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High-protein diets not advised for diabetics

Risks range from low blood sugar to more heart disease

By Jacqueline Stenson

SAN ANTONIO, June 12 —  For any of the estimated 80 percent of diabetics who are overweight and thinking of trying one of the popular high-protein diets popularized by national best-sellers, think twice, experts advised here Monday at the annual meeting of the American Diabetes Association.

       “THE DIETS that are low in carbohydrates and high in protein tend to be very high in fat, and a high intake of saturated fat is related to increased rates of high cholesterol and heart disease,” said Elizabeth Mayer-Davis, a nutritionist with the International Diabetes Center in Minneapolis.
       With diabetics already at increased risk for heart problems, “the last thing we want is for them to eat a diet that would worsen their risk for heart disease,” Mayer-Davis said. She noted that three-quarters of diabetics die from cardiac ills.
       The popular Atkins diet and others that promote consuming lots of protein and little carbohydrates are generally high in “bad” fat such as the saturated kind found in bacon, eggs and butter — all of which are encouraged by these plans. Followers are generally advised to limit or avoid foods that most health experts would consider smart choices, such as grains, fruits, vegetables, and milk and yogurt.

“There is no research published in peer-reviewed journals to support these diets,” said Anne Daly, a dietitian and director of nutrition and diabetes education at the Springfield Diabetes and Endocrine Center in Springfield, Ill.
       In addition to raising the risk of heart disease, Daly said, high-protein diets also may promote osteoporosis (because of reduced dairy consumption), some cancers (from too much dietary fat and reduced fruit and vegetable intake), constipation (from reduced fiber intake) and nutrient deficiencies (due to lack of food variety).
       Proponents of high-protein diets refute such claims.
       Most of the 16 million Americans with diabetes have the type 2 form, which results when the body does not make enough, or fails to properly use, the hormone insulin. Insulin is needed for cells to convert glucose, or blood sugar, to energy. This form of the disease most commonly affects people who are over age 45 and overweight.

Diabetes is considered a “silent killer” because many people don’t know they have it until they develop one of its serious complications, such as kidney disease, blindness, heart disease and foot or leg ulcerations that can require amputation.
       Doctors encourage diabetics to lose excess weight and exercise to help control their blood sugar and prevent complications.
       Jackie Boucher, a nutritionist with Health Partners, a managed care organization in Minneapolis, noted that diabetics who consume very little carbohydrates are at risk for hypoglycemia, or low blood sugar.
       “There also are concerns that high-protein diets could contribute to kidney problems, especially in diabetics who are already at risk,” she said.
       Boucher described one case in which a woman following a high-protein, low-carbohydrate diet experienced potassium levels so low that she developed heart palpitations and had to be treated in an emergency room.

Besides offering unconventional dietary advice, Boucher said, some of these diet books contain mistruths about diabetes, such as claims that high-protein diets can help to repair the pancreas, the organ that is involved in regulating blood sugar. And some diet plans tell readers that sugar should be avoided because it causes diabetes, a statement that is false, she said.
       But on the positive side, Boucher said, people’s interest in these fad diets does mean that they are motivated to do something to lose weight and improve their health.

       “Obviously there’s a message there that’s attracting consumers, and health-care providers should take advantage of the opportunity to counsel their patients,” she recommended.
       Some of the diets do offer sound advice, Boucher said, such as advising people to get more exercise or reduce stress levels.
       In May, the government announced plans to test two popular diets — low carbohydrate (similar to the Atkins diet) and low-fat (similar to the Ornish diet) — to see which is the safest, most effective way to shed unwanted pounds and promote long-term health.

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