Goals for high protein low carb diet

Diabetes is a metabolic disorder in which blood sugar remains high for prolonged periods. Beta cells of the pancreas produce the hormone insulin, which also carries blood glucose to cells for performing various functions. In type 1 diabetes, beta cells do not provide any insulin. In type 2, beta cells produce less amount of insulin, which takes a long time for glucose to get transported to cells.[1]

The World Health Organization estimates 425 million people globally are living with diabetes worldwide, and the number will swell to 629 million by 2045.[2]. This data is an alarming situation for the whole world.

Diabetes is responsible for the increasing number of deaths globally. Uncontrolled diabetes for prolonged periods can create various complications like cardiac diseases, hypertension, nephropathy, neuropathy, etc. Therefore, proper management of diabetes with conventional drugs, a well-balanced diet followed by exercise regime should be the target goal to lead a healthy life.

Role of diet in diabetes

Diet management in diabetes plays a very crucial role. Proper selection of foods from various food groups is a significant challenge depending on the case. Requirements of macronutrients like energy, proteins, and fats differ according to a specific situation. Similarly, the needs of micronutrients like vitamins and minerals also vary.


Main goals to achieve in diabetes through dietary modifications are:

●      Regulation of blood glucose levels

●      Prevention of Hypoglycemia

●      Prevention of significant complications related to diabetes, like neuropathy, nephropathy, retinopathy, dyslipidemia, foot damage, cardiovascular disease, and hypertension.

●      Improve on overall symptoms of diabetes [4]


See: Chickpea Patty high protein snacks for diabetics

How does high protein and low carbohydrate diet help diabetics?

Role of Carbohydrates and Proteins in a diabetic diet:

The benefit with a low-carbohydrate/high-protein diet is that it removes, or restricts, refined carbohydrates. These refined carbs in white bread or white rice give you a sugar uptick. By reducing these kinds of carbohydrates, the blood glucose and insulin levels could be better regulated. Furthermore, there are other possible health benefits, such as weight reduction and decreased blood-triglyceride levels. 

Carbohydrates and proteins are significant macronutrients required for their unique purpose in our bodies. Carbs provide the primary source of energy for performing various daily functions. We consume multiple types of carbohydrates in our diet, which include simple carbs and complex carbs. The big difference between simple and complex carbs is how quickly they are broken down and absorbed. Simple carbs like glucose, fructose, and galactose raise blood sugar rapidly, whereas complex carbs like starch and glycogen take a longer time. 

According to the National Health Services, adult men should consume less than 70g a day of sugar and under 50g of sugar a day for women. However, diabetic people will benefit from better blood glucose levels if sugar intake can be limited to lower levels.[4]

●      Complex carbs like starch, dextrin, and glycogen take a prolonged time to break down sugar and therefore proves a better option for people with diabetes. Examples include fiber-rich foods like salads, whole wheat products, grains, and oats.

●      Proteins are one of the three energy-providing macronutrients along with fat and carbohydrates. 1gram protein gives four kcals, which is similar to that of carbs.

●      The primary function of protein is tissue buildup and regulation of various enzymes and hormones. 60-70 % of the proteins get converted into glucose and enters blood bloodstream after 3-4 hours.[5]


However, the downside to the carb-free or very-low-carb diets is that in removing all or many carbohydrates, you do so at the cost of some healthier carbs, which are found in fresh fruits and vegetables and whole grains such as brown rice and whole-grain bread. One helpful way to rate carbs is the glycemic index (GI), a measure of how fast blood sugar increases when you eat specific foods. Low GI foods have a little effect on blood glucose and comprise most whole grains and veggies, together with many fruits. High GI raises blood glucose quickly; these foods comprise white, processed grains/starches, juices, and soda.


●      Proteins are the building bricks of our bodies. Various studies have shown that if proteins added to meals of diabetic people slow the breakdown of glucose from it. 

●      Weight loss and better blood glucose control results from diets rich in high-protein, low-carbohydrate. The advantage of the high-protein, low-carbohydrate diets is that it eliminates a whole category of nutrients. In this case, carbohydrates are lower in calories and so result in weight loss. This weight reduction can prove beneficial to those with a BMI above 27.

●      Taking high protein intake and strict limitation of carbohydrate, water stored with glycogen (carbohydrate) is released, which gives faster results. However, stored fat is not lost. Fasting ketosis may also result due to loss of appetite. 

●      Furthermore, with a high-protein diet, weight is lost, insulin needs drop, and blood glucose and sometimes even lipid levels often improve.[5]

●      However, restricting carbohydrates to less than 20grams in a meal can lead to ketosis. Ketosis is a condition in which due to less supply of carbs for energy production, fats start to break down for fulfilling the energy requirements and begin building ketone in the body. 

●      This condition can be fatal for people with diabetes and can cause Diabetic ketosis leading to diabetic coma and, possibly, death.

●      Avoid any kind of fad diets claiming weight loss in 7 days or superfoods for diabetics since they can lead to health damage.


The fast, higher jolt in blood glucose from high GI foods induces higher insulin levels. Insulin is a hormone that causes appetite by taking the sugar from your blood and giving it to your cells to use as energy or stored as fat. Since the blood glucose from high GI foods disappears faster (it is turning into fat), these foods cause less fullness and satisfaction, which may result in overeating, greater caloric consumption, and, ultimately, weight gain.


See: Fight diabetes & obesity with Strawberry Choco Lassi

Sample diet plan for Diabetics (high protein low carb)

SAMPLE INDIAN DIET PLAN FOR DIABETICS- HIGH PROTEIN LOW CARB 

Early Morning

●      Overnight soaked fenugreek seeds- 1 tbs

After 20 mins

●      Plain tea/ Green tea/ mild coffee- 1 cup


Breakfast (after 45 mins) 

●      Veg Poha/upma- 1 bowl (60g cooked)

●      Oats/ Muesli/ sorghum flakes with milk – 2 bowls

●      Paratha (Paneer/ fenugreek/ spinach/ cabbage or 

mix veg) - 2 medium size                                                          

●      Egg whites- 2

●      Dalia ( broken wheat)- 1 bowl with milk


Mid-morning

●      Fruit-1 (Apple/ orange/papaya/pear/ guava)


Lunch

●      Whole wheat plain roti- 2 medium size

●      Whole pulse salad or daal- 2 bowls (whole green gram/ whole moth beans/ whole rajma/ whole black gram)

●      Veg- 1 bowl ( all except potato/ yam)

●      Veg salad- Tomatoes/ cucumber/ carrot 25g grated – 1 bowl with curd mixed in it 

●      OR Low-fat Curd – 1 bowl


Evening Snack

Plain tea or green tea with a roasted snack like 

●      Makhana

●      Puffed rice

●      Puffed Sorghum flakes

●      Roasted chana/ peanuts


Soups before dinner 

●      Daal soup 

●      Mix veg soup

●      Lemon coriander 


Dinner 

●      Dalia khichdi ( Broken wheat )- 1 bowl with curd or buttermilk and Sprout salad- 1 bowl

●      Paneer Paratha- 2 medium size with curd- 1 bowl and Veg salad- 1 bowl

●      Lean chicken grilled – 60gm cooked form with veg Salad- 1 bowl

●      Fatty fish curry – 2 nos with two med size Rotis plain with veg salad- 1 bowl

●      1 Bowl- 50 gm cooked form

●      Oil: Refined sunflower/ corn/ groundnut/ safflower/ soybean oil- To be changed every month.

●      Extra virgin olive oil may be a better choice for salads if needed.

●      Avoid extra salt and sugar in any meal. 

See: Diabetic Shock or Severe Hypoglycemia

Ideal meal plan tips

Ideal plan tips when considering high protein low carb diet


●      Diabetes is a complex metabolic condition that can lead to further complications if not controlled. Therefore, talking about low carb and high protein diet concept sounds good for only those who are seeking for weight loss also along with sugar control.

●      Ideally, a low carb diet in case of people with diabetes means to have complex carbohydrates like more fiber in meals like salads, sprouts, whole grains, whole cereals. Fewer carbs slow down the glucose uptake, and insulin will have more time to carry it. This change is how peak glucose uptake will be maintained.

●      Studies published in the American Diabetes Association showed that there was no significant effect on blood glucose levels when people consumed animal-based proteins like meat, chicken, eggs, or plant-based proteins like dairy, soy products.[6]

●      However, animal proteins should be taken in limitation because they can lead to raised lipids developing cardiovascular disease. Plant proteins are not only rich in functional quality proteins but also a significant source of antioxidants, fiber, minerals, and vitamins.[7]

See: Asparagus soup for diabetes type II diet

Summary

High protein low carbohydrate diet shows positive results in maintaining blood glucose levels in diabetic people. However, one should not consume less than 20 grams of carbs, or else one can develop diabetic ketosis. If taken for prolonged periods can result in weight loss, so as per case quantity and quality of carbs should be watched. Animal-based or plant-based proteins show no specific effect on blood sugar levels. However, plant-based proteins are safer than animal proteins because many animal proteins can cause dyslipidemia.


References

1. Diabetes,  Medline Plus, US National library of medicine retrieved from

https://medlineplus.gov/diabetes.html#summary 

2. World Health Organization Sept, 2019 retrieved from

https://www.statista.com/topics/1723/diabetes/

3. Nutrition Principles and Recommendations in Diabetes, American Diabetes Association, Diabetes Care 2004 Jan; 27(suppl 1): s36-s36.

https://care.diabetesjournals.org/content/27/suppl_1/s36

4. Diabetes.co.uk retrieved from 

https://www.diabetes.co.uk/nutrition/simple-carbs-vs-complex-carbs.html

5. Diabetes Spectrum, Volume 13 Number 3, 2000, Page 132,Protein Controversies in Diabetes

6. Animal Versus Plant Protein Meals in Individuals With Type 2 Diabetes and Micro albuminuria, Effects on renal, glycaemic, and lipid parameters, Diabetes Care 2002 Aug; 25(8): 1277-1282. Retrieved from https://care.diabetesjournals.org/content/25/8/1277

7. Retrieved from 

https://www.webmd.com/diabetes/news/20190725/plant-based-diet-helps-keep-diabetes-at-bay#1

8. Harvard Health, https://www.health.harvard.edu/healthy-eating/low-carb-high-protein-diets

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