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Dietary carbohydrate restriction as the first approach in diabetes management: critical review and evidence base.

Publication ,  Journal Article
Feinman, RD; Pogozelski, WK; Astrup, A; Bernstein, RK; Fine, EJ; Westman, EC; Accurso, A; Frassetto, L; Gower, BA; McFarlane, SI; Nielsen, JV ...
Published in: Nutrition
January 2015

The inability of current recommendations to control the epidemic of diabetes, the specific failure of the prevailing low-fat diets to improve obesity, cardiovascular risk, or general health and the persistent reports of some serious side effects of commonly prescribed diabetic medications, in combination with the continued success of low-carbohydrate diets in the treatment of diabetes and metabolic syndrome without significant side effects, point to the need for a reappraisal of dietary guidelines. The benefits of carbohydrate restriction in diabetes are immediate and well documented. Concerns about the efficacy and safety are long term and conjectural rather than data driven. Dietary carbohydrate restriction reliably reduces high blood glucose, does not require weight loss (although is still best for weight loss), and leads to the reduction or elimination of medication. It has never shown side effects comparable with those seen in many drugs. Here we present 12 points of evidence supporting the use of low-carbohydrate diets as the first approach to treating type 2 diabetes and as the most effective adjunct to pharmacology in type 1. They represent the best-documented, least controversial results. The insistence on long-term randomized controlled trials as the only kind of data that will be accepted is without precedent in science. The seriousness of diabetes requires that we evaluate all of the evidence that is available. The 12 points are sufficiently compelling that we feel that the burden of proof rests with those who are opposed.

Duke Scholars

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Published In

Nutrition

DOI

EISSN

1873-1244

Publication Date

January 2015

Volume

31

Issue

1

Start / End Page

1 / 13

Location

United States

Related Subject Headings

  • Weight Loss
  • Randomized Controlled Trials as Topic
  • Nutrition & Dietetics
  • Hyperglycemia
  • Humans
  • Evidence-Based Medicine
  • Disease Management
  • Dietary Carbohydrates
  • Diet, Carbohydrate-Restricted
  • Diabetes Mellitus, Type 2
 

Citation

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Chicago
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Feinman, R. D., Pogozelski, W. K., Astrup, A., Bernstein, R. K., Fine, E. J., Westman, E. C., … Worm, N. (2015). Dietary carbohydrate restriction as the first approach in diabetes management: critical review and evidence base. Nutrition, 31(1), 1–13. https://doi.org/10.1016/j.nut.2014.06.011
Feinman, Richard D., Wendy K. Pogozelski, Arne Astrup, Richard K. Bernstein, Eugene J. Fine, Eric C. Westman, Anthony Accurso, et al. “Dietary carbohydrate restriction as the first approach in diabetes management: critical review and evidence base.Nutrition 31, no. 1 (January 2015): 1–13. https://doi.org/10.1016/j.nut.2014.06.011.
Feinman RD, Pogozelski WK, Astrup A, Bernstein RK, Fine EJ, Westman EC, et al. Dietary carbohydrate restriction as the first approach in diabetes management: critical review and evidence base. Nutrition. 2015 Jan;31(1):1–13.
Feinman, Richard D., et al. “Dietary carbohydrate restriction as the first approach in diabetes management: critical review and evidence base.Nutrition, vol. 31, no. 1, Jan. 2015, pp. 1–13. Pubmed, doi:10.1016/j.nut.2014.06.011.
Feinman RD, Pogozelski WK, Astrup A, Bernstein RK, Fine EJ, Westman EC, Accurso A, Frassetto L, Gower BA, McFarlane SI, Nielsen JV, Krarup T, Saslow L, Roth KS, Vernon MC, Volek JS, Wilshire GB, Dahlqvist A, Sundberg R, Childers A, Morrison K, Manninen AH, Dashti HM, Wood RJ, Wortman J, Worm N. Dietary carbohydrate restriction as the first approach in diabetes management: critical review and evidence base. Nutrition. 2015 Jan;31(1):1–13.
Journal cover image

Published In

Nutrition

DOI

EISSN

1873-1244

Publication Date

January 2015

Volume

31

Issue

1

Start / End Page

1 / 13

Location

United States

Related Subject Headings

  • Weight Loss
  • Randomized Controlled Trials as Topic
  • Nutrition & Dietetics
  • Hyperglycemia
  • Humans
  • Evidence-Based Medicine
  • Disease Management
  • Dietary Carbohydrates
  • Diet, Carbohydrate-Restricted
  • Diabetes Mellitus, Type 2