ADA: Brain’s Need for Glucose can be Fulfilled by the Body

In its recently published Consensus Report (April 18, 2019), the American Diabetes Association confirmed something that I have written about in several previous articles, including most recently in Part III of Carbohydrates are Not Evil and that is that it isn’t biologically essential to eat carbohydrate containing foods in the diet. From the top of page 4 of the Consensus Report:

“The amount of carbohydrate intake required for optimal health in humans is unknown. Although the recommended dietary allowance for carbohydrate for adults without diabetes (19 years and older) is 130 g/day and is determined in part by the brain’s requirement for glucose, this energy requirement can be fulfilled by the body’s metabolic processes, which include glycogenolysis, gluconeogenesis (via metabolism of the glycerol component of fat or gluconeogenic amino acids in protein), and/or ketogenesis in the setting of very low dietary carbohydrate intake.”

Body can make all the glucose it needs for the brain

That is, the body can make all the glucose the brain needs from the glycogenolysis (which is the breakdown of glycogen to glucose), via  gluconeogenesis (which is the generation of glucose from glycerol or glucogenic amino acids) and via ketogenesis(which is from ketones generated in a very low dietary carbohydrate [ketogenic] diet). In short, dietary intake of carbohydrate is not essential. While there is no biological need to eat carbohydrate-based food, one certainly can and there are many good reasons to include some types of carbohydrate-containing food in the diet.

Because there is no essential need to eat carbohydrate because the body can make all the glucose it needs itself, the American Diabetes Association includes among its eating patterns both a low carbohydrate pattern (26-45% daily calories as carbohydrate) and a very low carbohydrate (ketogenic) eating pattern (20-50 g carbohydrate / day). How much carbohydrate is a major consideration for those who are pre-diabetic or Diabetic because as the ADA stated in this new consensus report;

“Carbohydrate is a readily used source of energy and the primary dietary influence on postprandial blood glucose.

That is, it is the carbohydrate in a meal that is the biggest predictor of how high blood sugar will rise after a meal, and how quickly. For those who want to improve their blood sugar levels (glycemia) the same report also makes it clear that;

Reducing overall carbohydrate intake for individuals with diabetes has demonstrated the most evidence for improving glycemia* and may be applied in a variety of eating patterns that meet individual needs and preferences.”

For those adults with Type 2 Diabetes who are not meeting their blood sugar targets or who need to, or want to have their physician reduce their need for Diabetes medications, a low carbohydrate or very low carbohydrate (keto) eating pattern is a viable option;

“For select adults with type 2 diabetes not meeting glycemic targets or where reducing anti-glycemic medications is a priority, reducing overall carbohydrate intake with low or very low- carbohydrate eating plans is a viable approach.”

Remember, carbohydrate-based foods are not necessary for your brain because your body can make all the glucose it needs from the metabolic processes listed above. That’s not to say one has to avoid carbohydrate-based foods, but how much and how often can and is best determined based on people’s individual needs and glycemic response to carb-based foods.  I recently outlined in another article based on the American Diabetes Association’s Consensus Report and which was posted on my affiliated low carbohydrate-focused website, that in the US a well-designed low carb or ketogenic diet to lower blood sugar need not have all the same foods or food groups as a diet based on The Dietary Guidelines for Americans because it is used as Medical Nutrition Therapy (i.e. is a therapeutic diet).

While these are the guidelines in the US, in Canada individuals have the right to choose a low carbohydrate lifestyle if that is their personal preference.

If you would like some professional support to begin eating this way or to continue eating this way,  I can help. I provide Registered Dietitian services to those in any province in Canada (except PEI), and for those in the US, I can provide nutrition education to help you know how to eat according to a low carb eating pattern.

You can learn more about my services including individual hourly appointments and sessions as well as packages above under the Services tab or in the Shop and if you have questions, please feel free to send me a note using the Contact Me form above and I will reply as soon as I can.

To your good health!

Joy

Here are the links to other articles that I wrote about the new ADA Consensus Report:

April 24, 2019 – ADA Eating Patterns Differ from The Dietary Guidelines for Americans April 23, 2019 –  ADA includes use of a Very Low Carb (Keto) Eating Pattern in New Report

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Reference

Evert, AB, Dennison M, Gardner CD, et al, Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report, Diabetes Care, Ahead of Print, published online April 18, 2019, https://doi.org/10.2337/dci19-0014 Copyright

©2019 The LCHF-Dietitian (a division of BetterByDesign Nutrition Ltd.)

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