What is the best diabetic diet for weight loss?
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.
However, it seems much of that information was based on faulty science as even the recommendation of reducing saturated fat has fallen under scrutiny in multiple meta-analyses.
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%.
Vegan
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.’
For example, many people who choose to go vegan have already adopted many other healthy lifestyle values such as exercise, stress reduction, not smoking, portion control, etc.
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/Mediterranean Diet
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.
That said, there is much evidence to support the notion that a low carb diet is more effective for weight loss than low fat.
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!
Thanks for the info. I’ve been trying a low carb diet but this has jus convinced me to keep at it to reach my goal in 2023!
Very nice pattern and superb subject matter, practically nothing
else we need :D.
I am ready to begin taking control of my life but my problem is odd. I am trying to gain 5 to 8 pounds. My question is which eating plan do I need and how many calories per day are the meals. Does it show you what to eat for breakfast, lunch and dinner? Thank you Sue
This info on weight gain here will be of benefit to you Sue. As for DMPs meal plans, the calories per day does vary. The plans provide lunch and dinner fully planned, with a breakfast and snack selection you can add. You can learn more about the plans here.
Great post with lots of information. I am trying the low carb and so far is working. I have the occasional bloating so I am not sure if it could be caused by certain foods.
Marta, do you keep a food diet? I found out I bloated whenever I used soy sauce. I stopped using it in my dishes no more bloating. Could be wheat? The best to you. Sue
The meals that are coming up for me to see are often meat based. That’s what I meant – sorry if I wasn’t clear. I did highlight “vegetarian” when I registered.
Oh right yes, thanks for making that point!
That’s one area we definitely need to improve, so we can provide more info specifically for our vegetarian subscribers. Thanks for the push Ellen – we’ll make a note of it. 😉
I lost a lot of weight and cut tablets in half by replacing half my meat with pulses like chickpeas etc.
Great to hear Valerie – beans and legumes can be a good alternative to meat. They are full of fiber. Still, some people with type 2 diabetes and prediabetes can’t tolerate a lot of them, as they are also quite high in carbs. But in small portions they can be great!
I’ve been on a low carb diet for 4 months. Previously my hb1ac was 7.2. Last week it dropped to 5.5
I have lost 8 kilos. I am limiting my calories to below 1500 often closer to 1200. I’m averaging less than 50 grams of carbs per day. I am thrilled with my results. I am concerned however that I am missing nutrients or eating too much protein.
Congrats! Great results Ellen – yes, a lower carb diet does work! And it is also a sustainable way of eating long term, which is even better. Did you learn about low carb from DMP?
Various nutrients are found in all types of whole food sources, including fats and all your veggies. As long as you’re including plenty of variety, you should be okay.
No I didn’t hear about it from dmp. I discovered this site because I was on the 8 week blood sugar diet by Dr Mosley . Thanks for the feedback regarding nutrients. We have a very varied diet with vegetables and vegetarian proteins. Your site was recommended to me via a diabetic Facebook group who I only discovered from a celiac Facebook group. Gets a bit confusing the source of referral.
I’m thinking of subscribing to your meal plans but haven’t worked out the “vegetarian” bit in your plans. Many have meat based recipes.
Good to know Ellen – thanks for sharing, I’m always curious. 🙂
Yes, with being online it can get confusing. But the most important thing is that people find the help they need, help that can really make a difference!
What don’t you understand about the “vegetarian” plans? You mean, most low carbers are meat eaters? With meat-based recipes?
It is true, that is the case, but we like to add variety. And even some of our members who are meat eaters, like to eat vegetarian recipes sometimes.
We use tofu, tempeh, edamame – all of which have a lower carb content. Small quantities of beans and legumes as these are also higher in carbs. Plus the addition of nuts, seeds, eggs and that sort of thing. The end result is usually a similar carb content to the meat recipes overall. And as a meal plans member, you can access both plans without having to choose, which basically just gives you more meal options to choose from.
If that doesn’t clear up confusions, please let me know because other people likely have the same questions. Thanks!
I reduced my medicine intake by 50% after having 45-60 minutes regular exercise coupled with low carb diet for 3 months. My A1C reduced to 5.7 from 6.4 and my weight is in the normal range. so, I advice people with type 2 diabetes to try this.
Congrats Tsegazeab! That’s exactly why we encourage a lower carb diet – it works!
I got type 2 diabetes about a year ago. I studied through several diets to see which one would fit my schedule plus get some of this weight off of me. I was more than amazed with the low carb diet. I wasn’t hungry and I lost weight fast. All of my vital blood levels came back very well and my A1C dropped within a few months. I would definitely encourage anyone to at least try the low carb diet.
That’s what we encourage here Cathy, because it definitely produces great results – our members and subscribers can vouch for that too!
Great to hear you’re in better health.
Thanks for sharing, this is clear and useful post. And totally agree with you that the best diet is the one that works for you since each body converts and uses calories at a different rate that is influenced by numerous lifestyle factors. There are many opposing information around today that it’s easy to get confused and lost, and this article really helps to clear the air.
You have never mentioned fasting as a way of controlling obesity and blood sugar. I refer to the work done by Dr. Jason Fung, his books and his youtube presentations. Do you have any thoughts on this?
He Terence–that’s a good question. There is enough controversy that I don’t want to write it off completely, but certainly would not recommend it. The weight of the evidence seems to indicate the opposite. People with diabetes have a series of metabolic Derangements (ie insulin resistance, insufficient production) including Alpha cells leaking glucagon causing glucose to release from liver & muscle cells in greater amounts than ‘normal’ people. After about 4 hours of food, this starts to occur. Ingestion of food stops the process as the body can now use this energy coming in. In addition, fasting slows metabolic rate (which doesn’t help with weight loss). There are a handful of other reasons I’d avoid it (generally produces overeating later on being one) as I’ve seen much greater success the opposite–small frequent meals/snacks consisting of healthy foods. If a person is taking insulin, fasting can be dangerous and cause a bottoming out and should never be done apart from physician supervision.
you can find research/evidence to support just about anything depending on how studies are designed, but based on the weight of research and clinical practice, I’d not recommend it to people although as a spiritual discipline it can hold benefits–but even then, precautions should be taken & discussed with an appropriate practitioner.
I HAVE LOST WEIGHT ON THE DIABETIC DIET; HOWEVER I HAVE PANCREATITIS AND I MUST WATCH VEGETABLES AND FRUIT BECAUSE MY PANCREAS DOESN’T LIKE THE HIGH LEVELS OF CELLULOSE. EATING AN APPLE CAN SOMETIMES CAUSE A PANCREAS ATTACK. I ALSO HAVE TO BE CAREFUL EATING MEAT. HAM AND/OR SPICY MEATS ARE ALSO SOMETHING MY PANCREAS FIGHTS AGAINST. ANY SUGGESTIONS?
It can be tough when you have to avoid certain foods so I guess the best question is what foods don’t make you react? Are there certain meats and vegetables that seem to be fine? Eat more of those.
I agree with Jedha–keep a log/diary of which foods trouble you and perhaps try some new foods you don’t eat as often….there really are a LOT of healthy foods to choose from: https://diabetesmealplans.com/44/diabetes-friendly-food-list/
This is great information. the only problem for me is that I am at work all day and I don’t cook as much now that my kids are out of the home now. I dont stock food and mostly buy as I go.
I hear ya–we are very busy/convenience-driven society & it’s hard to plan ahead, but it makes such a big difference when you do and often find that once you get into a habit/routine, it becomes much easier….have you ever used a slow cooked (crock pot)? They are a great kitchen asset. Put some meat and vegetables along with some spices and you come home to a tasty meal that has been simmering all day. Another option is to batch cook & freeze individual portions on days when you do have more time to cook. Great strategy when kids are gone because you can still cook large meals, but don’t have to eat all of them!