Nutrition Revolution—The End of the High Carbohydrates Era for Diabetes Prevention and Management

US Endocrinology, 2014;10(2)103–4 DOI:

Now, it is obvious that increasing carbohydrates in the diet increases glucose toxicity and consequently increases insulin resistance, triglycerides level, and reduces HDL-cholesterol. Recently, the ADA departed from the recommendation of high carbohydrates intake and recommended individualization of the nutrition needs. It is clear that we made a major mistake in recommending the increase of carbohydrates load to >40 % of the total caloric intake. This era should come to an end if we seriously want to reduce the obesity and diabetes epidemics. Such a move may also improve diabetes control and reduce the risk of cardiovascular disease. Unfortunately, many physicians and dietitians across the nation are still recommending high carbohydrates intake for patients with diabetes, a recommendation that may harm their patients more than benefit them.

1. U. S. Government Printing Office: Stock No. 052-070-03913-2/ catalog No. Y 4.N95:D 63/3 . Available at archive/Dietary_Goals_For_The_United_States.pdf. Last accessed December 1st, 2014
2. U.S. Department of Agriculture and U.S. Department of Health and Human Services, Nutrition and Your Health: Dietary Guidelines for Americans. Home and Garden Bulletin No. 232, 1980. Available at: 0&content=PDF. Last accessed December 1st, 2014.
3. Flegal KM, Carroll MD, Kuczmarski RJ, and Johnson CL, Overweight and obesity in the United States: prevalence and trends, 1960- 1994, Int J Obes Relat Metab Disord, 1998;22(1):39–47.
4. Hedley AA, Ogden CL, Johnson CL, et al., Prevalence of overweight and obesity among US children, adolescents, and adults, 1999–2002, JAMA, 2004;291(23):2847–50.
5. Flegal KM, Carroll MD, Kit BK, and Ogden CL, Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010, JAMA, 2012;307(5):491–7.
6. Aldhahi W and Hamdy O, Adipokines, inflammation, and the endothelium in diabetes, Curr Diab Rep, 2003;3(4):293–8.
7. Westman EC, Yancy WS, Humphreys M. Dietary Treatment of Diabetes Mellitus in the Pre-Insulin Era (1914-1922). Perspect Biol Med. 2006;49(1):77-83.
8. Yancy WS Jr, Olsen MK, Guyton JR, et al., A low-carbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia: a randomized, controlled trial, Ann Intern Med, 2004;140(10):769–77.
9. Gannon MC, Nuttall FQ, Saeed A, et al., An increase in dietary protein improves the blood glucose response in persons with type 2 diabetes, Am J Clin Nutr, 2003;78(4):734–41.
10. Foster GD, Wyatt HR, Hill JO, et al., A randomized trial of a lowcarbohydrate diet for obesity, N Engl J Med, 2003;348(21):2082–90.
11. Stern L, Iqbal N, Seshadri P, et al., The effects of low-carbohydrate versus conventional weight loss diets in severely obese adults: one-year follow-up of a randomized trial, Ann Intern Med, 2004;140(10):778–85.
12. Gardner CD, Kiazand A, Alhassan S, et al., Comparison of the Atkins, Zone, Ornish, and LEARN diets for change in weight and related risk factors among overweight premenopausal women: the A to Z weight loss study: a randomized trial, JAMA, 2007;297(9):969–77.
13. Miyashita Y, Koide N, Ohtsuka M, et al., Beneficial effect of low carbohydrate in low calorie diets on visceral fat reduction in type 2 diabetic patients with obesity, Diabetes Res Clin Pract, 2004;65(3):235–41.
14. Larsen TM, Dalskov SM, van Baak M, et al., Diets with high or low protein content and glycemic index for weight-loss maintenance, N Engl J Med, 2010;363(22):2102–13.
Keywords: low carbohydrates, obesity, type 2 diabetes