PHE report recommends short-term low-carb diets to tackle Type 2 diabetes

27 May 2021 --- Following a low carbohydrate diet for up to six months can be an effective option in tackling Type 2 diabetes (T2D), according to a report released by the UK’s Scientific Advisory Committee on Nutrition (SACN).

The report, co-chaired by research charity Diabetes UK, is based on a “robust” assessment of existing evidence on weight change, blood sugar management, blood fats and medication use. 

It recommends that low carbohydrate diets can be an effective short-term measure for improving glycemic control and serum triacylglycerol concentrations in overweight people living with T2D. However, there was insufficient evidence that such diets can help T2D patients who were not overweight.

Overall, the report states that health professionals should “support any evidence-based dietary approach” that helps T2D patients achieve weight reductions, but emphasizes there is no evidence that low-carb diets are an effective long-term weight loss strategy.

The findings have been published by Public Health England (PHE), the UK government arm charged with protecting and improving health and well-being as well as reducing health inequalities. 

This follows a PHE review last year linking COVID-19 mortality with weight-related comorbidities, showing a significantly higher number of deaths among patients with diseases like T2D. 

COVID-19 deaths are ten times higher in countries where half the population is obese, according to the World Obesity Federation.Clear relation, unclear causation
The 350-page report concludes that for adults living with T2D or who are overweight or obese, there are clear, beneficial effects of a lower carbohydrate diet for up to six months for some of the outcomes considered, such as improving blood sugar management.

However, while people on lower carbohydrate diets lost more weight than those on higher carbohydrate diets in the first three months, this was not the case after that time period. Therefore, the report concludes it is unclear if the benefits of a lower carbohydrate diet are due to this early weight loss.

Overall, the quality of the evidence wasn’t strong enough to recommend a lower carbohydrate diet for longer than six months, says the report. 

Douglas Twenefour, co-chair of the joint working group and Deputy Head of Care of Diabetes UK, commented: “We know that for most people with T2D, managing their weight is key to managing their condition.”

“Health professionals should support any evidence-based dietary approach that helps achieve long-term weight reduction, and this can include a lower carbohydrate diet. It is vital that people get the support of their healthcare team so that any impact on diabetes management or medications can be closely monitored.”

Industry aid 
The report comes at a time when weight-related illnesses in the UK are at an all-time high, with the government announcing £100 million (US$141.7 million) earlier this month to mark World Obesity Day. The risk of death from COVID-19 is reportedly ten times higher in countries where over half of the population is obese, according to the World Obesity Federation. 

According to the UK’s Food and Drink Federation, the nutrition industry has a key role in aiding policy intervention in this area, which says it has long called for a holistic approach to address obesity and targeted support for those who most need it.

Lifestyle diets such as the ketogenic diet – which emphasizes low carbohydrate and high fat and protein consumption – are increasingly promoted by the industry as individualized regimens. Last year, NutritionInsight spoke with experts about the diet, observing a sharp rise in keto-themed NPD. 

Consumer caution 
Dr. Alison Tedstone, chief nutritionist at PHE, says the findings in the report are not clear-cut.

“SACN and Diabetes UK have thoroughly analyzed the evidence around this complex issue.” 

“It’s not clear whether a lower carbohydrate diet is effective in the longer term. We also don’t know whether it would work for all adults living with T2D, and not just those living with overweight or obesity.” 

She also urges caution for diabetic consumers who do choose to follow diets like keto, saying “adults living with T2D choosing a lower carbohydrate diet should aim to include wholegrain or higher fiber foods, a variety of fruits and vegetables and limit saturated fats.”

Edited

By Louis Gore-Langton