MONDAY, March 20, 2023 (HealthDay News) — Cutting back on some carbs could help people with type 2 diabetes live longer — as long as they swap sugar for vegetables instead of steak, new research suggests.
The study, of more than 10,000 American adults with type 2 diabetes, found that those who ate relatively fewer carbohydrates were less likely to die in the next 30 years, compared with those with a greater taste for carbohydrates.
But the quality of those low-carb diets was key: People who ate a moderate amount of carbs but still ate plenty of vegetables, fruits, high-fiber grains, and beans tended to live longer, compared with people on high-fiber diets. in carbs.
Then there were the people on low-carb diets that were high in meat and dairy. They saw no such survival advantage.
Experts said the findings, published in the April issue of diabetes care, endorse a familiar dietary advice: limit sugar and highly processed foods, and eat more plants.
More than 37 million Americans have diabetes, the vast majority of whom have type 2, according to the US Centers for Disease Control and Prevention. Type 2 diabetes arises when the body loses its sensitivity to insulin. , the blood sugar regulating hormone.
The disease is often linked to obesity, and changes in diet, exercise, and weight loss are the cornerstones of managing it.
Low-carb diets are often promoted for weight loss and blood sugar control. But popular diets that strictly limit carbohydrates, such as the keto diet, are very difficult to maintain over time, said study author Yang Hu, a research associate at the Harvard TH Chan School of Public Health.
Also, Hu said, not all carbohydrates are created equal. Avoiding sugar and starchy foods like white bread and processed snacks makes sense, especially for people with diabetes.
“But there are also plenty of healthy carbohydrates, such as vegetables and fiber-rich whole grains,” Hu said.
So he and his colleagues wanted to look at how people with diabetes actually eat over the long term, including the quality of their carbohydrate choices. They drew on data from two long-running studies of US health professionals and focused on more than 10,000 participants who developed type 2 diabetes after the start of the studies.
Every few years, the participants filled out detailed dietary questionnaires. From there, Hu’s team devised five different scoring systems: One was based on the simple amount of carbohydrates people ate each day; the other four focused on the quality of people’s low-carb eating patterns, whether they continued to eat healthy plant-based carbohydrates or preferred meat and other animal products, for example.
Over a 30-year period, just under 4,600 study participants died. But those odds were lower among people whose diets were relatively lighter in carbohydrates. When the researchers delved into diet quality, only diets low in carbohydrates and high in plant foods appeared protective.
People who scored in the top 20% for a healthy low-carb diet (high in plant foods, low in sugar and starch) were about 30% less likely to die during the study period, compared with those who scored in the top 20%. people who scored in the bottom 20%
It’s important to note that people’s diets weren’t really that low in carbs, said Julie Stefanski, a registered dietitian and certified diabetes educator.
Even those who scored in the top 20% for restricting carbs typically got about 40% of their daily calories from carbs. That’s way more than strict low-carb diets allow.
That more relaxed perspective on carbohydrates is also necessary to include enough nutrient-dense plant-based foods, said Stefanski, a spokesman for the Academy of Nutrition and Dietetics.
“We know that people with diabetes need to watch their carbohydrate intake,” Stefanski said.
But he added that it’s also clear that nutrient-dense, high-fiber plant foods have a host of health benefits.
Stefanski noted that the study group was mostly white and comprised of higher-income and educated health professionals. In the real world, many people managing type 2 diabetes cannot easily find and afford fresh, healthy food.
There are ways to make it more feasible, Stefanski said, like buying frozen vegetables to keep on hand. You can have a healthy low-carb breakfast, for example, by mixing some spinach with eggs, he said.
Ultimately, Stefanski said, there is no one diet that works for everyone. People with diabetes who need help putting together a diet that’s healthy, affordable and tasty can ask their doctor for a referral to a dietitian, he said.
However, diet is only part of the story. In this study, Hu’s team found that the link between healthy eating and longer life was stronger among people who also exercised regularly, abstained from smoking and kept alcohol consumption to a moderate amount.
The Academy of Nutrition and Dietetics has more about diabetes prevention and control.
SOURCES: Yang Hu, PhD, research associate, nutrition, Harvard TH Chan School of Public Health, Boston; Julie Stefanski, MEd, RDN, spokesperson, Academy of Nutrition and Dietetics, Chicago; diabetes care, April 2023