I get a bit of mail from folks wondering about my thoughts on the low-carb-high-fat (LCHF) diet (also known as Way-Of-Eating or WOE) and why I'm not pushing this as a lifestyle to everyone who has diabetes.
Here's one of my latest responses to one of the more polite inquirers about this:
Thanks so much for you email! How funny you should ask about LCHF - I'm actually in the middle of Dr. Bernstein's book right now. I'm pretty familiar with the LCHF movement, though I wouldn't call myself a dedicated subscriber at this time.
I think the LCHF results that people are reporting are really promising, but absent a comprehensive study similar to the DCCTs that occurred in the 90s, I'm forced to hold back a true opinion because the only published evidence of LCHF's success is anecdotal and/or represents results from a very small study (though the evidence is, admittedly, quite compelling).
My focus is to spend less time encouraging others to conform to a specific treatment method (and LCHF is certainly one method that has resulted in success for many), and instead encourage people to focus on getting their blood sugar into target range as often and as safely as possible. For some, that might mean adopting the LCHF lifestyle. For others, it might mean something completely different.
There are three other concerns I have about LCHF. Since you've been working with this WOE for awhile, maybe you can share your thoughts on them?
1. One concern I have is its sustainability. Are people actually going to be able to keep doing it for the rest of their lives? Obviously, some people are very successful at LCHF, but I'm not sure it's sustainable for every diabetic.
2. Next is affordability - eating healthful, unsaturated fats and ensuring you're getting enough protein, etc. can be expensive. This may not be practical for people in lower income brackets.
3. Lastly, and this is a big unknown for me - is adopting the LCHF way of eating a veritable rabbit hole of increased insulin resistance, essentially ensuring that if you start LCHF, you won't ever be able to stop, or even cheat? If you fail at LCHF, would you be worse off than if you'd never tried it in the first place due to the increased insulin resistance caused by the inevitable intake of saturated fat, the increased rate of gluconeogenesis, and the increase in hepatic glycogen conversion?
LCHF is a method of blood sugar control that I definitely intend to try, so perhaps I'll have more interesting things to say about it once I've done so.
Thanks for your email, it forced me to get my thoughts about this down on paper. I want my efforts with BootCamp for Betics/PureDiabetes to be as accurate and as helpful as possible, so, if you have some data that can help push me into the LCHF camp, I would love to hear it!