Dr. Michael Noonan

Dr. Michael Noonan
It has been known for some time that diabetics are prone to a host of problems: poor circulation, vision, even back pain.

But it seems a new one has been added to the list: dementia, including Alzheimer's disease. According to one review of the published literature, diabetic patients had a 46 percent higher risk of developing Alzheimer's and a whopping 250 percent increased risk of dementia caused by problems with blood supply to the brain. This is why these problems sometimes are called "Type 3" diabetes.

It appears the chronic high blood sugar associated with Types 1 and 2 diabetes is hard on the blood vessels. This, in turn, affects the tissues that rely on the oxygen and fuel these vessels' supply, including the brain.

I did not write this column to add to the woes of diabetics. But during my work with nutrition, I am amazed at how many diabetics, Types 1 and 2, still are eating carbohydrate-based diets, even if they are avoiding processed sugar.

The first recommendation I make to any diabetic patient is to eliminate grains, especially wheat, from the diet. This includes oatmeal and rice. Any grain supplies primarily one nutrient - carbs. When compared to veggies, they are a poor source even of fiber. In order to get the same amount of fiber from whole wheat as from broccoli, you have to consume five times more calories.

Even whole grains are not the nutritional powerhouses they are made out to be. Whole grains may cause less of a sugar spike than white grains, but they still are a carb-based food. If your carb-handling mechanism is impaired, why burden it further?

One study of 84 overweight Type 2 diabetics compared the effects of a very low-carb diet (fewer than 20 grams per day — one piece of whole-wheat bread typically has about 12 grams) to a reduced-calorie diet (no more than 55 percent of their calories from carbs). After 24 weeks, researchers found both groups benefited from their diets, but the very low-carb group fared better. They showed overall lower blood sugar levels; had better blood pressure; lost more weight; and 95 percent of them were able to reduce or eliminate their blood sugar meds, while 62 percent of the low-calorie group was able to do this.

The downside? There were some symptoms during the transition, such as headache and bowel complaints. Neither group had more problems than the other. In my experience, an even bigger challenge is cravings. Carbs tend to be addictive, and many patients feel deprived when they eliminate them from their diets.

There are ways we help patients make these changes. First, making a slower transition away from carbs. There was no "phase-in period" for this study; it was an abrupt change. I typically advise patients to change breakfast first. Starting the day with carbs usually means you will eat them all day. Once you adapt to that change, begin to improve the rest of the day's meals.

There also are supplements that can help. One of the best is an herb called gymnema. It has been used for centuries to help regulate blood sugar and cravings. I have patients monitor their blood sugar when they start using it. If they are on blood sugar meds, as it can lower it substantially.

However you do it — whether you get help or do it on your own, if you have diabetes or even pre-diabetes — greatly reducing carbs and eliminating grains will go a long ways toward protecting your blood vessel health and ultimately your brain.