Sometimes it feels like there's a new revolutionary diet or list of superfoods being "discovered" every other day, especially during Spring, when everyone is getting ready for swimsuit season! Weight issues plague both people with type 1 diabetes and type 2 diabetes, but some of these diets can be tricky to understand. When you have diabetes and are trying to balance blood sugars, it can be difficult to know whether any given diet is a good choice. For National Nutrition Month, we're examining a four diet plans that have gotten the most hype: the South Beach Diet, the Paleo Diet, the DASH Diet, and Juice Cleanses.
Of course, the word "diet" is almost a misnomer these days, because it implies that the eating plan will eventually end. The fact is, most of these diets have long-term "maintenance" phases, so you never really stop dieting. It becomes a lifestyle, not a diet — which can be a good thing, as long as it's truly sustainable.
The South Beach diet is extremely popular, because there are no special foods to eat, calories to count, or points to count, and the format is easy to follow, with just three phases. The first phase attempts to curb cravings and jumpstart weight loss. Folks skip all starches, like potatoes, fruit, bread, cereal, rice, pasta, beets, carrots, and corn for the first two weeks. You can eat lean meats, eggs, cheeses and other dairy, vegetables, and healthy fats like nuts and avocado. Alcohol is also a no-no.
The second and third phases introduce more food into the diet. Healthy whole grains, fruit and starchy vegetables are allowed back, but foods with added sugar or refined carbs are still off limits. In the third, maintenance phase, which begins when you reach your healthy weight, you continue with the same foods as phase two, but there are more allowances for indulgences.
"There are elements of the South Beach program that are basic principles many nutritionists would agree with, like the reduction in refined carbohydrates, inclusion of high fiber fruits and vegetables," says Robyn Webb, Food Editor for the ADA's magazine Diabetes Forecast. "However, the emphasis on the amount of protein will not work for everyone and some of the unnecessary restrictions will also not work for everyone."
The restrictions especially in the first phase can make PWDs feel like they have to "cheat" when treating lows with juice or sugar, which can be a slippery slope because we all know that it's hard to stay motivated once you feel like you've "fallen off the wagon." And we PWDs often experience more lows when altering our diets to try to lose weight.
A few years ago, Amy gave the South Beach diet a try and noted that even though the second phase seems easier, it can be a slippery slope too because, "As welcome as it sounds, I know this is where things get tricky. Once we get a taste, we want more than a little (extra carbohydrate), don't we now?"
Nora Saul, CDE and Manager of Nutrition Services at Joslin Diabetes Center, actually advises PWDs at risk of hypoglycemia against using phase 1 of the South Beach Diet because of the restrictions. "It's best if they skip over that section," she says.
The Paleo (or Paleolithic) Diet is based on the simple premise that we should all be eating exactly how our ancestors, the cavemen, ate. That is, we should eat anything that can be hunted (fish and grass-fed animals) or gathered (vegetables, fruit, roots, and nuts).
Off the list are whole grains, dairy, legumes (beans and nuts), salt, refined sugar and oils. Proponents of the diet theorize that some of our problems (including type 2 diabetes) were born out of the rise of agriculture in our society, and that we humans were never meant to eat grains.
The Paleo diet has a huge number of fans and a large number of resources, including its very own magazine. We even found one PWD who has devoted his blog to his experiences with the Paleo diet. Mark Koekemoer, a type 1 PWD in South Africa, was diagnosed in 1996 and started following the Paleo diet in November 2011 after hearing about it at his local gym.
Mark says, "By cutting out carbs, I immediately reduced my total daily dose of insulin by more than half. I found immediately that with less insulin in my body, the rate of fluctuation of my sugars decreased. So I have had fewer highs and fewer lows, my sugars became more consistent and the standard deviation smaller. Pre-Paleo, my A1c was 6.2%, which is pretty good, but 3 months after switching to Paleo my A1c was down to 5.9% and I know it'll be even better next time."
He also notes, "You have to cook. Eating the Paleo way requires more preparation and cooking than the convenient sandwich or cookies would. But I feel that if it makes me feel the way I do and gets me the control I'm after, it's all worth it."
Experts aren't so sure these restrictions are necessary, mainly because the Paleo Diet cuts out legumes and whole grains, and relies heavily on lean meats, which can be dangerous for folks with cardiovascular issues (aka lots of PWDs). Also, some researchers question the historical validity of Paleo and whether or not it's necessary to go back to that diet in order to be healthy.
"While the Paleo program includes good foods such as lean proteins, nuts, vegetables and fruits, it's also a limited program and I question the accuracy of the evolutionary logic," says ADA Food Editor Robyn. "It eliminates beans, which I think has no basis. The elimination of refined sugars is a good idea, but overall I think the program may be difficult for one to follow."
The DASH Diet is not primarily a weigh-loss diet; it was developed to promote (as you can imagine) heart health. This diet is simple to follow and has few restrictions, focusing on lots of fruits and vegetables, low fat or nonfat dairy, whole grains, lean meats and fish, and nuts and beans. The main restrictions are processed and red meats, sodium, and sugary drinks.
"Now we're talking!" says Robyn. "The DASH Diet is the most sensible one listed here. The reduction in sodium is a wise approach. The 'diet' is a healthy, balanced food program with great variety and emphasis on low sodium. It will naturally have one eating lean proteins, fruits, vegetables and whole grains."
"The DASH diet is great," says Joslin nutrition expert Nora. "Very high in fruits and vegetables. Low in saturated fat, and low in sodium. The diet was designed to lower blood pressure and it's a good diet for diabetes. It's higher in carbohydrates, but the carbs included are good choices."