The odds are stacked against diabetics. Type-one men have an average life expectancy of 66 years. That’s 11 years below average, according to a recent Scottish study (Colhoun, Jan 15, if you’re interested). Type-one women shouldn’t expect to live far beyond 68, or 13 years below average.
The same study behind these cheery statistics sheds light on what’s bumping us type-ones off: the over-50s are mostly succumbing to heart disease and other cardiovascular conditions resulting from prolonged high blood sugar levels; many younger diabetics are dying from coma-inducing ketoacidosis or hypoglycaemia.
In short, if low blood sugar levels or the build-up of ketones in your blood caused by higher levels don’t get you when you’re young, the accumulation of all that crud (not a medical term; see my disclaimer below) in your blood as a result of a lifetime of raised blood sugar levels probably will.
Of course this needn’t be the case; diabetics can beat the odds by balancing sugar levels. And in recent months I’ve maintained levels more or less within the boundaries a non-diabetic would expect. I’ve done it through a diet that flies in the face of current diabetes advice: the low carb, high fat and protein Natural Ketosis diet. I feel great on it. I’ve lost a stone. I haven’t had a single hypo.
So what is it? Surely there are risks? Low carb, high fat and protein diets are nothing new, so is this just the Atkins Diet by another name? And can a low carbohydrate diet really sustain me as I prepare to take on the Marathon de Sables – carb loading is essential if you’re going to run a marathon, let alone 150 miles across the Sahara Desert… isn’t it?
“Any proper low carb diet will help a diabetic by reducing insulin requirement,” says Helen Sutter, founder of the National Ketosis Co. “For that reason, and that reason alone, a low carb diet will help increase life expectancy. The amount of insulin a type-one diabetic is taking is one of the biggest life-reducing factors.”
Many will find this hard to swallow. After all, we all require insulin to convert sugar into energy. When I was diagnosed in the early 90s I was told carbohydrates – cereals, bread, potatoes, etc – should be a cornerstone of my diet (the advice hasn’t changed much since then). The more carbs you eat, the more insulin you inject; so long as you take the right dose to counteract the carbs, you can pretty much eat what you like. Simple.
Except it doesn’t quite work like that. Not all of the insulin we stick into ourselves actually ends up in our blood. In fact, a 2012 study (Nielsen et al) found that insulin absorption may vary by as much as 30% and, what’s more, estimation of the amount of carbs in a meal has an error rate of 50%.
No wonder most diabetics on higher carb diets spend their days seesawing between highs and lows (I certainly did) before having their lives cut short. “It is virtually impossible to match carbohydrates and insulin, which leads to unpredictable blood glucose levels after meals,” concluded the Nielsen study. “By reducing the carbohydrates and insulin doses the size of the blood glucose fluctuations can be minimized. The risk of hypoglycemia is therefore minimized as well.”
For most of the month I was on the Natural Ketosis Diet – I was roped into it by the wife, who was writing a feature about it for the Mail – my blood sugar was mostly in the sweet spot between 4 and 8mmol/l (72 and 144mg/dl). When my levels did occasionally veer higher I knew exactly why: cashew nuts (I’m a sucker for them and on occasion shovel far too many into my mouth). On a higher carb/insulin diet I wouldn’t have that level of certainty. That’s why I’m still on it.
Despite my delight at my newfound state of blood glucose equilibrium, alarm bells are still ringing with the thought of my arteries furring up with all the extra saturated fat I’ve been consuming thanks to all the butter, cheese, double cream and pork scratchings on the menu. Sutter has an answer for this, however (I’m due a cholesterol test in a few months; will let you know how I get on).
“Fats are essential,” she says. “We evolved to eat meat with fat. We didn’t evolve to eat a plate full of pasta. It’s true that if you eat a high carb diet with lots of fat that won’t be good for you. However, if you strip out the starch and sugar you won’t have the insulin response. If your insulin levels are nice and low, you can eat saturated fats in abundance. Your body will be burning fat for energy rather than storing it up.”
This process is known as ketosis, the body’s way of burning fat for energy. Sugars and starches (carbohydrates) are the body’s quickest and easiest source of energy; strip them out of your diet and your body has to look elsewhere for an energy source. It finds it in the fat you’re eating (which it has to work harder to convert into energy) and the extra layer of fat many of us carry around with us.
This might all sound a bit familiar. “If people want to draw associations between Natural Ketosis and the Atkins Diet or Harcombe or Dukan I’m fine with that – they’re all ketogenic,” says Sutter. If the theory is the same, it’s the execution that differs between the diets. With Natural Ketosis, dieters are sent 28 days’ supply of pouched meals with suggestions for vegetable side dishes. Everything is measured to ensure the body stays in ketosis.
Some experience side effects when the body first goes into ketosis. I had headaches and a raging thirst for the first few days but they soon disappeared. Other side effects can include bad breath, wind or constipation, sleep interruptions, nausea and lethargy. The latter was a particular concern, given that I’m steadily increasing the distance I run in preparation for the first marathon in my schedule next April.
Thankfully, I feel full of energy on the diet. And Sutter insists I won’t need to load up on pasta as my mileage increases. “If you’re doing any kind of activity that’s endurance based, fats will fuel you far better than carbs,” she says. “But if you are doing sprints you will want to drive those sprints with carbs because they give you a short, sharp burst of energy.”
Of course, the threat of hypo means that any diabetic runner should never leave the house without a decent supply of carbs. I’m going to find out if I can really become a low carb diabetic runner in coming months. Follow the blog to find out if I can. I’ll be reporting back soon…
Log on to The Natural Ketosis Co’s website to find out more about signing up for the 28-day plan. For those interested in incorporating low carb options into their diet without committing to the plan (it’s not cheap; prices vary from £6.50 to £10 a day), log on the Natural Low Carb Store. Readers of Diabetic Dad Runs are eligible for a 10% discount, using the code: AUG10.
*Disclaimer: I have no medical training (as this post makes abundantly clear). I am not a doctor, a nutritionist, a physio or a sports therapist; I doubt they’d even give me job handing out oranges at half time of a football match. I am just a type-one diabetic and former fat bloke with a stupid idea. This blog is my account of following that idea to its conclusion. Do not attempt anything similar without seeking prior medical (and psychiatric) advice.