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  • Writer's pictureLee Reeves

Should We Eat 25% Carbohydrates?

When I received my type 2 diabetes (T2D) diagnosis, I was introduced by a dietician to something called the Diabetes Plate Method. She drew a circle on a piece of paper, cut it in half by its diameter, and then cut that half in half on the right side yet again.

She explained that the American Diabetes Association (ADA) recommends that for T2D, half our plate should be vegetables, a quarter should be lean protein, and the last quarter should be carbohydrate foods like whole grains, starchy vegetables, fruits, and dried fruit.

I knew about the failure of the food pyramid and heard one food health metric recently ranking Lucky Charms as healthier than steak, so I was skeptical. I also just spent five days in the hospital having my blood glucose brought down from a high of 971 (yes, really), so I wanted to confirm everything for myself. People in the United States seemed to be getting fatter and sicker decade after decade. I wanted to know why.

T2D is characterized by high blood sugar levels resulting from insulin resistance. Dr. Jason Fung, in his book The Diabetes Code, explains that "Carbohydrates are the macronutrient that has the most significant impact on blood glucose levels." When consumed, carbohydrates are broken down into glucose and released into the bloodstream, leading to a spike in blood sugar levels. According to Fung, T2D is a disease of too-high insulin (hyperinsulinemia) packing the body's cells too full of glucose. He says that in T2D, "insulin drives insulin resistance."

A study published in the journal Nutrition & Diabetes found that reducing carbohydrate intake to less than 26% of total calories improved glycemic control in type 2 diabetics. The study's lead author, Dr. Eric Westman, explains, "There's no question that a low-carbohydrate diet is the best approach for managing blood glucose in people with type 2 diabetes."

Furthermore, in his book Metabolical, Dr. Robert Lustig explains that "the problem with carbohydrates is not just the quantity, but also the quality." Consuming high amounts of refined carbohydrates, such as those in processed foods, can lead to insulin resistance and other metabolic abnormalities. Refined carbohydrates are quickly broken down into glucose, leading to a rapid rise in blood sugar levels.

So if carbohydrates cause blood glucose to spike in T2D, and because of insulin resistance, there is not enough insulin to bring it down, why are we consuming even 25% of our diet in things like starchy carbs and dried fruit?

Wouldn't a very low-carbohydrate or ketogenic diet be more appropriate to manage blood sugar levels? Many doctors and researchers believe a low-carb, high/healthy fat (LCHF) or ketogenic diet is the answer to T2D. Fung adds the concept of intermittent fasting to the mix as well. I will talk more about this in future posts.

In conclusion, while fiber from vegetables can benefit people with type 2 diabetes (fiber feeds good gut bacteria), consuming 25% of calories from starchy carbohydrates and fruits seems imprudent. Dr. Jason Fung, in The Diabetes Code, recommends reducing carbohydrate intake and eating an LCHF diet for optimal blood sugar control. As with any dietary intervention, it is crucial to work with a healthcare provider to determine the appropriate macronutrient composition for managing and reversing type 2 diabetes.

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