Review
Dietary carbohydrate restriction in type 2 diabetes mellitus and metabolic syndrome: time for a critical appraisal
1 State University of New York Downstate Medical Center, Brooklyn, New York, USA
2 New York Diabetes Center, Mamaroneck, New York, USA
3 Private Practice, Njurunda, Sweden
4 University of Colorado Health Sciences Center, Denver, Colorado, USA
5 Albert Einstein College of Medicine, Bronx, New York, USA
6 Division of Pediatric Endocrinology, University of California Medical Center, San Francisco, California, USA
7 Manninen Nutraceuticals Oy, Oulu, Finland
8 Ballochmyle Medical Group, Mauchline Ayrshire, UK
9 County Hospital, Karlshamn, Sweden
10 Independent Researcher, Lund, Sweden
11 Department of Pediatrics, Creighton University, Omaha, Nebraska, USA
12 Portuguese Sports Institute, Cruz Quebrada, Portugal
13 Cosmopolitan International Diabetes Center, University of Missouri, Columbia, Missouri, USA
14 Slottsstadens Läkarhus, Malmö, Sweden
15 Department of Kinesiology, University of Connecticut, Storrs, Connecticut, USA
16 Lifestyle Medicine Clinic, Duke University Medical Center, Durham, North Carolina, USA
17 Springfield College, Springfield, Massachusetts, USA
18 Health Canada, First Nations Division, Vancouver, British Columbia, Canada
19 Private Practice, Lawrence, Kansas, USA
Nutrition & Metabolism 2008, 5:9 doi:10.1186/1743-7075-5-9
Published: 8 April 2008Abstract
Current nutritional approaches to metabolic syndrome and type 2 diabetes generally rely on reductions in dietary fat. The success of such approaches has been limited and therapy more generally relies on pharmacology. The argument is made that a re-evaluation of the role of carbohydrate restriction, the historical and intuitive approach to the problem, may provide an alternative and possibly superior dietary strategy. The rationale is that carbohydrate restriction improves glycemic control and reduces insulin fluctuations which are primary targets. Experiments are summarized showing that carbohydrate-restricted diets are at least as effective for weight loss as low-fat diets and that substitution of fat for carbohydrate is generally beneficial for risk of cardiovascular disease. These beneficial effects of carbohydrate restriction do not require weight loss. Finally, the point is reiterated that carbohydrate restriction improves all of the features of metabolic syndrome.
