Friday, October 31, 2014

Let’s Face It: Halloween Haunts Diabetics

Halloween treats are hardly Paleo. One bite-sized candy bar can contain anywhere from 10 – 30g of carbohydrate. And it’s not fibrous carbs or safe starches; it’s usually sugar. Pop two or three of these and, you’re looking at potentially 2-6 more units of insulin injections to maintain blood glucose control, let alone the risks of inducing hypoglycemia. One comprehensive review showed that this may induce up to a two-fold increased risk for severe hypoglycemia.² It has long been known that the best strategy for diabetics is carbohydrate restriction, especially restricting sugar intake, not increasing the insulin to counteract large sugar boluses. With symptoms ranging from tachycardia and sweating, to stupor and coma, hypoglycemia isn’t a laughing matter.¹

Furthermore, one study even showed a 71% increased risk of cardiovascular mortality in younger diabetic patients, and a threefold increased risk of hypoglycemia.⁴ While trick-or-treating one day out of the year will not be the end-all, it’s not without risks. If you must have your Halloween treats, keep it to a minimum, and if you’re diabetic, monitor your blood glucose. Choose dark chocolate over pure sugar confections, which have a healthy dose of dietary fat to attenuate the spike in blood glucose.

Even in healthy individuals, a candy bar containing 45g of carbohydrate (mostly sugar) can spike blood glucose by up to 30 points.³

Applied Physiology, Nutrition, and Metabolism, 2013, 38:484-489, 10.1139/apnm-2011-0226

Again, it’s only one day out of the year, but diabetic patients + candy = no bueno. The risks and consequences of hyper- and hypoglycemia are much greater.

The good news: a Paleo Diet does wonders for insulin sensitivity.⁶ In the figure below, the filled symbols represent glucose tolerance prior to the study, and the open symbols after 12 weeks.

Diabetologia. 2007 Sep;50(9):1795-807. Epub 2007 Jun 22.

The Paleo Diet is the optimal “diabetes diet” in type 2 diabetic patients.⁵ If that doesn’t say a lot, I don’t know what does!

William Lagakos, Ph.D.

@caloriesproper

CaloriesProper

Dr. William Lagakos received a Ph.D. in Nutritional Biochemistry and Physiology from Rutgers University where his research focused on dietary fat assimilation and integrated energy metabolism. His postdoctoral research at the University of California, San Diego, centered on obesity, inflammation, and insulin resistance. Dr. William Lagakos has authored numerous manuscripts which have been published in peer-reviewed journals, as well as a non-fiction book titled The Poor, Misunderstood Calorie which explores the concept of calories and simultaneously explains how hormones and the neuroendocrine response to foods regulate nutrient partitioning. He is presently a nutritional sciences researcher, consultant, and blogger.

REFERENCES

1. Ahren B. Avoiding hypoglycemia: a key to success for glucose-lowering therapy in type 2 diabetes. Vasc Health Risk Manag. 2013;9:155-163.

2. Boussageon R, Bejan-Angoulvant T, Saadatian-Elahi M, Lafont S, Bergeonneau C, Kassai B, . . . Cornu C. Effect of intensive glucose lowering treatment on all cause mortality, cardiovascular death, and microvascular events in type 2 diabetes: meta-analysis of randomised controlled trials. BMJ. 2011;343:d4169.

3. Dugan K, Campbell B, Dufour F, Roman S, Woodall C, McAdams M, . . . Wilborn CD. Acute glycemic and blood lipid response to the ingestion of a candy bar-like protein supplement compared with its candy bar counterpart. Appl Physiol Nutr Metab. May 2013;38(5):484-489.

4. Giorgino F. Intensive glucose-lowering results in increased cardiovascular mortality in younger but not older individuals with type 2 diabetes. Evid Based Med. Jul 15 2014.

5. Jonsson T, Granfeldt Y, Ahren B, Branell UC, Palsson G, Hansson A, . . . Lindeberg S. Beneficial effects of a Paleolithic diet on cardiovascular risk factors in type 2 diabetes: a randomized cross-over pilot study. Cardiovascular diabetology. 2009;8:35.

6. Lindeberg S, Jonsson T, Granfeldt Y, Borgstrand E, Soffman J, Sjostrom K, Ahren B. A Palaeolithic diet improves glucose tolerance more than a Mediterranean-like diet in individuals with ischaemic heart disease. Diabetologia. Sep 2007;50(9):1795-1807.

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