title: Carbohydrate restriction as the default treatment for type 2 diabetes and metabolic syndrome.
abstract: Dietary carbohydrate restriction in the treatment of diabetes and metabolic syndrome is based on an underlying principle of control of insulin secretion and the theory that insulin resistance is a response to chronic hyperglycemia and hyperinsulinemia. As such, the theory is intuitive and has substantial experimental support. It has generally been opposed by health agencies because of concern that carbohydrate will be replaced by fat, particularly saturated fat, thereby increasing the risk of cardiovascular disease as dictated by the so-called diet-heart hypothesis. Here we summarize recent data showing that, in fact, substitution of fat for carbohydrate generally improves cardiovascular risk factors. Removing the barrier of concern about dietary fat makes carbohydrate restriction a reasonable, if not the preferred method for treating type 2 diabetes and metabolic syndrome. We emphasize the ability of low carbohydrate diets to improve glycemic control, hemoglobin A1C and to reduce medication. We review evidence that such diets are effective even in the absence of weight loss.
authors.affiliation: Department of Biochemistry, SUNY Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, New York 11203, USA. rfeinman@downstate.edu
authors.forename: Richard D
authors.initials: RD
authors.lastname: Feinman
authors.forename: Jeff S
authors.initials: JS
authors.lastname: Volek
mesh_terms: D001786:Blood Glucose / Q000032:analysis; D002318:Cardiovascular Diseases / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy*; D050528:Diet, Carbohydrate-Restricted; D004038:Diet, Reducing; D004040:Dietary Carbohydrates / Q000008:administration & dosage*; D005227:Fatty Acids / Q000378:metabolism; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006943:Hyperglycemia / Q000097:blood; D007328:Insulin / Q000378:metabolism*; D007333:Insulin Resistance; D000078790:Insulin Secretion; D024821:Metabolic Syndrome / Q000178:diet therapy*; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D004040:Dietary Carbohydrates; D005227:Fatty Acids; D006442:Glycated Hemoglobin; D007328:Insulin