Ask 10 experts and you just might get 10 different answers!
Look at the American Diabetes Association, weight watchers, or talk to a registered dietitian (or 5) – and you’ll end up even more confused than ever.
Yep, join the club. Even as a nutrition “experts,” sorting through research is very cumbersome and can be overwhelming.
Many of the studies seem to contradict one another in their findings and it is impossible to do a perfectly designed study because human beings are very complex with a great multitude of barriers beyond our control.
That said, the research is helpful and one thing it tells us when it comes to weight loss, is that different things work better or worse for different people.
Below is a very brief synopsis and comparison of a few of the more popular diet approaches. And we’ll wrap it all up by trying to examine what the best diet for diabetic weight loss really is (based on the scientific evidence).
Low Fat Diet
Low fat diets were all the rage of the 1980s but started making considerable headway even earlier with Dr. Dean Ornish who promoted a diet high in fruits, vegetables and complex carbohydrates and very low in fat – especially fats from eggs, red meat, and full fat dairy.
The concept seemed to make a lot of sense in theory: if you want to lose fat, eat less fat, right? Especially the solid “artery clogging” kinds coming from saturated sources.
The low fat mantra has been the heartbeat of most of our public health recommendations for several decades, under the assumption that dietary fat caused heart disease and obesity.
Additionally, let’s consider that since we’ve begun telling the public to reduce their intake of fats generally, and saturated fats specifically (1977), intake of fat as a percentage shifted from 40% to 35%. Intake of cheese, butter, milk and red meat decreased, while intake of vegetable oils, margarines, and fat free products shot up dramatically, being sold as a “healthier” option.
Clearly there are flaws.
That said, the type of diet adopted by Westerners was very high in simple carbs, high in overall calories and the intake of sweetened beverages skyrocketed.
In terms of evidence toward a low fat diet and diabetic weight loss, a long term study in Diabetes Care, showed that adherence to a low fat diet improved glycemic control and sustained weight loss when followed over a 5 year period. In a large meta-analysis, researchers found low fat diets of around 27% fat effective at producing weight loss of about 7 pounds (3.2 kg) on average when compared with control groups with an average fat intake of 37%.
A vegan diet is entirely plant-based foods; that is it includes no animal products whatsoever. Those who choose this lifestyle often do so for ethical reasons (animal rights), but many choose it for health reasons as well.
This meta analysis summarizing 12 studies showed that those following vegetarian diets for an average 18 weeks lost significantly more weight (about 4.5 pounds/ 2 kg on average) than the control groups, but results were less significant after 1 year (about 2.4 pounds/ 1.1 kg).
There is a lot of evidence to support the general healthfulness of vegan diets. However, much controversy exists as to whether correlations observed are causative in nature or simply a result of the lifestyles adopted by those who tend toward veganism – what we’d call a ‘correlation.’
If these types of lifestyles were adopted more universally by those consuming animal products, would we see the same results?
It’s hard to tell – again this is where it becomes difficult to design such a study. That said, some drawbacks to a vegan diet are lack of low carb protein options – things like chicken, fish, turkey, beef, and eggs are all out.
And there is potential of choosing very unhealthy non animal-based foods. For instance, one could in theory have two frosted donuts fried in vegetable oil and a sprite for breakfast and call it vegan!
A vegan diet is almost inevitably higher in carbs and often people following a vegan diet need to take supplements to provide certain nutrients only available in animal products, such as Vitamin B12. Advantages are that if followed veganism correctly, it can be a very high fiber, environmentally-friendly, lower cost diet and lifestyle.
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DASH stands for ‘Dietary Approaches to Stopping Hypertension.’ It was developed by the National Institutes of Health. While originally designed to help people reduce high blood pressure, it has since been touted as an effective diet for weight loss.
The DASH diet adopts similar principles of a Mediterranean, promoting lots of fruits and vegetables and moderate amounts of low fat dairy, lean meat, and nuts seeds and ample intake of olive oils. While lower in fat than a standard diet, it doesn’t put a specific fat limit and does encourage intake of certain healthy fats, like olive oil for instance.
The DASH diet includes plenty of whole grains such as oats, whole grain cereal or whole grain pasta. And it also doesn’t limit starchy vegetables such as potatoes, beans, peas and so forth – though, it does emphasize low glycemic index choices.
There is quite a bit of research supporting the efficacy of the DASH/ Mediterranean diet in supporting a multitude of health benefits, including weight loss. If followed correctly, people would be consuming large amounts of fiber, potassium, magnesium, and many other vitamins and minerals. And they’d also be limiting salt, trans fats, and refined starches.
However, you could easily consume a LOT of carbs on these diets – breads and potatoes in the same meal, more sugar, juice…along with cereal and bread for breakfast.
For people with diabetes this is going to stack up your blood sugar and A1c and in turn you won’t be getting great weight loss results.
Low Carb Diet
The low carb diet is in large part a response to the perceived failure of the low fat diet.
One study among the obese (39% had diabetes) showed a weight loss of 12.8 pounds/ 5.8 kg for those on a low carb diet compared with 4.2 pounds/ 1.2 kg on the low fat.
Another study showed greater weight loss in those with type 2 diabetes on a low carb diet, 14.6 pounds/ 6.6 kg vs low fat, 4.6 pounds/ 2 kg; however it was very small study (only 13 people in each group) and short (only lasting 3 months).
This larger, 2 year study compared a low fat, Mediterranean and low carb diet and found a moderately better weight loss with the low carb group, 10.4 pounds/ 4.7 kg compared with the others, 6.4 pounds/ 2.9 kg in the low fat and 9.7 pounds/ 4.3 kg in the Mediterranean group.
This short 6-week (but small study) showed that a low carb approach was more effective at producing weight loss than the low fat group – 14.1 pounds/ 6.3 kg in low carb vs 9.3 pounds/ 4.2 kg in low fat group. It was also effective at reducing hunger.
A one year study comparing low fat to low carb diets on weight and glycemic control in type 2 diabetes showed similar results in both weight and A1c reduction with a slight improvement in HDL seen in those in the low carb group.
Another study comparing the two diets found greater weight loss with the low carb group (7.3% of body weight) than the low fat group (4.5%) for the first several months but a year out, no difference was seen. This study basically found the same thing.
A 2022 review in people with type 2 diabetes comparing low fat and low carb diets found that low carb reduced body weight by 3 kg/ 6.6 pounds more than the low fat group over short term 3-6 months.
Comparison of Best Diabetic Diet For Weight Loss
Low fat diet average weight loss: 7 pounds (3.2 kg)
Vegan diet average weight loss: 2.4 pounds (1.1 kg)
Low carb diet average weight loss: 12.9 pounds (5.8 kg)
Obviously we’ve seen the weight of evidence support the low carb approach, which is why we encourage it.
In our members we consistently see people losing weight and maintaining it long term too – and that’s the greatest challenge. Once you lose it, you want to keep it off!
If you follow a healthy low carb diet with a balance of protein, fats, and carbs, namely LOTS of fresh non starchy vegetables (like the type of diet we encourage here and in our weekly meal plans), then low carb is the clear winner in terms of the best diabetic diet for weight loss.
So, Which is the Best Diabetic Diet for Weight Loss?
Answer: the one that works best for you.
While we advocate a “low carb” approach here at Diabetes Meal Plans, if you are able to maintain a healthy weight, controlled blood glucose, and sustain energy on one of the other options and prefer that, by all means, go with what works best for you.
That said, our healthy low carb approach also has the benefit of assisting with blood sugar levels and other health outcomes more than any other diet. And, in many cases people also reduce or eliminate diabetes medications as well.
If you need help losing weight and eating well each day and each week: Join Us As A Member – we’ll help you achieve your goals and get results!