Diabetes and the Risk of Fad Diets
Plenty of popular gimmicks promise quick weight loss, but for people with diabetes, fad diets can be dangerous.
The famous Atkins high-protein/high-fat diet encourages eating red meat, full-fat cheese, chicken, bacon, fish and shellfish, butter, mayo, and olive oil. With Atkins, carbohydrates are severely restricted during the two-week induction period - which is intended to cause ketosis, a condition in which the body burns its own fat for fuel.
"Ketosis is not good for anyone, but especially if you have diabetes," Gidus tells WebMD. "Most people get into hypoglycemia before they even get to ketosis.
Atkins is "way too low in carbs," says Gidus, and the diet's high cholesterol and fat intake is another big problem, increasing the risk of heart disease. In addition, all that protein makes your kidneys work harder, which can worsen existing kidney problems.
"I definitely advise diabetes patients to stay away from Atkins," says Gidus.
Cutting carbs is a strategy for many dieters, and it's the cornerstone of the South Beach diet.
Like the Atkins diet, South Beach begins with a two-week induction period meant to trigger ketosis.
Simple carbs are forbidden, but "good carbs" are encouraged -- whole grains, vegetables, lean protein (fruits can be phased in after the induction). Unhealthy fats (including fatty meats) are banned. Most importantly, the diet does not leave out any major food groups.
"The South Beach diet is relatively healthy, since it just eliminates simple carbs," says Meneghini. "Many of my patients have discussed it with me. … For them, cutting those carbs might be an easier way of reducing overall calorie intake than reducing portions."
The first phase of South Beach is "too strict for diabetics," says Gidus. He recommends they avoid it. "But Phase Three, maintenance, is the type of food plan that I generally recommend … there's some good information there."
Glycemic index is a concept of controlling blood sugar based on the types of carbs you eat.
- High-glycemic-index foods -- such as white bread, rice, mashed potatoes, and most cold cereals -- cause a quick spike in blood sugar, so there's a burst of energy, then hunger again.
- Low glycemic index foods -- fruits, vegetables, beans, and whole grains -- cause levels to rise more slowly and last longer, so there's less hunger for a longer period.
"Glycemic index diets are very confusing, and they're not backed by the American Diabetes Association," says Gidus.
"There are several phases of these diets, where you're restricted to eating all green, all yellow, or all red foods," Gidus adds. "Mixing in other foods totally throws the whole thing off, but nobody eats just one food at a time -- which is why the ADA does not endorse it. You need to be aware of total carbs, that's what the science shows is most important."
Meal Replacement Diets
Meal replacement products -- like Slim-Fast diet shakes and snacks -- are another weight loss strategy.