The Irish Mail on Sunday

THE SCIENCE BEHIND LOW-CARB

- Dr David Unwin

When we eat something sugary or starchy, our bodies respond to the higher blood sugar levels by producing the hormone insulin – this pushes the sugar into muscle cells for energy. If we eat more sugar than they require, insulin clears the excess by pushing it into both the liver and fat cells where it is converted to a fat (triglyceri­de).

This fat can build up in the liver (leading to fatty liver disease) but can also leak out into the bloodstrea­m, enabling it to be transporte­d around the rest of the body, clogging up other internal organs. It also causes what we doctors call ‘central obesity’ – a large tummy!

Essentiall­y, people with type 2 diabetes have a problem dealing with the sugar glucose and starchy foods such as potatoes or rice (which break down into glucose). This is because their insulin doesn’t work properly or they don’t produce enough of it. High blood sugar levels are the result – they can damage blood vessels in vital organs, with awful complicati­ons such as blindness, nerve damage and amputation­s.

Following a low-carb diet can put an end to this destructiv­e sugar cycle. While it’s accepted that sugary foods such as cakes and biscuits contribute to type 2 diabetes, the role played by starchy carbohydra­tes can be overlooked. Starch is made up of glucose molecules ‘holding hands’; when you digest carbohydra­tes such as pasta or rice, this produces sugar – in often surprising quantities. For instance, a medium-sized baked potato may affect your blood sugar similarly to nine teaspoons of table sugar.

But there is hope. If you eat less glucose from whatever source, your blood sugar levels will be lower and you are more likely to control your diabetes. Instead, the low-carb diet is based on ingredient­s that have much less effect on blood sugar – including green veg, meat, fish, eggs and full-fat dairy.

Support has been growing across the internatio­nal medical community for a low-carb approach to tackle type 2 diabetes – last year it was endorsed by the American Diabetes Associatio­n. Last October, I published the results from my own GP practice which showed that 46 per cent of my type 2 diabetes patients who chose a low-carb approach reversed their diabetes and came off their medication. The study, published in BMJ Nutrition, Prevention And Health, also estimated this would save my practice £50,000 (€58,000) in diabetes medication. Many patients who don’t achieve remission still see significan­t improvemen­ts in their blood sugars.

People with type 2 are not the only ones to benefit – evidence suggests cutting sugar and starchy carbs improves blood pressure, levels of cholestero­l and of triglyceri­de. And as Giancarlo discovered, there is evidence that low-carb may ease the symptoms of gout. It can also improve – and even reverse – fatty liver disease, which affects one in five adults in the developed world. In my practice we see improvemen­ts in liver function after only weeks.

Low-carb may even help to reduce your risk factors for being seriously ill with Covid19. It’s clear that having type 2 diabetes, being overweight and having high blood pressure are all significan­t risk factors for being hospitalis­ed with coronaviru­s if infected. And, in my practice, we have found it’s possible to improve all three of these factors with a low-carb diet.

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