Low-Carb Diet Helps Cut HbA1c In Prediabetes
Sticking to a low-carbohydrate diet helped people with prediabetes bring down their HbA1c in just a few months, a randomized clinical trial found.
Compared with those eating their typical diet, people with an untreated, elevated HbA1c who ate a low-carb diet saw a significantly greater improvement in fasting plasma glucose (-10.3 mg/dL, 95% CI -15.6 to -4.9) at month 6, reported Kirsten S. Dorans, ScD, of Tulane University School of Public Health and Tropical Medicine in New Orleans, and colleagues.
especially on Halloween — shouldn't be demonized
Those on the low-carb diet, which also included dietary counseling, also saw a 0.23% greater drop in HbA1c at this time (95% CI -0.32 to -0.14), they wrote in JAMA Network Open.
Although the researchers acknowledged this HbA1c reduction was "modest," they explained it was still a little greater than the 0.17% reduction seen in the lifestyle intervention arm of the DPP trial, which subsequently led to a 58% reduced risk for type 2 diabetes progression over 2.8 years.
Participants on the low-carb diet also spent longer in target glucose range (70-120 mg/dL) according to readings from their continuous glucose monitors. In addition, they had significantly lower average 24-hour glucose levels than those eating their usual diets.
And low-carb-dieters also saw a 5.9 kg (95% CI -7.4 to -4.4) greater reduction in body weight (about 13 lb) after being on the diet for half the year. This was likely due to the significant decrease in caloric intake seen among those on the low-carb diet.
"Few participants had detectable urinary ketones, suggesting ketosis was unlikely to account for the findings," the authors noted.
The authors cautioned that "the study was unable to evaluate its [low-carb diet] effects independently of weight loss."
Still, Dorans said in a statement that "The key message is that a low-carbohydrate diet, if maintained, might be a useful approach for preventing and treating type 2 diabetes, though more research is needed."
Her group noted that study limitations included self-report of dietary intake, which is subject to potential recall bias. Also, "participants in the low-carbohydrate group had frequent interventionist interactions, whereas the usual diet group did not," they wrote.
All of the benefits seen at the end of the trial had already reached significance by month 3, with improvements only strengthening from months 3 to 6. By month 3, HbA1c dropped 0.16% more in the low-carb group, fasting plasma glucose dropped 8.0 mg/dL more, and body weight dropped 4.1 kg (around 9 lb) more.
A few other exploratory outcomes also showed significantly better 6-month outcomes with the low-carb diet:
Some other improvements were seen among the dieters, but these benefits were significantly better than those sticking to a usual diet. These included systolic blood pressure, cholesterol, diastolic blood pressure, and 10-year atherosclerotic cardiovascular disease risk.
A total of 150 adults with prediabetes were randomized for the parallel-group trial. At baseline, they were all untreated with diabetes medications and had an HbA1c level between 6.0% to 6.9%. A total of 59% of the cohort was Black and 41% were white. Nearly three-fourths were women and the average age was 59.
Those randomized to the "usual" diet group were only given standard dietary advice but no ongoing education or diet-specific recommendations. The low-carb dieters were instructed to keep their daily net carbohydrate intake to under 40 g for the first 2 months. Then, participants were told to pick their own lowest feasible target (anything under 60 g daily) for months 4 through 6. On top of these goals, participants were involved in individual and group sessions through the diet period and were also each given a handbook with dietary guidelines and recipes.
Kristen Monaco is a staff writer, focusing on endocrinology, psychiatry, and nephrology news. Based out of the New York City office, she’s worked at the company since 2015.
Disclosures
The study was supported by the National Institute of General Medical Sciences, Tulane University Carol Lavin Bernick Faculty Grant Program, the California Walnut Commission, the Simply Good Foods Company, and Swerve.
Dorans and co-authors disclosed relationships with the NIH.
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Why Parents Should Stop Freaking Out Over Halloween Candy: 'Kids Pick Up On Diet Culture Stuff Really Young'
Life comes at you pretty fast. One day you're a kid shoveling Snickers bars into your mouth five times a day; the next you're a parent wishing more houses would hand out toothbrushes to trick-or-treaters. With Halloween soon approaching, there's a lot of hand-wringing about candy, irrespective of the annual, often-unsubstantiated fears concerning poison-laced treats. Some parents may not want their kids eating any candy at all. Some may wonder just how many fun-size candy bars their little ones can scarf down without having a sugar-fueled meltdown. And some just want their families to enjoy the holiday without messaging that candy (or any food) is "bad" and needs to be restricted.
Why is Halloween candy so fraught? Diana Rice, a dietitian and intuitive eating counselor who runs Tiny Seed Nutrition and the popular Instagram account Anti-Diet Kids, notes that, thanks to its timing, Halloween is "kind of opening this floodgate of holiday food worries." Turkey feasts, festive cocktails, cookies and canapés galore are just around the corner, ushering in a lot of complex, and often negative, feelings about food, body image and diet culture. For many folks, the solution is to try to exert some control early on by not indulging in candy corn, caramel apples and other seasonal goodies. But that may be a losing battle when kids are involved, warns Rice.
"Candy is happening one way or another on Halloween," she tells Yahoo Life.
How can parents stop panicking about a one-off sugar binge? What are some ways to teach kids that a chocolate bar isn't "bad," nor is it a reward? And in which cases should parents exercise more caution around candy? Read on for expert answers from Rice and Dr. Erica Brody, a pediatrician at Mount Sinai Kravis Children’s Hospital and assistant professor at the Icahn School of Medicine at Mount Sinai.
When are kids too young to eat candy?Government dietary guidelines advise against introducing added sugars to children under the age of 2, though Rice notes that a "blanket statement" like that tends to overwhelm parents who worry that they've failed by giving their baby an applesauce pouch. That said, she does acknowledge that it's good for young children who are just starting to experience food to be introduced to a wide spectrum of flavors, not just sweets. The bigger concern, she says, isn't so much sugar as it is the choking hazard many candies present, especially if they are sticky, chewy, gummy, hard or shaped in such a way that it'd easily get lodged in a little one's throat (think: Jolly Ranchers, chewing gum, marshmallows, Starburst, etc.).
"Many candies can be choking hazards until children are at least 3 if not 4 years old," agrees pediatrician Brody, who recommends that parents scan all Halloween candy for safety beforehand, especially if their child has a health concern (such as an allergy or condition like diabetes). It's up to parents to weed out anything that seems risky, and to supervise their kids while they eat.
Why candy shouldn't be treated as a rewardNot all kids have a sweet tooth — but if yours does and asks to try candy, Brody recommends introducing it slowly. You can discuss the pros (the taste!) and cons (more toothbrushing, might make their belly ache if they eat too much), but demonizing sweets altogether can establish some toxic attitudes about food and give candy a power that makes it all the more alluring.
"Making it special — whether it’s describing it as a divine, rare treat or talking about it negatively, as the 'bad-for-you' stuff — instantly captures your toddler’s attention and makes the candy feel like something they NEED to have," Kristin Gallant, one half of the parenting coach duo Big Little Feelings, recently told Yahoo Life.
Gallant and co-founder Deena Margolin recommend offering small portions of sweets as part of a meal to make them more mundane — think of a cookie at the edge of the dinner plate, and not something that's only doled out if little Charlotte finishes her peas.
"Experts agree we shouldn't use food as a reward, and demonizing candy creates more problems," says Brody, adding that, when it comes to candy, "'in moderation' is a great party line."
Because moderation and self-regulation often go hand in hand, Rice notes that there's an unexpected benefit to, when age-appropriate, letting kids experiment with candy: It allows them gauge how their body feels afterwards and helps them establish what their limits are. Rice likens it to having a hangover, which tends to give a first-time drinker a benchmark for how much alcohol they can actually handle. Your kid might think they could eat their way through Willy Wonka's factory, but in reality, they'll figure out soon enough that they start to feel full or sickly after more than a handful of gummy bears.
"There's a misconception that the solution is to keep the candy away, when in fact it's the polar opposite: give opportunities to regulate around it," Rice says. "Those poor kids never get a chance to regulate themselves around what what it feels like to have candy in their body."
Avoiding body-shaming or diet culture pitfalls"Kids pick up on diet culture stuff really young," says Rice, who uses her Anti-Diet Kids platform to call out harmful messaging around what children eat. She cites the complicated relationships with food many parents have as a result of growing up under that same messaging, which in turn often compels them to exert more control and restrictions on what their offspring consume.
Brody agrees that there should be "no body shaming" involved in discussions about candy or other foods. Steer conversations away from appearances, she says, and focus instead on health — like how a food makes you feel, or what it does for your body. Think: "Eating makes me feel full/tired" rather than "This cupcake will make me fat."
Handling Halloween nightIt's showtime! Brody — who assures parents that "a single day's sugar binge is usually fine for a healthy child" who has a nutritious diet overall — also suggests that families establish a candy plan ahead of Halloween so expectations and rules are clear. Maybe that means setting a timer that gives your kids 10 minutes to chow down before the bedtime routine starts, maybe that means a free-for-all or maybe that means selecting a handful of their favorite treats and then saving the rest of their trick-or-treating bounty for later. Or, as journalist and mom Virginia Sole-Smith, author of the upcoming book Fat Talk: Parenting in the Age of Diet Culture, recently shared in her Burnt Toast Substack: "We just eat it until we get bored of it,
which seems to happen pretty quickly since nobody feels restricted about it in the first place."
Another pro tip: Serve a full meal before heading out to trick-or-treating (because, let's be honest, they'll only have eyes for Skittles when they get back home).
And relax. Says Brody, "Halloween may actually be an opportunity. You can role model and show your children that in the context of a healthy lifestyle, there's still room for flexibility. Being health-conscious does not equal being rigid."
Wellness, parenting, body image and more: Get to know the who behind the hoo with Yahoo Life's newsletter. Sign up here.
Karl-Anthony Towns On Reaction To Edwards Diet Comments: Not Hearing 'Outside Noise'
Minnesota Timberwolves center Karl-Anthony Towns called his team "special" and said it isn't concerned about any "outside noise" amid its 2-2 start after he made comments about fellow star Anthony Edwards' diet.
Edwards struggled mightily in a 115-106 loss to the San Antonio Spurs on Monday after shooting 3-of-15 (1-of-8 from three-point range) for nine points.
After the game, Towns had this to say to reporters when asked about how he can help Edwards on the back end of back-to-backs (the Wolves also played on Sunday).
"Maybe I could do a better job of teaching him how to take care of his body, diet and everything," Towns said.
"That'll be on me. I know you all think it's funny up here when he talks about Popeye's and all that s--t. That doesn't make me happy to hear. We're high-level athletes. But also, that falls on me too, you know. The old cliché falls on you. Everyone wants to take the blame, but it's on all of us."
Those comments led to various reactions on sports media outlets and Twitter, but Towns appears focused on the task at hand.
Edwards said during the preseason that he planned on improving his diet by cutting out some fast food, including Popeyes.
It's been a slow start for Edwards, who is shooting just 25.8 percent from three thus far. But Towns hasn't fared well either, shooting just 41.0 percent from the field while averaging 20.3 points per game. He has averaged 23.2 points on 52.7 percent shooting for his career.
The Timberwolves entered this season with higher expectations after adding All-Star center Rudy Gobert to the starting lineup alongside Towns, Edwards, D'Angelo Russell and Jaden McDaniels.
The early-season schedule looked easy on paper. However, the T-Wolves lost home games to the Spurs and Utah Jazz around a pair of wins versus the Oklahoma City Thunder. Their offense has struggled, with the team notably hitting just 28.7 percent of three-pointers (second-worst mark in the NBA).
The Jazz and Spurs are off to hot starts at 3-1, so it's conceivable that preseason notions had them pegged a bit too low, but Minnesota opened its championship window now after dealing a mountain of picks to the Jazz for Gobert.
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