A recent study suggests that individuals with type 2 diabetes might benefit from substituting some dietary carbohydrates with protein and fat to improve their cholesterol levels. This research highlights that a carbohydrate-reduced high protein (CRHP) diet could potentially lower triacylglycerol-rich lipoproteins (TRLs), apolipoprotein B, and low-density lipoprotein (LDL) cholesterol. As people with type 2 diabetes are at an increased risk of developing high cholesterol—a significant risk factor for heart disease—this finding could have important implications for dietary recommendations.
The CRHP diet, as proposed by the study, involves consuming 30% of calories from carbohydrates, 30% from protein, and 40% from fats. This stands in contrast to the conventional diabetes diet, which typically comprises 50% of calories from carbohydrates, 17% from protein, and 33% from fats. The research aligns with previous findings, including a January 2023 study that reported 51% of participants achieved type 2 diabetes remission following a low-carb diet.
The October 2024 publication further supports the potential benefits of a low-carbohydrate diet, indicating improved beta-cell function in individuals with type 2 diabetes. Traditionally, experts have advocated a high carbohydrate and low-fat diet for managing type 2 diabetes. However, emerging evidence suggests that a low-carbohydrate, high-fat diet may offer health benefits for these individuals.
Monique Richard, MS, RDN, LDN, provides practical dietary advice for individuals considering this approach. She recommends using alternative toppings other than butter, cheese, and bacon when consuming potatoes. Richard also suggests replacing pasta with options like spaghetti squash, cauliflower, or shirataki noodles to significantly decrease carbohydrate intake while adding nutrients.
“Cutting out carbs completely typically is not beneficial in the long-term either. We need carbohydrates for fuel, for brain health, for fiber, for numerous reasons. However, it is about the type, the amount, and the quality of carbohydrates needed alongside protein and fat per individual that can make a significant difference.” — Monique Richard, MS, RDN, LDN
Richard emphasizes that individuals with type 2 diabetes should not feel overwhelmed by dietary choices as "nothing is off the table" in terms of carbohydrates. The key is understanding portion sizes and how specific foods affect blood glucose levels.
“When educating my clients and patients on carbohydrates I let them know that ‘nothing is off the table’ (pun intended). It is all about understanding portion sizes as well as how that food acts in your body. One individual with diabetes may have a very different blood glucose reaction from pizza compared to another individual with diabetes,” — Monique Richard, MS, RDN, LDN
Yu-Ming Ni, MD, acknowledges the novelty of the study’s findings but cautions that they require further investigation. He points out that low carbohydrate diets generally lead to higher fat intake, which can increase cholesterol levels. Therefore, the results of this study challenge conventional wisdom and warrant additional research to determine if they translate into reduced cardiovascular disease risk.
“Usually low carbohydrate diets come with higher fat intake (and) that higher fat and cholesterol intake tends to lead to higher levels of cholesterol, so this finding would be a little bit unusual. I’d like to see it replicated in larger studies, but whether that actually leads to a reduction in cardiovascular disease is debatable, because we do know that generally higher carbohydrate, lower fat diets such as the Mediterranean diet tend to be a little bit more healthy and have lower rates of cardiovascular disease. My first reaction is definitely interesting and probably needs follow-up.” — Yu-Ming Ni, MD
The study adds to a growing body of literature exploring dietary interventions for managing type 2 diabetes. As researchers continue to investigate the potential benefits of low-carbohydrate diets, individuals with type 2 diabetes are encouraged to consult healthcare professionals before making significant changes to their dietary habits.
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