Mar 24th 2017

How the right diet can control diabetes and reduce its massive economic costs

by Chris Proud, Grant Brinkworth and Manny Noakes

Chris Proud is Theme Leader, Nutrition and Metabolism, South Australian Health & Medical Research Institute. Grant Brinkworth is Senior Research Scientist in Human Nutrition, CSIRO Manny Noakes is Professor of Nutrition & Research Director for the Food and Nutrition Flagship , CSIRO

More than 350 million people worldwide suffer from type 2 diabetes. The condition is already rampant in several Western countries and numbers are now rising fast in emerging economies, such as India and China. But the right kind of dietary changes could dramatically reduce the impact of the illness on both patients and economies.

Alongside the impact of the disease and its associated complications on the lives of patients and their families, diabetes’ cost to health-care systems is huge. In Australia, for example, the total economic impact of type 2 diabetes is estimated at A$10.3 billion, while in the United States it is likely to exceed US$174 billion.

There are many ways to beat diabetes or reduce its impact; the key is making changes to your diet and lifestyle that you then follow for life. Indeed, lifestyle modification – eating a healthy diet and exercising regularly – is the cornerstone of any effective diabetes-management plan.

More than sugar

For decades now, the general recommendation has been for everyone to cultivate a high-unrefined-carbohydrate, low-fat diet. More recently, reducing sugar intake, even though it is one of the most popular carbohydrates, has been receiving a lot of attention. But a healthy eating plan for diabetes is not just about cutting out sugar. And scientific opinion is now turning in favour of lower carbohydrate diets – for everyone.

While excessive sugar will no doubt increase blood sugar levels, especially if you’re having sweetened drinks, any source of carbohydrate will have the same effect. This includes anything that contains flour, rice or pasta, as well as fruit and potato.

Eating foods like this will only increase the risks of diabetes and its associated complications. Josephine Stenudd/Flickr, CC BY

Carbohydrate foods with a low glycaemic index (GI), such as oats and legumes, on the other hand, will dampen down the blood sugar response. That’s why careful carbohydrate selection is now recommended for everyone, especially people who have type 2 diabetes.

New data from high-quality nutrition research now strongly suggests that restricting carbohydrates even further, while moderately increasing protein and unsaturated fat intake, may have further benefits for controlling type 2 diabetes and reducing the risk of complications.

What we did and found

Based on these ideas, our research teams have been studying the effects of a “Mediterranean” diet – which has low carbohydrate, high protein and includes a lot of vegetables, nuts, lean meats and healthy fats – in combination with an exercise plan. We wanted to see how much we could improve the health of people with type 2 diabetes.

We assigned 115 adults with type 2 diabetes to one of two weight-loss programs. One group followed a very low-carbohydrate and high-protein diet for 24 weeks. The other had a higher carbohydrate, but still low GI, diet.

Early results have been ground-breaking; our diet is better at improving diabetes control compared to traditional weight-loss diets. But its most striking benefit is that it reduces the amount of medication someone with diabetes has to take by half. This reduction was three times greater than for people who followed the lifestyle program that incorporates a traditional high-carbohydrate diet plan.

Our very low-carbohydrate diet also improved blood cholesterol profile by increasing the levels of good (HDL) cholesterol and decreasing triglyceride (blood fat) levels to a greater extent than the traditional high-carbohydrate, low-fat diet. Both diets achieved similar reductions in bad (LDL) cholesterol levels – often a concern with some low-carbohydrate diets.

There’s more

Variation of blood glucose levels through the day is emerging as a strong independent risk factor for diabetes complications. In our study, the very low-carbohydrate diet was also more effective in reducing the number and levels of blood glucose variations over a 24-hour period.

In 2008-09, of the estimated A$1,507 million spent on the health care of diabetes in Australia, A$490 million was spent on diabetes-related medications. Our findings suggest that, by implementing a lifestyle program incorporating a healthy low-carbohydrate, high-protein, high-unsaturated-fat diet at a national level, the country could save up to A$250 million annually through reductions in diabetes-related medication alone.

This does not even account for any additional cost savings that could be generated from the marked improvements in diabetes control and patients’ well-being. It is these costs – related to the complications of diabetes and patients’ ability to contribute to the economy – that account for most of the economic impact of type 2 diabetes.

Our research shows evidence from the latest nutrition science can guide dietary approaches to tackling one of the most serious global health challenges of this century.


This article was originally published on The Conversation. Read the original article.

Browse articles by author

More Essays

Nov 18th 2020
EXTRACT: "Here are just a few ways exercise changes the structure of our brain."
Nov 15th 2020
EXTRACT: "Perhaps it is Piller’s discovery that when it comes to war there is no such thing as innocence...."
Nov 4th 2020
EXTRACT: "I imagined America as the land of the free that gave voice to the forgotten. Where race, color, and creed do not matter and human rights are guarded with zeal. Where the ingathering of all cultures and people made it richer and human resources and talent knew no limits or constraints. Where opportunity awaits the able and generosity is extended to the needy. Where everyone is equal before the law and political differences are valued to make America better. Where sacrifices are willingly made to right the wrong morals and fortitude guide its leaders. Where caring about friends and allies is the hallmark of the nation and opposing oppression near and far is the emblem that distinguished America. This is the character of America. This is the soul of America. This is what made America great. The America that gave me a home. The America that fulfilled my dreams."
Oct 15th 2020
EXTRACT: "“The paintings which I propose to do will depict the struggles of a people to create a nation and their attempt to build a democracy” – this is how Jacob Lawrence described his project in 1954. Over sixty-five years later his proposal has, if anything, become only more urgent. Two days after this exhibition closes, Americans will vote in what is arguably the most significant election in a generation, an election that will measure our commitment to preserving that democracy, the struggle for which was Lawrence’s mighty theme."
Oct 15th 2020
EXTRACT: "There are also other ways our life stories can be passed down through generations, besides being inscribed in our DNA...... One 2014 study looked at epigenetic changes in mice. Mice love the sweet smell of cherries, so when a waft reaches their nose, a pleasure zone in the brain lights up, motivating them to scurry around and hunt out the treat.... The researchers decided to pair this smell with a mild electric shock, and the mice quickly learned to freeze in anticipation....... The study found this new memory was transmitted across the generations. The mice’s grandchildren were fearful of cherries, despite not having experienced the electric shocks themselves. The grandfather’s sperm DNA changed its shape, leaving a blueprint of the experience entwined in the genes."
Oct 1st 2020
EXTRACT: "As we Americans face the potential loss of a peaceful transition of power after the election and the possible end of democracy as we know it, we are reminded that discourse matters, that words matter and that the one who quotes poetry is a man who reads—and that matters."
Sep 25th 2020
EXTRACT: "We now know the potentially appalling long-term effects of suffering cruelty from others, including damage to both physical and mental health. The benefits of being compassionate towards oneself, rather than treating oneself cruelly, are also increasingly recognised..... And the idea that we must suffer to grow is questionable. Positive life events, such as falling in love, having children and achieving cherished goals can lead to growth..... Teaching through cruelty invites abuses of power and selfish sadism. Yet Buddhism offers an alternative - wrathful compassion. Here, we act from love to confront others to protect them from their greed, hatred and fear. Life can be cruel, truth can be cruel, but we can choose not to be."
Sep 19th 2020
EXTRACT: "Over his incredible career, David Attenborough has seen more of earth’s natural wonders than almost anyone. To hear him talk, with such clarity, about how bad things are getting is deeply moving. Scientists have recently demonstrated what would be needed to bend the curve on biodiversity loss. As Attenborough says in the final scene, “What happens next, is up to every one of us”. "
Sep 15th 2020
EXTRACTS: "The Anglo-Australian multinational company Rio Tinto – the largest iron ore mining company in the world – demolished two 46,000-year-old Aboriginal rock shelters in May.......The Dampier Archipelago of Western Australia is home to thousands of Aboriginal pictographs, and perhaps the oldest surviving rock art in the world. Indeed, Australia’s Indigenous art represents the longest uninterrupted tradition of art in the world – going back over 50,000 years......Aboriginal people represent the oldest continuous culture in the world...."
Sep 13th 2020
EXTRACT: "Iran’s 1979 Islamic revolution was a defining event that changed how we think about the relationship between religion and modernity. Ayatollah Khomeini’s mass mobilisation of Islam showed that modernisation by no means implies a linear process of religious decline.....Reliable large-scale data on Iranians’ post-revolutionary religious beliefs, however, has always been lacking...........In June 2020, our research institute, the Group for Analyzing and Measuring Attitudes in IRAN...conducted an online survey......The results verify Iranian society’s unprecedented secularisation."
Sep 12th 2020
EXTRACT: "Just as you can upgrade your old computer’s operating system, culture can evolve even if intelligence doesn’t. Humans in ancient times lacked smartphones and spaceflight, but we know from studying philosophers such as Buddha and Aristotle that they were just as clever. Our brains didn’t change, our culture did."
Sep 2nd 2020
EXTRACT: "Our lab in Cambridge, England, is working with a promising new family of materials known as halide perovskites. They are semiconductors, conducting charges when stimulated with light. Perovskite inks are deposited onto glass or plastic to make extremely thin films – around one hundredth of the width of a human hair – made up of metal, halide and organic ions. When sandwiched between electrode contacts, these films make solar cell or LED devices."
Sep 2nd 2020
EXTRACT: "Bryant, a black man, was sentenced to life in prison for trying to steal hedge clippers from a Louisiana carport storage room in 1997. He has already served twenty-three years for this petty crime, and on 31 July the Louisiana Supreme Court denied a request to review his life sentence. The denial followed a lower appeals court’s 2019 decision that concluded “his life sentence is final.” The only judge on the Louisiana Supreme Court to dissent (or even issue an opinion) was Chief Justice Bernette Johnson. She wrote a stinging rebuke, observing that Bryant’s “life sentence for a failed attempt to steal a set of hedge clippers is grossly out of proportion to the crime and serves no legitimate penal purpose.” "
Aug 18th 2020
EXTRACT: "In 2016, the Brennan Center for Justice reported that as high as 40 percent of prisoners should not be in prison—”behind bars with no compelling public safety reason.” There are literally thousands of young prisoners, Black and white, who are serving life sentences without the possibility of parole for non-violent offences. It is unfathomable that we as a society are spending billions of dollars every year to sustain such pointless cruelty, to inflict needless pain on individuals, fathers and mothers, who pose no threat at all to the public."
Jul 31st 2020
EXTRACT: "From a Kantian standpoint discrimination based on race – or religion, or gender – is fundamentally wrong. It is wrong, first of all, because it is dehumanizing, a denial of human dignity. When I racially discriminate, I am denying the person’s intrinsic self-worth, I am, in fact, denying their very right to exist, whether I know it or not. The moral law demands that I treat every individual as a free person equal to everyone else. If the moral law grants each of us a kind of infinite worth, it does not grant someone greater worth than anyone else."
Jul 12th 2020
EXTRACT: "Remember, your wellbeing is extremely important when supporting someone with depression. Take time for self-care so you can model positive behaviours and be replenished enough to provide this crucial support."
Jul 4th 2020
EXTRACT: "--- Nobody is more dangerous than he who imagines himself pure in heart, for his purity, by definition, is unassailable. --- Author James Baldwin’s words, written in the America of the late 1950s."
Jun 29th 2020
EXTRACT: "Numerous studies have shown that children who grow up in more deprived neighbourhoods tend to have worse physical health as adults compared to those raised in more affluent areas. This is the case even when researchers take into account family income and education, and whether or not parents have major illnesses. In order to address this health disparity, researchers need to understand how those living in disadvantaged neighbourhoods end up with worse health outcomes. Our team’s latest study has highlighted one potential way your childhood neighbourhood may influence your health for years to come. It might do so through changing how the activity of your genes is regulated."
Jun 29th 2020
EXTRACT: "Ruth Poniarski is a painter and the author of Journey of the Self: Memoir of an Artist (Warren Publishing, 2020), in which she tells the story of her decade long struggle with mental illness, a “spiraling malady” which led her into a “pattern of psychosis”. I recently had the opportunity to talk with Poniarski about her life and work, and how she eventually overcame her demons."