems to have gone under the radar.

Associations between dairy intake and metabolic risk parameters in a healthy French-Canadian population

http://www.nrcresearchpress.com/doi/full/10.1139/apnm-2014-0154#.VBsOfvldXqs

Sadly, I only understood one word in three.
Can someone translate for us scientifically challenged types?

 

[this is too difficult two]

I feel that all this may be wrong. My own experience is that high fat (dairy or otherwise) low carb helps me. Eating full fat dairy seems to help me but, I don't think it is anything to do with fat helping or being bad. Eating sufficient fat (not high) enables me to eat less carbs yet still get enough calories.
Might just be me.

 

[jddukes]

As a very high fat diet will cause more insulin resistance and therefore is counter productive for diabetics on the other hand a very high carb diet is going to be disastrous for bg levels so my opinion is that a reduced carb diet with no added fat is the more sensible approach.

Sid, I respect your opinion but will have to completely disagree with you on this point, and what this does is highlight the great mine field of dietary interpretation of scientific data with human studies.

The problems all come down to 2 things largely - 1) Time and 2) definition.

You see this a lot with short, small studies maybe for 2-3 weeks that look at high fat versus low fat diets and starting with people not keto-adapted. Keto-adaption in itself takes 2-4 weeks to kick in thus before that we see some negative aspects of the diet as your body adjusts from (often years of) burning carbohydrates as the main source of fuel, to primarily ketones from fat.

Secondly, and this is the biggest issue, is definition. The definition of "high fat" and "low fat" (and conversely for carbohydrate) is so utterly loosley defined that it is completely understandable how confusing this subject is. For example, given our society's view of fat, most people would consider a diet >25-30% fat to be high fat, and expect a low fat to be <20%. Usually, protein will be 10-20% so therefore the carb aspect will vary from 60-70% on a low fat diet to as much as 50-65% on a "low carb" diet!

And this is the kicker - the research on "proper" LCHF shows quite the opposite of what these definitions of high fat give. Thus a proper LCHF, which will consist of 65-80% fat, 10-25% protein and <15% carbohydrate (When I talk about % I mean calories, not % weight as obviously fat is 2.25x more calorie dense than protein/carb) is completely different than what a traditionalist might consider high fat - e.g. 35% fat, 15% protein, 50% carbs.

In the very high fat/low carb (say <50-60g carbs per day, with most calories coming from fat) what we find is dramatic and long-lasting improvements on insulin resistance. We see the exact opposite on a moderate (public view of "high") fat diet when carbs are >60-100g/day (will range from individual to individual whether this is >60 or >100....).

For example, see:
Boden G et al. Effect of a low carbohydrate diet on appetite, blood glucose levels, and insulin resistance in obese patients with type 2 diabetes. Ann Intern Med, 2005. 142 (6): p. 403-11
Forsythe, C.E etl al. Comparison of low fat and low carbohydrate diets on circulating fatty acid composition and markers of inflammation. Lipids, 2008. 43(1): p. 65-77

Etc. This is the problem with floating about terms such as "low carb" and "high fat" without any real definition attached to them. It is a problem why? Because the results are dramatically different dependent upon which definition you use! Yet still, we have this debate on-going because largely, even people in the research field do not seem to catch on to the need for an effective LCHF diet, (i.e. a beneficial diet very rich in fats must be very low in carbs so that you are primarily using fat as your energy source), to have usually <60g/day from carbohydrate sources, not simply <300g/day as some definitions of low carb use!

Such an approach that adopts very low carbs and very high fats actually has the benefits of:
- Reducing serum triglycerides
- Increasing HDL (good cholesterol)
- Increasing "good sized" LDL particles
- Improving LDL:HDL ratio
- Reducing markers of inflammation
- Reducing ROS (reactive oxidation species)
- Reducing risk of metabolic syndrome and T2 diabetes
- Halting/slowing progression of metabolic syndrome/T2D
- Reducing blood pressure

All of these things have links to various aspects of health improvement, in particular with regards to cardio-vascular risk and disease, therefore improving all of these markers is of huge benefit - and this is all in the non-diabetic largely. In the diabetic (T2) it will improve resistance, reduce the need for medicine, and help with weight loss if that is a goal (and overall calories are reduced - high fat helps with satiety so can be easier to stick to). In a T1, it can stabilise BS levels reducing the need for insulin and therefore improving HbA1c, reducing hypo episodes, and generally improving health.

But I must emphasise again - the above is only generally true in people who adopt a very low carb diet (<40-100g carbs per day and do not overdo the protein i.e. get main energy 65-85% of calories from fat). With some people that needs to be <40g carbs, others <60g, others still can get away with <100g. But you go up with the carbs too much and reduce the fat you will lose this effect and you are worse off probably than a low fat high carb diet for those health markers.

So I would personally vehemently contest your notion that high fat diets increase insulin resistance. Unless you define high fat as 30-65% fat in which case I would agree. However, "proper" high fat (65-85% fat) will not increase insulin resistance, as a general rule.

J

 

[donnellysdogs]

Yes but what levels are actually defined as an intake of high fat or high protein or low carb? Does every research group use the same figures, do they actually also monitor carb intake etc.
until someone sits down and says these people ate xx for xx years never going above xx or below xx then we are all just guinea pigs in the world of medicine.
Great that research etc is being done, but believing it is truly accurate.. I don't know.. Do they include people that have smoked, have other diseases? Are all the patients completely honest with their foods?

I would love to pin some hope that one day there will be some 100% accuracy in medical research but me, at the moment I don't believe anything...

 

[Paul59]

High fat is not easy if you have to watch yr cholesterol lvls cause of blood pressure issues. Like myself.

 

[this is too difficult two]

Sid, I respect your opinion but will have to completely disagree with you on this point, and what this does is highlight the great mine field of dietary interpretation of scientific data with human studies.

The problems all come down to 2 things largely - 1) Time and 2) definition.

You see this a lot with short, small studies maybe for 2-3 weeks that look at high fat versus low fat diets and starting with people not keto-adapted. Keto-adaption in itself takes 2-4 weeks to kick in thus before that we see some negative aspects of the diet as your body adjusts from (often years of) burning carbohydrates as the main source of fuel, to primarily ketones from fat.

Secondly, and this is the biggest issue, is definition. The definition of "high fat" and "low fat" (and conversely for carbohydrate) is so utterly loosley defined that it is completely understandable how confusing this subject is. For example, given our society's view of fat, most people would consider a diet >25-30% fat to be high fat, and expect a low fat to be <20%. Usually, protein will be 10-20% so therefore the carb aspect will vary from 60-70% on a low fat diet to as much as 50-65% on a "low carb" diet!

And this is the kicker - the research on "proper" LCHF shows quite the opposite of what these definitions of high fat give. Thus a proper LCHF, which will consist of 65-80% fat, 10-25% protein and <15% carbohydrate (When I talk about % I mean calories, not % weight as obviously fat is 2.25x more calorie dense than protein/carb) is completely different than what a traditionalist might consider high fat - e.g. 35% fat, 15% protein, 50% carbs.

In the very high fat/low carb (say <50-60g carbs per day, with most calories coming from fat) what we find is dramatic and long-lasting improvements on insulin resistance. We see the exact opposite on a moderate (public view of "high") fat diet when carbs are >60-100g/day (will range from individual to individual whether this is >60 or >100....).

For example, see:
Boden G et al. Effect of a low carbohydrate diet on appetite, blood glucose levels, and insulin resistance in obese patients with type 2 diabetes. Ann Intern Med, 2005. 142 (6): p. 403-11
Forsythe, C.E etl al. Comparison of low fat and low carbohydrate diets on circulating fatty acid composition and markers of inflammation. Lipids, 2008. 43(1): p. 65-77

Etc. This is the problem with floating about terms such as "low carb" and "high fat" without any real definition attached to them. It is a problem why? Because the results are dramatically different dependent upon which definition you use! Yet still, we have this debate on-going because largely, even people in the research field do not seem to catch on to the need for an effective LCHF diet, (i.e. a beneficial diet very rich in fats must be very low in carbs so that you are primarily using fat as your energy source), to have usually <60g/day from carbohydrate sources, not simply <300g/day as some definitions of low carb use!

Such an approach that adopts very low carbs and very high fats actually has the benefits of:
- Reducing serum triglycerides
- Increasing HDL (good cholesterol)
- Increasing "good sized" LDL particles
- Improving LDL:HDL ratio
- Reducing markers of inflammation
- Reducing ROS (reactive oxidation species)
- Reducing risk of metabolic syndrome and T2 diabetes
- Halting/slowing progression of metabolic syndrome/T2D
- Reducing blood pressure

All of these things have links to various aspects of health improvement, in particular with regards to cardio-vascular risk and disease, therefore improving all of these markers is of huge benefit - and this is all in the non-diabetic largely. In the diabetic (T2) it will improve resistance, reduce the need for medicine, and help with weight loss if that is a goal (and overall calories are reduced - high fat helps with satiety so can be easier to stick to). In a T1, it can stabilise BS levels reducing the need for insulin and therefore improving HbA1c, reducing hypo episodes, and generally improving health.

But I must emphasise again - the above is only generally true in people who adopt a very low carb diet (<40-100g carbs per day and do not overdo the protein i.e. get main energy 65-85% of calories from fat). With some people that needs to be <40g carbs, others <60g, others still can get away with <100g. But you go up with the carbs too much and reduce the fat you will lose this effect and you are worse off probably than a low fat high carb diet for those health markers.

So I would personally vehemently contest your notion that high fat diets increase insulin resistance. Unless you define high fat as 30-65% fat in which case I would agree. However, "proper" high fat (65-85% fat) will not increase insulin resistance, as a general rule.

J

Well that's that solved then.

 

[JTL]

High fat is not easy if you have to watch yr cholesterol lvls cause of blood pressure issues. Like myself.

I have medication for high blood pressure.
I'm on the LCHF.
Blood pressures down cholesterol levels getting better .
BS under more control.
Losing weight.
Full of energy.

 

[douglas99]

it made mine better ..no ones IR/BG has gotten worse on LCHF that I know of. have a google of the subject

An interesting response.
If you low carb, how do you know your insulin response is better, as by definition low carb won't have an insulin response to speak of?
So, I guess the question we have is, what proof would you provide your insulin response is better?

Or are you becoming confused over BG, and insulin response, as they are two very different things?

 

[douglas99]

Consensus on this forum is that Diabetes UK is literally the devil conspiring with GPs to murder patients, so what's your point? We all "know" this

Well,to be honest, I have actually been to listen to the views of Diabetes UK, and the consensus of the one person that can actually say they have heard the views in person, is that the view above is completely off the mark, and not even close to what diabetes UK are actually saying, but it seems to be a good sound bite without any proof.
Correct me if I'm wrong, the ball is in your court here.

 

[douglas99]

Thanks. I'm into my second week now and I'm feeling so good. And best of all my blood sugars are down. Average 5 to 6 in the day....ive lost 8 lbs too.

To paraphrase.
Direct from the much maligned, mis quoted, or simply invented Diabetes UK.

If it works for you, and you're testing, and you can do it.
DO IT!
So you get on with it, and you will have the blessings of Diabetes UK.

And they're great numbers

 

[JTL]

I'm still on LCHF today my blood pressure medicine was put down from 10 mil to 2 n half mil.
Down to one Metformin a day.
Cholesterol right down and I don't take statins.
Wight down and BS under best control I've ever had.
I haven't gone on a LCHF diet I've changed my lifestyle choices to LCHF living.
Massive positive improvements all round.
The truth is right before the eyes of the people at my surgery who are a bit confused and concerned by the results they are recording and seeing.