"One study is never enough to change a recommendation, but this study is interesting in that it shows that a low-fat diet is no better than a low-carbohydrate diet in preventing type 2 diabetes," said Thomas Halton, lead author of the study "The one diet that did seem to show a protective effect was a vegetable-based, low-carb diet which consisted of higher amounts of vegetable fat and vegetable protein, and lower amounts of carbohydrate."

The findings, Halton added, were a bit surprising in that most doctors and nutritionists recommend a low-fat diet to prevent type 2 diabetes. "This study showed that a low-fat diet didn't really prevent type 2 diabetes in our cohort when compared to a low-carb diet. I was also surprised that total carbohydrate consumption was associated with type 2 diabetes, and that the relative risk for the glycemic load was so high."

People who reduce their carb intake generally take in more total and saturated fat and less whole grains, cereal fiber, fruit and vegetables, which can heighten the risk of type 2 diabetes.

For this study, Halton and his colleagues examined the association between low-carb diets and the risk of diabetes among 85,059 women participating in the Nurse's Health Study. The data included 20 years of follow-up.

Women were ranked according to what they ate. "We calculated a low-carbohydrate diet score based on the women's percent consumption of fat, protein and carbohydrate," Halton explained. "A higher score reflected a higher intake of fat and protein and a lower intake of carbohydrate. Therefore, the higher a woman's score, the more closely she followed a low carb-diet, and the lower her score, the more closely she followed a low-fat diet."

Women with a higher score did not have a heightened risk of diabetes. In fact, they seemed to have a small decreased risk when they derived their fat and protein from vegetable rather than animal sources.

Such a low-carb diet is similar to a healthy Atkins diet, meaning one which does not include large amounts of animal fat and animal protein, Halton said. "When focusing on vegetable sources of fat and protein, this version of Atkins is similar to a low-glycemic Mediterranean diet," he said.

How easy will it be for people to follow such a diet? "It's probably a very good thing to do . . . [but] people don't understand how to eat well. People don't know what simple and complex carbohydrates are and what it takes to have a good, balanced diet. People go to extremes," said Dr. Stuart Weiss, a clinical assistant professor of medicine at New York University School of Medicine in New York City. "In general, carbs should be limited just like saturated fat needs to be limited. . . If you eat too much of anything, you're bound to get into trouble."

February, 2008-American Journal of Clinical Nutrition.

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DID YOU KNOW:
Britain Pioneers Promising Type 1 Diabetes 'Cure': Researchers at Oxford University, King's College Hospital, and the Royal Free in London have successfully transplanted islet cells taken from the pancreas of deceased organ donors into more than a dozen patients with unstable Type 1 diabetes.  Results of the clinical trial indicate that some patients no longer need to take insulin, while others no longer have seizures when their blood sugar drops too low.  To increase the availability of this treatment, additional research will be funded by the Department of Health. During the first year of the study, about 20 patients will be injected with islet cells, which are grown in a laboratory for two days after extraction from the organ donor.  Patients can receive up to two injections into the liver, with a successful transplant requiring over 300,000 cells.  "The ultimate aim is to eventually be able to reverse diabetes in children soon after diagnosis," says Oxford University's Paul Johnson.

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