Those who have been most successful in lowering blood glucose, losing weight, and reversing other diabetes symptoms have eliminated (1) all refined carbohydrates (sugar and starches) and (2) transfats.

Goal: To achieve and maintain an A1C of 4.0-5.6%, fasting blood glucose of 70-99 mg/dL (3.8-5.6 mmol/l), no blood glucose spikes above 140 mg/dL (7.8 mmol/l), and no diabetes medications or insulin.

This way of eating is based on the premise that high blood sugar is caused by high carbohydrates. And all carbohydrates turn to sugar (glucose) in the digestion process, beginning with saliva in the mouth.

Proponents of low-carb high-healthy-fat moderate-protein (LCHF) claim that diabetes can be reversed and blood glucose will be in the normal non-diabetic range as long as the patient maintains a low-carb high-fat lifestyle. This dietary approach accommodates vegetarians/vegans as well as non-vegetarians. A typical LCHF diet consists of a protein source (meat, eggs, cheeses, nuts and seeds) and a foundation of green leafy and cruciferous vegetables and other low-carb vegetables. It omits all grains, legumes, starchy vegetables, and most fruit except for a few berries.

Many Adventist Vegetarian Diabetics group members have experienced success in reversing their diabetes symptoms by eating low-carb (LCHF). For them, the success rate is 100%.

It should be noted that LCHF is not a low-carb high-protein approach, though there are some low-carb proponents who recommend high-protein and moderate fat. Dr. Richard K. Bernstein, author of Dr. Bernstein’s Diabetes Solution: The Complete Guide to Achieving Normal Blood Sugar, is a prominent example. Dr. Bernstein is a Type 1 diabetic who was diagnosed at age 12. He is now (in March 2019), in his mid-80s, and maintains non-diabetic normal blood sugars. He also recommends an aggressive exercise regimen. He says,

“The kind of cardiovascular exercise I recommend to my patients (and follow myself) is very strenuous, operates in the anaerobic range, and accomplishes tremendous things. I work out in the gym every day with my weights. Cardiovascular workouts can be performed on a treadmill, a stair climber, or a recumbent bicycle. The degree of workout you’re getting is measured by how fast your heart works. When you get evaluated by a cardiologist before you start your exercise program, you should ask what your target pulse rate ought to be. Over time, you can increase it. Your goal should be to get your heart rate up to (but not above) the training level recommended by your physician. But, the point of this kind of exercise isn’t weight loss, so don’t start looking at the calorie counter thinking that if you burn 10 more calories you’ll lose another pound; exercise just doesn’t work that way.”

If you are not able—or willing—to follow such a rigorous exercise program, it’s probably best to stick with LCHF. Otherwise, you may risk increased blood sugar due to gluconeogenesis (glucose converted from excess protein).

LCHF may be carnivore, “clean-meat” non-vegetarian, pescatarian, lacto-ovo vegetarian, or vegan. The diet is high in healthy fat, supplies adequate protein, and is low in carbohydrates.

A true low-carb or ketogenic diet is one in which the percentage of calories from carbohydrates is closer to 5-10%, protein is 15-20%, and fat is 70-80% of total calories. Simply put, a ketogenic diet is any diet that allows your body to achieve and maintain ketosis.

A ketogenic diet forces the body to burn fats rather than carbohydrates. Normally, the carbohydrates contained in food are converted into glucose, which is then transported around the body and is particularly important in fueling brain function. However, if there is very little carbohydrate in the diet, the liver converts fat into fatty acids and ketone bodies. The ketone bodies pass into the brain and replace glucose as an energy source.

Note: Do not confuse “ketosis” with “ketoacidosis”! Diabetic ketoacidosis (DKA) is a complication of Type 1 diabetes. It’s a life-threatening condition resulting from dangerously high levels of ketones and blood sugar. DKA is rare in people with Type 2 diabetes. Nutritional ketosis is perfectly safe if you are not taking any diabetes medications!

A ketogenic diet is a very low-carb diet, but not all low-carb diets are ketogenic diets.

For anyone who is seriously interested in a very low-carb high-fat (or ketogenic) diet (20-30 grams of carbs per day), I have compiled a food list based on Keto Clarity: Your Definitive Guide to the Benefits of a Low-carb, High-fat Diet (2014) by Jimmy Moore with Eric C. Westman, MD; A Low Carbohydrate, Ketogenic Diet Manual: No Sugar, No Starch Diet (2013) by Eric C. Westman, MD; and The New Atkins for a New You (2010) by Eric C. Westman, MD; Stephen D. Phinney, MD; and Jeff S. Volek, PhD. With lists modified for Adventist Vegetarian Diabetics. You can find a printable PDF copy at Food Lists for Low-carb-High-fat.

Whimsically, I’ve even created an Adventist Vegetarian Diabetics food pyramid for LCHF! It defaults to Adventist non-vegetarian*, including pescatarian. Lacto-ovo vegetarians can just omit the flesh foods. Dietary vegans can also omit the dairy and eggs.

Here’s another resource for vegans: A comprehensive detailed food list, complete with charts, for foods permitted on a vegan keto diet can be found in this article: http://herbivorepost.com/vegan-keto-food-list/.

There’s also a new (August 2018) book out called Ketotarian: The (Mostly) Plant-Based Plan to Burn Fat, Boost Your Energy, Crush Your Cravings, and Calm Inflammation.

And, oh, if you’re wondering why you can’t eat low-carb and low-fat, re-read this page: https://adventistvegetariandiabetics.wordpress.com/approaches-to-diabetes-management/why-cant-i-eat-low-carb-and-low-fat/.

More information and references found at https://adventistvegetariandiabetics.wordpress.com/approaches-to-diabetes-management/lchf-low-carb-high-fat-moderate-protein/

* “Adventist non-vegetarian” is a non-vegetarian who eats only “clean” meat, as described in Leviticus and Deuteronomy.