Protein intake and insulin resistance.

A common dietary prescription for diabetes is to cut down on refined carbohydrates (some even say almost all carbohydrates), and increase protein and fat in your diet.  This usually is interpreted as eating more meat.  Of course there are the ketogenic proponents that want your carbohydrate intake to be so low that you go into ketosis, which forces your body to get energy from break-down products of fats, and proteins.

ALSO READ : Turning the Tide – The role of dietary fat in the development of diabetes (part 11)

There is no doubt that a low carbohydrate, high protein and high fat diet will result in weight loss in many people, and even normalise blood glucose and diminish the need for diabetic medication in the short term.  There are many people who will share their stories of success with this programme.  But unfortunately there are no long term studies showing benefit over many years and definitely no large population studies proving that this kind of diet is sustainable or that it prolongs life.  But more about that later.

Here is an article by Dr Cyrus Khambatta who has a PhD in nutritional biochemistry and together with his friend Robby Robeiro run a coaching programme for diabetics with amazing success.  They have helped thousands of people both in their programme as well as through lectures and information presented at conferences.

Weight loss strategies are important in bringing down insulin resistance.  Unfortunately when we lose weight, we not only lose fat from our bodies, but we inevitably also lose muscle mass, even if you are exercising a lot.  It is for this reason that most people who are on a weight-loss diet are encouraged to take in extra protein.  However a study discussed in the above article shows that although weight loss on its own reduces insulin resistance, increasing protein ingestion counteracts that benefit, and the insulin resistance remains high in spite of weight loss.

Here is another detailed study that showed a close correlation between protein excess and diabetes, especially but not only animal protein.

Other factors that may contribute to higher levels of diabetes related to high protein intake include Ferric iron in meat, saturated fats which are high in meat, as well as AGEs (Advanced Glycation End Products) which are produced when meat is heated to high temperatures as in Braai-ing, roasting, grilling and frying.

Unfortunately high animal protein diets have other negative effects.  They are well known to increase the risk of cancer, osteoporosis and renal failure. 

Here is another comprehensive article showing all the benefits of a plant-based diet, which comes with higher fibre, photo-nutrients, a kinder protein profile for the kidneys, and better long term control of diabetes.  Together with these specific benefits for diabetes are also the benefits in terms of reducing risk of cardio-vascular disease, Alzheimer’s disease, cancers, auto-immune conditions like rheumatoid arthritis, lupus, Crohn’s disease and ulcerative colitis.

A whole-food plant-based diet, is naturally low (but sufficient) in protein.  In fact the protein content is in the optimum range at around 10-15%. 

What are the take home messages about diabetes and protein?

1. Limit animal protein, and if you insist use white low fat meat rather than red meat.
2. A high protein diet seems to make diabetes worse, especially animal protein.
3. Boiled or cooked meat is less harmful than fried or roasted or grilled.
4. Avoid processed meats – especially red meat but even processed chicken.
5. Plant proteins as found in beans, whole grains, seeds and nuts are preferable.
6. Plant proteins are usually accompanied by high fibre which slows down absorption of carbohydrates.
7. Plant proteins may have protective effect on diabetic renal disease, whereas animal proteins tend to aggravate renal disease.
8. The best diet to both prevent diabetes, or reverse it has been proven to be high in unrefined carbohydrates in their natural form together with low protein and low fat.

To a week ahead where you are controlling your diabetes, rather than your diabetes controlling you.

Dave Glass

Dr David Glass graduated from UCT in 1975. He spent the next 12 years working at a mission hospital in Lesotho, where much of his work involved health education and interventions to improve health, aside from the normal busy clinical work of an under-resourced mission hospital.

He returned to UCT in 1990 to specialise in obstetrics/gynaecology and then moved to the South Coast where he had the privilege of, amongst other things, ushering 7000 babies into the world. He no longer delivers babies but is still very clinically active in gynaecology.

An old passion, preventive health care, has now replaced the obstetrics side of his work. He is eager to share insights he has gathered over the years on how to prevent and reverse so many of the modern scourges of lifestyle – obesity, diabetes, ischaemic heart disease, high blood pressure, arthritis, common cancers, etc.

He is a family man, with a supportive wife, and two grown children, and four beautiful grandchildren. His hobbies include walking, cycling, vegetable gardening, bird-watching, travelling and writing. He is active in community health outreach and deeply involved in church activities. He enjoys teaching and sharing information.

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