What is The Best Diet for Type 2 Diabetes? [HbA1C Change Comparison Betw...

in today's video i'm going to talk about  the best diet for type 2 diabetes as  that's still a highly debated topic  let's look at the data together and end  the debate so that we could focus on  doing what actually works i'll give you  the exact results from studies showing  how different diets affect hba1c levels  in type 2 diabetics  i'll compare four most commonly  recommended diets for type 2 diabetics  the low-fat mediterranean diet the very  low-fat vegan diet the low-carb diet and  the low-carb keto diet  i will look into the scientific  literature and give you answer to the  question  what is the best diet for type 2  diabetes will share an easy to  understand comparison between these  diets and show the exact hba1c glycated  hemoglobin change so that you would know  which diet to choose  i know most people don't read scientific  papers even most doctors don't read it  we either don't have time for this or  don't have the relevant scientific  background to be able to find these  studies read them and understand them  i'll present it in an easy to understand  way  by the way if you're new to my youtube  channel my name is greta and i'm an  online nutritionist and a holistic  health coach if you haven't yet consider  subscribing to my youtube channel for  weekly videos about insulin resistance  detox diabetes all the other chronic  health conditions and improving your  overall health so if you want to be  healthy you should definitely subscribe  and by the way this is not a medical  advice my videos are for educational  purposes only  now back to the best diet for type 2  diabetes i'll compare the regular lofa  diet also referred to as the  mediterranean diet with around 45 to 50  calories from carbohydrates and 30 35  calories from fat  that's their regular recommendation for  non-diabetics and diabetics  we can call it the mediterranean diet  that promotes whole grains low-fat foods  unsaturated fats fruits veggies lean  meats and so on  then the next diet is the very low fat  vegan diet with more carbs around 60 to  70 percent of calories coming from  carbohydrates and fat calories are  closer to 20 or even 10 percent of the  total calories  this diet focuses on removing all the  animal products which are naturally high  in saturated fat and cholesterol it  usually promotes more fruits and veggies  so these two diets that i've just  mentioned are both high in carbs and low  in fat but the vegan one is a lot lower  in fat  then the next diet is the low  carbohydrate diet with less than 45  percent calories from carbs it is higher  in fat but still is somewhat a moderate  carb diet and moderate fat diet this is  quite broad but your daily carbs could  be anywhere between 70 to 150 grams of  carbs a day  i would say this should be redefined to  up to 100 grams of carbohydrates a day  or 10 to 20 percent of daily calories  from carbohydrates  and the last diet is the low carb  ketogenic diet with 5 to 10 percent of  calories from carbs and 60 or more  percent calories from fat in grams that  would be something around 30 to 50 grams  of carbohydrates a day so that's the  very low carb diet  we will find out which narrative about  type 2 diabetes is correct now the first  narrative says that excess fat causes  type 2 diabetes meaning reducing fat  would be the best approach for managing  type 2 diabetes according to this  narrative the best diet for type 2  diabetes should be the one that is the  lowest in fat which is the very low-fat  vegan diet then the next would be the  regular low-fat diet the mediterranean  type diet then the next one would be low  carb higher fat diet and the worst one  would be the very low carb high-fat  ketogenic diet  and then there's another narrative  saying that excess carbohydrates but not  fat cause type 2 diabetes if this  narrative is correct the low-carb  ketogenic diet would be the most  effective for managing type 2 diabetes  the second one would be this simple  low-carb diet then the mediterranean  lofa diet and the worst one would be the  very low-fat vegan diet  the primary outcome that i will be  looking at in these studies will be the  change in hba1c yoga glycated hemoglobin  levels the hemoglobin a1c test tells you  your average level of blood sugar over  the past two to three months  type 2 diabetes is classified as having  hba1c of 6.6 or more while normal  non-diabetic levels are less than 5.7  percent  the type 2 diabetes remission is  classified as being able to achieve  hba1c of 6.4 or less some diabetics  manage to achieve full remission which  is hba1c of 5.7 or less  we will see how each diet makes someone  with type 2 diabetes closer to these  normal blood glucose levels  also at the end i will share a study  that compared the very low-fat high-carb  vegan diet with the regular lofa diet  and the very low-carb ketogenic diet and  their effects on insulin levels  because that's right type 2 diabetes is  not only about elevated blood glucose  it's a condition where you have elevated  blood sugar and elevated insulin until  the point it burns out and you have too  little insulin majority of type 2  diabetics are insulin resistant it's an  important area to discuss after watching  this video you will certainly know what  is the best diet for type 2 diabetes and  you will be able to apply this knowledge  to get the best possible results  there are people swearing that each one  of these four diets is the best one for  type 2 diabetes but they can't all be  the best that's data that can be  compared and we can see clear results  and if we get the basics wrong then  there's no chance for preventing or  successfully managing or even reversing  this condition  we can clearly see that type 2 diabetes  and obesity cases are growing  not shrinking in the past years  we must have got something wrong here i  will discuss only the highest quality  scientific evidence from randomized  control trials non-randomized trials or  systematic reviews which will help us to  answer the question what is the best  diet for type 2 diabetes  i see other youtube doctors or  nutritionists giving whatever dietary  advice they like while totally ignoring  the research when you look at all the  research it becomes pretty clear which  diet is the best  if your doctor supports one of the diets  that has poor results please show him or  her the reference list from this video  so that you could update their knowledge  and practices as for some reason many of  them are not up to date with the  scientific literature where they  actually have a responsibility to  constantly be checking it to give their  patients the best possible advice  people's lives depend on it and doctors  are seen as gods all they say is correct  so please feel free to share this  research with your doctor if needed  now let's look at the first diet the  mediterranean diet for type 2 diabetes  the first study biologic and quality of  life outcomes from the mediterranean  lifestyle program a randomized clinical  trial  the study tested the effectiveness of  the mediterranean lifestyle program for  reducing cardiovascular risk factors in  postmenopausal women with type 2  diabetes  this mediterranean lifestyle program  involved following a mediterranean low  saturated fat diet stress management  exercise group support and help for  quitting smoking  there were 279 type 2 diabetic women  they were divided into either usual care  which is control or mediterranean diet  group  and they were followed for six months  and their results showed that the  mediterranean diet group had  significantly greater improvements in  hba1c levels bmi plasma fatty acids and  quality of life at six-month follow-up  hb a1c decreased from a beginning level  of 7.43  to  7.07 percent at six months a 0.4 percent  reduction while the control subjects  stayed at 7.4 percent  after those six months the total  cholesterol triglycerides and ldl and  hdl cholesterol did not achieve  statistical significance between the  groups  we will focus on the hba1c change from  seven point four to three percent to  seven point zero seven percent at six  months a zero point four percent  reduction  the results were not that high to begin  with and decreased by  0.36 percent as we see participants did  not achieve diabetes remission only a  very small improvement in hba1c values  then there's a meta-analysis where we  can see combined results from several  studies  it's called  effects of the mediterranean style diet  on blood sugar control  weight loss and cardiovascular risk  factors among type 2 diabetes  individuals a meta-analysis  studies suggest that the  mediterranean-style diet may improve  glucose metabolism in patients with type  2 diabetes but the results are  inconsistent  that's why they decided to create this  meta-analysis of randomized control  trials  again that's the highest quality  evidence  we compared the mediterranean diet with  the control diet in patients with type 2  diabetes the meta-analysis included nine  studies with  1178 patients  and their results showed that compared  with control diets the mediterranean  diet decreased hba1c more  mean difference change compared to  controls minus  0.30 they don't state what was the  average hba1c level to begin with  so in this study hbe1c decreased by  minus 0.3 compared with controls we  don't know how meaningful is this change  did the decrease from hb a1c let's say 8  to 7.7 percent we don't know  we will later compare these results with  those from other diets  now let's look at the second diet the  very low-fat vegan diet for type 2  diabetes  that's the title of the study a low-fat  vegan diet and a conventional diabetes  diet in the treatment of type 2 diabetes  a randomized controlled 74-week clinical  trial  that's also a very high quality study  and one year and a half long  they start by saying that a low-fat  vegetarian and vegan diets are  associated with weight loss increased  insulin sensitivity and improved  cardiovascular health they decided to  compare the effects of the low-fat vegan  diet and conventional diabetes diet and  see how it affects blood glucose weight  and lipid profile  so they're basically comparing the very  low-fat vegan diet with this simple  low-fat diet  so that's how they've made the study  there were three living individuals with  type 2 diabetes and 49 of them were  assigned to a low-fat vegan diet and the  other 50 got assigned to following  american diabetes association guidelines  for 74 weeks  and every few weeks and at the end of  the trial they check their glycated  hemoglobin hba1c and plasmalipids which  are your blood fats  here's what they found both groups lost  three to four kilograms of weight but  there was no significant difference  between the groups  at the end of the study the vegan diet  group had hba1c change of minus 0.34  while the conventional diabetic diet  group had a change of minus 0.14  both diets were associated with  sustained reduction in weight and plasma  lipid concentrations  in an analysis controlling for  medication changes a low-fat vegan diet  appeared to improve blood glucose and  plasma lipids more than the conventional  diabetes diet recommendations  so the overall result of this study is  reduction of hba1c by minus 0.34 and if  you compare the change between the  groups it's only 0.2 difference  let's look at the third diet the low  carb diet for type 2 diabetes the title  of the study  effect of a 90 gram of carbs a day low  carbohydrate diet on blood sugar control  and small ldl cholesterol in type 2  diabetes patients an 18-month randomized  control trial  it's a very high quality study of 1.5  years  there were 92 poorly controlled type 2  diabetes patients aged 20 to 80 years  with hba1c of 7.5 or more they were  randomly assigned to a low-carb diet or  traditional diabetic diet the primary  outcomes were blood glucose control  status and change in medication effect  score  the low carb diet group consumed 88  grams of carbs a day on average while  the standard diabetic diet group  consumed 151 grams of carbs a day on  average which is around twice as much  when compared with the low carb group  let's see what they found after those 18  months the mean change in hba1c from the  start was statistically significant  between the groups  hba1c decreased by 1.6 in the low-carb  group compared with -1 for the regular  diet group  that's hba1c result of minus 1.6 in the  low-carb group and the difference  between the groups is 0.6  to our post-meal glucose decreased by  minus 94 milligrams per deciliter in the  low carb group compared with minus 18  milligrams per deciliter in the regular  diabetic diet group medication use was  decreased more in the low carb group  they lost more weight they lost more  belly fat so their waist measures were a  lot smaller they also had better blood  pressure results and all these were  statistically significantly lower in the  low carb group  so the overall result of this study with  hba1c change from 7.5 or more to around  5.9 percent and the change was 1.6 so  far that's the best result  people with poorly controlled diabetes  are getting into pre-diabetic range  pre-diabetic hba1c range is 5.7 to 6.4  percent  5x9 is very close to the normal  non-diabetic range and it is considered  diabetes remission  and finally let's look at the fourth  diet the very low carb ketogenic diet  for type 2 diabetes  the first study is called an online  intervention comparing a very low  carbohydrate ketogenic diet and  lifestyle recommendations versus a plate  method diet in overweight individuals  with type 2 diabetes a randomized  control trial  their aim was to compare the very low  carbohydrate ketogenic diet with  lifestyle changes with a diet program  based on american diabetes associations  create your plate and see if it would  improve blood glucose control and other  health outcomes in overweight diabetics  participants were 25 overweight adults  with type 2 diabetes who had hba1c  levels between 6.5 to 9  and the study was 32 weeks long which is  a bit more than 7 months and their  results showed that the keto diet group  had better hba1c improvements on average  it decreased by minus 0.8 percent  compared to the control group minus 0.3  percent so the difference between the  groups was 0.5 more than half of  participants in the keto diet group 6  out of 11 lower their hba1c level to  less than 6.5 percent which is a  pre-diabetic state or diabetes remission  and 0 of people in the control group  managed to achieve it  also keto diet group lost 12.7 kilograms  on average compared to only three  kilograms in the control group  participants in the keto group lower  their triglyceride levels by minus 60.1  milligrams per deciliter on average  compared to only minus 6.2 milligrams  per deciliter in the regular diabetic  diet group as some people got increased  triglycerides on the lofa diet  and there were way more people dropping  out in the control group when compared  to the keto group meaning people found  it easier to stick to keto  then there's another trial 90-day  ketogenic diet and type 2 diabetics  11 women who were recently diagnosed  with type 2 diabetes with an average  hba1c of 8.9 percent followed a low-carb  keto diet with 30 grams of carbs a day  for 90 days  after 90 days their average hba1c was  5.6 which means most of participants  achieved type 2 diabetes remission like  complete remission  and just to clarify they were not using  any diabetic medication unlike in other  studies only with the diet alone they  achieved type 2 diabetes remission even  reaching normal non-diabetic results  and then there was a systematic review  that is a summary of several  experimental studies it's called  efficacy of ketogenic diets on type 2  diabetes a systematic review  they included 14 studies out of which 12  were clinical trials  so these were the effects on glucose  control  10 out of 14 included studies showed a  positive impact on hba1c in short-term  studies hba1c improvements were variable  with reduction of 0.6  after three weeks to 0.9 percent  decrease after four months or even 1.3  percent hba1c decrease after 32 weeks so  as we see depending on the duration we  see different results the longer someone  follows this diet the better results get  now let's try to compare all the results  of different diets mediterranean lofa  diet the first trial hba1c change was  from 7.43 percent to 7.07 percent at 6  months  0.36 degrees from start to end which is  around 4.8  reduction diabetes remission was not  achieved  then the mediterranean diet systematic  review hba1c changed minus 0.3 points  compared between both groups  let's say one reduced 7.4 to 7.1 while  the control stayed at 7.4 that's a  change of 0.3 between the two groups  let's move to the next diet the very  low-fat vegan diet a 74-week randomized  control trial reduction of hba1c by  minus 0.34  hb a1c changed from 8.05 percent to 7.71  which is percentage-wise minus 4.22  reduction diabetes remission was not  achieved they reached 7.71  hba1c  then let's look at the next diet the  low-carb diet 18-month randomized  control trial  hba1c changed from 7.5 or more to around  5.9 percent the change was minus 1.6  which is 21 reduction diabetes remission  was achieved but the results could be  further improved to achieve complete  diabetes remission  then let's look at the very low carb  keto diet a 32-week keto trial hb a1c  change minus 0.8  went from 7.1 to 6.3 percent which is  11.3 percent reduction  type to diabetes remission achieved now  that's more than the vegan diet more  than the mediterranean diet but less  than the low carb diet but as we see the  low carb diet trial was 18 months while  this keto diet trial was only 7 months  then the next keto 90-day trial  hba1c went from 8.9 percent to 5.6  which is 3.3 percent less in hba1c  scores that is the best result so far  that's a reduction by 37 percent and it  was a very short trial only three months  a trial where no medication was used so  that's pretty impressive  and then the final keto systematic  review hba1c change minus 0.6 after  three weeks minus 0.9 after four months  minus 1.3 after 32 weeks which is seven  months  so as we see there were a lot of  variations between these studies they  had different durations  different number of participants  different hba1c values to begin with  some studies use participants who take  diabetic medication  some who don't use any medication some  express their results in mean change  values without providing average hba1c  values it's a total mess but here's what  we can see for certain  the low-fat mediterranean diet and the  very low fat vegan diet both had very  similar results hba1c change of around  -0.3 the vegan diet was a tiny bit  better minus 0.34  while the lower carbohydrate diets were  a lot better especially the 30 grams of  carbohydrates a day keto where people  achieved complete diabetes remission  reached non-diabetic blood glucose  levels without medication  and don't be tricked by the fact that  there are way more studies conducted on  the mediterranean diet and that studies  are bigger when compared to the keto  diet that has only a few trials  it simply shows that those who have the  money for funding studies prefer to fund  the mediterranean lofa diet studies they  want this diet to dominate the space  why  maybe they are not searching for the  best diet for type 2 diabetes  well i help you to find the answer  so now we know that a low-carb diet and  the low-carb keto diet are the best  diets for reducing your daily glucose  and your hba1c levels now a lot of  people would still say it's still bad  for you a hypha diet increases insulin  and causes insulin resistance let's  quickly have a look if that's true  are there any studies looking at how the  low-carb high-fat ketogenic diet  compared to a higher carb low-fat diet  affects insulin levels and insulin  resistance  there's a study called comparison of  isocaloric very low carbohydrate high  saturated fat and high carbohydrate low  saturated fat diets on body composition  and cardiovascular risk they compared  three different diets and measured  insulin levels  there were 83 subjects they were  randomly allocated to one of three  weight loss diets with the same number  of calories for eight weeks and on the  same diets in energy balance for four  weeks  the first diet was a very low fat high  carb diet with these macros carbs 70  percent of calories fat 10 of calories  protein 20 of calories marked in orange  the second high carb diet was a high  unsaturated fat high carb diet with  macros as follows  50 carbs 30 percent fat 20 protein and  six percent of fat was saturated fat  that's your mediterranean diet marked in  red  and the third diet was a very low carb  high-fat ketogenic diet with macros as  follows  four percent carbs 61 percent fat 35  percent protein 20 of the fat was  saturated fat marked in green so if  saturated fat is the problem this diet  should cause the most insulin and result  in insulin resistance because too much  insulin causes insulin resistance it's  same if you eat too much chocolate and  ice cream and you feel sick you've had  too much of it and you don't want it  anymore that's basically insulin  resistance  looking at the results we see that the  very low fat very high carb diet marked  in orange resulted in the highest levels  of insulin the more carbs you eat the  more insulin you need to bring it to the  cells  and we see that the high fat low carb  keto diet marked in green resulted in  the lowest levels of insulin  the less carbs you eat the less insulin  you need and the less insulin resistant  you become this clearly shows that the  high fat high saturated fat diet has  nothing to do with causing insulin  resistance  it helps you to lower insulin and  reverse insulin resistance and if you  need more proof i have a whole separate  video looking into the cause of insulin  resistance you can watch it later  now if you found this video useful like  it and subscribe to my youtube channel  and share it with someone who has type 2  diabetes  and also share it with your doctor if he  or she doesn't follow the most effective  practices for managing type 2 diabetes  why would you follow a diet that keeps  you in a diabetic range taking diabetic  medication if you can follow a diet that  makes your blood glucose normal in some  cases without any medication  feel free to join my type 2 diabetes  support group on facebook get my type to  diabetes meal plan or join my type 2  diabetes coaching program if you need  help for achieving diabetes remission  thanks much for watching and i hope to  see you in the next video  [Music]