Dietary considerations can present a Hobson's choice in diabetes. Even
when the intake is nutritious, assimilating it can be another matter.
Then there is the problem of progression of diabetic complications if
one ends up with excess glucose or fat in the system. Excess
carbohydrates in a meal, and the resulting uncontrolled blood sugar
levels can be detrimental to any number of tissues, from the lens of
the eye, to the neurons, small blood vessels and the kidneys.Dietary considerations can present a Hobson's choice in diabetes. Even
when the intake is nutritious, assimilating it can be another matter.
Then there is the problem of progression of diabetic complications if
one ends up with excess glucose or fat in the system. Excess
carbohydrates in a meal, and the resulting uncontrolled blood sugar
levels can be detrimental to any number of tissues, from the lens of
the eye, to the neurons, small blood vessels and the kidneys. Fat is
also a problem with increase incidences of atherosclerosis, large
vessel disease and cardiac complications. What, then is the appropriate
macronutrient for the diabetic population? Enough medical literature
exists to suggest that in diabetes, proteins are probably the best bet.
Proteins are the natural choice of the body when faced with diabetes.
In uncontrolled diabetes, muscle protein is broken down into amino
acids to be converted into glucose by the liver. If left to fend for
itself, this can create a commotion within the body. Since proteins
have to supply enough energy to substitute for carbohydrates, proteins
are broken down faster than they are made. The body ends up with a
protein deficit, a situation with subtle, yet far-reaching effects on
normal body functions. Importantly, for diabetics, a protein deficit
has been shown to impair resistance to infections (Ganong WF).
Replenishing the depleting protein stores is a vital requirement of all
diabetic diets.
Importance of proteins in a diabetic has been well documented. The
American Associations of Clinical Endocrinologists have made it clear
that not much evidence exists to indicate that the patients with
diabetes need to reduce their intake of dietary proteins. The AACE
recommends that 10-20% of the calorie intake in diabetes should come
from proteins (AACE Diabetes Guidelines). It is in fact believed that
this is one nutrient that does not increase blood glucose levels in
both diabetics and healthy subjects (Gannon et al).
Nutrition therapy for diabetes has progressed from prevention of
obesity or weight gain to improving insulin's effectiveness and
contributing to improved metabolic control (Franz MJ). In this new
role, a high protein diet (30% of total food energy) forms a very
pertinent part of nutrition therapy. One of the most important causes
for type II diabetes is obesity. Excess body fat raises insulin
resistance and higher levels of insulin are required to bring down
blood sugars as the weight increases (Ganong WF). Another problem with
excess fat is the clogging of arteries with atherosclerotic plaques
that is responsible for a wide range of diabetic complications. Any
mechanism that reduces body fat decreases insulin resistance and
improves blood glucose control. Parker et al have also shown that a
high protein diet decreased abdominal and total fat mass in women with
type II diabetes. Other studies by Gannon et al. and Nuttall et al have
verified that blood glucose levels and glycosylated hemoglobin (a
marker of long term diabetic control) reduce after 5 weeks on a diet
containing 30% of the total food energy in the form of proteins and low
carbohydrate content. It is speculated that a high protein diet has a
favorable effect in diabetes due to the ability of proteins and amino
acids to stimulate insulin release from the pancreas. Thus, a high
protein diet is not only safe in diabetes, but can also be therapeutic,
resulting in improved glycemic control, and decreased risk of
complications related to diabetes.
The benefits of a high protein diet do not end here. Individual protein
components of such a diet, when aptly chosen, can have other advantages
as well. Dietary supplements containing proteins like whey and casein
come highly recommended. Casein is a milk protein and has the ability
to form a gel or clot in the stomach. The ability to form this clot
makes it very efficient in nutrient supply. The clot is able to provide
a sustained, slow release of amino acids into the blood stream,
sometimes lasting for several hours (Boirie et al. 1997). A slow
sustained release of nutrients matches well with the limited amount of
insulin that can be produced by the pancreas in diabetes. A protein
supplement containing casein can thus increase the amount of energy
assimilated from every meal and, at the same time, reduce the need for
pharmacological interventions to control blood sugar.
Whey proteins and caseins also contain "casokinins" and "lactokinins',
(FitzGerald) which have been found to decrease both systolic and
diastolic blood pressure in hypertensive humans (Seppo). In addition,
whey protein forms bioactive amine in the gut that promotes immunity.
Whey protein contains an ample supply of the amino acid cysteine.
Cysteine appears to enhance glutathione levels, which has been shown to
have strong antioxidant properties -- antioxidants mop up free radicals
that induce cell death and play a role in aging.
Thus, development of a protein supplement containing casein and whey
can provide an apt high protein diet and its health benefits to
individuals suffering from diabetes, obesity and hypercholesterolemia.
ABOUT PROTICA
Founded in 2001, Protica, Inc. is a nutritional research firm with
offices in Lafayette Hill and Conshohocken, Pennsylvania. Protica
manufactures capsulized foods, including Profect, a compact,
hypoallergenic, ready-to-drink protein beverage containing zero
carbohydrates and zero fat. Information on Protica is available at
http://www.protica.com
You can also learn about Profect at http://www.profect.com
Copyright - Protica Research - http://www.protica.com
REFERENCES
The American Association of Clinical Endocrinologists. Medical
guidelines for the management of diabetes. AACE Diabetes Guidelines,
Endocr Pract. 2002; 8(Suppl 1).
Boirie, Y., Dangin, M., Gachon, P., Vasson, M.P., Maubois, J.L. and
Beaufrere, B. (1997) Slow and fast dietary proteins differently
modulate postprandial protein accretion. Proclamations of National
Academy of Sciences 94, 14930-14935.
Counous, G. Whey protein concentrates (WPC) and glutathione modulation
in cancer treatment. Anticancer Research 2000; 20, 4785-4792
FitzGerald RJ, Murray BA, Walsh D J. Hypotensive Peptides from Milk Proteins. J. Nutr. 134: 980S-988S, 2004.
Franz MJ. Prioritizing diabetes nutrition recommendations based on evidence. Minerva Med. 2004; 95(2):115-23.
Gannon et al An increase in dietary protein improves the blood glucose
response in persons with type 2 diabetes. Am J Clin Nutr 2003; 78:734-
41.
Gannon MC, Nuttall J A, Damberg G. Effect of protein ingestion on the
glucose appearance rate in people with type II diabetes. J Clin
Endocrinol Metab 86: 1040-1047, 2001
Ganong W F. Review of Medical Physiology, 21st Ed. Lange Publications 2003
Ha, E. and Zemel, M.B. Functional properties of whey, whey components,
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Kent KD, Harper WJ, Bomser JA. Effect of whey protein isolate on
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Nuttall et al. The Metabolic Response of Subjects with Type II Diabetes
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Parker et al. Effect of a High-Protein, High-Monounsaturated Fat Weight
Loss Diet on glycemic Control and Lipid Levels in Type 2 Diabetes.
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Seppo, L., Jauhiainen, T., Poussa, T. & Korpela, R. () A fermented
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