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Question: I consume a very low cost diet. The diet is 65% carbs, all from white wheat flour. If I stay physically fit and don't gain any weight, will this increase my risk of diabetes? In other words, the glycemic load is very high for every meal. The daily allowances, carbs-fats-proteins, and omegas are all good. Answer: Diabetes starts with muscular and liver insulin resistance, where evidence overwhelmingly implicates intracellular long-chain saturated fat accumulation and inflammation/innate immune response. Obesity (which increases free fatty acids & inflammation), dietary long chain saturated fatty acids and dietary fructose (from added sugars, which increase small intestinal dysbiosis and induce liver fat synthesis) are all strongly linked, and with plausible mechanisms. Diabetes is rare where traditional diets are consumed in developing nations and was rare in 19th century European/American populations, indicating high starch diets (75%+ carbs), when consumed with few long chain saturated fats or added sugars, and in slender populations, pose little risk. I would expect no acute issues with wheat in non-celiacs, indeed the arabinoxylans are an important prebiotic that feeds beneficial gut microbiota and improves gut barrier function. However, the arabinoxylans are largely in the bran. I would strongly discourage a refined flour diet of leavened bread, and encourage alternate forms, like whole wheat pasta and cracked wheat/bulghur. These are also better forms for those with insulin resistance or diabetes, as pasta & whole grains have much lower glycemic indices. Refined grains (flour) of any type are going to cause issues. Far more than other carbs. Rice is certainly better than wheat flour. So are oats and potatoes. Collectively, they are still a lot of carbs. I get that you want to keep cost down. Fats and protein don't have to be expensive if you shop around. Beans and eggs are generally good options. #diabetesdiet #nutritionanddiabetes #drdeepabestdietician
  • 2017-02-23T01:33:48

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