Best diets for people with T1D: What's worth the hype?

There is a lot of information out there about the best food plan for someone living with diabetes. How do you decide what is best for your own body? How can you understand the difference between the short-term solutions and the long-term, more sustainable options?

Just because you read an article that says something works doesn’t mean it is guaranteed to work for you. If it isn’t working, don’t stick to it. It’s okay to try different foods, different diets, different strategies. It might be challenging to change things up, but nothing changes if nothing changes.

What we teach clients in our coaching program is how to really tune into your body and discover what works best for you.

To help you get started, we want to talk about three of the most common trends out there today. What are the benefits? What are the downfalls? And what do we recommend in the end?

HIGH FAT/LOW CARB

Why there’s hype: A high fat/low carb diet almost seems like a no brainer for T1D. After all, carbs are what makes blood sugars fluctuate, so if we lower our carb intake, we should see less spikes, right? High fat diets are also touted as the gateway to ketosis, where the body runs on fat instead of glucose.

Why it’s NOT worth the hype: Limiting carbohydrate intake is a one-dimensional response to the multi-faceted condition that is type 1 diabetes.

• Dietary fat is one element of your diet that is often underestimated for how directly it impacts the effectiveness of insulin in your body.
• In America, the Diabetes Control and Complications Trial conducted research that found strong links between long-term dietary fat intake and blood glucose control (independent of BMI). Patients who consumed a lower range of fat (around 62g fat/day) had an average A1C of 7.14% compared with A1C 7.47% in those consuming a higher intake of fat (around 120g fat/day). This shows us that it is important to understand how fat contributes to blood sugar numbers and not focus only on carbs.
• If you’re cutting carbs and STILL having high blood sugars, this is why: When consuming large quantities of fat, excess fatty acids gain access to tissues and block insulin from working, leaving glucose trapped in your blood.

LOW FAT/HIGH CARB

Why there’s hype: Evidence from the 1950s shows that reducing dietary fat is the number one way to increase insulin sensitivity in the liver and muscle. With a low fat diet (limiting fat intake to 10-15 grams per day) makes it easier to eat hundreds of grams of carbs per day with stable blood sugars. Research has found that certain fats, like industrial-made trans fats, are highly inflammatory and lack any real nutrition.  

Why it’s NOT worth the hype:

• Fats are critical for the absorption of fat-soluble vitamins such as vitamins A, D, E, and K.
• 60% of our brain is made up of fat! Studies show that fatty acids are the most crucial molecules for brain functioning. Essential fatty acids (EFAs) are required for optimal brain health as well as maintaining the immune system, but they cannot be made by the body and must be sourced from food.
• Fat is an important macro for satisfaction and satiation.
• Fat is essential for hormonal balance and, for women, low fat diets can lead to loss of menstrual cycle.

INTERMITTENT FASTING (IF)

Why there’s hype:

Eating all of your food within a certain window and not eating during another window, for example: 16 hour fast, 24 hour fast, has shown to decrease insulin resistance and improve cognitive function. Fasting for extended periods of time allows the body to mobilize fat for energy rather than glucose, which is why IF is popular for weight loss. Building time between meals allows the digestive system to operate more effectively.

Why it’s not worth the hype:

• Most of the research on IF has been done on men and not women.
• Women and men do not have the same metabolic processes, men’s hormones aren’t as sensitive to changes in environment.
• Especially for women, IF can add more stress to the body because of fluctuating hormonal needs throughout the month.  
• When we wake up after fasting throughout the night, glycogen stores are low, and the body is ready for energy. When this gets delayed for several more hours, it can signal the release of cortisol, because it perceives it is in a threatening situation. When the body enters fight or flight mode, this triggers an inflammatory response, as well as a slowing of metabolism.

So… what IS worth the hype for T1D?

There are elements from each of these that are beneficial for everyone, including people with T1D!

Quality of food: emphasizing whole foods over processed foods.

With T1D, we know that 15 grams of carbs in an apple is different than 15 grams of carbs in cheese doodles. The apple has fiber and vitamins while the cheese doodles are lacking any real nutrients.

A study that assigned one group to eat a diet of processed foods for 2 weeks and another group to eat only whole foods found that the ultra processed food diet led to:

• Eating 500 more calories per day
• Gaining 2lbs in 2 weeks
• Increased insulin needs
• Elevated inflammation
• Changes in hunger hormones and speed of eating

The quality of what we are eating is so much broader than just the calories in/calories out or just counting carbs. We want to holistically zoom out and see how different foods are affecting our hormones, insulin sensitivity, and overall health.

Sustainability: What the popular diets have in common is that they are formed around rules and restrictions. It’s hard to figure that out when you are limited to a certain set of rules.

Restricting an entire food group, like carbs or fats, is difficult to sustain forever. While limiting dairy and land meat has been shown to increase insulin sensitivity, you do not have to cut out everything to see increased insulin sensitivity.

• Enjoy carbs (especially those with fiber, which digests more slowly and has lower glycemic affect)
• Be mindful of fats (nut butters, oils, etc.)
• Think about what you can ADD onto your plate instead of what you should take off (focus on adding in more whole plants, fruits, and veggies)
• Simplify the external noise and tune into your own body! It will guide you!
• Rather than cutting out the foods that make your blood sugar go up, learn how to bolus for them so that you can enjoy them when you want!

The most healthy way to eat is the way that makes your body feel the best!

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