Just like everybody else, a 65-year-old Pune businessman thought a calorie-restricted, low-carb diet would help him rein in his diabetes. Moderately obese, he relied on medication and packed in some exercise on days he could make time from work. But with his HbA1c (average blood sugar count of three months) on the rise, he thought a low-carb diet would do the trick. Instead his sugar levels started spiking and left him dejected.
That’s because a balanced diet, and not a fad diet, alone can work in diabetes management. That too with equal weightage given to lifestyle correction and exercise as the other two pillars in the pyramid. In fact, experts say that exercise, not diet, should be the first line of action to increase insulin sensitivity. And in the long-run, diets have to be tailored to the requirements of patients. “There is no one-size-fits-all pattern. The diet has to be sustainable and based on individual requirements. It also boils down to common sense and the need to reduce portions and calories. Ideally, it is a diet planned by a nutritionist in consultation with a doctor. A ten-day enthusiasm with a fad diet does not work,” says Dr Uday Phadke, Director, Head of the Department of Endocrinology and Diabetes at Sahyadri Group of Hospitals.
Why FAD diets don’t work
Each fad diet – low-carbohydrate, low-fat to high-protein – has its shortcomings. A person’s calorie requirement depends on his weight, height, level of activity, current diet and stage of diabetes (whether it is prediabetes or the abnormally high blood sugar range). It also depends on whether the person has high cholesterol levels or any other ailment. “For instance, if the person is pre-diabetic and wants to eat once a day and/or follow a twice-a-day meal pattern, then I am okay with it. The goal is to reduce weight and according to various trials, even if the carbohydrate content is reduced by ten per cent it goes a long way in reducing weight and sugar levels,” Dr Phadke adds. But this would not apply to those battling stubborn levels of blood sugar and who take insulin three times a day.
Often the simplest dietary correction, like substituting simple refined carbohydrates with complex carbohydrates, works. “These take time to get absorbed and cause fewer spikes in sugar levels. Mixed with fibre-rich foods, the glycemic index of the meal is lowered further. If the person is used to having an evening snack (for example) he/she is bound to feel hungry if that is cut down. It needs to be replaced accordingly,” he adds.
Risks of fad diets
There are risks with fad diets. A keto diet may lead to excess ketones (substances that your body makes if your cells don’t get enough glucose) which could lead to diabetic ketoacidosis (DKA), even coma. Vegan diets are not recommended for people with diabetes as they need meticulous planning to avoid nutrient deficiencies like vitamin B12, vitamin B6, niacin, iron, calcium, omega-3 fats, iodine, and zinc, which are all more prevalent in animal foods. This may not be sustainable on a daily basis.
Diet cannot replace medication
Food psychologist Dr Kinjal Goyal has many patients with diabetes who mistakenly think that a fad diet would work longer and reduce their dependence on medication. “When diets don’t work, dejection can set in and the patient may not even want to work out or become careless about medication. Drugs should not be stopped even if they are on a new diet,” he advises.
Only a holistic plan works
The Singapore Medical Journal, in its May issue, said, “Healthy eating, regular physical activity, smoking cessation and weight loss, complemented by pharmacotherapy are the key components of diabetes management.” That’s why an individual diabetes education model works best.
© The Indian Express Pvt Ltd
First published on: 20-12-2023 at 15:11 IST
Rohit Malhotra is a medical expert and health journalist who offers evidence-based advice on fitness, nutrition, and mental well-being. His articles aim to help readers lead healthier lives.
