Here's an interesting take on low carb eating for diabetics - found on the Diabetes NZ Website. It starts off with this case study:

"I've followed a low carbohydrate diet for a few months and my blood glucose levels have never been better. I used to eat 10 slices of bread each day but now fill up on protein and fat instead. I feel full for longer without the high blood glucose levels I once had. My daughter is also finding this a helpful way to control her weight. Why doesn't Diabetes New Zealand promote low carbohydrate diets?"

Then the explanation begins as to why diabetes NZ doesn't promote low carb diets, at first urging us to look at the big picture. Ok then, let's do that:

1. Severely restricting carbohydrates means giving up foods that are major sources of important nutrients.

My (CZ) comment: So? As long as we find those nutrients from other food sources, we'll be "sweet" for want of a better word!

2. As well as in bread, carbohydrate is found in cereals, rice, legumes, pasta, starchy vegetables, milk products and fruits which provide specific vitamins, minerals, fibre and antioxidants.

CZ: Great, no-one's arguing this and in the recent Ministry of Health promotion of "whole foods, let's focus on these, which means getting the best quality nutrients from the lowest carb load i.e., vegetables (yes, including starchy), some fruit (not loads), legumes, and dairy (whole foods of sorts, you can actually make it in your kitchen!)

3. Eating more protein and fat may increase your risk of heart disease in the long term.

CZ: Errrrr, time to revisit the literature, plus who says higher fat has to be saturated fat anyway?

4. Carbohydrate restriction is necessary for people with diabetes and you need to establish the amount with your health care team.

CZ: Yes exactly - Brilliant, now we need to convince the dietitian and health care team that eating 100g of carbs per day or less is easy, nutrient-rich, and works.

5. Recent research shows low carbohydrate diets do help some people to lose weight in the short term. However, after one year the benefits are no different than for those who have used more conventional weight loss diets.

CZ: Not according to the A to Z study

6. There are some risks involved with low carbohydrate diets.

CZ: ...and these are??

7. Low carb diets are certainly not recommended for growing children.

CZ: Why ever not? A whole food, nutrient-rich way of eating is great for children, even growing ones! Funnily enough, the main nutrients needed for actual growth come from protein-based foods and dairy products, not packaged pasta, rice, muesli bars or cereal!

8. Such a diet needs to be carefully managed.

CZ: Yes, yes, great comment, I totally agree, and that's our job as dietitians, to help with this part of it - that's precisely what we are trained to do!

9. You can improve your blood glucose level by: Eating a variety of wholegrain and unprocessed foods....

CZ: This depends, if you eat a shocking diet that mimics the Standard American Diet, then yes, you would most definitely improve your blood sugars by eating a variety of wholegrain and unprocessed foods. But what if you're already doing this? If you take the Ministry of Health guidelines of 6 whole grains, 2+ fruit, 3+ veg, 2+ dairy, and discretionary sugar (accounting for about 10% as per WHO guidelines) what you end up with is a high carb diet, and in my opinion NOT best practice for a group of people who have trouble handling carbs and want to minimise the amount of medication they take.

...and finally...

10. A low carbohydrate diet is not the answer for most people with diabetes.

CZ: A total contradiction to the comment at the start: "Carbohydrate restriction is necessary for people with diabetes"

PLEASE NOTE: I am an advocate of a low(er) carbohydrate, high(er) fat diet for people with diabetes. Of course this needs close monitoring and supervision, as it may also likely involve a reduction in medication. Bottom line, the curious diabetic is going to try this anyway. We as dietitians NEED to pull our heads out of the sand, do our homework and get prepared to HELP these people enjoy the benefits of stable (low) blood sugars, less medication, weight reduction, and improved health.