Listen to Dr. Neal address this topic on Episode 260 of the podcast Optimal Health Daily.

If you were to ask 10 physicians which diet is best with diabetes, you may hear 5 different answers (some of those often contradictory). Frustrating, I know.

My answer will only make sense after I mention a few things about diabetes.

First, I must say I am glad that I wasn’t a doctor back in the days of ancient Greece. Get this: during those days, doctors would diagnose diabetes by tasting their patient’s urine! Why would that even be a thing?! Well, because if the urine tasted sweet, it meant the person had diabetes. So why would that happen? Sweet tasting urine meant that there was sugar in it. If there’s sugar in the urine, this meant that the sugar was not being absorbed and used by the body. Basically, that’s the issue with diabetes – the fuel we’re eating is not being absorbed and used. In fact, the term diabetes mellitus translates to “sweet-tasting urine”!

I promise I have a point: when we think of which foods the body most readily converts to sugar (or glucose), it comes to carbohydrates. Foods like rice, pasta, cereals, breads, pastries, etc. are rapidly converted by the body to sugar. Protein-rich foods and those that are high in fat can also get converted to sugar, but not as efficiently. If we can control the types of foods we eat, we can help the body create less sugar and hopefully manage our diabetes better.

Which Diet is Best For Diabetes?

The answer really lies in the types of carbohydrates and types of fat we’re eating. The reason why some studies may mention that a high carbohydrate diet may be helpful while others say the exact opposite really comes down to this fundamental concept.

I mentioned that high-carbohydrate foods like rice, pasta, cereals, breads, etc. are easily converted to sugar by the body. But there’s one important detail I didn’t mention: the type of food is important. For example, the body converts white rice to sugar very quickly and very easily. Wild or brown rice, on the other hand – not so much. Whole grain pastas are not converted to sugar as quickly as white pastas… same goes for whole grain breads as opposed to highly refined breads. So not all carbohydrate-rich foods are bad –it’s the type that’s most important.

Also note that these less-refined carbohydrates are also higher in fiber. We’re learning that fiber can help our body’s cells absorb sugar more easily – which is what we want! So, one of the reasons you might hear that a high carbohydrate diet is beneficial for diabetes is because what they really mean to say is a diet high in whole or minimally processed carbohydrates may help manage diabetes.

What about fat? I mentioned that the body can also convert fat to sugar, just not as easily as it can carbohydrates. But just like carbohydrates, the type of fat is most important to consider.

The story regarding fat and its link to diabetes is a bit more complex. This is because it’s not just about how quickly the body can convert fat to sugar. There’s another factor that’s even more important to consider. For example, saturated fat – the kind you usually find in greater quantities in animal products like red meat and butter – actually change our bodies on a cellular level. We’re learning that a diet high in saturated fat may block your body’s ability to absorb sugar properly. Again, it’s not just about how quickly the body converts it to sugar, but instead, what it does to our bodies’ cells that can affect how we use that sugar.

When we look at how other fats affect our cells, we are finding that diets high in monounsaturated and polyunsaturated fats may improve our ability to process sugar. This means there will be less sugar in the urine, which is a good thing! Foods high in monounsaturated fat include avocado and most nuts. When it comes to polyunsaturated fats, the most beneficial type are omega-3 fats – the kind you find in cold-water fish like salmon, mackerel, halibut, and trout.

Conclusion

Which diet is best for managing diabetes: a high-carbohydrate, low-fat diet, or a low-carbohydrate, high-fat diet? Technically, either one. I would respond more specifically by saying the best diets for managing diabetes would be:

1. A diet that contains lots of whole or minimally processed carbohydrates, a decent amount of fiber, and low in saturated fat and/or
2. A diet that is high in monounsaturated and omega-3 fats, and low in refined carbohydrates

Listen to Dr. Neal address this topic on Episode 260 of the podcast Optimal Health Daily.

Neal Malik

Dr. Neal Malik ("Dr. Neal") has a Doctorate in Public Health with emphases in disease prevention and nutrition. He is also a Registered Dietitian and Certified Health Education Specialist. He is currently an assistant professor at California State University, San Bernardino. Dr. Neal has published peer-reviewed scientific research and been featured as a nutrition and wellness expert in over 70 media outlets including Parade and The L.A. Times. Send in your health related question and Dr. Neal will answer it on the Optimal Health Daily show!