“Whole food plant based diet” vs “Low carb diet high fat diet”… which is better for type 2 diabetics?

Posted on Posted in Diabetes, Food, Health, Insulin Resistance, Research, Thoughts

The following is just some thoughts about a video watched with all the information I have consumed so far and my practical experience of trying to follow a ketogenic diet. And again, I’m not a medical professional.

I came across this video in my suggested videos tonight from the same guy (Cyrus) that did a previous video I put in a post which was talking about the misconceptions of a plant based diet.

Basically, he is advocating for a plant based whole food diet for type 2 diabetics which follow a 15% protein, 15% fat and 70% carbohydrate diet but all from a plant based diet. A “low fat plant based whole foods diet”. I got intrigued so decided to sit through the whole 56min video and try and understand where he was coming from, as it worked from him and I would see what valid points could be made compared to a ketogenic diet which is almost telling you to do the opposite.

In this video, there are multiple references to type 1 diabetics and type 2 diabetics. Pretty much all of the ketogenic diet stories I’ve heard is for people with type 2 diabetes.

“Diabetes mellitus type 2 (also known as type 2 diabetes) is a long-term metabolic disorder that is characterized by high blood sugar, insulin resistance, and relative lack of insulin.[6] “

Type 1 diabetics have a problem when their pancreas just doesn’t produce enough insulin and is “The underlying mechanism involves an autoimmune destruction of the insulin-producing beta cells in the pancreas“.

He is a type 1 diabetic, so they will always have to inject insulin to some degree as their body is not producing it or enough of it, while type 2 diabetics start using drugs like metformin to handle blood sugar issues and later, insulin when their insulin resistance become worse.  So type 2 and type 1 diabetics are 2 different scenarios.

His definition of a “low carb diet” involved 100-150g of carbohydrates (6:06 mark). This is too high from the ketogenic diet where 20-50g of carbohydrates is the recommendation. With 100-150g of carbohydrates he would basically keep himself out of “fat adaption” and never really get into ketosis and be experiencing the “running off body fat” which provides a constant source of stable energy.  This explains his “glucose rollercoaster” of energy levels and “low energy” levels as he was basically a glucose burner and was only running off 100-150g of carbohydrates that converts to glucose a day.

He then went up from 100g to 600g per day of carbohydrates, but then cut his insulin use from 45 to 25 units of insulin in the first 3-4 weeks of changing his diet.

Cyrus defines: “Insulin resistance is caused by the storage of fat in the tissues that were not designed to store fat”.

“The accumulation of fat in muscle and liver traps glucose in the blood”.

“Dietary protein increases insulin resistance independently of dietary fat”

At (36:02) he shows a graph about the glucose response with different combinations of protein and fat.  The piece of information I found interesting was that it showed that adding more fat to the same amount of protein increased the glucose response, which you can then extrapolate to mean increases the insulin response. While what I have been lead to believe is eating a fatty meat is better than eating lean meat.

This can be broken down a little here with absolute numbers in a lab and reality.  If you eat volume x of low fat animal meat, i.e. a lean steak, it will weigh more than the same volume of a fatty version of the steak.  I won’t try and go into the maths here with volume and density and glucose response, etc. But I know if you eat more fat, you won’t eat as much meat. So, it could be still very true that a fatty piece of meat may end up producing a lower glucose response than the same size of lean piece of meat.

His definition of a “low carb, high fat, high protein” diet is: 10% carbohydrates, 50% fat, 40% protein. My understanding of a ketogenic diet is roughly “70% fat, 25% protein and 5% carbohydrates” as defined here.

But then it has been redefined by the “2 keto dudes” as: “no more than 20g of carbohydrates” per day, enough protein to maintain lean body mass calculated by the keto calculator (which is about 0.8g per pound or 1.8g/kg of lean body mass.  So ball park is about 100g of protein a day as a middle ground.  Now, even with this, there is no real agreed upon recommended amount as there as been non-scientific evidence to show that people can live off less protein than even 0.8g per pound per day and still be healthy with no muscle wastage and still build muscle), and enough fat so you don’t feel hungry between meals. Now the “fat” consumed can either be from dietary fat, or your own body fat.  So in reality, you don’t go and try and consume more fat than that found in the “fatty meats” you may be consuming.

<Continue from following night>

Found this video on “The Diet Doctor” youtube channel with a type 1 diabetic on a low carb diet, where it sounds like a ketogenic diet for the past 15 years as he is talking about running the body on ketones.  He mentions taking “small” numbers and small amounts of insulin as you are taking a small amount of carbohydrates. He is a specialist doctor of “internal medicine”.  Whether he uses less insulin than the whole foods plant based diet which is high in carbohydrates is unknown, but i’m guessing he is probably using less as the need for insulin would be less as he is eating less carbohydrates???

Again, I’m not a medical person, just someone who is interested in optimising my own diet and health and have found it a very interesting topic of the benefits of a low carb, high fat ketogenic diet treating many issues from obesity, weight loss, diabetes type 1 and type 2, improved general heath, improved quality of life, improved cognitive function, etc.

So what is the conclusion?

People’s definitions of what counts as a “low carb diet” can vary significantly depending on who you talk to and what studies have decided to allocate to the 3 macro nutrient groups. In this particular video, he defines it as “10% carbohydrates, 50% fat, 40% protein” which is not a ketogenic type diet and sounds more like an “Atkins” diet where they focus more on protein.   And all of the “issues” he mentions:

I believe do not apply as there have been people who I have heard doing ketogenic diets for 15+ years in good health.

It does appear that a “whole foods plant based diet” does have its benefits for type 1 and type 2 diabetes, however, the large percentage of carbohydrates, probably with a low GI and slow release energy and lower insulin load because they are “whole foods” still mean that type 1 diabetics they are injecting themselves with more insulin than their “ketogenic diet” eating counterparts.

It is also interesting to see the foods that they recommend to eat, eat some of, and avoid.

In the avoid column the ketogenic dieters are eating pretty much all of what is listed, except for Refined sugars, Patries and breads.  Oils for ketogenic dieters are just olive, avocado and coconut oils.  In the eat some of column, again most of them is what a ketogenic dieter eats except for pastas, and I don’t know what sprouted breads are but if any carbs are in there, then probably not.  And funnily enough, the “eat” column is what the ketogenic dieters avoid mostly, except for “Non-starchy vegetables”, “Green leafy vegetables”, and “Herbs and spices”.

So from the above “whole foods plant based dieters” are almost polar opposites to “ketogenic dieters”.  “Whole food plant based dieters” are basically following a “vegan” style diet, and that is more belief system supported which I fully understand and can appreciate.  I am stepping outside of any belief system and going straight for a “selfish” point of view. “What should I eat to provide me the best health in the long term”. Full stop.

I can see how it can be seen that a “whole foods plant based diet” and “paleo” style diets can be automatically assumed to “healthier”. Many valid principles can be extrapolated to a ketogenic dieter.

  • Eat unprocessed foods in their whole natural form.
  • Avoid processed foods which have fat and fibre stripped from them, and have very high GI
  • Avoid animal products that may be contaminated or be altered with antibiotics, hormones, or be fed with “unnatural” grains instead of natural grass, etc.
  • Eat lots of leafy greens.

I know a lot of nutrients can be obtained from a plant source, however, the density of nutrient is often the issue.  To be able to obtain the same amount of a particular nutrient from a plant source to match that of an animal source the volume is often significantly larger.  So basically a lot more food needs to be consumed.  So more space, time chewing, cleaning, peeling, etc etc. So more work.

A ketogenic dieter needs to eat less, prepare less as they are eating fats, and nutrient dense foods such as animal protein and fats. They should still be eating a LOT of leafy green vegetables to get their vitamins/minerals.  The thing is, once you become “fat adapted” and your body can utilise its own body fat as fuel, it doesn’t need the dietary fat (if you overweight, but you will need to eat more fat if you want to maintain weight). So in reality, your meals end up being a lot of leafy greens, and protein with only the “naturally occurring fat” that comes with the meat.  No additional fat is required to be added if you can go from one meal to the next without being hungry.  Taken a step further, because the level of protein required is still debatable for optimal health of maintenance of muscle mass, you could change your animal protein intake to a possible plant based source, however, you may end up consuming too many carbohydrates which would kick you out of ketosis and defeat the whole ketogenic diet.

In any case, the “optimal” diet is still under investigation by me.  At this point in time, a ketogenic diet appears to have the most benefits (weight loss, cognitive function, reduced cravings, hunger control) and when used with Intermittent Fasting provides even more benefits such as increased Human Growth Hormone, autophagy, etc, it appears to be the best combination by far.  It is also easy for me to maintain and reduces the amount of time and effort required to follow.  The only real down side is trying to avoid rice, pasta, bread, cereal, pastries, crackers, and sugars.


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