Friday, October 04, 2013

Sugar And Diabetes

Does eating sugar increase the risk for diabetes? It doesn't look that way:

A Prospective Study of Sugar Intake and Risk of Type 2 Diabetes in Women, Diabetes Care, 2003

Objective - To investigate prospectively whether intake of total or type of sugar (sucrose, glucose, fructose, and lactose) is associated with the risk of developing type 2 diabetes.
"In our large cohort of 38,480 initially healthy postmenopausal women followed for an average of 6 years, we accrued 918 incident cases of type 2 diabetes and found no definitive influence of sugar intake on the risk of developing type 2 diabetes.

Excluding subjects with hypertension and elevated cholesterol level, sucrose intake was inversely* associated with the risk of type 2 diabetes."
* An inverse relationship means as sugar intake went up, diabetes risk went down.

That was a big epidemiological study. Below is a tightly controlled intervention study on people with diabetes. Not only did a high-sugar diet have no influence on their diabetes, it improved their diabetes:

Improved Glucose Tolerance with High Carbohydrate Feeding in Mild Diabetes, New England Journal of Medicine, 1971

All subjects ingested formula diets consisting of:

Basal Diet:
  • 40% fat
  • 45% carbohydrate
  • 15% protein

High-Carb Intervention Diet:
  • 0% fat
  • 85% carbohydrate
  • 15% protein

After just 10 days, those on the high-carb diet experienced lower after-meal blood glucose (improved area under the curve in a 2-hour oral glucose tolerance challenge) than did those on the high-fat, basal diet. Lower insulin too:
"Fasting insulin levels also were lower on the high carbohydrate diet; however, insulin responses to oral glucose did not significantly change. These data suggest that the high carbohydrate diet increased the sensitivity of peripheral tissues to insulin."
The low-fat aspect of the high-carb diet likely contributed to lower blood glucose. Dietary fat increases insulin resistance. Notice that the high-carbers secreted less insulin ... even though they ate a lot more carb! So, it isn't just the amount of carbohydrate someone eats that controls how much insulin they secrete.

I've been saying this for years ... that the American diet presents a one-two punch. The high fat increases insulin resistance, and the highly-refined carbs dump glucose quickly and abundantly into a blood stream that can't clear it. A high-carb diet (vegetarian and vegan diets are typically high-carb) has to be accompanied by low-fat for it to be effective. Low-fat means 10% to 15% of calories coming from fat, not 30%. If you want to know how much fat you're eating, a program like the CRON-O-Meter can help. Diets that include a lot of meat, dairy, and added oil are usually high in fat.

Sugar And Diabetes, Part II
Study: People Who Eat More Sugar Weigh Less
Is Sugar All That Bad?

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