Dr. Ahmed
A low-fat diet is generally recommended for all patients who have metabolic syndrome, prediabetes, diabetes, hypertension, heart disease, and stroke.
A low-fat diet is aimed to restrict the number of calories per day. This may have indirect effects on prediabetes and diabetes because of its weight-reducing properties.
However, low fat does not mean replacing fats with carbohydrates.
Introduction:
Prediabetes is a warning signal that you are on the path to Type 2 Diabetes. It is a condition in which individuals are in a stage of impaired glucose tolerance or impaired fasting glucose levels.
This condition poses a greater risk of developing type 2 diabetes but the good news is that you spotted it early and you have time to turn the train.
Prediabetes can be reversed if managed with proper counseling, and lifestyle interventions such as energy restriction and regular physical activity.
The American Diabetes Association (ADA) describes prediabetes as a condition in which:
- HbA1c levels are between 5.7 and 6.4%.
- Fasting blood glucose levels range between 100 and 125 mg/dL (5.6-6.9 mmol/L)
- Oral Glucose Tolerance Test 2 hours after eating, is between 140 and 199 mg/dL.
What Factors put you at risk of Prediabetes?
Some factors and conditions that put you at risk of developing prediabetes include:
- Physical inactivity
- Overweight (BMI >25kg/m2)
- Family history of diabetes or having a first-degree relative with prediabetes
- Hypertensive individuals
- History of CVD
- High waist circumference (35+ for women and 40+ for men)
- Consuming a diet rich in simple sugars
- History of gestational diabetes
- PCOS
- Obstructive sleep apnea
Role of diet in the management of pre-diabetes:
In no other disease does diet and lifestyle play an important role than in diabetes. The same is the case with the management of prediabetes. With proper diet, prediabetes can be managed and the risk of diabetes can be reduced.
The type and amount of carbohydrates have a substantial impact because the body converts carbohydrates into glucose and glucose levels are regulated by insulin. Continuous consumption of diets rich in simple sugars, less energy expenditure, and other factors lead to less effectiveness of insulin.
When we think of diabetes management, we often think of sweet foods like cookies, cakes, jam, and chocolate, but starchy meals like bread, rice, pasta, and potatoes will also affect our blood sugar.
To adopt a healthy diet for prediabetes you must consume lean protein, low fat, low GI, low GI foods, and lower your salt intake. This can help you regulate blood sugar levels and even reverse prediabetes.
Low-fat Diet for Pre-diabetes:
Several diets have been practiced and studied for the management of prediabetes. Among these, the most common are low-carbohydrate and low-fat diets.
Low-fat diets aim to reduce total energy intake to initiate weight loss and improve insulin sensitivity.
The relationship between low-fat diets and glucose regulation is different from low-carbohydrate diets. For weight loss and control of cardiovascular risk factors, dietary strategies focused on lowering the proportion of calories from fat have been recommended.
According to studies, a low-fat vegetarian is linked to weight loss, greater insulin sensitivity, and lower levels of cardiovascular risk factors. [Ref]
The most important measure in prediabetes management is weight loss and improvement in glycemic control. Well-planned low-fat diets that include carbohydrates from good sources have better results than other therapeutic diets.
Low-fat diet and Body weight:
Low-fat diets have a greater and more gradual effect on weight loss rather than low-carb diets. But in some individuals, the results can vary.
One study that compared the effects of a low-fat vegan diet to a low-carb diet suggested that out of 74 participants, both diets caused significant weight loss. but a greater weight loss of approximately 6.8 kg was associated with the low-fat vegan diet. [Ref]
Low dietary fat intakes of less than 10-15% with restricted intake of saturated and trans fat have the most significant effect. When significant weight loss is achieved, insulin sensitivity increases, and the prediabetic stage can be reversed.
Low-fat diet and glycemic control:
The effect of a low-fat diet on blood glucose levels is still a matter of debate. Some studies suggest that a very low-fat diet balances glucose levels due to body weight reduction, while others continue to debate the fact that a low-fat diet increases the amount of carbohydrate intake to 70% which adds an additional risk for the management of glucose levels.
Should we follow a low-fat diet to manage prediabetes?
The NHS recommends people to cut back on fat, particularly saturated and trans fat, in their diet.
However, low-fat diets have received some criticism because they frequently demand a relatively large amount of carbohydrates in the diet, which can lead to insulin overproduction and, as a result, increased hunger throughout the day, weight gain, and increased risk of other chronic health problems.
Low-fat diets also put you at risk of Vitamin A and D deficiencies, increasing the risk of osteoporosis.
Because fat is the most calorie-dense macronutrient, it stands to reason that eating less fat may help in managing prediabetes. But, the overall quality of your diet has a significantly bigger influence on diabetes prevention than the amount of each macronutrient you consume.
Meanwhile, diets high in vegetables, fruits, whole grains, and healthy fats like olive oil help to prevent the development of diabetes.
Unfortunately, nutritional advice frequently focuses on specific macronutrients, such as lipids or carbohydrates, rather than the total quality of your meal.
Enhancing overall nutrition is a better approach to managing prediabetes and diabetes.
