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Is a no-carbohydrate, low-carbohydrate, or moderate-carbohydrate diet the best choice for someone with diabetes?
This is a question I receive almost every day. Today I would like to answer by sharing my experience with all three diet types.
Before we dive into different diet methods, let’s put the obvious answers aside. It depends.
The best diet for you will always depend on your health goals, activity level, weight, and other factors. A diet that works for you may not work for me, and vice versa.
For example, if you’re trying to build strength or muscle, you shouldn’t follow the same diet as if you’re trying to lose weight.
Similarly, someone who runs every day will have different dietary requirements than someone who sits in an office all day and doesn’t exercise.
Your health care provider or registered dietitian (RD) can help you decide what type of dietary approach is best for you and your diabetes management.
Okay, now that that’s out of the way, let’s take a look at the details of the different diets!
of Ketogenic diet (“keto”) Usually defined as Contains less than Eat 50 grams of carbohydrates per day, with an emphasis on high-fat foods and moderate protein foods.
The theory behind this dietary approach is that by consuming very few carbohydrates (about 5 to 10 percent of total calories), your body will begin to convert fat into fatty acids and ketones.
Ketone bodies can replace glucose as the body’s main energy source. This means that the body relies primarily on fat for energy. In theory, it will be much easier to lose excess body fat if you limit your calorie intake at the same time.
Because you eat very few carbohydrates, your need for insulin is theoretically much lower, making it easier to control your blood sugar. (Carbohydrates are the main nutrients that affect blood sugar levels.)
Sample foods recommended for this diet include:
- meat (Example: beef, pork, lamb, chicken, game meat. Preferably grass-fed organic meat)
- fatty fish (Example: salmon, mackerel, sardines, trout, and other fish rich in omega-3 fatty acids)
- egg (Preferably free-range eggs or omega-3 enriched eggs)
- high fat dairy products (butter, cream, certain cheeses, etc.)
- nuts and seeds (Example: almonds, walnuts, flaxseeds, pumpkin seeds, chia seeds)
- healthy oil (Mainly extra virgin olive oil, coconut oil, avocado oil)
- avocado (Whole avocado or freshly made guacamole)
- low carb vegetables (e.g. green vegetables, tomatoes, onions, peppers)
- seasoning (e.g. vinegar, mustard, hot sauce, garlic, herbs, spices)
- beverage (Example: water, unsweetened coffee, tea)
A registered dietitian can help you determine the optimal balance of your diet, taking into account your lifestyle and overall health goals.
So what was my experience with the keto diet? Unfortunately, it had no effect on me at all. My insulin sensitivity was messed up because I was only eating 20 grams of carbohydrates per day.
Fats are released into the bloodstream more slowly than complex or refined carbohydrates, so I didn’t see any abnormal fluctuations in blood sugar levels, but when I was eating a low-carb or moderate-carbohydrate diet. compared to , the need for insulin has increased dramatically.
Needless to say, my experience with the ketogenic diet has been rapid weight gain. It wasn’t really what I was aiming for.
My blood sugar levels were good and stable, but often tended to be high. But gaining fat is not part of my goals, so to be honest, I probably will never try a ketogenic diet again.
I know that some people have had success with ketogenic diets for diabetes management, so my experience may not be typical, but I cannot recommend the ketogenic diet at this time. Although it is not necessary to properly manage blood sugar levels, the downsides can be severe.
(In addition to the problems I experienced, risks of this diet include: hypoglycemia [low blood sugar] For those taking insulin or drugs that increase the release of insulin, nutrients defectkidney stone, acceleration of For people with renal impairment kidney diseaseand constipation. )
There is currently no widely accepted standard definition of Low-carbohydrate diets, but most of the time resource Defined as less than 26 percent of total daily calories or less than 130 grams of carbohydrates per day.
Sample foods recommended for this diet include:
- low starch vegetables (Example: leafy vegetables, broccoli, cauliflower, zucchini, peppers, cucumbers, asparagus)
- lean protein (Example: chicken, turkey, red meat such as beef or pork, fish, etc.) [especially fatty fish like salmon]other seafood)
- egg (Good source of protein and nutrients)
- dairy products (e.g. unsweetened Greek yogurt, cheese) [especially hard cheeses]cottage cheese)
- nuts and seeds (Example: almonds, walnuts, flaxseeds, chia seeds, pumpkin seeds)
- healthy fats (Example: olive oil, avocado oil, coconut oil, butter, ghee)
- avocado (Rich in healthy fats and very low in carbohydrates)
- Berries in moderation (Example: strawberries, blueberries, raspberries, blackberries)
- fruits in moderation (Example: watermelons, cantaloupes, peaches, plums, citrus fruits, preferably whole or minimally processed)
- Whole grains, in moderation (Example: wheat, quinoa, barley, oats)
- Legumes in moderation (lentils, black beans, chickpeas, etc.)
- beverage (e.g. water, unsweetened tea, coffee)
A registered dietitian can help you determine the optimal balance of your diet, taking into account your lifestyle and overall health goals.
For most women with type 1 diabetes, myself included, I find that low-carbohydrate diets are the best choice for weight management and fat loss. The only time I lower my daily carbohydrate intake this low is when I want to slim down, such as when I want to drop those last few pounds for a photoshoot or fitness competition.
An additional benefit of a low-carbohydrate diet is that it makes it easier to manage your blood sugar. Because you spread your daily carbohydrates over several meals and combine them with lean protein and good fats, you’ll see fewer fluctuations in blood sugar levels after meals.
That said, I know this is controversial to many people in the diabetes community, but in general, I do not recommend a low-carbohydrate diet as an optimal daily maintenance diet. It supports weight loss and blood sugar control, but it can also lower your energy levels.
If you lead an active lifestyle (especially if you do strength training), a moderate carbohydrate diet will provide you with the energy you need for your workouts while allowing for good blood sugar control.
a moderate carbohydrate diet Typically, 26 to 44 percent of your daily calories come from carbohydrates. If you eat 2,000 calories per day, you’ll be consuming 130 to 220 grams of carbohydrates per day.
Although carbohydrates may be too high for some people with diabetes, most research suggests that a moderate carbohydrate diet is appropriate for this population. Personally, I eat at the higher end of this carbohydrate range when I’m working out a lot and trying to gain muscle mass.
Sample foods recommended for this diet include:
- whole grain (Example: brown rice, whole wheat pasta, quinoa, barley, whole wheat bread)
- fruit (Example: apples, oranges, pears, berries, peaches, preferably whole or minimally processed)
- low starch vegetables (Example: leafy greens, broccoli, cauliflower, peppers, and other colorful vegetables)
- lean protein sources (Example: chicken, turkey, lean beef, fish, tofu, legumes)
- low fat dairy products (e.g. low-fat or non-fat milk, yogurt, cheese)
- legumes (Example: beans, lentils, chickpeas)
- nuts and seeds (Example: almonds, walnuts, chia seeds, flaxseeds)
- Moderate amounts of starchy vegetables (Example: potatoes, sweet potatoes, corn)
- healthy fats (e.g. olive oil, avocado, nuts)
- beverage (Example: water, unsweetened herbal tea, coffee)
A registered dietitian can help you determine the optimal balance of your diet, taking into account your lifestyle and overall health goals.
During my last muscle-building phase, I was consuming an average of about 200-250 grams of carbohydrates per day while lifting heavy weights 5-6 days a week. As long as you’re consuming low-glycemic carbohydrates (except right after a workout), you can eat that much carbohydrate and still have very good blood sugar control.
The great thing about a moderate carbohydrate diet (aside from eating lots of delicious carbohydrates) is that it allows you to “lean up” and gain modest muscle mass while slightly reducing your body fat percentage.
For those with weight loss goals, mediterranean dietIt has been shown to support weight loss in people with the following conditions, especially when combined with regular exercise (not necessarily at a competitive level): type 2 diabetes and type 1 diabetes.
In this post you can see exactly what my typical diet looks like.
No matter how many carbohydrates you’re targeting in your meal plan, it’s best to limit or avoid certain foods, both for your blood sugar levels and your general health. These include:
- Processed foods (retort food, baked goods, candy, potato chips, etc.)
- Foods high in sugar (carbonated drinks, juices, pastries, etc.)
- Refined starch (white bread, white rice, white pasta, etc.)
- Foods high in sodium (fast foods, canned foods, frozen instant foods, processed meats, etc.)
- alcoholic drinks
As mentioned above, there is no universal approach to diet that is suitable for everyone with diabetes. This is reflected in the American Diabetes Association (ADA) nutritional guidelines.
Based on current research, Diabetes treatment standards — 2024 suggest that different dietary patterns may be appropriate, including the Mediterranean diet, Dietary Approaches to Stop Hypertension (DASH) diet, low-carbohydrate vegetarian, and plant-based diets.
The ADA also recommends limiting processed meats, animal fats, refined grains, and added sugars and focusing on whole, plant-based foods.
As mentioned at the beginning, the best diabetic diet for you will depend on your goals. Personally, I believe that a low-carbohydrate diet is best for weight loss, and a moderate-carbohydrate diet is best for maintaining and building muscle mass.
(As a final note, some people with diabetes have had great results following an all-carbohydrate, all-fruit diet that consumes more than 600 grams of carbohydrates per day.) Although it is not something I would ever attempt and is not recommended by any medical professional, it clearly shows that various diets can be effective in managing diabetes).
The best thing for you to do is work with your medical team, experiment, take notes, learn from your mistakes, and find a diet that works for you and your body.
We recommend the following posts: How to lose weight when you have diabetes.